Age-specific symptom prevalence in women 35-64 years old: a population-based study

Thermographic findings related to facial pain - a survey of 40 subjects

OBJECTIVE

The purpose of this study was to assess how thermography findings relate painful symptoms and signs of temporomandibular disorders (TMD).

METHODS

Thermography, combined with chewing of paraffin wax, was performed on 40 subjects. The results were analyzed according to gender and pain-related TMD symptoms and clinical signs.

RESULTS

The overall temperatures after chewing were higher in TMD patients than in controls. For females, the most significant findings were the thermal increase between the relaxed state and subjects' state after chewing in temporal and temporomandibular joint (TMJ) regions. For males, all calculated parameters demonstrated a poor ability to discriminate TMD from controls.

CONCLUSION

Thermography could be a potential tool in diagnostics of female TMD patients. The results suggest that the thermal information assessed in specific facial areas could help to discriminate TMD patients from non-TMD patients and could be used to quantify the pain associated with TMD.

Arthralgia in female Masters weightlifters

BACKGROUND

Arthralgia or joint pain is a heterogeneous condition including organic and nonorganic joint pain. It is common in older populations, particularly in females. There is evidence that menopausal changes are associated with increased prevalence of arthralgia. While physical activities have been recommended to mitigate osteoarthritis (OA) and arthralgia, sport participation also carries risk factors due to excessive loading of some joints and possible injuries. The aim was to evaluate the association of training patterns, prior injuries, and severity of menopausal symptoms with arthralgia in female Masters weightlifters.

METHODS

Competitive female Masters weightlifters (n=868, 30-78 years) from 30 countries completed an online survey including joint pain for different anatomical sites, weightlifting training and performance, sport history, and menopausal symptoms. Logistic regression models were used to estimate the association of training patterns, prior sport participation, and menopausal symptom severity with arthralgia separately for shoulders, spine, hips, knees, ankles, elbows, and hands.

RESULTS

Arthralgia was most reported in knees (38.8%), shoulders (29.8%), hands/wrists (28.8%), and hips (24.9%). The prevalence of arthralgia was 51.5% in pre-menopausal women, 62.4% in women post natural menopause and 73.3% in women post medical or surgical menopause. Lifting heavier weights was associated with arthralgia in hips (OR=1.05, p=0.03), knees (OR=1.06, p=0.01), and hands/wrists (OR=1.05, p=0.04), but prior strength training was protective for arthralgia in the shoulders (OR=0.66, p=0.02). Prior injuries and psychological menopausal symptom severity were associated with an increased risk for arthralgia (p<0.01).

CONCLUSIONS

Arthralgia was common in competitive female weightlifters. Training frequency was not associated with arthralgia, but lifting heavier weights relative to age and body mass was. Prior injuries and menopausal symptoms were associated with arthralgia, but prior strength training was protective of arthralgia in the shoulders. Athletes, coaches and sports medicine professionals should be aware that prevalence of polyarthralgia increases in post-menopausal athletes.

Endogenous estrogen deficiency and the development of chronic musculoskeletal pain: A review

Sexual dimorphism of chronic diseases is a phenomenon determined by differences in the hormonal status of men and women. In this regard, estrogens, which have a complex effect on the body, are of great interest. In particular, estrogens play an important role in the natural control of pain and inflammation. A decrease in estrogen levels associated with menopause or iatrogenic effects (hysterectomy, use of aromotase inhibitors), as well as mutations of genes responsible for the synthesis of structural components of membrane estrogen receptors (ESR1 and ESR2), can significantly reduce the positive effects of these hormones. Deficiency of estrogen can become one of the reasons for the development of serious pathological changes in particular, the formation of chronic pain associated with the pathology of the musculoskeletal system.

Epidemiology of Perceived Physical Fatigability in Older Adults: The Long Life Family Study

BACKGROUND

Fatigability is a construct that measures whole-body tiredness anchored to activities of a fixed intensity and duration; little is known about its epidemiology and heritability.

METHODS

Two generations of family members enriched for exceptional longevity and their spouses were enrolled (2006-2009) in the Long Life Family Study (LLFS). At Visit 2 (2014-2017, N = 2,355) perceived physical fatigability was measured using the 10-item self-administered Pittsburgh Fatigability Scale (PFS), along with demographic, medical, behavioral, physical, and cognitive risk factors.

