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Vespa A, Spatuzzi R, Fabbietti P, Di Rosa M, Bonfigli AR, Corsonello A, Gattafoni P, Giulietti MV. Association between Sense of Loneliness and Quality of Life in Older Adults with Multimorbidity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2615. [PMID: 36767986 PMCID: PMC9915419 DOI: 10.3390/ijerph20032615] [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: 12/14/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Multimorbidity has been associated with adverse health outcomes, such as reduced physical function, poor quality-of-life (QoL), poor self-rated health. OBJECTIVE The association between quality of life, social support, sense of loneliness and sex and age in older adult patients affected by two or more chronic diseases (multimorbidity) was evaluated. METHODS Patients n. 162 with multimorbidity and living with family members. TESTS MMSE-Mini-Mental-State-Examination; ADL-Activities of Daily Living; Social Schedule: demographic variables; Loneliness Scale -de Jong Gierveld; Quality-of-Life-FACT-G; WHOQOL-BRIEF Social relationships. STATISTICAL ANALYSIS Multivariate Regression Analysis. RESULTS The patients with three or more diseases have worse dimensions of FACT-G total score (p = 0.029), QoL Physical-well-being (p = 0.003), Social well-being (p = 0.003), Emotional-well-being (p = 0.012), Functional-well-being (p < 0.001), than those with two. Multiple linear regression QoL: FACT_G total score, PWB, SWB, EWB, FWB as dependent variables. In the presence of multimorbidity with an increase in the patient's age FACT-G total score (B = -0.004, p = 0.482), PWB (B = -0.024, p = 0.014), SWB (B = -0.022, p = 0.051), EWB (B = -0.001, p = 0.939), FWB (B = -0.023, p = 0.013) decrease by an average of 0.1, and as the sense of solitude increases FACT-G total score (B = -0.285, p < 0.000), PWB (B = -0.435, p < 0.000), SWB(B = -0.401, p < 0.000), EWB(B = -0.494, p < 0.000), FWB(B = -0.429, p < 0.000) decrease by 0.4. CONCLUSIONS A sense of loneliness and advancing age are associated with bad quality-of life in self-sufficient elderly patients with multimorbidity. IMPLICATIONS FOR PRACTICE Demonstrating that loneliness, as well as in the presence of interpersonal relations, is predictive of worse quality of life in patients with multimorbidity helps identify people most at risk for common symptoms and lays the groundwork for research concerning both diagnosis and treatment.
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Affiliation(s)
- Anna Vespa
- Scientific and Technological Area, Department of Neurology, Italian National Research Center On Aging (IRCCS INRCA), 60124 Ancona, Italy
| | - Roberta Spatuzzi
- Department of Mental Health, ASP Basilicata, 85100 Potenza, Italy
| | - Paolo Fabbietti
- Laboratory of Biostatistics, Italian National Research Center On Aging (IRCCS INRCA), 60124 Ancona, Italy
| | - Mirko Di Rosa
- Laboratory of Biostatistics, Italian National Research Center On Aging (IRCCS INRCA), 60124 Ancona, Italy
| | - Anna Rita Bonfigli
- Scientific Direction, Italian National Research Center On Aging (IRCCS INRCA), 60124 Ancona, Italy
| | - Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, Italian National Research Center On Aging (IRCCS INRCA), 87100 Cosenza, Italy
| | - Pisana Gattafoni
- Clinic of Internal Medicine and Geriatric, Italian National Research Center On Aging (IRCCS INRCA), 60124 Ancona, Italy
| | - Maria Velia Giulietti
- Department of Neurology, Italian National Research Center On Aging (IRCCS INRCA), 60124 Ancona, Italy
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van de Vijver S, Hummel D, van Dijk AH, Cox J, van Dijk O, Van den Broek N, Metting E. Evaluation of a Digital Self-management Platform for Patients With Chronic Illness in Primary Care: Qualitative Study of Stakeholders' Perspectives. JMIR Form Res 2022; 6:e38424. [PMID: 35921145 PMCID: PMC9386583 DOI: 10.2196/38424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Population aging and multimorbidity has led to increasing chronic care needs associated with new challenges in managing growing costs, rising health care professional workloads, and the adoption of rigorous guidelines. These issues could all benefit from greater digitalization and a more patient-centered approach to chronic care, a situation brought to the fore by the COVID-19 pandemic. Little is known about real-life use in primary care. OBJECTIVE This study aimed to explore the views, thoughts, usability, and experiences concerning a recently introduced digital self-care platform for chronic conditions in 3 Dutch primary care practices. METHODS We conducted an explorative study combining questionnaires and interviews among patients and general practitioners from 3 general practices that used the digital platform. Questionnaires were sent to patients in each practice to seek the views and experiences of both patient nonusers (n=20) and patient users (n=58) of the platform, together with standardized questionnaires about illness perception and quality of life. In addition, patients (n=15) and general practitioners (n=4) who used the platform took part in semistructured interviews. We transcribed interviews verbatim and performed qualitative content analysis using a deductive approach. The results of the questionnaires were analyzed with descriptive analysis. RESULTS Among patients who had not actively used the platform but had received an explanation, only 35% (7/20) would recommend its use due to concerns over communication and handling. However, this percentage increased to 76.3% (45/59) among the people who actively used the platform. Interviews with patients and general practitioners who used the platform uncovered several key benefits, including reduced time requirements, reduced workload, improved care quality, and improved accessibility due to the greater patient-centeredness and use of different communication tools. In addition, the self-management tool led to greater patient autonomy and empowerment. Although users considered the platform feasible, usable, and easy to use, some technical issues remained and some patients expressed concerns about the reduction in human contact and feedback. CONCLUSIONS The overall experience and usability of the platform was good. Support for the online self-management platform for chronic care increased when patients actively used the tool and could experience or identify important advantages. However, patients still noted several areas for improvement that need to be tackled in future iterations. To ensure benefit in the wider population, we must also evaluate this platform in cohorts with lower digital and health literacy.
