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Preventive Medicine via Lifestyle Medicine Implementation Practices Should Consider Individuals' Complex Psychosocial Profile. Healthcare (Basel) 2022; 10:healthcare10122560. [PMID: 36554083 PMCID: PMC9777994 DOI: 10.3390/healthcare10122560] [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: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Noncommunicable chronic diseases are associated with lifestyle behaviors. Psychological and social factors may influence the adoption of such behaviors. Being mentally and physically energized or fatigued may influence the intention-behavior gap of healthy lifestyle adoption accordingly. We investigated the associations of age, sex, lifestyle behaviors, mood, and mental and physical energy and fatigue at both the trait and state levels. The participants (N = 670) completed questionnaires assessing their sleep, mood, mental and physical state energy and fatigue, physical activity, mental workload, and diet. The ordinary least squares regression models revealed an overlap between the mental state and trait energy levels for males who consume polyphenols, have a high mental workload, and sleep well. Being younger, having a high stress level, bad sleep habits, and being confused and depressed were associated with high mental fatigue. Physical energy and fatigue shared the same commonalities with the previous results, with greater discrepancies observed between the state and trait indicators compared to that between mental energy and fatigue. Diet and stress management seem to be predictors of high physical energy, and females report higher physical fatigue levels. Health care professionals should consider this psychosocial complex profiling in their differential diagnosis and when one is implementing lifestyle behavioral changes to address the facets of preventive medicine, wellness, and health promotion.
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Mongeau-Pérusse V, Rizkallah E, Bruneau J, Chênevert D, Menvielle L, Jutras-Aswad D. Changes in Alcohol Habits Among Workers During the Confinement of COVID-19: Results of a Canadian Cross-Sectional Survey. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 15:11782218211033298. [PMID: 34349516 PMCID: PMC8287356 DOI: 10.1177/11782218211033298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/24/2021] [Indexed: 11/17/2022]
Abstract
Background The restrictions implemented around the world to contain the spread of the coronavirus disease 2019 (COVID-19) impact workers. Emotional distress and maladaptive behaviors such as alcohol misuse are expected, particularly in vulnerable groups such as front-line health workers. In the present study, we examined if alcohol consumption behaviors in Quebec workers changed during confinement of the COVID-19 pandemic, and whether healthcare workers reported specific patterns of changes. Methods Data were obtained from an anonymous online survey conducted among adult workers aged ⩾18 years in the province of Quebec, Canada, between May 25, 2020 and June 26, 2020. Participants provided self-reported data regarding sociodemographic including field of work, as well as mental health disorders, alcohol use, alcohol craving, and type of alcohol consumed. Changes in alcohol behaviors were assessed using Wilcoxon signed rank test for categorial variables and paired-t tests for continuous variables. Results The survey was completed by 847 participants (77.8% women), with 42.5% healthcare workers. Participants reported increased daily alcohol use (Z = -10.60; P < .001, r = -.372) and alcohol craving (P < .001, d = 0.485) during the confinement. Only the type of alcohol consumed during the confinement differed between health care workers and other workers (OR = 0.45, P = .003). Health care workers used less high alcohol products during the confinement. Conclusion Our results show a significant increase in daily alcohol consumption and in alcohol craving during the confinement in the Quebec working population.
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Affiliation(s)
- Violaine Mongeau-Pérusse
- Research Center, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Elie Rizkallah
- Research Center, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Julie Bruneau
- Research Center, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Denis Chênevert
- Department of Human Resources Management, HEC Montréal, Chemin de la Côte-Sainte-Catherine, Montreal, QC, Canada
| | | | - Didier Jutras-Aswad
- Research Center, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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Mora M, Dupas de Matos A, Vázquez-Araújo L, Puente V, Hernando J, Chaya C. Exploring young consumers' attitudes and emotions to sensory and physicochemical properties of different red wines. Food Res Int 2021; 143:110303. [PMID: 33992323 DOI: 10.1016/j.foodres.2021.110303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
To gain deeper understanding on young consumers' attitudes and preferences to wines is needed to connect wine industry with the youth. The aims of the present study were (i) to define 'trendy wine' for young consumers and (ii) to identify chemical drivers of liking in red wines for the youth. The study was divided in two phases: phase I explored young consumers' attitudes towards wines using an online survey, and phase II studied the relationship between hedonic and emotional responses elicited by 12 red wine samples and their physico-chemical characteristics. Consumers' responses and physico-chemical data were related using Principal Component Analysis (PCA). Results of the online survey showed that trendy wines were associated to: sparkling, soft, fresh, fruity, sweet, light, and balanced wines. Also, young consumers reported that, although flavor was considered the most important attribute, price and Protected Designation of Origin could be valuable attributes. PCA results of phase II showed that wines with a lower ratio [total polyphenol index/polysaccharides] were more liked and elicited more positive emotions than wines with higher total polyphenol index, color intensity, volatile acidity, and alcohol content. Liking and positive emotions were positively related to higher Odor Activity Values of the volatile compounds from the organic acids group. The presence of benzenoids and lactones, and the lower presence of terpenoids & norisoprenoids were associated with negative emotions. In conclusion, red wines should be soft (described as lower ratio [total polyphenol index/polysaccharides]), and have floral, and fruity aromas to better connect with young consumers.
