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Hajji EB, Traore B, Hassoune S, Khoubila A, Bellakhdar S, Rafai MA, Lakhdar A. Prevalence and associated factors of psychiatric comorbidities in epilepsy in the Casablanca-Settat region of Morocco: A cross-sectional study. Epilepsia Open 2024; 9:1321-1332. [PMID: 38738817 PMCID: PMC11296105 DOI: 10.1002/epi4.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/29/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVE To determine the estimated prevalence of anxiety, depression, and anxiety-depression syndrome (ADS) and to identify the associated factors in Moroccan people with epilepsy (PWE). METHOD A cross-sectional study was conducted among adult PWE (June 2021-December 2022) in the Casablanca-Settat region. PWE were interviewed by completing a questionnaire collecting sociodemographic and clinical data. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Out of 21 points, a score ≥8 is in favor of considerable anxiety/depression symptoms and a sum of the two scores ≥15 indicates the presence of ADS. Data were analyzed using Statistical Package for Social Sciences (SPSS) 21.0. p-values ≤0.05 were considered statistically significant and logistic regression was performed to determine the associated factors. RESULTS Among 294 PWE, the median age was 39 years (interquartile range [IQR]: 25.75-54.00). The median anxiety, depression, and ADS scores were 8 (IQR: 5.00-10.00), 7 (IQR: 4.00-10.00), and 15 (IQR: 10.00-20.00), respectively. Anxiety, depression, and ADS were revealed in 51.4%, 44.9%, and 51.0% of PWE, respectively. Depression was the only predictor for anxiety (aOR = 24.20; 95%CI: 12.45-47.01). Antiseizure polytherapy (aOR = 3.35; 95%CI: 1.72-6.54) and anxiety (aOR = 24.04; 95%CI: 12.12-47.67) were the factors associated with depression. The risk of ADS was increased by female gender (aOR = 2.83; 95%CI: 1.68-4.78), antiseizure polytherapy (aOR = 2.75; 95%CI: 1.62-4.65), structural epilepsy (aOR = 1.73; 95%CI: 1.01-2.94), and the presence of concomitant conditions with epilepsy (aOR = 1.96; 95%CI: 1.16-3.31). SIGNIFICANCE Our study reports high psychiatric comorbidity prevalence in epilepsy, which supports the bidirectional link hypothesis. Associated factors found are important in the prognosis and prevention. PLAIN LANGUAGE SUMMARY The neural mechanisms underlying epilepsy tend to expose PWE to psychiatric disorders. Our study aims to quantify the rate of psychiatric comorbidities and their predictive factors in Moroccan PWE. The estimated prevalences of significant symptoms of anxiety, depression, and ADS were 51.4%, 44.9%, and 51.0%, respectively. Depression was the predictor of anxiety. Antiseizure polymedication and anxiety were the associated factors with depression. The risk of SAD was increased by female gender, antiseizure polymedication, structural epilepsy, and concomitant diseases with epilepsy. Our results are important for considering the psychiatric aspect of PWE and improving their care and quality of life.
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Affiliation(s)
- El Bachir Hajji
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
| | - Boubacar Traore
- Laboratory of Epidemiology, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
- Direction de la Pharmacie et du Médicament (DPM)BamakoMali
| | - Samira Hassoune
- Laboratory of Epidemiology, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
- Laboratory of Cellular and Molecular Pathology, Team “Epidemiology and Histology of Chronic and Cancerous Diseases”, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
| | - Adil Khoubila
- Clinical Neurosciences and Mental Health Research LaboratoryUniversity Hassan IICasablancaMorocco
- University Psychiatric Centre, University Hospital Ibn RochdCasablancaMorocco
| | - Salma Bellakhdar
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
- Department of NeurologyIBN ROCHD University HospitalCasablancaMorocco
| | - Mohammed Abdoh Rafai
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
- Department of NeurologyIBN ROCHD University HospitalCasablancaMorocco
| | - Abdelhakim Lakhdar
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and PharmacyHassan II UniversityCasablancaMorocco
- Department of NeurosurgeryIBN ROCHD University HospitalCasablancaMorocco
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Lin H, Zhou W, Tian X, Wang F. Detection Rates of Mental Health Problems Among Sexual Minorities in Mainland China: A Meta-Analysis. JOURNAL OF HOMOSEXUALITY 2024; 71:1991-2009. [PMID: 37256336 DOI: 10.1080/00918369.2023.2217678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Previous studies that have addressed the growing mental health problems among sexual minorities in mainland China, but failed to inform mental health programs and public health policies with consistent detection results. To obtain robust results on aggregate detection rates and moderators of these problems, we performed a meta-analysis of the related Chinese and English literature published before 2022. Ultimately, 305 eligible studies (ndepression = 127, nanxiety = 71, nsuicide ideation = 55, nsuicide plan = 13, nsuicide attempt = 39) were pooled in the analysis. The results revealed "Money boys" and people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) had higher detection rates than general men who have sex with men. Depression was more prevalent in gays than lesbians, and the latter had a higher detection rate of suicide. Detection rates of anxiety and depression among sexual minorities in China were moderated by detection time, measurement tools, and their detection thresholds. Suggested future priorities include developing more targeted measurement tools that consider the living conditions and psychological characteristics of local sexual minorities, enhancing mental health programs for sexual minorities, and devising more practical and effective interventions to prevent and reduce their mental health problems.
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Affiliation(s)
- Hongyi Lin
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Wenqin Zhou
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Xuan Tian
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Fengyan Wang
- School of Psychology, Nanjing Normal University, Nanjing, China
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Young CA, Langdon D, Rog D, Chhetri SK, Tanasescu R, Kalra S, Webster G, Nicholas R, Ford HL, Woolmore J, Paling D, Tennant A, Mills R. Prevalence, treatment and correlates of depression in multiple sclerosis. Mult Scler Relat Disord 2024; 87:105648. [PMID: 38713965 DOI: 10.1016/j.msard.2024.105648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND The prevalence of depression in Multiple Sclerosis (MS) is often assessed by administering patient reported outcome measures (PROMs) examining depressive symptomatology to population cohorts; a recent review summarised 12 such studies, eight of which used the Hospital Anxiety and Depression Scale-Depression (HADS-D). In clinical practice, depression is diagnosed by an individual structured clinical interview; diagnosis often leads to treatment options including antidepressant medication. It follows that an MS population will include those whose current depressive symptoms meet threshold for depression diagnosis, plus those who previously met diagnostic criteria for depression and have been treated such that depressive symptoms have improved below that threshold. We examined a large MS population to establish a multi-attribute estimate of depression, taking into account probable depression on HADS-D, as well as anti-depressant medication use and co-morbidity data reporting current treatment for depression. We then studied associations with demographic and health status measures and the trajectories of depressive symptoms over time. METHODS Participants were recruited into the UK-wide Trajectories of Outcome in Neurological Conditions-MS (TONiC-MS) study, with demographic and disease data from clinical records, PROMs collected at intervals of at least 9 months, as well as co-morbidities and medication. Interval level conversions of PROM data followed Rasch analysis. Logistic regression examined associations of demographic characteristics and symptoms with depression. Finally, a group-based trajectory model was applied to those with depression. RESULTS Baseline data in 5633 participants showed the prevalence of depression to be 25.3 % (CI: 24.2-26.5). There were significant differences in prevalence by MS subtype: relapsing 23.2 % (CI: 21.8- 24.5), primary progressive 25.8 % (CI: 22.5-29.3), secondary progressive 31.5 % (CI: 29.0-34.0); disability: EDSS 0-4 19.2 % (CI: 17.8-20.6), EDSS ≥4.5 31.9 % (CI: 30.2-33.6); and age: 42-57 years 27.7 % (CI: 26.0-29.3), above or below this range 23.1 % (CI: 21.6-24.7). Fatigue, disability, self-efficacy and self esteem correlated with depression with a large effect size (>0.8) whereas sleep, spasticity pain, vision and bladder had an effect size >0.5. The logistic regression model (N = 4938) correctly classified 80 % with 93 % specificity: risk of depression was increased with disability, fatigue, anxiety, more comorbidities or current smoking. Higher self-efficacy or self esteem and marriage reduced depression. Trajectory analysis of depressive symptoms over 40 months in those with depression (N = 1096) showed three groups: 19.1 % with low symptoms, 49.2 % with greater symptoms between the threshold of possible and probable depression, and 31.7 % with high depressive symptoms. 29.9 % (CI: 27.6-32.3) of depressed subjects were untreated, conversely of those treated, 26.1 % still had a symptom level consistent with a probable case (CI: 23.5-28.9). CONCLUSION A multi-attribute estimate of depression in MS is essential because using only screening questionnaires, diagnoses or antidepressant medication all under-estimate the true prevalence. Depression affects 25.3 % of those with MS, almost half of those with depression were either untreated or still had symptoms indicating probable depression despite treatment. Services for depression in MS must be pro-active and flexible, recognising the heterogeneity of outcomes and reaching out to those with ongoing symptoms.
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Affiliation(s)
- Carolyn A Young
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK; Walton Centre NHS Trust, Liverpool, UK.
| | - Dawn Langdon
- Royal Holloway, University of London, Egham, Surrey, UK
| | - David Rog
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, UK
| | | | | | - Seema Kalra
- University Hospital of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Gillian Webster
- Cumbria Partnership NHS Foundation Trust, Carlisle, Cumbria, UK
| | | | | | | | | | - Alan Tennant
- Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK
| | - Roger Mills
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK; Walton Centre NHS Trust, Liverpool, UK
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Aalders MB, van der List JP, Keijser LCM, Benner JL. Anxiety and depression prior to total knee arthroplasty are associated with worse pain and subjective function: A prospective comparative study. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38943459 DOI: 10.1002/ksa.12336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/13/2024] [Accepted: 06/16/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE The aim of this study was to investigate the influence of preoperative anxiety and depression on subjective function, pain and revision rates following total knee arthroplasty (TKA). METHODS A prospective comparative study was conducted, including 349 patients undergoing TKA surgery between January 2019 and April 2021. Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively, and a set of Patient-Reported Outcome Measures (PROMs) preoperatively and at 6, 12 and 24 months postoperatively. Patients were categorized into anxiety and depression groups based on HADS scores. PROMs included the Knee injury and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), Oxford Knee Score (OKS) and NRS-Pain. Differences in PROM scores between the anxiety/depression group and, respectively, nonanxiety/nondepression group were assessed, as well as differences in minimal clinical important difference (MCID) and attainment of Patient Acceptable Symptom State (PASS). Lastly, revision rates were compared. RESULTS Anxiety and depression groups exhibited inferior subjective function preoperatively and postoperatively compared to nonanxiety and nondepression groups (all p < 0.05), experienced more pain preoperatively (p < 0.001) and also postoperatively for depression patients (all p < 0.05). Significantly fewer patients with anxiety and depression reached the PASS for KOOS-PS, OKS and NRS-Pain (all p < 0.05). There were no differences in the proportion of patients reaching the MCID for all PROMs (all p > 0.060), and revision rates did not differ between groups (both p > 0.96). CONCLUSION Preoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2-year follow-up in patients undergoing TKA. Revision rates did not differ between groups, and there were no relevant differences in clinical improvement of subjective function and pain. LEVEL OF EVIDENCE Level II, prospective comparative study.
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Affiliation(s)
- Margot B Aalders
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, The Netherlands
- Department of Orthopaedic Surgery, Flinders University, Adelaide, South Australia, Australia
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Lucien C M Keijser
- Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, The Netherlands
- Department of Orthopaedic Surgery, Flinders University, Adelaide, South Australia, Australia
| | - Joyce L Benner
- Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, The Netherlands
- Centre for Orthopaedic Research Alkmaar (CORAL), Alkmaar, The Netherlands
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Radtke T, Künzi L, Kopp J, Rasi M, Braun J, Zens KD, Winter B, Anagnostopoulos A, Puhan MA, Fehr JS. Effects of Pycnogenol® in people with post-COVID-19 condition (PYCNOVID): study protocol for a single-center, placebo controlled, quadruple-blind, randomized trial. Trials 2024; 25:385. [PMID: 38879571 PMCID: PMC11179231 DOI: 10.1186/s13063-024-08187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/17/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND A significant proportion of the global population has been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at some point since the onset of the pandemic. Although most individuals who develop coronavirus disease 2019 (COVID-19) recover without complications, about 6% have persistent symptoms, referred to as post-COVID-19 condition (PCC). Intervention studies investigating treatments that potentially alleviate PCC-related symptoms and thus aim to mitigate the global public health burden and healthcare costs linked to PCC are desperately needed. The PYCNOVID trial investigates the effects of Pycnogenol®, a French maritime pine bark extract with anti-inflammatory and antioxidative properties, versus placebo on patient-reported health status in people with PCC. METHODS This is a single-center, placebo-controlled, quadruple blind, randomized trial. We aim to randomly assign 150 individuals with PCC (1:1 ratio) to receive either 200 mg Pycnogenol® or placebo daily for 12 weeks. Randomization is stratified for duration of PCC symptoms (≤ 6 months versus > 6 months) and presence of symptomatic chronic disease(s). The primary endpoint is perceived health status at 12 weeks (EuroQol-Visual Analogue Scale) adjusted for baseline values and stratification factors. Secondary endpoints include change in self-reported PCC symptoms, health-related quality of life, symptoms of depression and anxiety, cognitive function, functional exercise capacity, physical activity measured with accelerometry, and blood biomarkers for endothelial health, inflammation, coagulation, platelet function, and oxidative stress. Investigators, study participants, outcome assessors, and data analysts are blinded regarding the intervention assignment. Individuals with PCC were involved in the design of this study. DISCUSSION This is the first trial to investigate the effects of Pycnogenol® versus placebo on patient-reported health status in people with PCC. Should the trial proof clinical effectiveness, Pycnogenol® may serve as a therapeutic approach to mitigate symptoms associated with PCC. TRIAL REGISTRATION The study is registered at ClinicalTrials.gov. :NCT05890534, June 6, 2023.
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Affiliation(s)
- Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland.
| | - Lisa Künzi
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julia Kopp
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Manuela Rasi
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julia Braun
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Kyra D Zens
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Babette Winter
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Alexia Anagnostopoulos
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
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Wang HQ, Lin H, Liu B. Research progress on the psychological burden and intervention measures in cancer patients. Front Psychiatry 2024; 15:1408762. [PMID: 38938456 PMCID: PMC11208330 DOI: 10.3389/fpsyt.2024.1408762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
In the past 40 years, the gradually increasing incidence and mortality rates of malignant tumors have severely impacted the quality of life of patients, bringing significant physical and psychological burdens and becoming an increasingly serious social issue. With the development of medical standards, new methods for cancer detection and treatment have been continuously proposed. Although it has been proven that cancer is related to increased psychological burden and suicidal behaviors in patients, current research on the psychological burden caused by cancer is insufficient. Clinicians often overlook the psychological health issues of patients while treating their physical diseases. Considering the high incidence of cancer, this review will outline the psychological burdens of cancer patients worldwide in recent years and its high-risk factors. Moreover, this review will summarize the common methods for evaluating psychological burdens, present current predictive models and treatment methods for the psychological burden of cancer patients, aiming to provide a research basis and future direction for the timely and accurate assessment of the psychological burden in cancer patients.