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Affiliation(s)
- Steven van de Vijver
- Amsterdam Health & Technology Institute, Amsterdam University Medical Center, Amsterdam, Netherlands
- Family Medicine Department, OLVG, Amsterdam, Netherlands
| | - Deirdre Hummel
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | | | - Jan Cox
- Medicine Men, Utrecht, Netherlands
| | | | - Nicoline Van den Broek
- Department of General Practice and Elderly Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Esther Metting
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
- Department of General Practice and Elderly Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Data Science Center in Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Hu B, Liu C, Lv T, Luo F, Qian C, Zhang J, Ye M, Liu Z. Meta-Analysis of Sleep Deprivation Effects on Depression in Rodents. Brain Res 2022; 1782:147841. [DOI: 10.1016/j.brainres.2022.147841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/28/2022] [Accepted: 02/15/2022] [Indexed: 01/31/2023]
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GLP-1a: Going beyond Traditional Use. Int J Mol Sci 2022; 23:ijms23020739. [PMID: 35054924 PMCID: PMC8775408 DOI: 10.3390/ijms23020739] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 02/07/2023] Open
Abstract
Glucagon-like peptide-1 (GLP-1) is a human incretin hormone derived from the proglucagon molecule. GLP-1 receptor agonists are frequently used to treat type 2 diabetes mellitus and obesity. However, the hormone affects the liver, pancreas, brain, fat cells, heart, and gastrointestinal tract. The objective of this study was to perform a systematic review on the use of GLP-1 other than in treating diabetes. PubMed, Cochrane, and Embase were searched, and the PRISMA guidelines were followed. Nineteen clinical studies were selected. The results showed that GLP-1 agonists can benefit defined off-medication motor scores in Parkinson’s Disease and improve emotional well-being. In Alzheimer’s disease, GLP-1 analogs can improve the brain’s glucose metabolism by improving glucose transport across the blood–brain barrier. In depression, the analogs can improve quality of life and depression scales. GLP-1 analogs can also have a role in treating chemical dependency, inhibiting dopaminergic release in the brain’s reward centers, decreasing withdrawal effects and relapses. These medications can also improve lipotoxicity by reducing visceral adiposity and decreasing liver fat deposition, reducing insulin resistance and the development of non-alcoholic fatty liver diseases. The adverse effects are primarily gastrointestinal. Therefore, GLP-1 analogs can benefit other conditions besides traditional diabetes and obesity uses.
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Li R, Zhan W, Huang X, Liu Z, Lv S, Wang J, Liang L, Ma Y. Association of Dietary Inflammatory Index (DII) and Depressive Disorders. J Inflamm Res 2021; 14:6959-6973. [PMID: 34949933 PMCID: PMC8691198 DOI: 10.2147/jir.s344002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
A lot of evidence shows that inflammation is related to the development of depression. However, the heterogeneity of depression hinders efforts to understand, prevent and treat this disease. The purpose of this comprehensive review is to summarize the links between inflammation and the established core features of depression, which show more homogeneity than the syndrome itself: overreaction to negative information, changes in reward processing, and cognitive control decline, and somatic syndrome. For each core feature, we first briefly outline its relevance to depression and neurobiological basis, and then review the evidence to investigate the potential role of inflammation. We mainly focus on the discovery of the experimental paradigm of exogenous inflammation. We concluded that inflammation may play a role in overreaction to negative information, altered reward responses, and physical symptoms. There is less evidence to support the effect of inflammation on cognitive control by standard neuropsychological measures. Finally, we discussed the implications for future research and recommendations on how to test the role of inflammation in the pathogenesis of heterogeneous mental illness.
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Affiliation(s)
- Ruiqiang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
| | - Wenqiang Zhan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Xin Huang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
| | - Zhan Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
| | - Shuaishuai Lv
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
| | - Jiaqi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
| | - Luyao Liang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
| | - Yuxia Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, People's Republic of China
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Fan J, Qian F, Wang Q, Chen B, Wang L. Efficacy and safety of Qigong Baduanjin exercise in the treatment of depression with insomnia: A randomized controlled study protocol. Medicine (Baltimore) 2021; 100:e27764. [PMID: 34964736 PMCID: PMC8615342 DOI: 10.1097/md.0000000000027764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression is a common mental illness often associated with insomnia. Baduanjin exercise has been found to improve depressive symptoms and has also been found to have good effects on insomnia. However, there are no rigorous clinical studies to evaluate the effects of Baduanjin exercise on depressed patients with insomnia, so this randomized controlled trial will evaluate the efficacy of Qigong Baduanjin exercise in treating depression with insomnia. METHODS This is a prospective randomized controlled trial to investigate the clinical efficacy of Baduanjin exercise in the treatment of depression with insomnia. The included patients will be randomly divided into a treatment group and control group. The treatment group will be treated with Baduanjin exercise and the control group will be treated with oral mirtazapine. After 8 weeks of continuous treatment, they will be followed up for 3 months. Observed indexes included Pittsburgh sleep quality index, Hamilton expression Rating Scale score, and adverse reactions. Finally, the data are statistically analyzed by SPSS 20.0 software. DISCUSSION This study will evaluate the efficacy and safety of Baduanjin exercise in the treatment of depression with insomnia, and the results of this study will provide a clinical basis for the treatment of depression with insomnia.Trial registration: OSF Registration number: DOI 10.17605/OSF.IO/KC48H.