RESULTS

Residual genetic heritability of fatigability was 0.263 (p = 6.6 × 10-9) after adjustment for age, sex, and field center. PFS physical scores (mean ± SD) and higher physical fatigability prevalence (% PFS ≥ 15) were greater with each age strata: 60-69 (n = 1,009, 11.0 ± 7.6, 28%), 70-79 (n = 847, 12.5 ± 8.1, 37%), 80-89 (n = 253, 19.3 ± 9.9, 65.2%), and 90-108 (n = 266, 28.6 ± 9.8, 89.5%), p < .0001, adjusted for sex, field center, and family relatedness. Women had a higher prevalence of perceived physical fatigability compared to men, with the largest difference in the 80-89 age strata, 74.8% versus 53.5%, p < .0001. Those with greater body mass index, worse physical and cognitive function, and lower physical activity had significantly higher perceived physical fatigability.

CONCLUSIONS

Perceived physical fatigability is highly prevalent in older adults and strongly associated with age. The family design of LLFS allowed us to estimate the genetic heritability of perceived physical fatigability. Identifying risk factors associated with higher perceived physical fatigability can inform the development of targeted interventions for those most at risk, including older women, older adults with depression, and those who are less physically active.

Increasing gender differences in the prevalence and chronification of orofacial pain in the population

Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course are lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, 2 screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010 to 2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least 2 consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (odds ratio 2.58, 95% confidence interval [CI] 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (incidence rate ratio 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (incidence rate ratio 2.56; 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.

Validation of the Pittsburgh Fatigability Scale in a mixed sample of adults with and without chronic conditions

The aim of this study was to validate the Pittsburgh Fatigability Scale in three different groups: adults with multiple sclerosis (n = 65), fibromyalgia (n = 64), and healthy adults (n = 86). Participants completed the Pittsburgh Fatigability Scale and other self-report measures. While findings supported the internal consistency of the Pittsburgh Fatigability Scale (all Cronbach's alpha ⩾ 0.85), standard error of measurement estimates were larger than hypothesized. In addition, while item-level reliability was generally supported, item-total correlations for two items were lower than expected. Convergent and discriminant validity were supported, and the Pittsburgh Fatigability Scale was able to distinguish between individuals with and without chronic disease. Overall, the Pittsburgh Fatigability Scale exhibited acceptable psychometric properties.

Predictive factors of life quality among packaging workers in Taiwan

The semiconductor plants on the top of high-tech industrial chain hire many packaging workers to carry out miscellaneous packing tasks for various product orders from different companies and countries. Under tremendous workload the quality of life (QoL) of such packaging workers need to be concerned. The aim of this study was to explore factors influencing their QoL. This study recruited 247 packing workers (162 male and 85 female; mean age: 35.6 years old) in 2015 and 2016 from a semiconductor plant in Taiwan by convenience sampling. The questionnaire comprised four parts: demographics, the World Health Organization Quality of Life (WHOQOL-BREF), an occupational burnout inventory and the Nordic Musculoskeletal Questionnaire. The four domains of the WHOQOL-BREF were defined as outcome variables. Predictive factors included gender (reference: male), age (reference: ≤ 35), BMI (reference: ≤ 25), educational level (reference: below university), marital/partner status (reference: married/cohabiting), years of work (reference: ≤ 5), work shift (reference: day shift), personal burnout, work-related burnout, over-commitment to work and the number of body parts with discomfort (0-9). The findings showed that physical QoL was negatively correlated with night -shift work, personal burnout, and number of body parts with discomfort. Psychological QoL was negatively correlated with night shift work and personal burnout. Environment QoL was negatively correlated with being male, night shift work and personal burnout. The results showed that the QoL among the packaging workers could be improved by reducing musculoskeletal discomfort, personal burnout and by improving work schedules.

Neuropsychological correlates of subjective fatigue in non-demented older adults and the moderating effect of physical activity

This study examined the association between self-reported fatigue and neuropsychological performance in 167 middle-aged and older (age range: 50-91 years) adults without dementia. Participants completed the Fatigue Symptom Inventory, a comprehensive neuropsychological evaluation, and frailty assessment. Higher levels of fatigue were significantly associated with poorer attention/information processing, executive functioning, and psychomotor speed, even after controlling for depression, sleep quality, physical weakness, and other covariates. Participants endorsing moderate-severe fatigue faced higher odds (OR = 6.6, 95% CI = 1.1, 39.1) of exhibiting clinical attention/information processing impairments than those without. Moderation analyses showed that fatigue was related to select cognitive deficits among those reporting mean or lower levels of activity, but not high levels. These findings highlight fatigue as an important clinical marker of select cognitive deficits in non-demented older adults that is distinct from the common confounding conditions examined in this study. High levels of physical activity may buffer this relationship.