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Affiliation(s)
- Han-Qi Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Lin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Chen Z, Gao C, Zhang Y, Gao Y, Zhang L, Zhao S, Zhang H, Zhao X, Jin Y. Effects of Ultrasound-Guided Thoracic Paravertebral Nerve Block Combined with Perineural or IV Dexmedetomidine on Acute and Chronic Pain After Thoracoscopic Resection of Lung Lesions: A Double-Blind Randomized Trial. Drug Des Devel Ther 2024; 18:2089-2101. [PMID: 38882043 PMCID: PMC11177863 DOI: 10.2147/dddt.s457334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/22/2024] [Indexed: 06/18/2024] Open
Abstract
Background Thoracic paravertebral block (TPVB) analgesia can be prolonged by local anesthetic adjuvants such as dexmedetomidine. This study aimed to evaluate the two administration routes of dexmedetomidine on acute pain and chronic neuropathic pain (NeuP) prevention compared with no dexmedetomidine. Methods A total of 216 patients were randomized to receive TPVB using 0.4% ropivacaine alone (R Group), with perineural dexmedetomidine 0.5 μg·kg-1 (RD0.5 Group) or 1.0 μg·kg-1 (RD1.0 Group), or intravenous (IV) dexmedetomidine 0.5 μg·kg-1·h-1 (RDiv Group). The primary outcome was the incidence of chronic NeuP, defined as a Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain score > 12 points at 3-month after surgery. Results (1) For the primary outcome, RD0.5 Group and RD1.0 Group demonstrated a decreased incidence of chronic NeuP at 3-month after surgery; (2) Compared with R Group, RDiv Group, RD0.5 Group, and RD1.0 Group can reduce VAS scores at rest and movement and Prince-Henry Pain scores at 12 and 24-h after surgery, the consumption of oral morphine equivalent (OME) and improve QOD-15 at POD1; (3) Compared with RDiv Group, RD0.5 Group and RD1.0 Group can reduce VAS scores at rest and movement and Prince-Henry Pain scores at 12 and 24-h after surgery, the consumption of postoperative OME and improve QOD-15 at POD1; (4) Compared with RD0.5 Group, RD1.0 Group effectively reduced VAS scores at rest at 12 and 24-h after surgery, VAS scores in movement and Prince-Henry Pain scores at 12-h after surgery. However, RD1.0 Group showed an increased incidence of drowsiness. Conclusion Perineural or IV dexmedetomidine are similarly effective in reducing acute pain, but only perineural dexmedetomidine reduced chronic NeuP. Moreover, considering postoperative complications such as drowsiness, perineural dexmedetomidine (0.5 μg·kg-1) may be a more appropriate choice. Clinical Trial Registration Chinese Clinical Trial Registry (ChiCTR2200058982).
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Affiliation(s)
- Zheping Chen
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Changli Gao
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- Department of Anesthesiology, Laoling People Hospital, Laoling, People's Republic of China
| | - Yingchao Zhang
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- Department of Anesthesiology, Shouguang People Hospital, Weifang, People's Republic of China
| | - Yongxu Gao
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- Department of Anesthesiology, Jinan Third People's Hospital, Laoling, People's Republic of China
| | - Le Zhang
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Shanshan Zhao
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - He Zhang
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Xin Zhao
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yanwu Jin
- Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
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Xu F, Zhang J, Xie S, Li Q. Effects of Mindfulness-Based Cancer Recovery training on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients undergoing chemotherapy. Medicine (Baltimore) 2024; 103:e38460. [PMID: 38847730 PMCID: PMC11155580 DOI: 10.1097/md.0000000000038460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/03/2024] [Indexed: 06/10/2024] Open
Abstract
RATIONALE Mindfulness-Based Cancer Recovery (MBCR) program is a group course training for cancer patients that combines cancer knowledge and psychological knowledge, emphasizing focusing on the psychosomatic symptoms of cancer patients. Currently, the application value of Mindfulness-Based Cancer Recovery in improving psychosomatic health of cancer patients has been confirmed, however, its intervention effect on breast neoplasm patients has not yet been widely studied in China. PATIENT CONCERNS AND DIAGNOSES This study introduced the Mindfulness-Based Cancer Recovery protocol into the rehabilitation process of breast cancer patients, aiming to elucidate the effects of Mindfulness-Based Cancer Recovery on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients, to provide a practical basis for improving the physical and mental health of breast cancer patients. INTERVENTION In this study, 80 patients with chemotherapy-stage breast neoplasm attending the oncology department of a tertiary-level hospital from January 2022 to December 2022 were selected, 40 patients attending from January 2022 to June 2022 were included in the study group, and 40 patients attending from July 2022 to December 2022 were included in the control group. The control group was administered conventional care, and the study group was administered Mindfulness-Based Cancer Recovery based on conventional care in the control group for 8 weeks. After the intervention, hospital anxiety and depression scale, impact of event scale-revised, and cancer fatigue scale were used for evaluation. OUTCOMES After the intervention, hospital anxiety and depression scale scores decreased in both groups compared with pre-intervention, with the study group scoring lower than the control group (P < .05). After the intervention, the impact of event scale-revised scores of the 2 groups decreased from the preintervention period, with the study group scoring lower than the control group (P < .05). After the intervention, cancer fatigue scale scores decreased in the 2 groups compared with the preintervention period, with the study group scoring lower than the control group (P < .05). LESSONS Mindfulness-Based Cancer Recovery can effectively reduce the levels of anxiety, depression and post-traumatic stress disorder in breast neoplasm patients undergoing chemotherapy, reduce the levels of cancer-related fatigue, and promote the physical and mental health of patients.
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Affiliation(s)
- Fan Xu
- Oncology Department, Deyang People’s Hospital, Deyang, China
| | - Jiquan Zhang
- Nephrology Department, Deyang People’s Hospital, Deyang, China
| | - Shaoju Xie
- Oncology Department, Deyang People’s Hospital, Deyang, China
| | - Qiao Li
- Oncology Department, Deyang People’s Hospital, Deyang, China
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Fernández-Palacios FG, Pacho-Hernández JC, Fernández-de-las-Peñas C, Gómez-Calero C, Cigarán-Méndez M. Evaluation of Cognitive Performance in Patients with Fibromyalgia Syndrome: A Case-Control Study. Life (Basel) 2024; 14:649. [PMID: 38792669 PMCID: PMC11122595 DOI: 10.3390/life14050649] [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: 04/18/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Patients with fibromyalgia syndrome tend to report deficits in cognitive functions; however, there is no clear consensus on which cognitive domains are impaired. The aim of this study was to compare the differences in cognitive performance between a group of patients with fibromyalgia syndrome and a group of pain-free subjects controlling for the covariables anxiety, depression, and sleep quality. In total, 130 patients with fibromyalgia syndrome and 111 pain-free subjects with an average age of 54.96 years completed the evaluation protocol consisting of sociodemographic data, psychological data, and neurocognitive tests. All data were collected from May 2022 to May 2023. Multivariate analyses of covariance (MANCOVAs) were conducted to assess intergroup differences in all neurocognitive tests. MANCOVA analyses showed that the group of patients with fibromyalgia showed a worse cognitive performance than the group of pain-free subjects after controlling for anxiety, depression, and sleep quality. This study found that fibromyalgia patients exhibited worse cognitive performance and executive function than pain-free subjects. Thus, cognitive performance seems to not be related with anxiety, depression, or sleep quality in our sample of women with FMS.
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Affiliation(s)
- Francisco G. Fernández-Palacios
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933 Madrid, Spain;
- Department of Psychology, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (C.F.-d.-l.-P.); (C.G.-C.)
| | - Cristina Gómez-Calero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (C.F.-d.-l.-P.); (C.G.-C.)
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Bramness JG, Hjellvik V, Høye A, Tesli M, Haram M, Nystad W, Krokstad S. The epidemiology of major depression among adults in Norway: an observational study on the concurrence between population surveys and registry data - a NCDNOR project. BMC Public Health 2024; 24:1330. [PMID: 38755615 PMCID: PMC11100182 DOI: 10.1186/s12889-024-18754-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Mental health problems, and major depression in particular, are important public health issues. Following trends in the prevalence of major depression is difficult because of the costs and complications of diagnostic interviews and general population self-report health surveys. Scandinavian countries, however, have several central, population-based health registries. We aimed to investigate how well these registries capture the epidemiology of major depression in the population. METHODS In two Norwegian regional surveys of general population health, each repeated after 10 years, responders were asked to report depressive symptoms using the Hopkins Symptom Checklist (HSCL) or the Hospital Anxiety and Depression Scale (HADS). Data were linked to three central health registries capturing contact with primary care, specialist care and prescriptions for antidepressants, to investigate how well these registries reflected self-reported depressive symptoms. RESULTS Most responders scored low on Hopkins Symptom Checklist (HSCL) and the Hospital Anxiety and Depression Scale (HADS), but 10% and 13%, respectively, scored above cut-off, with only minor changes between the two survey times. Females scored higher than males. Older people scored lower than younger, and a social gradient was visible. Around 12% of those who scored above the cut-off on either scale were recorded in the central health registries during the following year. This correlation was highest in primary care data, followed by prescription data and lowest in specialist care. Females were more often recorded in registries (p < 0.001), as were younger people (p < 0.001). CONCLUSIONS There was a strong association between scores on screening for major depression in the general population surveys and being recorded in central health registries. There was a low sensitivity of these registries. and there was some variation in how sensitive the central health registries were in picking up depression, especially for males and older people. However, the stability of the measures over time suggests we may get an impression of the prevalence of major depression in the general population by using data from the central health registries. A combination of primary care data, prescription data and specialist care data have a higher sensitivity.
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Affiliation(s)
- Jørgen G Bramness
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, P.O.Box 222, Oslo, 0213, Norway.
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
- Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway.
| | - Vidar Hjellvik
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Høye
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Martin Tesli
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marit Haram
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Wenche Nystad
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Saudelli E, Moscatiello S, Baldari M, Bongiorno C, Zucchini S, Maltoni G, Agostini A, Paccapelo A, Nardi E, Ribichini D, Bruco A, Lo Preiato V, Laffi G, Pagotto U, Di Dalmazi G. Sex-driven factors associated with anxiety and depression in autoimmune diabetes. Acta Diabetol 2024:10.1007/s00592-024-02275-4. [PMID: 38743078 DOI: 10.1007/s00592-024-02275-4] [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: 01/22/2024] [Accepted: 03/11/2024] [Indexed: 05/16/2024]
Abstract
AIM To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors. MATERIALS AND METHODS In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy), to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4 months from the questionnaires' administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled). RESULTS Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31-0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1 year increase, 95% CI 0.92-1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1 mmol/mol increase, 95% CI 1.03-1.13; p = 0.002). CONCLUSION Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females.
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Affiliation(s)
- Enrico Saudelli
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Simona Moscatiello
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michele Baldari
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Bongiorno
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stefano Zucchini
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandro Agostini
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Alexandro Paccapelo
- Research and Innovation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elena Nardi
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Danilo Ribichini
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessia Bruco
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Valentina Lo Preiato
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gilberto Laffi
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Uberto Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Guido Di Dalmazi
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
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Liu L, Marshall IJ, Pei R, Bhalla A, Wolfe CDA, O’Connell MDL, Wang Y. Natural history of depression up to 18 years after stroke: a population-based South London Stroke Register study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 40:100882. [PMID: 38745986 PMCID: PMC11092885 DOI: 10.1016/j.lanepe.2024.100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 05/16/2024]
Abstract
Background Current evidence on the long-term natural history of post-stroke depression (PSD) is limited. We aim to determine the prevalence, incidence, duration and recurrence rates of depression to 18-years after stroke and assess differences by onset-time and depression severity. Methods Data were from the South London Stroke Register (1995-2019, N = 6641 at registration). Depression was defined using the Hospital Anxiety and Depression scale (scores > 7 = depression) at 3-months, then annually to 18-years after stroke. We compared early- (3-months post-stroke) vs late-onset depression (1-year) and initial mild (HADS scores > 7) vs severe depression (scores > 10). Findings 3864 patients were assessed for depression at any time-points during the follow-up (male:55.4% (2141), median age: 68.0 (20.4)), with the number ranging from 2293 at 1-year to 145 at 18-years after stroke. Prevalence of PSD ranged from 31.3% (28.9-33.8) to 41.5% (33.6-49.3). The cumulative incidence of depression was 59.4% (95% CI 57.8-60.9), of which 87.9% (86.5-89.2) occurred within 5-years after stroke. Of patients with incident PSD at 3-months after stroke, 46.6% (42.1-51.2) recovered after 1 year. Among those recovered, 66.7% (58.0-74.5) experienced recurrent depression and 94.4% (87.5-98.2) of recurrences occurred within 5-years since recovery. Similar estimates were observed in patients with PSD at 1-year. 34.3% (27.9-41.1) of patients with severe depression had recovered at the next time-point, compared to 56.7% (50.5-62.8) with mild depression. Recurrence rate at 1-year after recovery was higher in patients with severe depression (52.9% (35.1-70.2)) compared to mild depression (23.5% (14.1-35.4)) (difference: 29.4% (7.6-51.2), p = 0.003). Interpretation Long-term depressive status may be established by 5-years post-onset. Early- and late-onset depression presented similar natural history, while severe depression had a longer duration and quicker recurrence than mild depression. These estimates were limited to alive patients completing the depression assessment, who tended to have less severe stroke than excluded patients, so may be underestimated and not generalizable to all stroke survivors. Funding National Institute for Health and Care Research (NIHR202339).