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Affiliation(s)
- Jing Fan
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
| | - Fangmin Qian
- The Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Qingqing Wang
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
| | - Bihua Chen
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
| | - Linchuang Wang
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
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Duan-Porter W, Nelson DB, Ensrud KE, Spoont MR. Physical functioning and mental health treatment initiation and retention for veterans with posttraumatic stress disorder: a prospective cohort study. BMC Health Serv Res 2021; 21:1005. [PMID: 34551770 PMCID: PMC8457897 DOI: 10.1186/s12913-021-07035-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/14/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Most US adults with posttraumatic stress disorder (PTSD) do not initiate mental health treatment within a year of diagnosis. Increasing treatment uptake can improve health and quality of life for those with PTSD. Individuals with PTSD are more likely to report poor physical functioning, which may contribute to difficulty with treatment initiation and retention. We sought to determine the effects of poor physical functioning on mental health treatment initiation and retention for individuals with PTSD. METHODS We used data for a national cohort of veterans in VA care; diagnosed with PTSD in June 2008-July 2009; with no mental health treatment in the prior year; and who responded to baseline surveys on physical functioning and PTSD symptoms (n = 6,765). Physical functioning was assessed using Veterans RAND 12-item Short Form Health Survey, and encoded as limitations in physical functioning and role limitations due to physical health. Treatment initiation (within 6 months of diagnosis) was determined using VA data and categorized as none (reference), only medications, only psychotherapy, or both. Treatment retention was defined as having ≥ 4 months of appropriate antidepressant or ≥ 8 psychotherapy encounters. RESULTS In multinomial models, greater limitations in physical functioning were associated with lower odds of initiating only psychotherapy (OR 0.82 [95 % CI 0.68, 0.97] for limited a little and OR 0.74 [0.61, 0.90] for limited a lot, compared to reference "Not limited at all"). However, it was not associated with initiation of medications alone (OR 1.04 [0.85, 1.28] for limited a little and OR 1.07 [0.86, 1.34] for limited a lot) or combined with psychotherapy (OR 1.03 [0.85, 1.25] for limited a little and OR 0.95 [0.78, 1.17] for limited a lot). Greater limitations in physical functioning were also associated with lower odds of psychotherapy retention (OR 0.69 [0.53, 0.89] for limited a lot) but not for medications (e.g., OR 0.96 [0.79, 1.17] for limited a lot). Role limitations was only associated with initiation of both medications and psychotherapy, but there was no effect gradient (OR 1.38 [1.03, 1.86] for limitations a little or some of the time, and OR 1.18 [0.63, 1.06] for most or all of the time, compared to reference "None of the time"). Accounting for chronic physical health conditions did not attenuate associations between limitations in physical functioning (or role limitations) and PTSD treatment; having more chronic conditions was associated with lower odds of both initiation and retention for all treatments (e.g., for 2 + conditions OR 0.53 [0.41, 0.67] for initiation of psychotherapy). CONCLUSIONS Greater limitations in physical functioning may be a barrier to psychotherapy initiation and retention. Future interventions addressing physical functioning may enhance uptake of psychotherapy.
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Affiliation(s)
- Wei Duan-Porter
- Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, One Veterans Dr, MN, 55417, Minneapolis, United States.
- University of Minnesota Medical School, MN, Minneapolis, USA.
| | - David B Nelson
- Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, One Veterans Dr, MN, 55417, Minneapolis, United States
- University of Minnesota Medical School, MN, Minneapolis, USA
| | - Kristine E Ensrud
- Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, One Veterans Dr, MN, 55417, Minneapolis, United States
- University of Minnesota Medical School, MN, Minneapolis, USA
- School of Public Health, University of Minnesota, MN, Minneapolis, USA
| | - Michele R Spoont
- Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, One Veterans Dr, MN, 55417, Minneapolis, United States
- University of Minnesota Medical School, MN, Minneapolis, USA
- National Center for PTSD, Department of Veterans Affairs, Minneapolis, USA
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Toepfer S, König M, Spira D, Drewelies J, Kreutz R, Bolbrinker J, Demuth I. Sex Differences in Characteristics Associated with Potentially Inappropriate Medication Use and Associations with Functional Capacity in Older Participants of the Berlin Aging Study II. Gerontology 2021; 68:664-672. [PMID: 34569530 DOI: 10.1159/000518411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 07/04/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Medication safety is a vital aim in older adults' pharmacotherapy. Increased morbidity and vulnerability require particularly careful prescribing. Beneath avoiding unnecessary polypharmacy and prescribing omissions, physicians have to be aware of potentially inappropriate medications (PIMs) and related outcomes to optimize older adults' drug therapy, and to reduce adverse drug events. OBJECTIVE The aim of this study was to identify participants characteristics associated with PIM use and associations of PIM use with functional capacity with a focus on sex differences. METHODS Multivariable logistic regression analyses of cross-sectional Berlin Aging Study II (BASE-II) data (N = 1,382, median age 69 years, interquartile range 67-71, 51.3% women) were performed with PIM classification according to the EU(7)-PIM list. RESULTS In the overall study population, higher education was associated with lower odds of PIM use (odds ratio [OR] 0.93, confidence interval [CI] 95% 0.87-0.99, p = 0.017). Falls (OR 1.53, CI 95% 1.08-2.17, p = 0.016), frailty/prefrailty (OR 1.68, 1.17-2.41, p = 0.005), and depression (OR 2.12, CI 95% 1.32-3.41, p = 0.002) were associated with increased odds of PIM use. A better nutritional status was associated with lower odds of PIM use (OR 0.88, CI 95% 0.81-0.97, p = 0.008). In the sex-stratified analysis, higher education was associated with lower odds of PIM use in men (OR 0.90, CI 95% 0.82-0.99, p = 0.032). Frailty/prefrailty was associated with increased odds of PIM use in men (OR 2.04, CI 95% 1.18-3.54, p = 0.011) and a better nutritional status was associated with lower odds of PIM use in men (OR 0.83, CI 95% 0.72-0.96, p = 0.011). Falls in the past 12 months were related to an increased prevalence of PIM use in women (OR 1.74, CI 95% 1.10-2.75, p = 0.019). Depression was associated with a higher prevalence of PIM use in both men (OR 2.74, CI 95% 1.20-6.24, p = 0.016) and women (OR 2.06, CI 95% 1.14-3.71, p = 0.017). We did not detect sex differences regarding the overall use of drugs with anticholinergic effects, but more men than women used PIMs referring to the cardiovascular system (p = 0.036), while more women than men used PIMs referring to the genitourinary system and sex hormones (p < 0.001). CONCLUSION We found similarities, but also differences between men and women as to the associations between PIM use and participants' characteristics and functional capacity assessments. The association of lower education with PIM use may suggest that physicians' prescribing behavior is modified by patient education, a relationship that could evolve from more critical attitudes of educated patients towards medication use. We conclude that sex differences in associations of PIM use with functional capacities might be partly attributable to sex differences in drug classes used, but not with regard to anticholinergics, as these are used to a similar extent in men and women in the cohort studied here.