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Affiliation(s)
- María Mora
- BCC Innovation, Technology Center in Gastronomy, Basque Culinary Center, Donostia-San Sebastián, Spain; Basque Culinary Center, Faculty of Gastronomy Sciences, Mondragon Unibersitatea, Donostia-San Sebastián, Spain.
| | - Amanda Dupas de Matos
- Department of Agricultural Economics, Statistics and Business Management. Universidad Politécnica de Madrid, Escuela Técnica Superior de Ingeniería Agronómica, Alimentaria y de Biosistemas, Ciudad Universitaria s/n, 28040 Madrid, Spain; FEAST and Riddet Institute, Massey University, Palmerston North 4410, New Zealand
| | - Laura Vázquez-Araújo
- BCC Innovation, Technology Center in Gastronomy, Basque Culinary Center, Donostia-San Sebastián, Spain; Basque Culinary Center, Faculty of Gastronomy Sciences, Mondragon Unibersitatea, Donostia-San Sebastián, Spain
| | - Víctor Puente
- Laffort España, Polígono Txirrita Maleo 12, 20100 Rentería, Spain
| | - Jesús Hernando
- Laffort España, Polígono Txirrita Maleo 12, 20100 Rentería, Spain
| | - Carolina Chaya
- Department of Agricultural Economics, Statistics and Business Management. Universidad Politécnica de Madrid, Escuela Técnica Superior de Ingeniería Agronómica, Alimentaria y de Biosistemas, Ciudad Universitaria s/n, 28040 Madrid, Spain
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Kuklová M, Kagstrom A, Kučera M, Mladá K, Winkler P, Cermakova P. Educational inequalities in mental disorders in the Czech Republic: data from CZEch Mental health Study (CZEMS). Soc Psychiatry Psychiatr Epidemiol 2021; 56:867-877. [PMID: 32789560 DOI: 10.1007/s00127-020-01930-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE We aimed to study the association of educational attainment with occurrence of mental disorders in the Czech Republic. METHODS Data were derived from the CZEch Mental health Study (CZEMS), a cross-sectional study of community-dwelling individuals. Mental disorders were assessed with Mini International Neuropsychiatric Interview (M.I.N.I.), and information on completed education was acquired as a part of a paper and pencil interview. Logistic regression was used to estimate odds ratio (OR) with 95% confidence intervals (CI) for the association of educational attainment with all mental disorders as well as with specific groups (affective, anxiety, alcohol use and substance use disorders), stepwise adjusting for socio-demographic, social and health-related characteristics. RESULTS We studied 3175 individuals (average age 50 years, range 18-96 years; 54% women). Compared to individuals with higher education, those educated below high school graduation had higher odds of mental disorders (OR 2.07; 95% CI 1.58-1.71), even after adjustment for all covariates (OR 1.64; 95% CI 1.21-2.23). Education showed the strongest association with alcohol use disorders, even when covariates were adjusted for, but was not related to anxiety disorders. The association of education with affective as well as substance use disorders was explained by covariates. CONCLUSIONS Interventions aimed at reducing the burden of mental disorders should target individuals with low education. Strategies to improve population mental health need to go hand in hand with policies to enhance education as well as reduce alcohol consumption in the Czech Republic.
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Affiliation(s)
- Marie Kuklová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Faculty of Science, Charles University Prague, Prague, Czech Republic
| | - Anna Kagstrom
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Matěj Kučera
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Karolína Mladá
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University Prague, Prague, Czech Republic
| | - Petr Winkler
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Pavla Cermakova
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic. .,Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic. .,Second Faculty of Medicine, Charles University Prague, Prague, Czech Republic.