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Affiliation(s)
- Lu Liu
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
| | - Iain J. Marshall
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
- NIHR Applied Research Collaboration (ARC) South London, London, United Kingdom
| | - Ruonan Pei
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
| | - Ajay Bhalla
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
- Department of Ageing Health and Stroke, Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London, United Kingdom
| | - Charles DA. Wolfe
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
- NIHR Applied Research Collaboration (ARC) South London, London, United Kingdom
| | - Matthew DL. O’Connell
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
| | - Yanzhong Wang
- School of Life Course and Population Sciences, King's College London, London, United Kingdom
- NIHR Applied Research Collaboration (ARC) South London, London, United Kingdom
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Ferhi M, Marwen N, Abdeljabbar A, Mannai J. Psychological Outcomes and Quality of Life After Hysterectomy for Benign Diseases: A Prospective Cohort Study. Cureus 2024; 16:e60871. [PMID: 38910628 PMCID: PMC11192439 DOI: 10.7759/cureus.60871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Background Hysterectomy is a common surgical procedure performed for benign gynecological diseases. While the physical benefits have been extensively studied, less attention has been given to its impact on psychological well-being and overall quality of life (QoL). This study aimed to assess the psychological outcomes and QoL before and after hysterectomy for benign diseases. Methodology This prospective cohort study included women undergoing hysterectomy for benign diseases at Ibn El Jazzar Hospital in Kairouan, Tunisia. The study was conducted from January 2, 2020, to December 31, 2021. We used the Short-Form-36 Health Survey (SF-36) to evaluate the QoL and the Hospital Anxiety and Depression Scale (HADS) to assess psychological outcomes preoperatively and after six months. Data entry and analysis were performed using SPSS version 26 (IBM Corp., Armonk, NY, USA) with the significance level (p) set to 0.05. Results Of 84 assessed patients, 60 were included. Following the hysterectomy, there were improvements in QoL and psychological outcomes across all domains, regardless of whether total or subtotal hysterectomy was performed. The mean HADS score for anxiety decreased from 12.57 to 8.77 after hysterectomy and from 14.83 to 9.57 for depression. Moreover, the median SF-36 total score increased from 29.81 to 68.1. We found no statistically significant difference between the two groups in all assessed outcomes. Conclusions Hysterectomy for benign conditions, whether total or subtotal, positively impacted symptoms of depression and anxiety, as well as the overall QoL for patients. A thorough preoperative psychiatric assessment is recommended to address and support mental health outcomes in these patients. Future research should consider a larger multicenter approach for a broader application of findings.
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Affiliation(s)
- Mohamed Ferhi
- Psychiatry, Ibn El Jazzar University Hospital, Kairouan, TUN
- Psychiatry, Mohamed Taher Maamouri University Hospital, Nabeul, TUN
| | - Nadia Marwen
- Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, TUN
| | - Ameni Abdeljabbar
- Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, TUN
| | - Jihenne Mannai
- Psychiatry, Ibn El Jazzar University Hospital, Kairouan, TUN
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14
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Martins EC, Teixeira TM. Correlation between psychological status, revised Müller AO classification and patient-reported outcomes: a prospective cohort analysis. Arch Orthop Trauma Surg 2024; 144:2149-2155. [PMID: 38554207 DOI: 10.1007/s00402-024-05288-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION The impact of psychological status on clinical outcomes is valued in several medical conditions, but rare attention is given to it in orthopedic trauma. We aimed to assess the correlation between psychological status, fracture severity and patient-reported outcomes in fractured patients needing urgency surgical treatment. MATERIALS AND METHODS We prospectively followed 139 consecutive patients undergoing urgency surgical treatment of a lower/upper limb fracture. Before surgery, all patients were divided into grades of fracture severity according to the Revised AO Müller Classification (AO grades). On the 15th and the 120th days after surgery, all patients underwent a psychological status assessment through the Hospital Anxiety and Depression Score (HADS), in addition to a pain evaluation through VAS. One year after surgery, patient-reported outcomes were obtained by using specific scales depending on the site of fracture. RESULTS AO grades and VAS scores were significantly correlated to scores at HADS-A (anxiety component) and HADS-D (depression component), both on the 15th and the 120th. Patients presenting persistent HADS-A and HADS-D scores equal or greater than 8 points had a risk of more than 2.5 or 2.0 times of experiencing unsatisfactory surgical outcomes, respectively [HADS-A: RR = 2.8 (95% CI: 2.2-3.5)] [HADS-D: RR = 2.2 (95% CI: 1.7-3.1)]. AO grade C and the persistency of significant symptoms of anxiety or depression were independent predictors of unsatisfactory patient-reported outcomes (OR: 1.7, p = 0.03 // OR: 2.9, p < 0.01). Female gender, age, and BMI did not present any statistically significant utility in predicting unsatisfactory patient-reported outcomes. CONCLUSION In fractured patients needing urgency surgical treatment, the risk of presenting unsatisfactory outcomes is more than twice as high in patients that present significant persistent changes in psychological status. Changes in psychological status are more frequent in patients presenting more severe pain and more severe fractures. AO grades and HADS scores are independent predictors of unsatisfactory outcomes in these patients.
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Affiliation(s)
- Eduardo Campos Martins
- Department of Surgery, Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
- Fractures Institute, Baía Sul Medical Center, Florianópolis, Santa Catarina, Brazil.
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15
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Griffin NE, Feldman R, Althouse AD, Yadav D, Phillips AE. Clinical diagnosis of psychiatric comorbidities, performance of screening tests and pattern of psychotropic medication use in patients with chronic pancreatitis. Pancreatology 2024; 24:378-383. [PMID: 38423915 DOI: 10.1016/j.pan.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/30/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Psychiatric comorbidity measured by screening instruments is common in patients with chronic pancreatitis (CP) but whether this accurately reflects clinical diagnosis of psychiatric comorbidity is unknown and the prevalence of psychotropic medication prescription in CP remains largely unexplored. METHODS Adult patients (≥18 years) with definite CP were enrolled and completed the Hospital Anxiety and Depression Scale (HADS). Demographics, clinical characteristics and medications were retrieved from case report forms and the electronic health record (EHR). Clinical diagnosis of depression or anxiety was determined by presence of ICD-10 code or inclusion in the patient's EHR problem list or treatment plan. Comparisons were made between patients with and without clinical psychiatric comorbidity. RESULTS Total of 81 patients (48, 59.3% male; mean age 57.6 ± 14.3 years) were included. Clinical diagnoses of anxiety and depression were each noted in 47 (58%) patients, with overlap in 42 (51.9%). Compared to clinical diagnoses, the sensitivity and specificity of a positive screen for anxiety (HADS >7) were 76.6% and 91.2%; for depression 55.3% and 88.2%. Patients with anxiety and/or depression were more frequently female (51.9% v 20.7%), younger (53.6 v 64.9 years), and had alcohol etiology (51.9% v 27.6%) (all p < 0.01). In those with psychiatric comorbidity, 42 (80.8%) were prescribed psychotropic medication, most commonly gabapentinoid (24, 57.1%), selective serotonin reuptake inhibitor (n = 22, 52.4%) or benzodiazepine (n = 20, 47.6%). CONCLUSIONS Psychiatric comorbidities are common among CP patients and many receive psychotropic medications. Further studies are needed to evaluate the impact of these medications on CP symptoms.
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Affiliation(s)
- Natalie E Griffin
- Internal Medicine Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Robert Feldman
- Center for Research on Health Care Data Center, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew D Althouse
- Center for Research on Health Care Data Center, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dhiraj Yadav
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anna Evans Phillips
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Lu J, Dou X, Yi Y, Yu Y, Zhou L. Prevalence and Determinants of Anxiety and Depression Among Healthcare Workers in Liaoning Province, China. Risk Manag Healthc Policy 2024; 17:983-993. [PMID: 38680481 PMCID: PMC11055524 DOI: 10.2147/rmhp.s460118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose To assess the anxiety and depression and their predictors among healthcare workers in Liaoning Province, China. Methods In order to explore the influencing factors and prevalence of anxiety and depression among healthcare workers, a cross-sectional research design was used to survey 500 healthcare workers using the 14-item Hospital Anxiety Depression Scale (HADS), the Rosenberg Self-Esteem Scale (RSES), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Survey of Perceived Organizational Support (SPOS). Results About 47.12% of the healthcare workers suffered from anxiety and 71.63% suffered from depression. In our study, we found that the health status (OR: 0.540, 95% CI: 0.298-0.976), self-esteem (OR: 0.395, 95% CI: 0.251-0.619), PSS (OR: 0.621, 95% CI: 0.388-0.994), organizational support (OR: 0.533, 95% CI. 0.333-0.854) were protective factors for healthcare workers suffering from anxiety, and resistance to COVID-19 (OR: 1.703, 95% CI: 1.082-2.681) was a risk factor for healthcare workers suffering from anxiety, while good quality of life (OR: 0.385, 95% CI: 0.206-0.719) self-esteem (OR: 0.187, 95% CI: 0.110-0.317), and PSS (OR: 0.475, 95% CI: 0.267-0.847) were protective factors for healthcare workers suffering from depression, and at the age of 35-40 years (OR: 2.475, 95% CI: 1.140-5.369) and resistance to COVID-19 (OR: 2.219, 95% CI: 1.313-3.751) were risk factors for healthcare workers suffering from depression. Conclusion The anxiety and depression status of healthcare workers in China is poor, and hospital administrators should take positive measures to support healthcare workers and give positive expectations to alleviate negative emotions such as anxiety and depression.
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Affiliation(s)
- Jiachen Lu
- School of Public Health, Dalian Medical University, Dalian, People’s Republic of China
| | - Xiaofeng Dou
- School of Public Health, Dalian Medical University, Dalian, People’s Republic of China
| | - Yaohui Yi
- School of Public Health, Dalian Medical University, Dalian, People’s Republic of China
| | - Yingying Yu
- School of Public Health, Dalian Medical University, Dalian, People’s Republic of China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, Dalian, People’s Republic of China
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Derendorf L, Stock S, Simic D, Shukri A, Zelenak C, Nagel J, Friede T, Herbeck Belnap B, Herrmann-Lingen C, Pedersen SS, Sørensen J, Müller And On Behalf Of The Escape Consortium D. Health economic evaluation of blended collaborative care for older multimorbid heart failure patients: study protocol. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:29. [PMID: 38615050 PMCID: PMC11015692 DOI: 10.1186/s12962-024-00535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/21/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Integrated care, in particular the 'Blended Collaborative Care (BCC)' strategy, may have the potential to improve health-related quality of life (HRQoL) in multimorbid patients with heart failure (HF) and psychosocial burden at no or low additional cost. The ESCAPE trial is a randomised controlled trial for the evaluation of a BCC approach in five European countries. For the economic evaluation of alongside this trial, the four main objectives were: (i) to document the costs of delivering the intervention, (ii) to assess the running costs across study sites, (iii) to evaluate short-term cost-effectiveness and cost-utility compared to providers' usual care, and (iv) to examine the budgetary implications. METHODS The trial-based economic analyses will include cross-country cost-effectiveness and cost-utility assessments from a payer perspective. The cost-utility analysis will calculate quality-adjusted life years (QALYs) using the EQ-5D-5L and national value sets. Cost-effectiveness will include the cost per hospital admission avoided and the cost per depression-free days (DFD). Resource use will be measured from different sources, including electronic medical health records, standardised questionnaires, patient receipts and a care manager survey. Uncertainty will be addressed using bootstrapping. DISCUSSION The various methods and approaches used for data acquisition should provide insights into the potential benefits and cost-effectiveness of a BCC intervention. Providing the economic evaluation of ESCAPE will contribute to a country-based structural and organisational planning of BCC (e.g., the number of patients that may benefit, how many care managers are needed). Improved care is expected to enhance health-related quality of life at little or no extra cost. TRIAL REGISTRATION The study follows CHEERS2022 and is registered at the German Clinical Trials Register (DRKS00025120).
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Affiliation(s)
- Lisa Derendorf
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.
| | - Stephanie Stock
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Dusan Simic
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Arim Shukri
- Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
| | - Christine Zelenak
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Jonas Nagel
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Tim Friede
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- Department of Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | - Birgit Herbeck Belnap
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- Center for Behavioral Health, Media, and Technology, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Jan Sørensen
- Healthcare Outcomes Research Centre, Dublin, Ireland
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Dahlin Redfors Y, Björsne A, Finizia C. Psychometric properties of the Swedish version of the international outcome inventory - alternative interventions (IOI-AI) - ear surgery (IOI-AI op). Int J Audiol 2024:1-8. [PMID: 38587069 DOI: 10.1080/14992027.2024.2332774] [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: 04/19/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE The aims of this study were to adapt the Swedish version of the International Outcome Inventory for Hearing Aids (IOI-HA) to the International Outcome Inventory for Alternative Interventions (IOI-AI) in the context of ear surgery (IOI-AIop) and to test the psychometric properties. DESIGN The validated Swedish questionnaire IOI-HA was adapted to the IOI-AIop by omitting the question about hearing aid use and changing the term "hearing aid" to "surgery" in the remaining items. The validity, component structure and reliability of the IOI-AIop were assessed. STUDY SAMPLE Subjects diagnosed with otosclerosis and undergoing stapedotomy were included in the study (n = 162). RESULTS High mean scores were noted for all items. Ceiling effects were noted, most pronounced for the satisfaction item. Principal component analysis (PCA) yielded a two-component structure explaining 77.5% of the variance. The test-retest reliability measured by intra class correlation coefficient was >0.9, and the internal consistency coefficient measured by Cronbach's alfa was >0.8. CONCLUSION The IOI-AIop showed good psychometric properties. However, ceiling effects were observed. The two-component solution was in line with previous factor analyses of the IOI-HA and the IOI-AI. The comprehensive IOI-AIop is recommended as a useful tool to evaluate patient perspectives after ear surgery.
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Affiliation(s)
- Ylva Dahlin Redfors
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andreas Björsne
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Unit of Audiology, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Hearing Organization, Habilitation & Health, Region Västra Götaland, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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19
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Parás-Bravo P, Fernández-de-Las-Peñas C, Ferrer-Pargada D, Druet-Toquero P, Fernández-Cacho LM, Cifrián-Martínez JM, Arendt-Nielsen L, Herrero-Montes M. Evaluating Sensitization-associated, Neuropathic-like Symptoms and Psychological Factors in Patients With Interstitial Lung Disease. THE JOURNAL OF PAIN 2024:104533. [PMID: 38593969 DOI: 10.1016/j.jpain.2024.104533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/11/2024]
Abstract
The aims of this study were to phenotype pain in patients with interstitial lung disease (ILD) by investigating the association between sensitization-associated symptoms with quality of life, anxiety/depression, pain catastrophizing, and kinesiophobia levels and identifying those risk factors explaining the variance of quality of life in individuals with ILD and pain. One hundred and thirty-two (38.6% women, mean age: 70, standard deviation: 10.5 years) patients with ILD completed clinical (age, sex, height, weight), psychological (Hospital Anxiety and Depression Scale [HADS] and the Pittsburgh Sleep Quality Index), and health-related quality of life (EQ-5D-5L) variables, as well as the Central Sensitization Inventory (CSI), the Self-Report Leeds Assessment of Neuropathic Symptoms (S-LANSS), Pain Catastrophizing Scale, and Tampa Scale for Kinesiophobia (TSK-11) questionnaires. The prevalence of sensitization-associated symptomatology (CSI), neuropathic-like features (S-LANSS), anxiety symptoms, depressive symptoms, or poor sleep was 20.5%, 23.5%, 23.6%, 22.9%, or 51.6%. Significant associations between CSI, S-LANSS, HADS-A, HADS-D, Pain Catastrophizing Scale, TSK-11, and EQ-5D-5L (.220 < r < .716) were found. The regression analysis revealed that CSI, TSK-11, and HADS-D explained 44.8% of the variance of EQ-5D-5L (r2 adjusted: .448). This study found the presence of sensitization-associated and neuropathic-like symptoms as well as other central nervous system-derived symptoms, such as anxiety, depression, poor sleep, pain catastrophizing, and kinesiophobia in 25% of ILD patients with pain. Sensitization-associated symptoms, depression, and kinesiophobia were associated with a worse quality of life. These findings would support that individuals with ILD can exhibit different pain phenotypes, including nociplastic-like pain phenotype based on self-reported measurements. PERSPECTIVE: Pain in patients with ILD can fulfill features of different phenotypes, including nociplastic pain, when sensory, emotional, and cognitive mechanisms are involved at the same time.