Age and sex related self-reported symptoms in a general population across 30 years: Patterns of reporting and secular trend

Objective

To study age and sex specific prevalence of 30 symptoms in random samples from the general population and to analyze possible secular trends across time.

Study population

The study was based on data from eight on-going Swedish cohort studies, with baseline investigations performed between 1973 and 2003. Samples were drawn from the general population of the cities of Gothenburg and Eskilstuna, and of Uppsala County. Overall, 20,160 subjects were sampled, 14,470 (71.8%) responded, of whom 12.000 were unique subjects, and 2548 were part of more than one sample.

Methods

The Complaint score sub-scale of the Gothenburg Quality of Life instrument, listing 30 general symptoms was used. Responders were asked to indicate which symptoms they had experienced during the last three months.

Results

Women reported on average 7.8 symptoms, and men 5.3 (p<0.0001). Women reported higher prevalence than men for 24 of the 30 symptoms. In multivariate analyses four patterns of prevalence across age were identified in both men and women; increasing prevalence, decreasing, stable and biphasic prevalence. The symptoms in the various pattern groups differed somewhat between men and women. However, symptoms related to strain were prominent among symptoms decreasing with age. Moreover, there were secular trends. Across all symptoms reporting prevalence increased over time in men (p<0.001) as well as in women (p<0.0001).

Conclusions

Women reported higher total symptom prevalence than men. Symptoms related to health generally increased with age, while symptoms related to stress decreased markedly. Significant secular trends across time regarding symptom prevalence were found.

Development of a person-centered conceptual model of perceived fatigability

PURPOSE

Perceived fatigability, reflective of changes in fatigue intensity in the context of activity, has emerged as a potentially important clinical outcome and quality of life indicator. Unfortunately, the nature of perceived fatigability is not well characterized. The aim of this study is to define the characteristics of fatigability through the development of a conceptual model informed by input from key stakeholders who experience fatigability, including the general population, individuals with multiple sclerosis (MS), and individuals with fibromyalgia (FM).

METHODS

Thirteen focus groups were conducted with 101 participants; five groups with n = 44 individuals representing the general population, four groups with n = 26 individuals with MS, and four groups with n = 31 individuals with FM. Focus group data were qualitatively analyzed to identify major themes in the participants' characterizations of perceived fatigability.

RESULTS

Seven major themes were identified: general fatigability, physical fatigability, mental fatigability, emotional fatigability, moderators of fatigability, proactive and reactive behaviors, and temporal aspects of fatigability. Relative to those in the general sample, FM or MS groups more often described experiencing fatigue as a result of cognitive activity, use of proactive behaviors to manage fatigability, and sensory stimulation as exacerbating fatigability.

CONCLUSIONS

Fatigability is the complex and dynamic process of the development of physical, mental, and/or emotional fatigue. Trait- and state-like biological, psychological, social, and environmental moderators contribute to tremendous variability in fatigability (both between and within-person variability). Future research to further characterize fatigability across populations, test treatments for fatigability, and develop new measures of this construct are greatly needed.

Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland

OBJECTIVES

The burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact.

DESIGN

A large cross-sectional population-based study.

SETTING

Community in 2 regions of French-speaking Switzerland.

PARTICIPANTS

Community-dwelling older adults aged 68 years and older in 2011 (N=5300).

OUTCOMES

Disability in BADL defined as difficulty or help needed with any of dressing, bathing, eating, getting in/out of bed or an arm chair, and using the toilet. Overall QoL dichotomised as favourable (ie, excellent or very good) or unfavourable (ie, good, fair or poor). Disturbance by any of the following 14 chronic symptoms for at least 6 months: joint pain, back pain, chest pain, dyspnoea, persistent cough, swollen legs, memory gaps, difficulty concentrating, difficulty making decisions, dizziness/vertigo, skin problems, stomach/intestine problems, urinary incontinence and impaired sexual life.

RESULTS

Only 17.1% of participants did not report being disturbed by any of these chronic symptoms. Weighted prevalence ranged from 3.1% (chest pain) to 47.7% (joint pain). Most chronic symptoms were significantly associated with disability in BADL or unfavourable QoL, with substantial gender differences. The number of chronic symptoms was significantly associated with disability in BADL and unfavourable QoL, with gradients suggesting dose-response relationships. Joint pain and back pain had the highest population attributable fractions.