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Davies EL, Cooke R, Maier LJ, Winstock AR, Ferris JA. Where and What You Drink Is Linked to How Much You Drink: An Exploratory Survey of Alcohol Use in 17 Countries. Subst Use Misuse 2021; 56:1941-1950. [PMID: 34378484 DOI: 10.1080/10826084.2021.1958864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This paper aimed to explore the differences in subjective experiences of intoxication depending on drinking location and drink type. Methods: Data came from 32,194 respondents to The Global Drug Survey (GDS) 2015, an annual, cross-sectional, online survey. Respondents selected their usual drinking location (home alone: home with partner/family: house parties: pubs/bars or clubs) and usual drink (wine; beer/cider/lager; spirits or alcopops/coolers). They indicated how many drinks they required to reach three stages of intoxication (feeling the effects; an ideal stage of intoxication; and the tipping point) and how frequently they reached each stage. Results: Drink type affected grams of alcohol reported to reach the tipping point: 109 gm wine, 127 gm alcopops, 133 gm of beer, and 134 gm of spirts. Respondents who drank at home alone, or in clubs reached their tipping point more frequently compared to other locations. Conclusions: Where people drink, and the type of alcohol they drink, affected the amount of alcohol reported to reach different stages of intoxication. Understanding why different drinking locations, and drink types lead to a need for greater consumption to reach an ideal state of drunkenness, such as social cues from other people who drink, may enable people to reduce their drinking.
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Affiliation(s)
- Emma L Davies
- The Centre for Psychological Research, Oxford Brookes University, UK
| | - Richard Cooke
- Department of Psychology, University of Liverpool, Liverpool, UK.,Liverpool Centre for Alcohol Research
| | - Larissa J Maier
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA.,Swiss National Science Foundation, Bern, Switzerland
| | - Adam R Winstock
- Institute of Epidemiology & Health, University College London, London, UK.,Global Drug Survey, UK
| | - Jason A Ferris
- Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
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The Contagion of Sentiments during the COVID-19 Pandemic Crisis: The Case of Isolation in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165918. [PMID: 32824110 PMCID: PMC7460470 DOI: 10.3390/ijerph17165918] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022]
Abstract
This study examines how confinement measures established during the COVID-19 pandemic crisis affected the emotions of the population. For this purpose, public sentiment on social media and digital ecosystems in Spain is analyzed. We identified affective tones towards media and citizens published on social media focusing on six basic emotions: anger, fear, joy, sadness, disgust and uncertainty. The main contribution of this work is the evidence of contagious sentiments and, consequently, the possibility of using this new dimension of social media as a form of a “collective therapy”. This paper contributes to understanding the impact of confinement measures in a pandemic from the point of view of emotional health. This analysis provides a set of practical implications that can guide conceptual and empirical work in health crisis management with an alternative approach, especially useful for decision-making processes facing emergency responses and health crises, even in an unprecedented global health crisis such as the traumatic events caused by the COVID-19 disease.
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Abstract
Due to socioeconomic changes, the demand for and interest in alcoholic beverages have recently been increasing. Among various alcoholic drinks, consumer preference for wine could be varied. It might be related with its complexity, as wine is known to have characteristics that are difficult to understand. Several factors, such as intrinsic or extrinsic factors interact to influence wine complexity and consumer perception. Many studies have been conducted to understand the complexity of wine, allowing deeper insight into its perception by consumers. Studies over the last decade on wine sensory perception using descriptive analysis and consumer tests were reviewed. Additionally, chemical analysis studies were included because flavor constituents information would contribute to a better understanding of sensory perception. Descriptive sensory analysis of wine was reviewed considering panels and flavor characterization for better understanding wine-related research. Several consumer studies regarding liking/preference, emotion, context, and extrinsic factors to understand consumer preference or perception were reviewed. Research on chemical constituents may affect consumer perception and is thus presented in this review. However, most of the research was focused on a narrow range of wine, thus is missing overall wine category evaluations. Furthermore, evaluations were mainly in wine-producing countries, resulting in limited understanding of an emergent market. This review will help guide wine researchers and industry by providing information on factors influencing consumer wine perception.
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Winstock AR, Holmes J, Ferris JA, Davies EL. Perceptions of Alcohol Health Warning Labels in a Large International Cross-Sectional Survey of People Who Drink Alcohol. Alcohol Alcohol 2019; 55:315-322. [DOI: 10.1093/alcalc/agz099] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract
Aims
This paper aimed to explore perceptions of alcohol health warning labels amongst a large international sample of people who drink alcohol.