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Affiliation(s)
- Paula Parás-Bravo
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain; Grupo de Investigación en Enfermería, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Madrid, Spain; Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - Diego Ferrer-Pargada
- Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | | | | | | | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark; Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - Manuel Herrero-Montes
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain; Grupo de Investigación en Enfermería, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
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20
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Nikolovski A, Gamgoum L, Deol A, Quilichini S, Kazemir E, Rhodenizer J, Oliveira A, Brooks D, Alsubheen S. Psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in individuals with stable chronic obstructive pulmonary disease (COPD): a systematic review. Disabil Rehabil 2024; 46:1230-1238. [PMID: 36861817 DOI: 10.1080/09638288.2023.2182918] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE The Hospital Anxiety and Depression Scale (HADS) is used to assess anxiety and depression in individuals with chronic obstructive pulmonary disease (COPD); however, its measurement properties lack critical appraisal. We aimed to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in COPD. MATERIALS AND METHODS Five electronic databases were searched. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines were used to assess the methodological and evidence quality in the selected studies. RESULTS Twelve studies assessed the psychometric properties of the HADS-Total and its subscales HADS-Anxiety and HADS-Depression in COPD. High-quality evidence supported the structural and criterion validity of the HADS-A, the internal consistency of the HADS-T, HADS-A, and HADS-D with Cronbach's alpha values of 0.73-0.87, and before-after treatment responsiveness of HADS-T and its subscales (minimal clinically important difference = 1.4-2; effect size = 0.45-1.40). Moderate-quality evidence supported the test-retest reliability of the HADS-A and HADS-D with excellent coefficient values of 0.86-0.90. CONCLUSIONS The HADS-A is recommended for use in individuals with stable COPD. The lack of high-quality evidence on the validity of the HADS-D and HADS-T prevented drawing robust conclusions about their clinical utility in COPD.
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Affiliation(s)
| | - Lara Gamgoum
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Arshpreet Deol
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Shea Quilichini
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Ethan Kazemir
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | | | - Ana Oliveira
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- West Park Healthcare Centre, Toronto, Canada
- School of Health Sciences, Lab 3R Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), IBMED, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, Canada
| | - Sanaa Alsubheen
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
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21
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Verdonk F, Cambriel A, Hedou J, Ganio E, Bellan G, Gaudilliere D, Einhaus J, Sabayev M, Stelzer IA, Feyaerts D, Bonham AT, Ando K, Choisy B, Drover D, Heifets B, Chretien F, Aghaeepour N, Angst MS, Molliex S, Sharshar T, Gaillard R, Gaudilliere B. An immune signature of postoperative cognitive decline in elderly patients. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.02.582845. [PMID: 38496400 PMCID: PMC10942349 DOI: 10.1101/2024.03.02.582845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Postoperative cognitive decline (POCD) is the predominant complication affecting elderly patients following major surgery, yet its prediction and prevention remain challenging. Understanding biological processes underlying the pathogenesis of POCD is essential for identifying mechanistic biomarkers to advance diagnostics and therapeutics. This longitudinal study involving 26 elderly patients undergoing orthopedic surgery aimed to characterize the impact of peripheral immune cell responses to surgical trauma on POCD. Trajectory analyses of single-cell mass cytometry data highlighted early JAK/STAT signaling exacerbation and diminished MyD88 signaling post-surgery in patients who developed POCD. Further analyses integrating single-cell and plasma proteomic data collected before surgery with clinical variables yielded a sparse predictive model that accurately identified patients who would develop POCD (AUC = 0.80). The resulting POCD immune signature included one plasma protein and ten immune cell features, offering a concise list of biomarker candidates for developing point-of-care prognostic tests to personalize perioperative management of at-risk patients. The code and the data are documented and available at https://github.com/gregbellan/POCD . Teaser Modeling immune cell responses and plasma proteomic data predicts postoperative cognitive decline.
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22
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Sturgeon JA, Pierce J, Trost Z. Initial validation of the 12-item Tampa Scale of Kinesiophobia in a retrospective sample of adults with chronic headache. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:187-193. [PMID: 37930882 PMCID: PMC11032727 DOI: 10.1093/pm/pnad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/22/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION An area of emerging interest in chronic pain populations concerns fear of pain and associated fear of movement (kinesiophobia)-a cognitive appraisal pattern that is well-validated in non-headache chronic pain. However, there is limited research on whether this construct can be measured in a similar manner in headache populations. METHODS The current project details a confirmatory factor analysis of the 12-Item Tampa Scale of Kinesiophobia (TSK-12) using a clinical data set from 210 adults with diverse headache diagnoses presenting for care at a multidisciplinary pain clinic. One item (concerning an "accident" that initiated the pain condition) was excluded from analysis. RESULTS Results of the confirmatory factor analysis for the remaining 12 items indicated adequate model fit for the previously established 2-factor structure (activity avoidance and bodily harm/somatic focus subscales). In line with previous literature, total TSK-12 scores showed moderate correlations with pain severity, pain-related interference, positive and negative affect, depressive and anxious symptoms, and pain catastrophizing. DISCUSSION The current study is the first to examine the factor structure of the TSK-12 in an adult headache population. The results support the relevance of pain-related fear to the functional and psychosocial status of adults with chronic headache, although model fit of the TSK-12 could be characterized as adequate rather than optimal. Limitations of the study include heterogeneity in headache diagnosis and rates of comorbid non-headache chronic pain in the sample. Future studies should replicate these findings in more homogenous headache groups (eg, chronic migraine) and examine associations with behavioral indices and treatment response.
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Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48105, United States
| | - Jennifer Pierce
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48105, United States
| | - Zina Trost
- Department of Psychology, Texas A&M University, College Station, TX 77840, United States
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23
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Negeri ZF, Levis B, Ioannidis JPA, Thombs BD, Benedetti A. An empirical comparison of statistical methods for multiple cut-off diagnostic test accuracy meta-analysis of the Edinburgh postnatal depression scale (EPDS) depression screening tool using published results vs individual participant data. BMC Med Res Methodol 2024; 24:28. [PMID: 38302928 PMCID: PMC10832258 DOI: 10.1186/s12874-023-02134-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Selective reporting of results from only well-performing cut-offs leads to biased estimates of accuracy in primary studies of questionnaire-based screening tools and in meta-analyses that synthesize results. Individual participant data meta-analysis (IPDMA) of sensitivity and specificity at each cut-off via bivariate random-effects models (BREMs) can overcome this problem. However, IPDMA is laborious and depends on the ability to successfully obtain primary datasets, and BREMs ignore the correlation between cut-offs within primary studies. METHODS We compared the performance of three recent multiple cut-off models developed by Steinhauser et al., Jones et al., and Hoyer and Kuss, that account for missing cut-offs when meta-analyzing diagnostic accuracy studies with multiple cut-offs, to BREMs fitted at each cut-off. We used data from 22 studies of the accuracy of the Edinburgh Postnatal Depression Scale (EPDS; 4475 participants, 758 major depression cases). We fitted each of the three multiple cut-off models and BREMs to a dataset with results from only published cut-offs from each study (published data) and an IPD dataset with results for all cut-offs (full IPD data). We estimated pooled sensitivity and specificity with 95% confidence intervals (CIs) for each cut-off and the area under the curve. RESULTS Compared to the BREMs fitted to the full IPD data, the Steinhauser et al., Jones et al., and Hoyer and Kuss models fitted to the published data produced similar receiver operating characteristic curves; though, the Hoyer and Kuss model had lower area under the curve, mainly due to estimating slightly lower sensitivity at lower cut-offs. When fitting the three multiple cut-off models to the full IPD data, a similar pattern of results was observed. Importantly, all models had similar 95% CIs for sensitivity and specificity, and the CI width increased with cut-off levels for sensitivity and decreased with an increasing cut-off for specificity, even the BREMs which treat each cut-off separately. CONCLUSIONS Multiple cut-off models appear to be the favorable methods when only published data are available. While collecting IPD is expensive and time consuming, IPD can facilitate subgroup analyses that cannot be conducted with published data only.
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Affiliation(s)
- Zelalem F Negeri
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
| | - John P A Ioannidis
- Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
- Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada.
- Department of Medicine, McGill University, Montréal, Québec, Canada.
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.
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Garza C, Chapa D, Hernandez C, Aramburu H, Mayes TL, Emslie GJ. Measurement-Based Care for Depression in Youth: Practical Considerations for Selecting Measures to Assess Depression, Associated Features and Functioning. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01652-4. [PMID: 38217644 DOI: 10.1007/s10578-023-01652-4] [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] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
Identification and management of major depressive disorder (MDD) in children and adolescents remains a significant area of public health need. The process for identifying depression (e.g. screening) and management (e.g. measurement based care [MBC]) is substantially enhanced by utilization of clinical measures and rating scales. Measures can be self- or caregiver reported or clinician rated. They can aid recognition of at-risk individuals for future assessment and assist in clinical diagnosis and management of depression. In addition to assessing symptoms of depression, rating scales can be used to assess important associated features (e.g. anxiety, trauma) and functional outcomes (e.g. quality of life, performance/productivity). In this manuscript, we discuss practical considerations for clinicians and researchers when selecting rating instruments for assessing depression, associated factors, functioning, and treatment outcomes (i.e. adherence and side effects) as part of MBC in youth and provide a summary of rating scales commonly used in research and clinical settings.
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Affiliation(s)
- Cynthia Garza
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA.
| | - Diana Chapa
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - Catherine Hernandez
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - Hayley Aramburu
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Graham J Emslie
- Children's Health, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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25
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Rizwan Khan AY, Abdullah MA, Gul R, Bhutta HR, Imran M, Mazhar SB, Tariq N. Prevalence of Anxiety and Depression Among Women With Polycystic Ovarian Syndrome: A Cross-Sectional Study From a Tertiary Care Hospital of Islamabad, Pakistan. Cureus 2024; 16:e52540. [PMID: 38371069 PMCID: PMC10874487 DOI: 10.7759/cureus.52540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Background Depression and anxiety are common psychological conditions associated with polycystic ovarian syndrome (PCOS). It is important to understand the role of various demographic and socio-economic factors that contribute to the development of these psychological conditions. Objectives The aims of this study were to determine the prevalence of anxiety and depression in women with PCOS and to find the association of various demographic and socio-economic factors with anxiety and depression. Methods This was a single-center cross-sectional study conducted at a tertiary care hospital in Islamabad, Pakistan, from May 2021 to August 2022. All female patients, aged 18 to 40 years and diagnosed with PCOS, who presented to the department of Gynecology during the study period were eligible to be enrolled in the study. The Hospital Anxiety and Depression scale (HADS) was used to determine the level of anxiety and depression in the participants. HADS comprises 14 items scored on a Likert scale ranging from 0 to 3. Seven items correspond to depression and anxiety each. The scores range from 0 to 21 for both domains. A score of 7 or less was considered normal, 8-10 as borderline, and 11 or above as abnormal for both anxiety and depression. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY, USA). Results A total of 74 patients with PCOS were included in the study. The mean age of all the participants was 26.8 ± 5.2 and the mean body mass index (BMI) was 28.7 ± 5.4. The presence of PCOS-related symptoms was observed in all 74 cases. Menstrual cycle abnormalities were the most common symptom, which was present in 57 (77.0%) cases, followed by weight gain, which was present in 50 (67.6%) cases, and hirsutism, which was present in 41 (55.4%) cases. Diabetes mellitus and hypertension were present only in three (4.1%) and two (2.7%) cases, respectively, and positive family history of depression and/or anxiety was reported by 20 (27%) cases. The mean HAD score was 7 ± 3.8 for depression and 8 ± 3.7 for anxiety. Depression was diagnosed in 13 (17.6%) cases, and anxiety was diagnosed in 15 (20.3%) cases. Depression was found to be significantly associated with BMI (p = 0.015), level of education (p = 0.033), and monthly household income (p = 0.004). Anxiety was found to be associated with employment status (p = 0.009) and current pregnancy (p = 0.007). Rest of the factors such as age, marital status, ethnicity, menstrual irregularities, comorbidities such as diabetes mellitus and hypertension, and a family history of PCOS, anxiety, or depression did not show statistically significant association with either anxiety or depression (p < 0.05). Conclusion Anxiety and depression are common in patients with PCOS. These psychological conditions are associated with various demographic and socio-economic factors such as BMI, level of education, monthly household income, employment status, and pregnancy. It is recommended to involve a multidisciplinary team while managing patients with PCOS to timely identify and treat these psychological conditions in these patients.
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Affiliation(s)
| | | | - Rumaan Gul
- Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK
| | - Haider Raza Bhutta
- Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK
| | - Maryam Imran
- Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK
| | - Syeda Batool Mazhar
- Obstetrics and Gynecology, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Nabia Tariq
- Obstetrics and Gynecology, Maroof International Hospital, Islamabad, PAK
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26
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Zhou J, Radojčić MR, Ashton-James CE, Yang H, Chen Z, Wang R, Yang Y, Si J, Yao L, Li G, Chen L. Optimal cut-offs of depression screening tools during the COVID-19 pandemic: a systematic review. BMC Psychiatry 2023; 23:953. [PMID: 38114961 PMCID: PMC10729515 DOI: 10.1186/s12888-023-05455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Studies have reported an increase in the prevalence of depression during the COVID-19 pandemic. The accuracy of screening tools may change with the prevalence and distribution of a disease in a population or sample: the "Spectrum Effect". METHODS First, we selected commonly used screening tools and developed search strategies for the inclusion of original studies during the pandemic. Second, we searched PsycINFO, EMBASE, and MEDLINE from March 2020 to September 2022 to obtain original studies that investigated the accuracy of depression screening tools during the pandemic. We then searched these databases to identify meta-analyses summarizing the accuracy of these tools conducted before the pandemic and compared the optimal cut-offs for depression screening tools during the pandemic with those before. RESULT Four original studies evaluating the optimal cut-offs for four screening tools (Beck Depression Inventory [BDI-II], Hospital Anxiety and Depression Scale-Depression [HADS-D], Patient Health Questionnaire-9 [PHQ-9], and Geriatric Depression Scale-4 [GDS-4]) were published during the pandemic. Four meta-analyses summarizing these tools before the pandemic. We found that the optimal cut-off of BDI-II was 14 during the pandemic (23.8% depression prevalence, screening patients with Type 2 diabetes) and 14.5 before the pandemic (17.6% depression prevalence, screening psychiatric, primary care, and healthy populations); HADS-D was 10 during the pandemic (23.8% depression prevalence, screening patients with type 2 diabetes) and 7 before the pandemic (15.0% depression prevalence, screening medically ill patients); PHQ-9 was 11 during the pandemic (14.5% depression prevalence, screening university students) and 8 before the pandemic (10.9% depression prevalence, screening the unrestricted population), and GDS-4 was 1.8 during the pandemic (29.0% depression prevalence, screening adults seen in a memory clinic setting) and 3 before the pandemic (18.5% depression prevalence, screening older adults). CONCLUSION The optimal cut-off for different screening tools may be sensitive to changes in study populations and reference standards. And potential spectrum effects that should be considered in post-COVID time which aiming to improve diagnostic accuracy.