CONCLUSIONS

Chronic symptoms are highly prevalent in older people, and are associated with disability in BADL and unfavourable QoL, particularly when multiple chronic symptoms co-occur. Owing to their high public health impact, musculoskeletal chronic symptoms represent good targets for preventive interventions.

Fatigue: Relevance and implications in the aging population

Frailty has been identified as a promising condition for distinguishing different degrees of vulnerability among older persons. Several operational definitions have proposed fatigue as one of the features characterizing the frailty syndrome. However, such a subjective symptom is still not yet sufficiently explored and understood. Fatigue is a common and distressing self-reported symptom perceived by the person while performing usual mental and physical activities, highly prevalent in older people, and strongly associated with negative health-related events. The understanding of fatigue is hampered by several issues, including the difficulty at objectively operationalizing, the controversial estimates of its prevalence, and the complex pathophysiological mechanisms underlying its manifestation. Despite such barriers, the study of fatigue is important and might be encouraged. Fatigue may be the marker of the depletion of the body's homeostatic reserves to a threshold leading to its psycho-physical functional impairment, mirroring the concept of frailty. Its subjective and symptomatic nature resembles that of other conditions (e.g., pain, depression), which equally affect the individual's quality of life, expose to negative outcomes, and severely burden healthcare expenditures. In the present paper, we present an overview of the current knowledge on fatigue in older persons in order to increase awareness about its clinical and research relevance. Future research on this topic should be encouraged and developed because it could potentially lead to novel interventions against this symptom as well as against frailty and age-related conditions.

Subjective and clinically assessed hearing loss; a cross-sectional register-based study on a swedish population aged 18 through 50 years

OBJECTIVES

Questionnaire studies suggest that hearing is declining among young adults. However, few studies have examined the reliability of hearing questionnaires among young adult subjects. This study examined the associations between pure tone audiometrically assessed (PTA) hearing loss and questionnaire responses in young to middle aged adults.

MATERIALS AND METHODS

A cross-sectional study using questionnaire and screening PTA (500 through 6000 Hz) data from 15322 Swedish subjects (62% women) aged 18 through 50 years. PTA hearing loss was defined as a hearing threshold above 20 dB in both ears at one or more frequencies. Data were analysed with chi-square tests, nonlinear regression, binary logistic regression, and the generalized estimating equation (GEE) approach.

RESULTS

The prevalence of PTA hearing loss was 6.0% in men and 2.9% in women (p < 0.001). Slight hearing impairment was reported by 18.5% of the men and 14.8% of the women (p < 0.001), whereas 0.5% of men and women reported very impaired hearing. Using multivariate GEE modelling, the odds ratio of PTA hearing loss was 30.4 (95% CI, 12.7-72.9) in men and 36.5 (17.2-77.3) in women reporting very impaired hearing. The corresponding figures in those reporting slightly impaired hearing were 7.06 (5.25-9.49) in men and 8.99 (6.38-12.7) in women. These values depended on the sound stimulus frequency (p = 0.001). The area under the ROC curve was 0.904 (0.892-0.915) in men and 0.886 (0.872-0.900) in women.

CONCLUSIONS

Subjective hearing impairment predicted clinically assessed hearing loss, suggesting that there is cause for concern as regards the future development of hearing in young to middle-aged people.

Focus points in prevention actions against legal substances' abuse

AIM

To determine the factors associated with alcohol and tobacco abuse in Slovenian general population.

MATERIAL AND METHODS

We performed an observational cross-sectional study in a representative sample of 1002 Slovenian inhabitants in June 2011. It was performed using a method of computer-assisted telephone interview. The telephone interview consisted of questions about the prevalence and duration of preselected health-related symptoms in the past month, questions about the presence of chronic diseases, question about the presence of current smoking, EQ-5D questionnaire and AUDIT-C questionnaire.

RESULTS

Risky drinking was found in 103 (14.3 %) of the sample and smoking was found in 226 (22.6 %) of the sample. Men reported risky drinking more often when compared with women (17.7 vs. 10.5 %, P = 0.007). Multivariate analysis showed that male sex, current tobacco smoking, lower education level, self-reported presence of anxiety/depression and self-reported presence of muscle pain and excessive fatigue in the past month were independently associated with risky drinking and that male sex, lower education and income, the presence of chronic disease, self-reported problems in daily activities, risky drinking, self-reported troubles in sleeping and restless leg syndrome were independently associated with current tobacco smoking.