Methods
The Global Drug Survey (GDS) is the world’s largest annual cross sectional survey of drug use. Seven health warning labels were presented (relating to heart disease, liver, cancer, calories, violence, taking two days off and the myth of benefits to moderate drinking). People were asked if they were aware of the information, believed it, if it was personally relevant, and if it would change their drinking. This paper included data from 75,969 respondents from 29 countries/regions who reported the use of alcohol in the last 12 months, collected during November–December 2017 (GDS2018).
Results
The fact that drinking less can reduce the risk of seven types of cancer was the least well known, and yet was demonstrated to encourage almost 40% of drinkers to consider drinking less. Women and high risk drinkers were more likely to indicate they would reduce their drinking in response to all labels. Personal relevance was identified as a key predictor of individual responses.
Conclusion
Findings highlight the potential of a range of health messages displayed on alcoholic beverages to raise awareness of alcohol-related harms and potentially support a reduction in drinking. Further research should explore what influences personal relevance of messages as this may be a barrier to effectiveness.
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Affiliation(s)
- Adam R Winstock
- Institute of Epidemiology and Health Care, University College London, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jason A Ferris
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
| | - Emma L Davies
- Department of Psychology, Oxford Brookes University, Gipsy Lane, Oxford, UK
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Gallis JA, Turner EL. Relative Measures of Association for Binary Outcomes: Challenges and Recommendations for the Global Health Researcher. Ann Glob Health 2019; 85:137. [PMID: 31807416 PMCID: PMC6873895 DOI: 10.5334/aogh.2581] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Binary outcomes-which have two distinct levels (e.g., disease yes/no)-are commonly collected in global health research. The relative association of an exposure (e.g., a treatment) and such an outcome can be quantified using a ratio measure such as a risk ratio or an odds ratio. Although the odds ratio is more frequently reported than the risk ratio, many researchers, policymakers, and the general public frequently interpret it as a risk ratio. This is particularly problematic when the outcome is common because the magnitude of association is larger on the odds ratio scale than the risk ratio scale. Some recently published global health studies included misinterpretation of the odds ratio, which we hypothesize is because statistical methods for risk ratio estimation are not well known in the global health research community. Objectives To compare and contrast available statistical methods to estimate relative measures of association for binary outcomes and to provide recommendations regarding their use. Methods Logistic regression for odds ratios and four approaches for risk ratios: two direct regression approaches (modified log-Poisson and log-binomial) and two indirect methods (standardization and substitution) based on logistic regression. Findings Illustrative examples demonstrate that misinterpretation of the odds ratio remains a common issue in global health research. Among the four methods presented for estimation of risk ratios, the modified log-Poisson approach is generally preferred because it has the best numerical performance and it is as easy to implement as is logistic regression for odds ratio estimation. Conclusions We conclude that, when study design allows, studies with binary outcomes should preferably report risk ratios to measure relative association.
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Affiliation(s)
- John A Gallis
- Duke Global Health Institute, Duke University, Durham, North Carolina, US
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, US
| | - Elizabeth L Turner
- Duke Global Health Institute, Duke University, Durham, North Carolina, US
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, US
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Testa A, Weiss DB, Rennó Santos M. A Cross-National Analysis of Alcohol Consumption and Suicide Rates: Variations by Population-Level Drinking Patterns. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619855998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study assesses the association between the population-level consumption of different types of alcohol and cross-national suicide rates and examines whether this association is moderated by country-specific drinking patterns. We apply negative binomial regression to test whether the consumption of beer, wine, or spirits is predictive of suicide rates. Next, we use interaction terms to examine whether the effect of beverage-specific consumption on suicide rates is moderated by total alcohol consumption, prevalence of consumption, or the riskiness of drinking patterns. We find that only spirit consumption has a positive and statistically significant association with suicide rates. The effect of spirit consumption on suicide is higher among countries where the total alcohol consumption and the prevalence of alcohol consumption are lower, and patterns of drinking are riskier. Future research should continue to investigate this relationship to develop interventions that reduce suicide mortality related to alcohol use.