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Affiliation(s)
- Sarah Toepfer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany,
| | - Maximilian König
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany
| | - Dominik Spira
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany
| | - Johanna Drewelies
- Humboldt-Universität zu Berlin, Department of Psychology, Berlin, Germany
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
| | - Juliane Bolbrinker
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
| | - Ilja Demuth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
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Liu Y, Gellatly J. Barriers and facilitators of engagement in psychological therapies among older adults with depression: A systematic review and thematic synthesis. J Psychiatr Ment Health Nurs 2021; 28:509-520. [PMID: 33043526 DOI: 10.1111/jpm.12697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 12/26/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: The utilization rate of psychological therapies is low in older adults with depression. The barriers and facilitators to engaging in psychological therapies experienced by older adults with depression are unclear. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Personal suitability for therapy engagement, practical abilities, personal therapy preferences, and familiarity with psychological therapies are associated with psychological therapy engagement. Psychological therapists can also impact psychological therapy engagement among older adults with depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Proving the effectiveness and suitability of chosen psychological therapies is important for improving therapy engagement. Strategies for handling functional impairments among older adults with depression are necessary for engaging this population in psychological therapies. Although in-home psychological therapies are accessible, barriers to handling the technologies used for delivering the therapies should be addressed. More methods of accessing information about psychological therapies should be available to older adults in order for them to increase their knowledge on the topic. Psychological therapists should have positive attitudes and the competence to treat depression in older adults. ABSTRACT INTRODUCTION: Although psychological therapies are preferred by older adults, the utilization rate of these therapies is significantly low in older adults with depression. Understanding the barriers and facilitators to engaging in psychological therapies experienced by older adults is important for improving utilization rates. AIM This review aimed to explore the barriers and facilitators to engaging in psychological therapies experienced by older adults with depression. METHODS A systematic review of qualitative studies on psychological therapy engagement among older adults with depression. Relevant published studies and grey literature were searched. The Critical Appraisal Skills Programme tool was used to assess the quality of the included studies. The results of the included studies were synthesized using thematic synthesis. RESULTS Personal suitability for therapy engagement, practical abilities, personal therapy preferences and familiarity with psychological therapies was associated with therapy engagement. Therapists' competencies also affected therapy engagement. DISCUSSION Older adult's personal health status and requirements for psychological therapy should be considered. IMPLICATIONS FOR PRACTICE Mental health practitioners should consider whether specific psychological therapies are beneficial and acceptable for older adults. Improvements are needed in older adult's familiarity with psychological therapies and the ability of therapists to address the mental problems of older adults.
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Affiliation(s)
- Yuan Liu
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Judith Gellatly
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Hu B, Liu C, Mou T, Luo F, Lv T, Qian C, Zhang J, Ye M, Liu Z. Meta-Analysis of Sleep Deprivation Effects on Patients With Depression. Front Psychiatry 2021; 12:783091. [PMID: 34916978 PMCID: PMC8669147 DOI: 10.3389/fpsyt.2021.783091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Depression is a common disorder with a high recurrence rate. Since the effect of sleep deprivation on depression in existing studies were inconsistent, the present study aimed to reassess the effects of SD on patients by performing a meta-analysis of updated research. Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched for articles before January 20th, 2021. Data on participant characteristics, SD characteristics, adjunctive method and tests for depression were extracted. A comprehensive analysis was conducted to assess the effect of SD on depression and subgroup analysis was used to determine the sources of heterogeneity. Results: In total, 8 articles were included. An SD time of <7 days slightly worsened depression levels [0.24 (-0.21, 0.69); I 2 = 0%; P = 0.43], a time of 7-14 days had antidepressant effects [-1.52 (-2.07, -0.97); I 2 = 19.6%; P = 0.288], and a time of more than 14 days also worsened depression [0.76 (0.12, 1.40); I 2 = 43.7%; P = 0.169]. Conclusion: SD may serve as an effective antidepressant measure in humans when the time was 7-14 days, while a time of <7 days and more than 14 days worsened depression.