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Affiliation(s)
- Jieru Zhou
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Maja R Radojčić
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Claire E Ashton-James
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Hanqiao Yang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichua, 610041, People's Republic of China
| | - Ziyi Chen
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Ruijia Wang
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, People's Republic of China
| | - Ying Yang
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Jinhua Si
- Tianjin University of Traditional Chinese Medicine Library, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Ge Li
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China.
| | - Lingxiao Chen
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Sydney Musculoskeletal Health, School of Health Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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Humayun MM, Brouillette MJ, Fellows LK, Mayo NE. The Patient Generated Index (PGI) as an early-warning system for predicting brain health challenges: a prospective cohort study for people living with Human Immunodeficiency Virus (HIV). Qual Life Res 2023; 32:3439-3452. [PMID: 37428407 DOI: 10.1007/s11136-023-03475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE In research people are often asked to fill out questionnaires about their health and functioning and some of the questions refer to serious health concerns. Typically, these concerns are not identified until the statistician analyses the data. An alternative is to use an individualized measure, the Patient Generated Index (PGI) where people are asked to self-nominate areas of concern which can then be dealt with in real-time. This study estimates the extent to which self-nominated areas of concern related to mood, anxiety and cognition predict the presence or occurrence of brain health outcomes such as depression, anxiety, psychological distress, or cognitive impairment among people aging with HIV at study entry and for successive assessments over 27 months. METHODS The data comes from participants enrolled in the Positive Brain Health Now (+ BHN) cohort (n = 856). We analyzed the self-nominated areas that participants wrote on the PGI and classified them into seven sentiment groups according to the type of sentiment expressed: emotional, interpersonal, anxiety, depressogenic, somatic, cognitive and positive sentiments. Tokenization was used to convert qualitative data into quantifiable tokens. A longitudinal design was used to link these sentiment groups to the presence or emergence of brain health outcomes as assessed using standardized measures of these constructs: the Hospital Anxiety and Depression Scale (HADS), the Mental Health Index (MHI) of the RAND-36, the Communicating Cognitive Concerns Questionnaire (C3Q) and the Brief Cognitive Ability Measure (B-CAM). Logistic regressions were used to estimate the goodness of fit of each model using the c-statistic. RESULTS Emotional sentiments predicted all of the brain health outcomes at all visits with adjusted odds ratios (OR) ranging from 1.61 to 2.00 and c-statistics > 0.73 (good to excellent prediction). Nominating an anxiety sentiment was specific to predicting anxiety and psychological distress (OR 1.65 & 1.52); nominating a cognitive concern was specific to predicting self-reported cognitive ability (OR 4.78). Positive sentiments were predictive of good cognitive function (OR 0.36) and protective of depressive symptoms (OR 0.55). CONCLUSIONS This study indicates the value of using this semi-qualitative approach as an early-warning system in predicting brain health outcomes.
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Affiliation(s)
- Muhammad Mustafa Humayun
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, 5252 de Maisonneuve, Montreal, QC, H4A 3S5, Canada.
- Center for Outcome Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, QC, Canada.
| | - Marie-Josée Brouillette
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Lesley K Fellows
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Nancy E Mayo
- Center for Outcome Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Hoshyari N, Mesgarani A, Far ES, Nataj AH, Ahmadi M. Comparison of Anaheal Plus and Ibuprofen's Analgesic Effect after Root Canal Treatment in Patients Referred to Amol Private Clinic: a Clinical Trial Study. MAEDICA 2023; 18:651-658. [PMID: 38348069 PMCID: PMC10859192 DOI: 10.26574/maedica.2023.18.4.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Background and purpose: Since pain control in dental treatments, including root canal treatment, is challenging, and no study has measured the appropriate pattern of Anaheal Plus drug consumption in reducing pain after root canal treatment, in this study the appropriate pattern of taking Anaheal Plus drug in reducing pain after root canal treatment was evaluated. Material and methods:The present study examined maxillary and mandibular molar teeth with irreversible pulpitis. Patients were divided into three groups: A) Anaheal Plus capsule; B) control; and C) ibuprofen. Teeth were treated in two sessions, pulpectomy treatment was performed and drugs were used between sessions. A visual analog scale questionnaire was used to assess pain. Patients were asked to record the pain score before the root canal treatment as well as eight hours, 48 hours and five days after root canal treatment. All procedures were done in Amol's private clinic, where root canal treatment was administered by a dentist, and the teeth were obturated after a week. Findings: This study examined 90 patients with an average age of 33.94 years. Rescue doses were reported only in the control group, and there was a significant difference between groups (p-value < 0.001). In all groups, pain had decreased significantly (p-value<0.001), but the average pain in groups A and C was lower than that of group B at all times, and there was no difference between them. Conclusion:Anaheal Plus significantly reduced pain after root canal treatment compared to the control group.
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Affiliation(s)
- Narjes Hoshyari
- Assistant Professor, Department of Endodontics, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Mesgarani
- Associate Professor, Department of Endodontics, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ebrahim Salehi Far
- Professor of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abolfazl Hossein Nataj
- Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ahmadi
- Student Research Committee, School of Dentistry , Mazandaran University of Medical Sciences, Sari, Iran
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Li J, Wu W, Li N, Wang J, Zu L, Ye X. Predictive value of type D personality for cardiac events in Chinese patients with acute myocardial infarction. BMC Cardiovasc Disord 2023; 23:556. [PMID: 37964193 PMCID: PMC10648328 DOI: 10.1186/s12872-023-03598-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Our study aimed to investigate the association between type D personality and adverse cardiac events in chinese patients after acute myocardial infarction (AMI). METHODS Patients with AMI admitted to cardiac care unit (CCU) of China-Japan Friendship Hospital, Beijing, China between January 2016 and December 2017 were enrolled. 257 patients completed psychological questionnaires at enrollment. Type D personality was assessed with 14-item Type D Scale-14 (DS14). Anxiety and depression were quantified using Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regression analysis was used to determine the independent predictors of in-hospital major adverse cardiac events (MACEs), while cox regression analysis was used to evaluate post-discharge endpoints. RESULTS 54 patients (21%) were classified as Type D personality defined by the combination of a negative affectivity (NA) score ≥ 10 and a social inhibition (SI) score ≥ 10 on the DS14. Patients with Type D personality displayed significantly higher scores of anxiety (7.4 ± 3.1 vs. 4.2 ± 3.1, p < .001) and depression (7.2 ± 3.8 vs. 4.0 ± 3.4, p < .001). AMI patients with Type D personality had higher prevalence rates of anxiety (χ2 = 30.095, P < .001) and depression (χ2 = 27.082, P < .001). Type D group also displayed a significantly higher level of blood lipoprotein(a) (177.2 ± 200.7 vs. 118.1 ± 255.7 mg/L, P = .048). The incidence of in-hospital MACEs was higher in type D than in non-Type D patients (24.1% vs. 11.3%, χ2 = 5.751, P = .026). Multivariable logistic regression showed three significant independent predictors of in-hospital MACEs: age [odds ratio(OR) = 1.055; 95%CI 1.016-1.095, p = .004], type-D personality(OR 3.332; 95% CI 1.149-9.661, p = .014) and killip classification(OR 2.275, 95% CI 1.506-3.437, p < .001). The average follow-up time was 31 (23-37.5) months. Type D patients had higher incidences of post-discharge events(23.1% vs. 11.5%, p = .032). In the analysis of post-discharge events by Cox regression, χ2 of the Cox regression equation was 16.795 (P = .032). Smoking (HR 2.602; 95% CI1.266-5.347, p = .009) and type-D personality (HR 2.265; 95%CI 1.028-4.988, p = .042) were independent predictors of long-term cardiac events. Kaplan-Meier curves showed significant difference in event-free survival between type D and non-type D group (p = .043). CONCLUSIONS Type D personality is an independent predictor of in-hospital and post-discharge cardiac events after AMI in Chinese patients.
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Affiliation(s)
- Jiahui Li
- Department of Cardiology, China-Japan Friendship Hospital, 2 Yinghuayuan Street East, Chaoyang District, 100029, Beijing, China
| | - Wenjing Wu
- Department of Cardiology, China-Japan Friendship Hospital, 2 Yinghuayuan Street East, Chaoyang District, 100029, Beijing, China
| | - Nan Li
- Department of Cardiology, China-Japan Friendship Hospital, 2 Yinghuayuan Street East, Chaoyang District, 100029, Beijing, China
| | - Jian Wang
- Department of Cardiology, China-Japan Friendship Hospital, 2 Yinghuayuan Street East, Chaoyang District, 100029, Beijing, China
| | - Liyuan Zu
- Department of Cardiology, China-Japan Friendship Hospital, 2 Yinghuayuan Street East, Chaoyang District, 100029, Beijing, China
| | - Xiaojun Ye
- Department of Cardiology, China-Japan Friendship Hospital, 2 Yinghuayuan Street East, Chaoyang District, 100029, Beijing, China.
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Jacobsen HB, Solvoll Lyby P, Johansen T, Reme SE, Klungsøyr O. Can cognitive inflexibility reduce symptoms of anxiety and depression? Promoting the structural nested mean model in psychotherapy research. Psychother Res 2023; 33:1096-1116. [PMID: 37433125 DOI: 10.1080/10503307.2023.2221808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVE To estimate the causal effect of executive functioning on the remission of depression and anxiety symptoms in an observational dataset from a vocational rehabilitation program. It is also an aim to promote a method from the causal inference literature and to illustrate its value in this setting. METHOD With longitudinal (four-time points over 13 months) data from four independent sites, we compiled a dataset with 390 participants. At each time point, participants were tested on executive function and self-reported symptoms of anxiety and depression. We used g-estimation to evaluate whether objectively tested cognitive flexibility affected depressive/anxious symptoms and tested for moderation. Multiple imputations were used to handle missing data. RESULTS The g-estimation showed a strong causal effect of cognitive inflexibility reducing depression and anxiety and modified by education level. In a counterfactual framework, a hypothetical intervention that could lower cognitive flexibility seemed to cause improvement in mental distress at the subsequent time-point (negative sign) for low education. The less flexibility, the larger improvement. For high education, the same but weaker effect was found, with a change in sign, negative during the intervention and positive during follow-up. DISCUSSION An unexpected and strong effect was found from cognitive inflexibility on symptom improvement. This study demonstrates how to estimate causal psychological effects with standard software in an observational dataset with substantial missing and shows the value of such methods.
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Affiliation(s)
- Henrik Børsting Jacobsen
- CatoSenteret Rehabilitation Center, Son, Norway
- The Mind-Body Lab, Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Thomas Johansen
- Norwegian National Advisory Unit on Occupational Rehabilitation, Rauland, Norway
| | - Silje Endresen Reme
- The Mind-Body Lab, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole Klungsøyr
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department for Research and Innovation, Division of Mental Health and Addiction, Oslo Centre for Biostatistics and Epidemiology, Oslo, Norway
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Kouraki A, Kelly A, Vijay A, Gohir S, Astbury S, Georgopoulos V, Millar B, Walsh DA, Ferguson E, Menni C, Valdes AM. Reproducible microbiome composition signatures of anxiety and depressive symptoms. Comput Struct Biotechnol J 2023; 21:5326-5336. [PMID: 37954149 PMCID: PMC10637863 DOI: 10.1016/j.csbj.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
The gut microbiome is a significant contributor to mental health, with growing evidence linking its composition to anxiety and depressive disorders. Gut microbiome composition is associated with signs of anxiety and depression both in clinically diagnosed mood disorders and subclinically in the general population and may be influenced by dietary fibre intake and the presence of chronic pain. We provide an update of current evidence on the role of gut microbiome composition in depressive and anxiety disorders or symptoms by reviewing available studies. Analysing data from three independent cohorts (osteoarthritis 1 (OA1); n = 46, osteoarthritis 2 (OA2); n = 58, and healthy controls (CON); n = 67), we identified microbial composition signatures of anxiety and depressive symptoms at genus level and cross-validated our findings performing meta-analyses of our results with results from previously published studies. The genera Bifidobacterium (fixed-effect beta (95% CI) = -0.22 (-0.34, -0.10), p = 3.90e-04) and Lachnospiraceae NK4A136 group (fixed-effect beta (95% CI) = -0.09 (-0.13, -0.05), p = 2.53e-06) were found to be the best predictors of anxiety and depressive symptoms, respectively, across our three cohorts and published literature taking into account demographic and lifestyle covariates, such as fibre intake. The association with anxiety was robust in accounting for heterogeneity between cohorts and supports previous observations of the potential prophylactic effect of Bifidobacterium against anxiety symptoms.
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Affiliation(s)
- Afroditi Kouraki
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Anthony Kelly
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Amrita Vijay
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sameer Gohir
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Stuart Astbury
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Vasileios Georgopoulos
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Bonnie Millar
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
| | - David Andrew Walsh
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Eamonn Ferguson
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- School of Psychology, University of Nottingham, University Park, Nottingham, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Ana M. Valdes
- Academic Unit of Injury, Recovery and Inflammation Sciences, Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
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Sharp L, Watson LJ, Lu L, Harding S, Hurley K, Thomas SJ, Patterson JM. Cancer-Related Fatigue in Head and Neck Cancer Survivors: Longitudinal Findings from the Head and Neck 5000 Prospective Clinical Cohort. Cancers (Basel) 2023; 15:4864. [PMID: 37835558 PMCID: PMC10571913 DOI: 10.3390/cancers15194864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023] Open
Abstract
Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments. For head and neck cancer (HNC), CRF may exacerbate the symptom burden and poor quality-of-life. Using data from the Head and Neck 5000 prospective clinical cohort, we investigated clinically important CRF over a year post-diagnosis, assessing temporal trends, CRF by HNC site and treatment received, and subgroups at higher risk of CRF. Recruitment was undertaken in 2011-2014. Socio-demographic and clinical data, and patient-reported CRF (EORTC QLQ-C30 fatigue subscale score ≥39 of a possible 100) were collected at baseline (pre-treatment) and 4- and 12- months post-baseline. Mixed-effects logistic multivariable regression was used to investigate time trends, compare cancer sites and treatment groups, and identify associations between clinical, socio-demographic and lifestyle variables and CRF. At baseline, 27.8% of 2847 patients scored in the range for clinically important CRF. This was 44.7% at 4 months and 29.6% at 12 months. In the multivariable model, after adjusting for time-point, the odds of having CRF over 12 months were significantly increased in females and current smokers; those with stage 3/4 disease, comorbidities and multimodal treatment; and those who had depression at baseline. The high prevalence of clinically important CRF indicates the need for additional interventions and supports for affected HNC patients. These findings also identified patient subgroups towards whom such interventions could be targeted.