CONCLUSION

Risky alcohol drinking and smoking are still major public health problems in Slovenia and are associated with known demographic risk factors but also with some symptoms of somatoform disorders. These findings should be incorporated into the guidelines for family physicians as the important focus points for screening and intervening against legal substances' abuse in their patients.

Chronic pain and the development of a symptom checklist: a pilot study

BACKGROUND

There is currently no instrument to systematically assess the range of symptoms/problems and their bothersomeness in patients with chronic non-cancer pain (CNPN). Systematic assessment and prioritizing may target treatments and improve outcomes.

METHODS

The authors developed a checklist of symptoms and problems, the Copenhagen Symptom Checklist (CSC), presented clinically by patients. Fifty-three items representing biological, psychological and social areas were selected. Symptom/problem severity was rated on a 5-point scale anchored at 0 = 'not at all' and 4 = 'severe'. Patients ranked the five most bothersome symptoms/problems and could add five open-ended items. Patients completed the CSC after the first visit at the multidisciplinary pain centre.

RESULTS

One hundred and twelve consecutive patients completed the CSC. Eighty-nine percent scored pain as rather severe or very severe (score = 3 plus score = 4), followed by reduction in physical activity (67%), fatigue (66%) and sleep disturbance (53%). Pain and fatigue, but not reduction in physical activity, were given highest priority. Cognitive problems were important to a third of the patients. Depressive symptoms, cognitive problems and worry explained 17.5% of the total variance. Patients filled in the CSC without important loss of information, but a minority prioritized more than three areas or used the free text alternative.

CONCLUSIONS

Patients prioritized pain and fatigue as the most burdensome symptoms, but reduction in physical activity and sleep problems were also highly ranked. Patients were positive to the idea of symptom reporting; however, the 53-item number in this version of CSC is larger than may be necessary.

Seeking health advice on the Internet in patients with health problems: a cross-sectional population study in Slovenia

AIM

To determine the one-month prevalence of the seeking of web-based health information in the general adult population and to identify the symptoms associated with more frequent searching for information online.

METHODS

This was an observational cross-sectional study in a representative sample of 1,002 randomly selected Slovenian inhabitants. We used the method of computer-assisted telephone interviews. The questionnaire consisted of demographic questions, questions about the prevalence and duration of pre-selected symptoms in the past month, questions on the presence of chronic disease and a question about using the Internet for seeking health advice in the past month.

RESULTS

Among 774 respondents who reported having had symptoms in the past month, 25.8% of them reported seeking health information on the Internet. The factors found to be independently associated with the seeking of health information on the Internet were a younger age, a higher education level and the presence of constipation, irritability, fatigue, memory impairment and excessive sweating in the past month.

CONCLUSIONS

The study showed that the Internet was a common source of health information in the general adult population, particularly used for symptoms which are common but not well defined and not associated with a particular disease.

Self-reported hearing difficulties, main income sources, and socio-economic status; a cross-sectional population-based study in Sweden

BACKGROUND

Hearing difficulties constitute the most common cause of disability globally. Yet, studies on people with hearing difficulties regarding socio-economic status (SES), work, long-term unemployment, sickness absence, and disability pension are scarce. The aim of the present study was to investigate the main income sources of men and women of working ages with and without self-reported hearing difficulties and associations with gender, age, SES, type of living area, and country of birth.

METHODS

A cross-sectional population-based study, using information on self-reported hearing difficulties and SES of 19 045 subjects aged 20-64 years participating in Statistics Sweden's annual Living Conditions Surveys in any of the years 2004 through 2008. The information was linked to a nationwide database containing data on demographics and income sources. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated, using binary logistic regression analysis.

RESULTS

Hearing difficulties increased with age and were more common in men (age-adjusted OR: 1.42 (95% CI: 1.30-1.56)) with an overall prevalence of 13.1% in men and 9.8% in women. Using working men as reference, the OR of having hearing difficulties was 1.23 (0.94-1.60) in men with unemployment benefits and 1.36 (1.13-1.65) in men with sickness benefits or disability pension, when adjusting for age and SES. The corresponding figures in women were 1.59 (1.17-2.16) and 1.73 (1.46-2.06). The OR of having sickness benefits or disability pension in subjects with hearing difficulties was 1.36 (1.12-1.64) in men and 1.70 (1.43-2.01) in women, when adjusting for age and SES and using men and women with no hearing difficulties as reference.