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Affiliation(s)
- Baiqi Hu
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center, Medical College of Shaoxing University, Shaoxing, China.,Department of Behavioral Neurosciences, Science Research Center of Medical School, Shaoxing University, Shaoxing, China.,Department of Neurology, Shaoxing Hospital, China Medical University, Shaoxing, China
| | - Chunyan Liu
- Department of Orthopedics, Shaoxing People's Hospital, The First Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Tingting Mou
- Department of Behavioral Neurosciences, Science Research Center of Medical School, Shaoxing University, Shaoxing, China
| | - Fangyi Luo
- Department of Behavioral Neurosciences, Science Research Center of Medical School, Shaoxing University, Shaoxing, China
| | - Tingting Lv
- Department of Behavioral Neurosciences, Science Research Center of Medical School, Shaoxing University, Shaoxing, China
| | - Chao Qian
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center, Medical College of Shaoxing University, Shaoxing, China
| | - Jian Zhang
- Department of Behavioral Neurosciences, Science Research Center of Medical School, Shaoxing University, Shaoxing, China
| | - Mengfei Ye
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center, Medical College of Shaoxing University, Shaoxing, China
| | - Zheng Liu
- Department of Behavioral Neurosciences, Science Research Center of Medical School, Shaoxing University, Shaoxing, China
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11
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Ferrari S, Mattei G, Marchi M, Galeazzi GM, Pingani L. Is Consultation-Liaison Psychiatry 'Getting Old'? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207389. [PMID: 33050480 PMCID: PMC7601334 DOI: 10.3390/ijerph17207389] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022]
Abstract
There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.
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Affiliation(s)
- Silvia Ferrari
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (M.M.); (G.M.G.)
| | - Giorgio Mattei
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (M.M.); (G.M.G.)
- Department of Economics “Marco Biagi”, University of Modena and Reggio Emilia, Via Jacopo Berengario 51, 41121 Modena, Italy
| | - Mattia Marchi
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (M.M.); (G.M.G.)
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (M.M.); (G.M.G.)
| | - Luca Pingani
- Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy; (S.F.); (G.M.); (M.M.); (G.M.G.)
- Department of Health Professions, Azienda USL–IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
- Correspondence: ; Tel.: +39-0522-522077
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12
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Ribeiro-Carvalho F, Gonçalves-Pinho M, Bergantim R, Freitas A, Fernandes L. Trend of depression and its association with sociodemographic and clinical factors among multiple myeloma hospitalizations: A Portuguese nationwide study from 2000 to 2015. Psychooncology 2020; 29:1587-1594. [PMID: 32658348 DOI: 10.1002/pon.5469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Patients hospitalized with multiple myeloma (MM) are particularly vulnerable to depression. The present study aims to determine the frequency of depression among MM hospitalized patients, in order to assess the possible differences between those with and without depression in relation to sociodemographic and clinical variables and to measure the impact of depression on hospitalization outcomes. METHODS An observational retrospective study was performed using an administrative data set of all hospitalizations with a primary diagnosis of MM between 2000 and 2015 in Portuguese mainland public hospitals. Codes related to depressive disorders were grouped to generate the dichotomous variable of depression (yes/no). A multivariate analysis was conducted and adjusted odd ratios (aOR) calculated between different variables and depression. RESULTS Of a total of 14.575 MM hospitalizations studied, a concurrent code of depression was registered in 666 patients (4.6%). A greater odds of depression was observed in female patients (aOR = 2.26; 95%CI = 1.91-2.66), transplanted patients (aOR = 1.78; 95%CI = 1.44-2.20), patients with plasma cell leukemia (aOR = 1.79; 95%CI = 1.22-2.64) and patients with a higher Charlson Comorbidity Index (CCI) (aOR = 1.10; 95%CI = 1.05-1.15). Length of stay was longer in patients with a registered diagnosis of depression (aOR = 1.01; 95%CI = 1.01-1.02) while the odds of in-hospital mortality were lower in these patients (aOR = 0.53; 95%CI = 0.41-0.68). CONCLUSIONS These results may help identify MM inpatients at higher risk of presenting depression (female gender, younger age, high CCI, plasma cell leukemia, transplant procedure). This will enable timely psychological assessment and treatment to prevent worse outcomes and higher healthcare costs associated with depression.
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Affiliation(s)
| | - Manuel Gonçalves-Pinho
- Department of Psychiatry and Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.,Center for Health Technology and Services Research (CINTESIS), FMUP, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), FMUP, Porto, Portugal
| | - Rui Bergantim
- Hematology Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Cancer Drug Resistance Group, IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
| | - Alberto Freitas
- Center for Health Technology and Services Research (CINTESIS), FMUP, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), FMUP, Porto, Portugal
| | - Lia Fernandes
- Center for Health Technology and Services Research (CINTESIS), FMUP, Porto, Portugal.,Department of Clinical Neurosciences and Mental Health, FMUP, Porto, Portugal.,Psychiatry Service, CHUSJ, Porto, Portugal
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13
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Cheng C, Inder K, Chan SW. Coping with multiple chronic conditions: An integrative review. Nurs Health Sci 2020; 22:486-497. [DOI: 10.1111/nhs.12695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery The University of Newcastle Callaghan New South Wales Australia
- Department of Nursing Bengbu Medical College Bengbu China
| | - Kerry Inder
- School of Nursing and Midwifery The University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
| | - Sally Wai‐Chi Chan
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
- The University of Newcastle Singapore Singapore Singapore
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14
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Guo H, Huang B, Wang Y, Zhang Y, Ma Q, Ren Y. Bone marrow mesenchymal stem cells-derived exosomes improve injury of hippocampal neurons in rats with depression by upregulating microRNA-26a expression. Int Immunopharmacol 2020; 82:106285. [PMID: 32088640 DOI: 10.1016/j.intimp.2020.106285] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/16/2020] [Accepted: 02/02/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Bone marrow mesenchymal stem cells (BMSCs)-derived exosomes have been widely applied in disease therapies. However, the role of BMSCs-derived exosomes in depression remains obscure. This study aims to explore the mechanism of BMSCs-derived exosomal microRNA-26a (miR-26a) on hippocampal neuronal injury of depressed rats. METHODS BMSCs and their exosomes were obtained and identified. Rat models of depression were established by corticosterone injection, then injected with BMSCs-derived exosomes. The contents of superoxide dismutase (SOD), imalondialdehyde (MDA), lactate dehydrogenase (LDH), tumor necrosis factor α (TNF-α), and interleukin-1β (IL-1β) in rats' serum, hippocampal tissues and neurons were determined. The expression of miR-26a in hippocampal tissues and neurons was detected by RT-qPCR. The injury models of rat hippocampal neurons were established to figure out the role of BMSCs-derived exosomes and miR-26a in neuron apoptosis and proliferation. RESULTS In hippocampal tissues of depressed rats, miR-26a was lowly expressed, and BMSCs-derived exosomes upregulated miR-26a expression. BMSCs-derived exosomes restrained apoptosis in hippocampal tissues of depressed rats. BMSCs-derived exosomes and upregulated miR-26a elevated SOD level, lessened MDA, LDH, TNF-α and IL-1β levels, boosted hippocampal neuron proliferation and suppressed apoptosis in depressed rats. CONCLUSION Collectively, our study reveals that miR-26a is lowly expressed in depressed rats, and BMSCs-derived exosomes improve hippocampal neuron injury of rat with depression by upregulating miR-26a.