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Boolani A, O’Connor PJ, Reid J, Ma S, Mondal S. Predictors of feelings of energy differ from predictors of fatigue. FATIGUE-BIOMEDICINE HEALTH AND BEHAVIOR 2018. [DOI: 10.1080/21641846.2018.1558733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, NY, USA
| | | | - Jeri Reid
- Department of Physician Assistant, Clarkson University, Potsdam, NY, USA
| | - Sai Ma
- Department of Mathematics, Clarkson University, Potsdam, NY, USA
| | - Sumona Mondal
- Department of Mathematics, Clarkson University, Potsdam, NY, USA
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Larsson I, Andersson MLE. Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study. BMJ Open 2018; 8:e024367. [PMID: 30552279 PMCID: PMC6303608 DOI: 10.1136/bmjopen-2018-024367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The aims were to identify patients with rheumatoid arthritis (RA) who had stopped drinking alcohol and compare them with patients drinking alcohol, and to explore reasons for stopping drinking alcohol. DESIGN A sequential explanatory mixed methods design was used. SETTING Six rheumatology clinics in Southern Sweden Better Anti-Rheumatic FarmacOTherapy cohort. PARTICIPANTS A total of 1509 patients completed the questions about alcohol and were included in the study. 86 of these had stopped drinking alcohol and 72 responded to the open question and their answers were analysed with qualitative content analysis. OUTCOME MEASURES The quantitative data were from a cross-sectional survey assessing disease severity, physical function (Health Assessment Questionnaire, HAQ) and health-related quality of life (EuroQol five dimensions, EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors, for example, alcohol. The questions assessing alcohol included an open question 'Why have you stopped drinking alcohol?' RESULTS The patients who stopped drinking alcohol were older (median (min-max) 69 (36-90) vs 66 (23-95), p=0.011), had worse HAQ (1.00 (0-2.75) vs 0.50 (0-3.00), p<0.001), worse EQ5D (0.69 (-0.02-1.00) vs 0.76 (-0.58-1.00), p<0.001) worse PatGA (5 (0-10) vs 3 (0-10), p<0.001), more pain (5 (0-10) vs 3 (0-10), p<0.001) and more fatigue (6 (0-10) vs 4 (0-10), p<0.001 compared with patients drinking alcohol. The qualitative content analysis revealed five categories describing reasons for patients with RA to stop drinking alcohol: illness and treatment; health and well-being; work and family; faith and belief; and dependences and abuse. CONCLUSIONS The patients who had stopped drinking had worse physical functioning and higher levels in pain-related variables. Most stopped drinking due to their illness or a desire to improve health.
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Affiliation(s)
- Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Center, Spenshult, Halmstad, Sweden
| | - Maria L E Andersson
- Spenshult Research and Development Center, Spenshult, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Loy BD, Cameron MH, O'Connor PJ. Perceived fatigue and energy are independent unipolar states: Supporting evidence. Med Hypotheses 2018. [PMID: 29523293 DOI: 10.1016/j.mehy.2018.02.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Persistent fatigue is a common problem (∼20-45% of U.S. population), with higher prevalence and severity in people with medical conditions such as cancer, depression, fibromyalgia, heart failure, sleep apnea and multiple sclerosis. There are few FDA-approved treatments for fatigue and great disagreement on how to measure fatigue, with over 250 instruments used in research. Many instruments define fatigue as "a lack of energy", thus viewing energy and fatigue states as opposites on a single bipolar continuum. In this paper, we hypothesize that energy and fatigue are distinct perceptual states, should be measured using separate unipolar scales, have different mechanisms, and deficits should be treated using tailored therapies. Energy and fatigue independence has been found in both exploratory and confirmatory factor analysis studies. Experiments in various fields, including behavioral pharmacology and exercise science, often find changes in energy and not fatigue, or vice versa. If the hypothesis that energy and fatigue are independent is correct, there are likely different mechanisms that drive energy and fatigue changes. Energy could be increased by elevated dopamine and norepinephrine transmission and binding. Fatigue could be increased by elevated brain serotonin and inflammatory cytokines and reduced histamine binding. The hypothesis could be tested by an experiment that attempts to produce simultaneously high ratings of energy and fatigue (such as with two drugs using a randomized, double-blind, placebo-controlled design), which would offer strong evidence against the common viewpoint of a bipolar continuum. If the hypothesis is correct, prior literature using bipolar instruments will be limited, and research on the prevalence, mechanisms, and treatment of low energy and elevated fatigue as separate conditions will be needed. In the immediate future, measuring both energy and fatigue using unipolar measurement tools may improve our understanding of these states and improve therapeutic outcomes.
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Affiliation(s)
- Bryan D Loy
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States.
| | - Michelle H Cameron
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States; Multiple Sclerosis Center of Excellence-West, VA Portland Health Care System, Portland, OR, United States
| | - Patrick J O'Connor
- Department of Kinesiology, University of Georgia, Athens, GA, United States
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