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Affiliation(s)
- Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle NE1 7RU, UK;
| | - Laura-Jayne Watson
- Speech & Language Therapy, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK;
| | - Liya Lu
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle NE1 7RU, UK;
| | - Sam Harding
- Speech and Language Therapy Research Unit, Southmead Hospital North Bristol NHS Hospital Trust, Bristol BS10 5NB, UK;
| | - Katrina Hurley
- Head & Neck 5000 Study, Weston NHS Foundation Trust, University of Bristol, Bristol BS8 1TU, UK (S.J.T.)
| | - Steve J. Thomas
- Head & Neck 5000 Study, Weston NHS Foundation Trust, University of Bristol, Bristol BS8 1TU, UK (S.J.T.)
| | - Joanne M. Patterson
- Liverpool Head and Neck Centre, School of Health Science, University of Liverpool, Liverpool L69 3BG, UK;
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Gil-Ibanez B, Tejerizo-Garcia A, Oliver MR, Madariaga A, Maiz Jimenez M, Gil Garcia A, Lopez-Gonzalez G. Side effects screening and early intervention to impact in quality of life of patients with gynecological cancers (HALIS study). Int J Gynecol Cancer 2023; 33:1645-1648. [PMID: 37748803 DOI: 10.1136/ijgc-2023-004802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Advances in the treatment of gynecological cancers have led to increased survival in patients with gynecological cancers. Nevertheless, patients may still experience prevalent long term consequences, including lower limb lymphedema, depression, anxiety, sexual dysfunction, malnutrition, and sarcopenia, that negatively impact their quality of life. PRIMARY OBJECTIVE To assess the impact on self-perceived quality of life of systematic screening and early treatment of lower limb lymphedema, anxiety and depression, sexual dysfunction, and sarcopenia and malnutrition compared with standard practice. STUDY HYPOTHESIS Systematic screening with validated questionnaires leading to early diagnosis and treatment of side effects will have a positive impact on quality of life. TRIAL DESIGN This prospective clinical trial will randomize candidates for surgery to either standard of care or systematic screening every 2 months for 2 years. Quality of life data will be collected every 4 months. After randomization, patients in the control group will follow standard usual care. Their screening scales will not be considered. In the experimental group, positive screenings will generate an alert to the physician, and patients will be referred to the corresponding specific area (rehabilitation unit, psycho-oncology unit, sexual health unit, or nutrition unit). MAJOR INCLUSION AND XCLUSION CRITERIA Patients aged ≥18 years with ovarian, cervical, or endometrial cancer who are candidates for surgery will be included. PRIMARY ENDPOINT Self-reported quality of life questionnaire score. SAMPLE SIZE 168 patients will be randomized to detect a difference of 6 points in the questionnaires. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS Study completion is estimated for January 2026 and the results will be presented in May 2026. TRIAL REGISTRATION NUMBER NCT05918770.
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Affiliation(s)
- Blanca Gil-Ibanez
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alvaro Tejerizo-Garcia
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Reyes Oliver
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ainhoa Madariaga
- Medical Oncology and Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria Maiz Jimenez
- Endocrinology and Nutrition Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alejandra Gil Garcia
- Physical Medicine and Rehabilitation Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gregorio Lopez-Gonzalez
- Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit (Departament of Obstetrics and Gynecology), Hospital Universitario 12 de Octubre, Madrid, Spain
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Wu Y, Sun Y, Liu Y, Levis B, Krishnan A, He C, Neupane D, Patten SB, Cuijpers P, Ziegelstein RC, Benedetti A, Thombs BD. Depression screening tool accuracy individual participant data meta-analyses: data contribution was associated with multiple factors. J Clin Epidemiol 2023; 162:63-71. [PMID: 37619800 DOI: 10.1016/j.jclinepi.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVES To examine the proportion of eligible primary studies that contributed data, study characteristics associated with data contribution, and reasons for noncontribution using diagnostic test accuracy Individual Participant Data Meta-Analysis (IPDMA) data sets from the DEPRESsion Screening Data project. STUDY DESIGN AND SETTING We reviewed data set contributions from four IPDMAs. A multivariable logistic regression model was fitted to evaluate study factors associated with data contribution. RESULTS Of 456 eligible studies from four included IPDMAs, 295 (65%) contributed data. More recent year of publication and higher journal impact factor were associated with greater odds of data contribution. Studies conducted in Europe (excluding the United Kingdom), Oceania, Canada, the Middle East, Africa, and Central or South America (reference = the United States), that have recruitment from inpatient care or nonmedical settings (reference = outpatient), that reported screening accuracy results, or that drew negative conclusions (reference = positive conclusions) were more likely to contribute data. Studies of the Geriatric Depression Scale (reference = the Patient Health Questionnaire) or lacking funding information were negatively associated with data contribution. Over 80% of noncontributions were due to authors being unreachable or data being unavailable. CONCLUSION The study identified factors associated with data contribution that may support future research to promote data contribution to IPDMAs.
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yi Liu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
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Oei CW, Ng EYK, Ng MHS, Tan RS, Chan YM, Chan LG, Acharya UR. Explainable Risk Prediction of Post-Stroke Adverse Mental Outcomes Using Machine Learning Techniques in a Population of 1780 Patients. SENSORS (BASEL, SWITZERLAND) 2023; 23:7946. [PMID: 37766004 PMCID: PMC10538068 DOI: 10.3390/s23187946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Post-stroke depression and anxiety, collectively known as post-stroke adverse mental outcome (PSAMO) are common sequelae of stroke. About 30% of stroke survivors develop depression and about 20% develop anxiety. Stroke survivors with PSAMO have poorer health outcomes with higher mortality and greater functional disability. In this study, we aimed to develop a machine learning (ML) model to predict the risk of PSAMO. We retrospectively studied 1780 patients with stroke who were divided into PSAMO vs. no PSAMO groups based on results of validated depression and anxiety questionnaires. The features collected included demographic and sociological data, quality of life scores, stroke-related information, medical and medication history, and comorbidities. Recursive feature elimination was used to select features to input in parallel to eight ML algorithms to train and test the model. Bayesian optimization was used for hyperparameter tuning. Shapley additive explanations (SHAP), an explainable AI (XAI) method, was applied to interpret the model. The best performing ML algorithm was gradient-boosted tree, which attained 74.7% binary classification accuracy. Feature importance calculated by SHAP produced a list of ranked important features that contributed to the prediction, which were consistent with findings of prior clinical studies. Some of these factors were modifiable, and potentially amenable to intervention at early stages of stroke to reduce the incidence of PSAMO.
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Affiliation(s)
- Chien Wei Oei
- Management Information Department, Office of Clinical Epidemiology, Analytics and kNowledge (OCEAN), Tan Tock Seng Hospital, Singapore 308433, Singapore;
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Eddie Yin Kwee Ng
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Matthew Hok Shan Ng
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore 308232, Singapore;
| | - Ru-San Tan
- National Heart Centre Singapore, Singapore 169609, Singapore;
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Yam Meng Chan
- Department of General Surgery, Vascular Surgery Service, Tan Tock Seng Hospital, Singapore 308433, Singapore;
| | - Lai Gwen Chan
- Department of Psychiatry, Tan Tock Seng Hospital, Singapore 308433, Singapore;
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Udyavara Rajendra Acharya
- School of Mathematics, Physics and Computing, University of Southern Queensland, Springfield, QLD 4305, Australia;
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Economos G, Kepenekian V, Barbaret C, Villeneuve L, Haesebaert J, Glehen O. Epidemiology of psychiatric disorders following cytoreductive surgeries plus hyperthermic intraperitoneal chemotherapy: a prospective cohort analysis. Sci Rep 2023; 13:14750. [PMID: 37679494 PMCID: PMC10484920 DOI: 10.1038/s41598-023-42047-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/05/2023] [Indexed: 09/09/2023] Open
Abstract
The peritoneal surface malignancy (PSM) is an advanced disease, the prognosis of which has been radically improved since the development of cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). These procedures are associated with many complications. However, very few data are available regarding the psychiatric morbidities that might occur. The present study assessed the epidemiology of depressive mood and anxiety during the 6 months following the procedure. The analysis of a prospective cohort that included patients who underwent CRS with or without HIPEC between December 2016 and December 2019 was performed. A total of 115 patients were included. During the 6-months follow-up, the mean (SD) Hospital Anxiety and Depression Scale -D (HADS-D) score was 7.8 (48) and a significant increase compared with the pre-operative period (t(49) = - 4.36, p < 0.005) was found. Thirty-seven patients (32%) had a HADS-D score higher than 7. The incidence of a HADS-D score higher than 7 during the follow-up was 0.05 patient per patient-month. Anxiety and the overall mental disorders intensity scores also increased. The results showed an important increase of mental disorders and their intensity during the 6-months following a CRS with or without HIPEC.
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Affiliation(s)
- Guillaume Economos
- Hospices Civils de Lyon - Centre de soins palliatifs - Hôpital Lyon Sud, Pierre-Bénite, France.
- Claude Bernard Université Lyon 1 - EA3738 -Centre pour l'innovation en cancérologie de Lyon, Faculty Lyon Sud, Oullins, France.
| | - Vahan Kepenekian
- Claude Bernard Université Lyon 1 - EA3738 -Centre pour l'innovation en cancérologie de Lyon, Faculty Lyon Sud, Oullins, France
- Hospices Civils de Lyon - Department of Surgical Oncology, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Cécile Barbaret
- Grenoble University Hospital - Service de soins palliatifs, La Tronche, France
| | - Laurent Villeneuve
- Claude Bernard Université Lyon 1 - EA3738 -Centre pour l'innovation en cancérologie de Lyon, Faculty Lyon Sud, Oullins, France
- Hospices Civils de Lyon - Unité Recherche et Epidémiologie Cliniques - Pôle de Santé Publique, Hôpital Lyon Sud, Pierre, Bénite, France
| | - Julie Haesebaert
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, 69003, Lyon, France
| | - Olivier Glehen
- Claude Bernard Université Lyon 1 - EA3738 -Centre pour l'innovation en cancérologie de Lyon, Faculty Lyon Sud, Oullins, France
- Hospices Civils de Lyon - Department of Surgical Oncology, Hôpital Lyon Sud, Pierre-Bénite, France
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Foubert A, Roussel NA, Chantrain VA, Maes P, Durnez L, Lobet S, Lambert C, Hermans C, Meeus M. The Classification of Suspected Predominant Nociplastic Pain in People with Moderate and Severe Haemophilia: A Secondary Exploratory Study. Biomedicines 2023; 11:2479. [PMID: 37760921 PMCID: PMC10525501 DOI: 10.3390/biomedicines11092479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
In people with haemophilia (PwH), joint pain is a major comorbidity that is often overlooked and under-treated. It is believed that, to ensure the most successful outcome, pain management should be tailored to the predominant pain phenotype (i.e., nociceptive, neuropathic and nociplastic). The 2021 clinical criteria and grading system for nociplastic pain, established by the International Association for the Study of Pain (IASP), emphasize the necessity of early-stage identification and predominant pain type classification. Consistent with findings in other chronic musculoskeletal pain conditions, studies suggest that a subgroup of PwH suffers from nociplastic pain, i.e., pain arising from altered nociception rather than structural damage, but this has not yet been explored in PwH. This study aimed to identify PwH with "unlikely", "possible" and "probable" nociplastic pain and investigate differences in anthropometric, demographic and clinical characteristics and psychological factors between subgroups of PwH and healthy individuals.: The IASP clinical criteria and grading system were used to classify pain types in adult men with moderate or severe haemophilia recruited from two Belgian haemophilia treatment centres. Statistical analyses were applied to study between-subgroup differences. Of 94 PwH, 80 PwH (85%) were classified with "unlikely" and 14 (15%) with "at least possible" nociplastic pain (including 5 PwH (5%) with "possible" and 9 PwH (10%) with "probable" nociplastic pain). PwH in both the "unlikely" and "at least possible" nociplastic pain groups showed significantly higher levels of unhelpful psychological factors compared to healthy individuals. Additionally, age may partially account for the observed differences in body height and psychological factors. Larger sample sizes may be needed to detect more subtle between-group differences. study confirmed the presence of nociplastic pain in haemophilia, categorising a notable subgroup as individuals who experience at least possible nociplastic pain. These exploratory insights may provide a starting point for future studies and the development of more effective and tailored pain management.
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Affiliation(s)
- Anthe Foubert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2000 Antwerp, Belgium; (A.F.); (V.-A.C.); (L.D.); (M.M.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, 1348 Louvain-La-Neuve, Belgium
| | - Nathalie Anne Roussel
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2000 Antwerp, Belgium; (A.F.); (V.-A.C.); (L.D.); (M.M.)
| | - Valérie-Anne Chantrain
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2000 Antwerp, Belgium; (A.F.); (V.-A.C.); (L.D.); (M.M.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, 1348 Louvain-La-Neuve, Belgium
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
| | - Philip Maes
- Department of Paediatrics, University Hospital Antwerp, 2650 Edegem, Belgium;
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 2000 Antwerp, Belgium
| | - Lies Durnez
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2000 Antwerp, Belgium; (A.F.); (V.-A.C.); (L.D.); (M.M.)
| | - Sébastien Lobet
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
- Haemostasis and Thrombosis Unit, Division of Hematology, Clinique Universitaires Saint-Luc, 1000 Brussels, Belgium; (C.L.); (C.H.)
- Secteur de Kinésithérapie, Cliniques Universitaires Saint-Luc, 1000 Brussels, Belgium
| | - Catherine Lambert
- Haemostasis and Thrombosis Unit, Division of Hematology, Clinique Universitaires Saint-Luc, 1000 Brussels, Belgium; (C.L.); (C.H.)
| | - Cédric Hermans
- Haemostasis and Thrombosis Unit, Division of Hematology, Clinique Universitaires Saint-Luc, 1000 Brussels, Belgium; (C.L.); (C.H.)