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Affiliation(s)
- Huirong Guo
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China.
| | - Bailing Huang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yali Wang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yanyan Zhang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Quangang Ma
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yuming Ren
- School of Basic Medicine, Xinxiang Medical University, 450052 Xinxiang, Henan, China.
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15
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Antidepressant Potential of Cinnamic Acids: Mechanisms of Action and Perspectives in Drug Development. Molecules 2019; 24:molecules24244469. [PMID: 31817569 PMCID: PMC6943791 DOI: 10.3390/molecules24244469] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 01/12/2023] Open
Abstract
Depression is a health problem that compromises the quality of life of the world's population. It has different levels of severity and a symptomatic profile that affects social life and performance in work activities, as well as a high number of deaths in certain age groups. In the search for new therapeutic options for the treatment of this behavioral disorder, the present review describes studies on antidepressant activity of cinnamic acids, which are natural products found in medicinal plants and foods. The description of the animal models used and the mechanisms of action of these compounds are discussed.
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16
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Shaw BH, Stiles LE, Bourne K, Green EA, Shibao CA, Okamoto LE, Garland EM, Gamboa A, Diedrich A, Raj V, Sheldon RS, Biaggioni I, Robertson D, Raj SR. The face of postural tachycardia syndrome - insights from a large cross-sectional online community-based survey. J Intern Med 2019; 286:438-448. [PMID: 30861229 PMCID: PMC6790699 DOI: 10.1111/joim.12895] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patients with postural tachycardia syndrome (POTS) experience chronic symptoms of orthostatic intolerance. There are minimal data detailing the demographics, clinical features and clinical course of this condition. This online, community-based survey highlights patients' experience with POTS. It consists of the largest sample of POTS patients reported to date. OBJECTIVES To describe the demographics, past medical history, medications, treatments and diagnostic journey for patients living with POTS. METHODS Postural tachycardia syndrome patients completed an online, community-based, cross-sectional survey. Participants were excluded if they had not received a diagnosis of POTS from a physician. The questions focused on the patient experience and journey, rather than physiological responses. RESULTS The final analysis included 4835 participants. POTS predominantly affects white (93%) females (94%) of childbearing age, with approximately half developing symptoms in adolescence (mode 14 years). POTS is a chronic multisystem disorder involving a broad array of symptoms, with many patients diagnosed with comorbidities in addition to POTS. POTS patients often experience lengthy delays [median (interquartile range) 24 (6-72) months] and misdiagnosis, but the diagnostic delay is improving. POTS patients can present with a myriad of symptoms most commonly including lightheadedness (99%), tachycardia (97%), presyncope (94%), headache (94%) and difficulty concentrating (94%). CONCLUSIONS These data provide important insights into the background, clinical features and diagnostic journey of patients suffering from POTS. These data should serve as an essential step for moving forward with future studies aimed at early and accurate diagnoses of these patients leading to appropriate treatments for their symptoms.
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Affiliation(s)
- B H Shaw
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - L E Stiles
- Department of Neurology, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Dysautonomia International, East Moriches, NY, USA
| | - K Bourne
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - E A Green
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - C A Shibao
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L E Okamoto
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - E M Garland
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - A Gamboa
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - A Diedrich
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - V Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - R S Sheldon
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - I Biaggioni
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - D Robertson
- Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - S R Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.,Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
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17
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Marroig A, Čukić I, Robitaille A, Piccinin A, Muniz Terrera G. Importance of modelling decisions on estimating trajectories of depressive symptoms and co-morbid conditions in older adults: Longitudinal studies from ten European countries. PLoS One 2019; 14:e0214438. [PMID: 30943221 PMCID: PMC6447220 DOI: 10.1371/journal.pone.0214438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/12/2019] [Indexed: 01/22/2023] Open
Abstract
Background International comparisons of trajectories of depressive symptoms in older adults are scarce and longitudinal associations with co-morbid conditions not fully understood. Objective To compare trajectories of depressive symptoms from participants living in 10 European Countries and identify ages at which the associations of co-morbid conditions with these trajectories become more relevant. Methods Latent growth curve models were fitted to depressive symptoms scores from participants of the Survey of Health and Retirement in Europe (SHARE) initiative (combined n = 21,253) and co-morbid conditions modelled as time varying covariates. To identify the ages at which the association between co-morbid conditions and depressive symptoms was significant the Johnson-Neyman (JN) technique was used. Results The shape of depressive symptoms trajectories varied between countries, and was highly dependent on modelling decisions. The association between the average number of co-morbidities reported over time and depressive symptoms was consistent and positive across countries and ages. Conclusion International differences in ageing-related trajectories of depressive symptoms emerged. The longitudinal association of co-morbid conditions with trajectories of depressive symptoms was found, but the results overall suggest that modelling decisions could greatly influence the outcomes, and should thus be interpreted with caution.
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Affiliation(s)
- Alejandra Marroig
- Instituto de Economia, Universidad de la Republica del Uruguay, Montevideo, Uruguay
| | - Iva Čukić
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Annie Robitaille
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Graciela Muniz Terrera
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
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18
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Cheng C, Inder K, Chan SWC. Patients' experiences of coping with multiple chronic conditions: A meta-ethnography of qualitative work. Int J Ment Health Nurs 2019; 28:54-70. [PMID: 30232822 DOI: 10.1111/inm.12544] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2018] [Indexed: 12/21/2022]
Abstract
Multiple chronic conditions (MCCs) pose a major and growing burden on the individuals' health. The ways in which people cope with their stresses related to their chronic conditions are significant to their health outcomes. This review sought to understand lived experiences of coping with MCCs by a meta-ethnography of qualitative studies. Twenty-six studies were identified in four electronic databases including PubMed, PsycINFO, EMBASE, and CINAHL that were searched from 1966 to 2017. A seven-step analytic method was used after a quality evaluation based on Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The findings illustrated that experiences of coping with MCCs were interacted with (i) appraisals of MCCs, (ii) strategies to maintain a normal life, (iii) strategies to keep the spirits up, and (iv) coping in the social context. To sum up, this review provided a collection of narratives on coping with MCCs. The findings would help to recognize the high complexity experienced by these patients, also potentially offered a foundation for the design of a feasible intervention to more optimally highlight the demands of managing MCCs.
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Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia.,School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Kerry Inder
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Sally Wai-Chi Chan
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
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19
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Aznar-Lou I, Iglesias-González M, Rubio-Valera M, Peñarrubia-Maria MT, Mendive JM, Murrugarra-Centurión AG, Gil-Girbau M, González-Suñer L, Peuters C, Serrano-Blanco A. Diagnostic accuracy and treatment approach to depression in primary care: predictive factors. Fam Pract 2019; 36:3-11. [PMID: 30423158 DOI: 10.1093/fampra/cmy098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The study assessed the predictive factors of diagnostic accuracy and treatment approach (antidepressants versus active monitoring) for depression in primary care. METHODS This is a cross-sectional study that uses information from a naturalistic prospective controlled trial performed in Barcelona (Spain) enrolling newly diagnosed patients with mild to moderate depression by GPs. Treatment approach was based on clinical judgement. Diagnosis was later assessed according to DSM-IV criteria using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview by an external researcher. Patients (sociodemographic, psychiatric diagnosis, severity of depression and anxiety, health-related quality of life, disability, beliefs about medication and illness and comorbidities) and GP factors associated with diagnostic accuracy and treatment approach were assessed using multilevel logistic regression. Variables with missing data were imputed through multiple imputations. RESULTS Two hundred sixty-three patients were recruited by 53 GPs. Mean age was 51 years (SD = 15). Thirty percent met DSM-IV criteria for major depression. Mean depression symptomatology was moderate-severe. Using multivariate analyses, patients' beliefs about medicines were the only variable associated with the antidepressant approach. Specialization in general medicine and being a resident tutor were associated with a more accurate diagnosis. CONCLUSIONS Clinical depression diagnosis by GPs was not always associated with a formal diagnosis through a SCID-I. GPs' training background was central to an adequate depression diagnosis. Patients' beliefs in medication were the only factor associated with treatment approach. More resources should be allocated to improving the diagnosis of depression.
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Affiliation(s)
- Ignacio Aznar-Lou
- Teaching, Research and Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain
| | - Maria Iglesias-González
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,School of Medicine, University of Barcelona, Barcelona, Spain
| | - Maria Rubio-Valera
- Teaching, Research and Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - M Teresa Peñarrubia-Maria
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain.,SAP Delta Llobregat, DAP Costa Ponent, Institut Català de la Salut, Catalonia, Spain
| | - Juan M Mendive
- Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain.,Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain.,La Mina Primary Care Centre, Institut Català de la Salut, Sant Adrià de Besós, Spain
| | - Ana G Murrugarra-Centurión
- Teaching, Research and Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain
| | - Montserrat Gil-Girbau
- Teaching, Research and Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain.,Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain
| | | | - Carmen Peuters
- Department of Movement and Sports Sciences, Ghent University, Belgium
| | - Antoni Serrano-Blanco
- Teaching, Research and Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,Fundació Idiap Jordi Gol i Gurina, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,School of Medicine, University of Barcelona, Barcelona, Spain
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20
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DiNapoli EA, Bramoweth AD, Whiteman KL, Hanusa BH, Kasckow J. Mood Disorders in Middle-Aged and Older Veterans With Multimorbidity. J Aging Health 2017; 29:657-668. [PMID: 27020938 PMCID: PMC5435543 DOI: 10.1177/0898264316641082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study identified the prevalence of and relationship between mood disorders and multimorbidity in middle-aged and older veterans. METHOD Cross-sectional data were obtained from veterans who received primary care services at VA Pittsburgh Healthcare System from January 2007 to December 2011 ( n = 34,786). RESULTS Most veterans had three or more organ systems with chronic disease (95.3%), of which 4.1% had a depressive disorder, 2.5% had an anxiety disorder, and 0.7% had co-occurring depression and anxiety. The odds of having a mood disorder increased with each additional organ system with chronic disease, with odds being the greatest in those with 10 to 13 organ systems with chronic disease. Younger age, female gender, non-married marital status, and having a service connected disability were also significant predictors of having a mood disorder. DISCUSSION These findings suggest a need to integrate mental health assessment and treatment in chronic health care management for veterans.