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2000 Antwerp, Belgium; (A.F.); (V.-A.C.); (L.D.); (M.M.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
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Brehaut E, Neupane D, Levis B, Wu Y, Sun Y, Ioannidis JPA, Markham S, Cuijpers P, Patten SB, Benedetti A, Thombs BD. 'Optimal' cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study. Int J Methods Psychiatr Res 2023; 32:e1956. [PMID: 36461893 PMCID: PMC10485315 DOI: 10.1002/mpr.1956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/13/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screening results. We evaluated how depression screening tool studies select optimal cutoffs. METHODS We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation. RESULTS Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies (76%) identified an optimal cutoff other than the standard; most did not make use recommendations (N = 56; 43%) or recommended using a non-standard cutoff (N = 53; 40%). Only 4 studies cited a reporting guideline, and 4 described a protocol with optimal cutoff selection methods, but none used the protocol method in the published study. CONCLUSIONS Research is needed to guide how selection of cutoffs for depression screening tools can be standardized and reflect clinical considerations.
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Affiliation(s)
- Eliana Brehaut
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
| | - Dipika Neupane
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
| | - Brooke Levis
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Centre for Prognosis ResearchSchool of MedicineKeele UniversityStaffordshireUK
| | - Yin Wu
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of PsychiatryMcGill UniversityMontréalQuébecCanada
| | - Ying Sun
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
| | - John P. A. Ioannidis
- Department of MedicineDepartment of Epidemiology and Population HealthDepartment of Biomedical Data ScienceDepartment of Statisticsand Meta‐Research Innovation Center at Stanford (METRICS)Stanford UniversityStanfordCaliforniaUSA
| | - Sarah Markham
- Department of Biostatistics and Health InformaticsKing's College LondonLondonUK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije UniversiteitAmsterdamThe Netherlands
| | - Scott B. Patten
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
- Department of MedicineMcGill UniversityMontréalQuébecCanada
- Respiratory Epidemiology and Clinical Research UnitMcGill University Health CentreMontréalQuébecCanada
| | - Brett D. Thombs
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
- Department of PsychiatryMcGill UniversityMontréalQuébecCanada
- Department of MedicineMcGill UniversityMontréalQuébecCanada
- Department of PsychologyMcGill UniversityMontréalQuébecCanada
- Biomedical Ethics UnitMcGill UniversityMontréalQuébecCanada
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Engel S, Jacobsen HB, Reme SE. A cross-sectional study of fear of surgery in female breast cancer patients: Prevalence, severity, and sources, as well as relevant differences among patients experiencing high, moderate, and low fear of surgery. PLoS One 2023; 18:e0287641. [PMID: 37352256 PMCID: PMC10289430 DOI: 10.1371/journal.pone.0287641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 06/11/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Fear of surgery has been associated with more postoperative pain, disability, and a lower quality of life among patients undergoing various surgical procedures. While qualitative studies indicate breast cancer patients to be afraid of surgery, detailed quantitative analyses are lacking. The present research aimed at investigating the prevalence, severity, and sources of fear of surgery in this patient group and to compare patients reporting different degrees of such fear. METHODS This cross-sectional study included 204 breast cancer patients, 18-70 years old, and scheduled for surgery at Oslo University Hospital, Norway. Following their preoperative visit participants completed validated psychological questionnaires online. Among these, the primary outcome measure, the Surgical Fear Questionnaire (SFQ; scores: 0-10 per item, 0-80 overall). Patients were grouped based on SFQ-percentiles (<25th = little, 25th-75th = moderate and >75th percentile = high fear) and compared on psychological (anxiety, depression, experienced injustice, optimism and expected postsurgical pain), sociodemographic, and medical outcomes. RESULTS 195 patients completed the SFQ. On average fear of surgery was low (M = 26.41, SD = 16.0, median = 26, min-max = 0-80), but omnipresent. Only 1.5% (n = 3) indicated no fear at all. Overall, patients feared surgery itself the most (M = 3.64, SD = 2.8). Groups differed significantly (p < .001) in their experience of anxiety, depression, and injustice, as well as their disposition to be optimistic, and expectance of postsurgical pain. Differences between groups concerning demographic and medical information were largely insignificant. DISCUSSION This study was the first to demonstrate fear of surgery to be prevalent and relevant among female breast cancer patients. The higher a patients' fear group, the poorer their preoperative psychological constitution. This, largely irrespective of their current diagnoses or treatments, medical history, and demographics. Fear of surgery might thus cater as a prognostic marker and treatment target in this patient group. However, given the cross-sectional character of the present data, prognostic studies are needed to evaluate such claims.
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Affiliation(s)
- Sophia Engel
- The Mind Body Lab, Department of Psychology, University of Oslo, Oslo, Norway
| | - Henrik Børsting Jacobsen
- The Mind Body Lab, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Silje Endresen Reme
- The Mind Body Lab, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
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Zhamaliyeva LM, Zhamankulova DG, Abenova NA, Koshmaganbetova GK. Educational Intervention Effects on Depression and Anxiety in Patients after Myocardial Infarction: A Randomized Controlled Trial. J Cardiovasc Dev Dis 2023; 10:267. [PMID: 37504523 PMCID: PMC10380402 DOI: 10.3390/jcdd10070267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n = 76) or control (n = 69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points, respectively (p < 0.05). The control group showed reductions of 1.5 and 1.2 points (p < 0.05). The difference in the Hamilton Rating Scale for Depression between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized mean difference was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. The limitations include the lack of blinding of study participants and a relatively small sample size.
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Affiliation(s)
- Lazzat M Zhamaliyeva
- Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Damira G Zhamankulova
- Department of Internal Diseases, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Nurgul A Abenova
- Department of General Practice 1, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
| | - Gulbakit K Koshmaganbetova
- Department of Master's and Doctoral Studies, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan
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C Manikis G, Simos NJ, Kourou K, Kondylakis H, Poikonen-Saksela P, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Mattson J, Roziner I, Marzorati C, Marias K, Nuutinen M, Karademas E, Fotiadis D. Personalized Risk Analysis to Improve the Psychological Resilience of Women Undergoing Treatment for Breast Cancer: Development of a Machine Learning-Driven Clinical Decision Support Tool. J Med Internet Res 2023; 25:e43838. [PMID: 37307043 PMCID: PMC10337304 DOI: 10.2196/43838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/04/2023] [Accepted: 04/19/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Health professionals are often faced with the need to identify women at risk of manifesting poor psychological resilience following the diagnosis and treatment of breast cancer. Machine learning algorithms are increasingly used to support clinical decision support (CDS) tools in helping health professionals identify women who are at risk of adverse well-being outcomes and plan customized psychological interventions for women at risk. Clinical flexibility, cross-validated performance accuracy, and model explainability permitting person-specific identification of risk factors are highly desirable features of such tools. OBJECTIVE This study aimed to develop and cross-validate machine learning models designed to identify breast cancer survivors at risk of poor overall mental health and global quality of life and identify potential targets of personalized psychological interventions according to an extensive set of clinical recommendations. METHODS A set of 12 alternative models was developed to improve the clinical flexibility of the CDS tool. All models were validated using longitudinal data from a prospective, multicenter clinical pilot at 5 major oncology centers in 4 countries (Italy, Finland, Israel, and Portugal; the Predicting Effective Adaptation to Breast Cancer to Help Women to BOUNCE Back [BOUNCE] project). A total of 706 patients with highly treatable breast cancer were enrolled shortly after diagnosis and before the onset of oncological treatments and were followed up for 18 months. An extensive set of demographic, lifestyle, clinical, psychological, and biological variables measured within 3 months after enrollment served as predictors. Rigorous feature selection isolated key psychological resilience outcomes that could be incorporated into future clinical practice. RESULTS Balanced random forest classifiers were successful at predicting well-being outcomes, with accuracies ranging between 78% and 82% (for 12-month end points after diagnosis) and between 74% and 83% (for 18-month end points after diagnosis). Explainability and interpretability analyses built on the best-performing models were used to identify potentially modifiable psychological and lifestyle characteristics that, if addressed systematically in the context of personalized psychological interventions, would be most likely to promote resilience for a given patient. CONCLUSIONS Our results highlight the clinical utility of the BOUNCE modeling approach by focusing on resilience predictors that can be readily available to practicing clinicians at major oncology centers. The BOUNCE CDS tool paves the way for personalized risk assessment methods to identify patients at high risk of adverse well-being outcomes and direct valuable resources toward those most in need of specialized psychological interventions.
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Affiliation(s)
- Georgios C Manikis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Nicholas J Simos
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Konstantina Kourou
- Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Haridimos Kondylakis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Paula Poikonen-Saksela
- Comprehensive Cancer Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare,The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Berta Sousa
- Breast Unit, Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | | | - Johanna Mattson
- Comprehensive Cancer Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ilan Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Kostas Marias
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | | | - Evangelos Karademas
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Dimitrios Fotiadis
- Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
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Hovagemyan F, Dugerdil A, Braggion A, Mallet L, Flahault A. Psychiatric consequences and issues of long COVID on patients with prior psychiatric comorbidities: a scoping review. Front Psychiatry 2023; 14:1181767. [PMID: 37351002 PMCID: PMC10282140 DOI: 10.3389/fpsyt.2023.1181767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/24/2023] [Indexed: 06/24/2023] Open
Abstract
SARS-CoV-2 is a growing field of research and mental health in long COVID is one of its interesting domains. This scoping review aims at studying the outcomes of mental health in patients already known for psychiatric illness. This was done by researching the literature in two databases (Embase and PubMed) for articles studying mental health consequences of long COVID in patients already known for psychiatric history. Eleven studies were included. 6/11 studies found an effect of long COVID, with varying severity of outcomes studied, with either a worsening in length or severity. 4/11 did not find any correlation between worsening symptoms and psychiatric history. The methods for assessing which psychiatric symptoms to include and how to determine prior history were heterogeneous, making direct comparison sometimes difficult. The data seem to show worse effects of long COVID on mental health of patients with prior mental illness, with limitations regarding the heterogeneity of the studies' designs and focuses. It also highlights how neglected this population of patients is in the current state of research.
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Affiliation(s)
- Francesca Hovagemyan
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Adeline Dugerdil
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Axelle Braggion
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Luc Mallet
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Mental Health and Psychiatry, University of Geneva, Geneva, Switzerland
- Univ Paris-Est Créteil, DMU IMPACT, Département Médical-Universitaire de Psychiatrie et d’Addictologie, Hôpitaux Universitaires Henri Mondor—Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Wu X, Zhang W. Reminiscence therapy-based care program alleviates anxiety and depression, as well as improves the quality of life in recurrent gastric cancer patients. Front Psychol 2023; 14:1133470. [PMID: 37351436 PMCID: PMC10282646 DOI: 10.3389/fpsyg.2023.1133470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/12/2023] [Indexed: 06/24/2023] Open
Abstract
Objective Reminiscence therapy is a non-drug method that eases psychological burden and enhances quality of life by memories and communications in cancer patients. This study aimed to evaluate influence of reminiscence therapy-based care program on anxiety, depression, and quality of life in recurrent gastric cancer patients. Methods Totally, 96 recurrent gastric cancer patients were randomly assigned as 1:1 ratio into reminiscence therapy-based care group (N = 48) and usual care group (N = 48) to receive 12-week corresponding interventions. Besides, all patients were follow-up for 6 months. Results Hospital Anxiety and Depression Scales-anxiety score at 4th month (p = 0.031) and 6th month (p = 0.004), Hospital Anxiety and Depression Scales-depression score at 6th month (p = 0.018), and anxiety severity at 4th month (p = 0.041) and 6th month (p = 0.037) were lower in reminiscence therapy-based care group than in usual care group. Quality of Life Questionnaire-Core 30 global health status score at 2nd month (p = 0.048), 4th month (p = 0.036), and 6th month (p = 0.014), Quality of Life Questionnaire-Core 30 function score at 4th month (p = 0.014) and 6th month (p = 0.021) were higher, while Quality of Life Questionnaire-Core 30 symptoms score at 2nd month (p = 0.041) and 4th month (p = 0.035) were lower in reminiscence therapy-based care group than in usual care group. Furthermore, reminiscence therapy-based care was more effective on improving mental health and quality of life in recurrent gastric cancer patients with anxiety or depression at baseline than those without. Conclusion Reminiscence therapy-based care serves as an effective intervention, which relieves anxiety and depression, and improves quality of life in recurrent gastric cancer patients.
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Affiliation(s)
- Xing Wu
- Department of General Surgery, HanDan Central Hospital, Handan, China
| | - Weiwei Zhang
- Department of Hematology, HanDan Central Hospital, Handan, China
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Uenishi S, Buyo M, Sato S, Kojitani H, Odachi R, Matsuoka T, Okuda Y, Kimoto S, Hironishi M, Takahashi S. Impact of individual factors and personality trait on psychological problems of family members living with staff of a COVID-19 frontline hospital: A cross-sectional self-administered anonymous questionnaire survey. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e110. [PMID: 38868148 PMCID: PMC11114314 DOI: 10.1002/pcn5.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 05/03/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2024]
Abstract
Aim This study aims to evaluate the association between individual factors/personality traits and depression and anxiety in family members living with staff working on the frontline of COVID-19 care. Methods The subjects were family members over the age of 15 years living with staff members of a COVID-19 frontline hospital. Between March 27 and April 11, 2021, 204 self-administered anonymous questionnaires were distributed, and 149 responses were received. Symptoms of depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Personality trait was assessed using the Big Five personality traits, and fear of COVID-19 was assessed using the Fear of COVID-19 Scale. We examined associations between HADS depression or anxiety scores with individual background factors, scores of Big Five personality traits, and Fear of COVID-19 Scale. Results The participants with anxiety had significantly higher scores for neuroticism and for the Fear of COVID-19 Scale. The participants with depression had significantly lower scores for extraversion and higher scores for the Fear of COVID-19 Scale. No individual background factors were significantly associated with HADS depression or anxiety scores. Conclusion Among family members of staff of a COVID-19 frontline hospital, lower extraversion, higher neuroticism, and fear of COVID-19 were associated with anxiety and depression. This questionnaire survey was conducted before wide-spread rollout of COVID-19 vaccination, so the findings of this study are expected to be applicable to other future novel infectious outbreaks.