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Affiliation(s)
- Elizabeth A. DiNapoli
- VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Adam D. Bramoweth
- VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Karen L. Whiteman
- Dartmouth Centers for Health and Aging, Lebanon, NH, USA
- The Dartmouth Institute, Lebanon, NH, USA
| | - Barbara H. Hanusa
- VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - John Kasckow
- VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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21
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von Faber M, van der Weele GM, van der Geest G, Blom JW, van der Zouwe N, Reis R, van der Mast RC, Gussekloo J. [Coping strategies of older people with low mood]. Tijdschr Gerontol Geriatr 2016; 47:249-257. [PMID: 27830438 DOI: 10.1007/s12439-016-0196-y] [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: 06/25/2016] [Accepted: 10/06/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND To gain new insights for support for older people with low mood, we explored the perceptions of 'screenpositive' older people on underlying causes and possible solutions. DESIGN AND METHOD We conducted two in-depth interviews with 38 participants (≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, we included 19 persons with and 19 without complex problems. Complex problems were defined as a combination of functional, somatic, psychological or social problems. RESULTS All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Some participants, especially those with complex problems, were ambivalent about possible interventions. CONCLUSION Most older participants perceived their coping strategies as sufficient. General practitioners can support self-management by exploring the (effectiveness of) personal coping strategies, providing information, elaborating on perceptions of risks and discussing alternative options with older persons.
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Affiliation(s)
- Margaret von Faber
- Afdeling Public Health en Eerstelijnsgeneeskunde, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, Nederland
- Marente, Voorhout, Nederland
| | - Gerda M van der Weele
- Afdeling Richtlijnontwikkeling en Wetenschap, Nederlands Huisartsen Genootschap, Utrecht, Nederland
| | - Geertje van der Geest
- Afdeling Public Health en Eerstelijnsgeneeskunde, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, Nederland
| | - Jeanet W Blom
- Afdeling Public Health en Eerstelijnsgeneeskunde, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, Nederland
| | | | - Ria Reis
- Afdeling Public Health en Eerstelijnsgeneeskunde, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, Nederland
- Amsterdam Institute for Social Science Research, Universiteit van Amsterdam, Amsterdam, Nederland
- The Children's Institute, University of Cape Town, Cape Town, Zuid-Afrika
| | - Roos C van der Mast
- Afdeling Psychiatrie, Leiden University Medical Center, Leiden, Nederland
- Afdeling Psychiatrie, CAPRI-Universiteit van Antwerpen, Antwerp, België
| | - Jacobijn Gussekloo
- Afdeling Public Health en Eerstelijnsgeneeskunde, Leiden University Medical Center, Postbus 9600, 2300 RC, Leiden, Nederland.
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Barra M, Evensen GSH, Valeberg BT. Cues and clues predicting presence of symptoms of depression in stroke survivors. J Clin Nurs 2016; 26:546-556. [DOI: 10.1111/jocn.13482] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Mathias Barra
- Health Services Research Center (HØKH); Akershus University Hospital; Lørenskog Norway
| | - Gina Sophie Hvidsten Evensen
- Health Services Research Center (HØKH); Akershus University Hospital; Lørenskog Norway
- Faculty of Nursing; Oslo and Akershus University College of Applied Sciences; Oslo Norway
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Abstract
BACKGROUND To gain new insight into support for older people with low mood, the perceptions, strategies, and needs of older people with depressive symptoms were explored. METHODS Two in-depth interviews were held with 38 participants (aged ≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, 19 persons with and 19 without complex problems were included. Complex problems were defined as a combination of functional, somatic, psychological or social problems. RESULTS All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Most participants felt they could deal with their feelings sufficiently, whereas a few participants with complex problems expressed a need for professional support. Some participants, especially those with complex problems, were ambivalent about possible interventions mainly because they feared putting their fragile balance at risk due to changes instigated by an intervention. CONCLUSION Most older participants with depressive symptoms perceived their coping strategies to be sufficient. The general practitioners (GPs) can support self-management by talking about the (effectiveness of) personal coping strategies, elaborating on perceptions of risks, providing information, and discussing alternative options with older persons.
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Turabián JL, Pérez Franco B. [A way of helping "Mr. Minotaur" and "Ms. Ariadne" to exit from the multiple morbidity labyrinth: the "master problems"]. Semergen 2015; 42:38-48. [PMID: 25817854 DOI: 10.1016/j.semerg.2015.02.004] [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: 01/06/2015] [Revised: 02/07/2015] [Accepted: 02/09/2015] [Indexed: 11/24/2022]
Abstract
Multiple morbidity seems to be "infinite" and so is not easy to make useful decisions. A new concept is introduced: the "master problems", as a qualitative method to facilitate the exit from this maze of multiple morbidity. Metaphors from the art world have been used to teach this concept. These "master problems" generally remain hidden and can only "unravel" between the interstices of multiple morbidity, when the details of the system that defines the problem are explained. A problem with "energy" or a "master problem" is complex, multiple and dramatic or theatrical--everything in the clinical history history make us look into that particular question. It is what gives us a blow to the stomach, which causes our hearts to beat faster, that moves us on many levels, which has a high "density of emotions", human elements, social symbols, and opens solutions in a patient.
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Affiliation(s)
- J L Turabián
- Medicina de Familia y Comunitaria, Centro de Salud Polígono Industrial, Toledo, España.
| | - B Pérez Franco
- Medicina de Familia y Comunitaria, Centro de Salud La Estación, Talavera de la Reina, Toledo, España
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