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Affiliation(s)
- Shinya Uenishi
- Department of NeuropsychiatryWakayama Medical UniversityWakayamaJapan
- Department of PsychiatryHidaka HospitalGoboJapan
| | - Momoko Buyo
- Division of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | - Seiji Sato
- Nursing DepartmentWakayama Medical University Kihoku HospitalKatsuragiJapan
| | - Hiroko Kojitani
- Nursing DepartmentWakayama Medical University Kihoku HospitalKatsuragiJapan
| | - Ryo Odachi
- Division of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | - Toshiko Matsuoka
- Nursing DepartmentWakayama Medical University Kihoku HospitalKatsuragiJapan
| | - Yuka Okuda
- Department of AnesthesiologyWakayama Medical UniversityWakayamaJapan
| | - Sohei Kimoto
- Department of NeuropsychiatryWakayama Medical UniversityWakayamaJapan
| | - Masaya Hironishi
- Department of Internal MedicineWakayama Medical University Kihoku HospitalKatsuragiJapan
| | - Shun Takahashi
- Department of NeuropsychiatryWakayama Medical UniversityWakayamaJapan
- Department of PsychiatryOsaka University Graduate School of MedicineSuitaJapan
- Graduate School of Rehabilitation ScienceOsaka Metropolitan UniversityHabikinoJapan
- Clinical Research and Education CenterAsakayama General HospitalSakaiJapan
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Hecht CJ, Burkhart RJ, Karimi AH, Acuña AJ, Kamath AF. What is the Association Between Clinically Diagnosed Psychiatric Illness and Total Joint Arthroplasty? A Systematic Review Evaluating Outcomes, Healthcare Use, and Patient-reported Outcome Measures. Clin Orthop Relat Res 2023; 481:947-964. [PMID: 36730492 PMCID: PMC10097587 DOI: 10.1097/corr.0000000000002481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/12/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Studies evaluating the effects of a psychiatric illness on orthopaedic surgical outcomes have yielded mixed results. Because awareness of patient comorbid mental health disorders has become increasingly important to tailor treatment plans, the aim of our systematic review was to present the findings of all studies reporting on the association between clinically diagnosed psychiatric illnesses and total joint arthroplasty (TJA) outcomes and evaluate the quality of evidence to provide a comprehensive summary. QUESTION/PURPOSE Is there a consistently reported association between comorbid psychiatric illness and (1) complication risk, (2) readmission rates, (3) healthcare use and discharge disposition, and (4) patient-reported outcome measures (PROMs) after TJA? METHODS The PubMed, EBSCO host, Medline, and Google Scholar electronic databases were searched on April 9, 2022, to identify all studies that evaluated outcomes after TJA in patients with a comorbid clinically diagnosed mental health disorder between January 1, 2000, and April 1, 2022. Studies were included if the full-text article was available in English, reported on primary TJA outcomes in patients with clinically diagnosed mental health disorders, included patients undergoing TJA without a psychiatric illness for comparison, and had a minimum follow-up time of 30 days for evaluating readmission rates, 90 days for other perioperative outcomes such as length of stay and complications, and 1-year minimum follow-up if assessing PROMs. Studies that used a mental health screening examination instead of clinical diagnoses were excluded to isolate for verified psychiatric illnesses. Additionally, systematic reviews, case reports, duplicate studies between the databases, and gray literature were excluded. Twenty-one studies were included in our final analysis comprising 31,023,713 patients with a mean age range of 57 to 69 years. Mental health diagnoses included depression, anxiety, bipolar disorder, schizophrenia, major personality disorder, and psychosis as well as concomitant mental disorders. Two reviewers independently evaluated the quality of included studies using the Methodological Index for Nonrandomized Studies (MINORS) tool. The mean MINORS score was 19.5 ± 0.91 of 24, with higher scores representing better study quality. All the articles included were retrospective, comparative studies. Given the heterogeneity of the included studies, a meta-analysis was not performed, and results are instead presented descriptively. RESULTS Patients with schizophrenia were consistently reported to have higher odds of medical and surgical complications than patients without psychiatric illness, particularly anemia and respiratory complications. Among studies with the largest sample sizes, patients with depression alone or depression and anxiety had slightly higher odds of complications. Most studies identified higher odds of readmission among patients with depression, schizophrenia, and severe mental illness after TJA. However, for anxiety, there was no difference in readmission rates compared with patients without psychiatric illness. Slightly higher odds of emergency department visits were reported for patients with depression, anxiety, concomitant depression and anxiety, and severe mental illness across studies. When evaluating healthcare use, articles with the largest sample sizes reporting on depression and length of stay or discharge disposition found modestly longer length of stay and greater odds of nonhome discharge among patients with depression. Although several studies reported anxiety was associated with slightly increased total costs of hospitalization, the most robust studies reported no difference or slightly shorter average length of stay. However, the included studies only reported partial economic analyses of cost, leading to relatively superficial evidence. Patients with schizophrenia had a slightly longer length of stay and modestly lower odds of home discharge and cost. Likewise, patients with concomitant depression and anxiety had a slightly longer average length of stay, according to the two articles reporting on more than 1000 patients. Lastly, PROM scores were worse in patients with depression at a minimum follow-up of 1 year after TJA. For anxiety, there was no difference in improvement compared with patients without mental illness. CONCLUSION Our systematic review found that individuals with psychiatric illness had an increased risk of postoperative complications, increased length of stay, higher costs, less frequent home discharge, and worse PROM scores after TJA. These findings encourage inclusion of comorbid psychiatric illness when risk-stratifying patients. Attention should focus on perioperative interventions to minimize the risk of thromboembolic events, anemia, bleeding, and respiratory complications as well as adequate pain management with drugs that do not exacerbate the likelihood of these adverse events to minimize emergency department visits and readmissions. Future studies are needed to compare patients with concomitant psychiatric illnesses such as depression and anxiety with patients with either diagnosis in isolation, instead of only comparing patients with concomitant diagnoses with patients without any psychiatric illnesses. Similarly, the results of targeted interventions such as cognitive behavioral therapy are needed to understand how orthopaedic surgeons might improve the quality of care for patients with a comorbid psychiatric illness.
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Affiliation(s)
- Christian J. Hecht
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Robert J. Burkhart
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Amir H. Karimi
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Alexander J. Acuña
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Atul F. Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
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Kourou K, Manikis G, Mylona E, Poikonen-Saksela P, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Mattson J, Roziner I, Pettini G, Kondylakis H, Marias K, Nuutinen M, Karademas E, Simos P, Fotiadis DI. Personalized prediction of one-year mental health deterioration using adaptive learning algorithms: a multicenter breast cancer prospective study. Sci Rep 2023; 13:7059. [PMID: 37120428 PMCID: PMC10148884 DOI: 10.1038/s41598-023-33281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Identifying individual patient characteristics that contribute to long-term mental health deterioration following diagnosis of breast cancer (BC) is critical in clinical practice. The present study employed a supervised machine learning pipeline to address this issue in a subset of data from a prospective, multinational cohort of women diagnosed with stage I-III BC with a curative treatment intention. Patients were classified as displaying stable HADS scores (Stable Group; n = 328) or reporting a significant increase in symptomatology between BC diagnosis and 12 months later (Deteriorated Group; n = 50). Sociodemographic, life-style, psychosocial, and medical variables collected on the first visit to their oncologist and three months later served as potential predictors of patient risk stratification. The flexible and comprehensive machine learning (ML) pipeline used entailed feature selection, model training, validation and testing. Model-agnostic analyses aided interpretation of model results at the variable- and patient-level. The two groups were discriminated with a high degree of accuracy (Area Under the Curve = 0.864) and a fair balance of sensitivity (0.85) and specificity (0.87). Both psychological (negative affect, certain coping with cancer reactions, lack of sense of control/positive expectations, and difficulties in regulating negative emotions) and biological variables (baseline percentage of neutrophils, thrombocyte count) emerged as important predictors of mental health deterioration in the long run. Personalized break-down profiles revealed the relative impact of specific variables toward successful model predictions for each patient. Identifying key risk factors for mental health deterioration is an essential first step toward prevention. Supervised ML models may guide clinical recommendations toward successful illness adaptation.
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Affiliation(s)
- Konstantina Kourou
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Georgios Manikis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Eugenia Mylona
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Helsinki, Finland
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
- Dept. of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
- NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Johanna Mattson
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Helsinki, Finland
| | - Ilan Roziner
- Dept. of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Greta Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Haridimos Kondylakis
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
| | | | - Evangelos Karademas
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
- Dept. of Psychology, University of Crete, Rethymno, Greece
| | - Panagiotis Simos
- Foundation for Research and Technology-Hellas, Institute of Computer Science, Heraklion, Greece
- School of Medicine, University of Crete, Heraklion, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Dept. of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
- Foundation for Research and Technology-Hellas, Biomedical Research Institute, Ioannina, Greece.
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47
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Sung C, Hershberger PE, Lockwood MB. Sickness Symptoms in Kidney Transplant Recipients: A Scoping Review. West J Nurs Res 2023; 45:344-362. [PMID: 36333867 PMCID: PMC10853985 DOI: 10.1177/01939459221128125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sickness symptoms (depressive symptoms, anxiety, and fatigue) are common among people with chronic illness, often presenting as a symptom cluster. Sickness symptoms persist in many patients with chronic kidney disease, even after kidney transplantation (KT); however, little is known about sickness symptom-induced burden in KT recipients. This scoping review synthesizes available evidence for sickness symptoms in KT recipients, including findings on symptom prevalence, predictors, outcomes, interrelationships, and clustering. Among 38 reviewed studies, none identified sickness symptoms as a cluster, but we observed interrelationships among the symptoms examined. Fatigue was the most prevalent sickness symptom, followed by anxiety and depressive symptoms. Predictors of these symptoms included demographic, clinical, and psychosocial factors, and health-related quality of life was the most researched outcome. Future research should use common data elements to phenotype sickness symptoms, include biological markers, and employ sophisticated statistical methods to identify potential clustering of sickness symptoms in KT recipients.
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Affiliation(s)
- Choa Sung
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - Mark B. Lockwood
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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48
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Li M, Zou X, Lu H, Li F, Xin Y, Zhang W, Li B, Wang Y. Association of sleep apnea and depressive symptoms among US adults: a cross-sectional study. BMC Public Health 2023; 23:427. [PMID: 36879197 PMCID: PMC9987095 DOI: 10.1186/s12889-023-15358-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Sleep apnea exerts adverse health effects due to inflammation and metabolic disruption. It is associated with metabolic diseases. However, the evidence of its relationship with depression is inconsistent. Therefore, this study aimed to investigate the relationship between sleep apnea and depressive symptoms in adults in the United States. METHODS This study utilized data from the National Health and Nutrition Examination Survey (NHANES), wherein the data from 2005 to 2018 of 9,817 individuals were obtained. Sleep apnea was self-reported by the participants using a questionnaire on sleep disorders. The 9-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. We implemented multivariable logistic regression and stratified analyses to assess the correlation between sleep apnea and depressive symptoms. RESULTS A total of 515 (6.6%) participants among 7,853 non-sleep apnea participants and 269 (13.7%) subjects among 1,964 sleep apnea participants had a depression score ≥ 10, they were deemed to have depressive symptoms. The multivariable regression model, showed that individuals with sleep apnea were 1.36-fold more likely to experience depressive symptoms when adjusted for potential covariates (odds ratios [OR] with 95% confidence intervals of 2.36 [1.71-3.25]), and a positive correlation between depressive symptoms and sleep apnea severity was found. The stratified analyses, revealed that sleep apnea was related to an increased incidence of depressive symptoms in most subgroups, except for those with coronary heart disease. Further, there was no interaction between sleep apnea and the covariates. CONCLUSIONS Adults with sleep apnea in the US have a relatively high prevalence of depressive symptoms. and the severity of sleep apnea positively correlated with the depressive symptoms.
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Affiliation(s)
- Mei Li
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Xue Zou
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Hongbin Lu
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Fang Li
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Yang Xin
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Wenwen Zhang
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Bo Li
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China
| | - Ying Wang
- Xi'an International Medical Center Hospital, No.777 Xitai Road, Xi'an, 710100, Shaanxi, China.
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49
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Lăcraru AE, Busnatu ȘS, Pană MA, Olteanu G, Șerbănoiu L, Gand K, Schlieter H, Kyriazakos S, Ceban O, Andrei CL, Sinescu CJ. Assessing the Efficacy of a Virtual Assistant in the Remote Cardiac Rehabilitation of Heart Failure and Ischemic Heart Disease Patients: Case-Control Study of Romanian Adult Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3937. [PMID: 36900948 PMCID: PMC10002163 DOI: 10.3390/ijerph20053937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of mortality in Europe, with potentially more than 60 million deaths per year, with an age-standardized rate of morbidity-mortality higher in men than women, exceeding deaths from cancer. Heart attacks and strokes account for more than four out of every five CVD fatalities globally. After a patient overcomes an acute cardiovascular event, they are referred for rehabilitation to help them to restore most of their normal cardiac functions. One effective way to provide this activity regimen is via virtual models or telerehabilitation, where the patient can avail themselves of the rehabilitation services from the comfort of their homes at designated timings. Under the funding of the European Union's Horizon 2020 Research and Innovation program, grant no 769807, a virtual rehabilitation assistant has been designed for elderly patients (vCare), with the overall objective of supporting recovery and an active life at home, enhancing patients' quality of life, lowering disease-specific risk factors, and ensuring better adherence to a home rehabilitation program. In the vCare project, the Carol Davila University of Bucharest (UMFCD) was in charge of the heart failure (HF) and ischemic heart disease (IHD) groups of patients. By creating a digital environment at patients' homes, the vCare system's effectiveness, use, and feasibility was evaluated. A total of 30 heart failure patients and 20 ischemic heart disease patients were included in the study. Despite the COVID-19 restrictions and a few technical difficulties, HF and IHD patients who performed cardiac rehabilitation using the vCare system had similar results compared to the ambulatory group, and better results compared to the control group.
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Affiliation(s)
- Andreea-Elena Lăcraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Ștefan-Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Maria-Alexandra Pană
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Gabriel Olteanu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Liviu Șerbănoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Kai Gand
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, 7400 Aarhus, Denmark
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, University of Economic Studies, 010374 Bucharest, Romania
| | - Cătălina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Crina-Julieta Sinescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
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50
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Sardella A, Musetti A, Caponnetto P, Quattropani MC, Lenzo V. Prolonged Grief Disorder and Symptoms of Anxiety and Depression among Bereaved Family Caregivers in the Context of Palliative Home Care. Eur J Investig Health Psychol Educ 2023; 13:490-500. [PMID: 36826221 PMCID: PMC9955476 DOI: 10.3390/ejihpe13020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Background: This study aimed to investigate the prevalence and the psychological comorbidity of PGD among bereaved family caregivers of palliative care cancer patients. We also examined the discriminant validity of two simple and reliable tools in correctly categorized individuals with PGD. Methods: A cross-sectional study was conducted with 157 bereaved participants (77.1% females, mean age = 43.50 ± 14.04 years, mean time since the loss = 3.59 years) recruited from three palliative home care services. These participants completed the Prolonged Grief Scale (PG-13) and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of PGD within the sample was 4.46% (i.e., = 7/157). Participants scored higher than the cut-off on the PG-13 and the HADS-D. Symptoms of PGD were positively correlated with depression levels. The ROC curve analysis showed that the HADS-D was outstanding in categorizing individuals with prolonged grief disorder from those without PGD. A HADS-D score of ≥7.5 was able to categorize participants with a sensitivity of 0.90 and a specificity of 0.73. Conclusions: Overall, these results highlight the relationship between grief and depression symptoms and their exceptional discriminant validity among correctly identified individuals with PGD.
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
- Correspondence:
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43121 Parma, Italy
| | - Pasquale Caponnetto
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, 95123 Catania, Italy
| | | | - Vittorio Lenzo
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy
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