CONCLUSIONS

Hearing difficulties were more prevalent in men. After adjustment with age and SES as well as with type of living area and country of birth, a significant association with unemployment benefits was found only in women, and the associations with long-term sickness absence and disability pension tended to be stronger in women.

Is a diagnosis of "mild traumatic brain injury" a category mistake?

BACKGROUND

Efforts to produce definitions and diagnostic standards for mild traumatic brain injury (TBI) have a long and complex history. The diagnosis of TBI must be considered in the larger context of neuropsychiatric diagnosis. A major reconceptualization of diagnosis is now underway in which the classical syndrome conceptualization is being discarded. We address the question, what are the implications of this revision of thinking in the specific context of TBI?

METHODS

A recent literature on logical structures for neuropsychiatric disorders was reviewed. The symptom pattern of TBI was identified, and a literature survey determined the frequency of these symptom patterns in other disorders and in healthy control populations.

RESULTS

The frequency of symptom endorsement in populations without a history of TBI can be equal to endorsement frequencies in populations with a history of mild TBI. In some studies, the frequency of symptom endorsement in healthy controls having no history of head injury actually exceeded the endorsement rates in a comparison group with a history mild TBI.

CONCLUSION

The heterogeneity of this clinical population and their clinical presentations, the absence of a unitary etiology of postinjury deficits, and the complex idiosyncratic time course of the appearance of these deficits argue against the valid implementation of the classical model of diagnosis. In addition, the accepted criteria of diagnostic utility are not satisfied. TBI is not a disease; it is an event. More precisely, TBI is an event or a sequence of events that can, in some instances, lead to a diagnosable neurological or psychiatric disorder.

Physical, psychological, and menopause-related symptoms and minor psychiatric disorders in a community-based sample of Brazilian premenopausal, perimenopausal, and postmenopausal women

OBJECTIVE

The aim of this study was to identify the prevalence of physical, psychological, and menopause-related symptoms and their association with minor psychiatric disorders in premenopausal, perimenopausal, and postmenopausal women.

METHODS

This was a nested cross-sectional study. Demographic characteristics, education, and climacteric symptoms were investigated. The 20-item Self-Reporting Questionnaire was used to screen for minor psychiatric disorders, with a score of 8 or higher indicating positive screening.

RESULTS

We studied 324 Brazilian women aged 36 to 62 years (86 premenopausal women, 156 perimenopausal women, and 82 postmenopausal women). Mean (SD) age was 44.8 (3.6), 46.3 (4.6), and 53.3 (3.8) years, respectively (P < 0.001); 52.4% had 8 years or less of schooling (whereas 22.8% had 4 years or less). Forty-five (28.8%) perimenopausal women and 32 (39%) postmenopausal women were users of hormone therapy; 15 (17.4%) and 21 (13.5%) premenopausal and perimenopausal participants, respectively, were users of oral contraceptives. Hormone therapy and oral contraceptive users were excluded from the analysis of symptom prevalence. Hot flashes, night sweats, and vaginal dryness were more prevalent among perimenopausal women (P < 0.001). Fatigue was the most frequent complaint in all groups (61%, 81%, and 88% in premenopausal, perimenopausal, and postmenopausal women, respectively). The variables most frequently associated with positive findings during the screening for minor psychiatric disorders were very low education level and memory loss and irritability. Classic vasomotor complaints were weakly associated with nonpsychotic disease. In turn, perimenopausal women, but not postmenopausal women, were at greater risk of minor psychiatric disorders.

CONCLUSIONS

Low education level, memory loss, irritability, and the menopausal transition represent risk factors for positive findings in a screening for minor psychiatric disorders.

Prevalence and predictors of sleep difficulty in a national cohort of women with primary breast cancer three to four months postsurgery

CONTEXT

Mounting evidence suggests that many cancer patients suffer from sleep difficulty, but there is conflicting evidence regarding the prevalence and predictors of this adverse symptom.

OBJECTIVES

The present study investigated the prevalence and predictors of clinically significant sleep difficulty in women with primary breast cancer.

METHODS

Danish women (n=3343) with primary breast cancer completed the Pittsburgh Sleep Quality Index (PSQI) along with measures of depression, anxiety, physical activity/functioning, and health behaviors three to four months postsurgery. Data on disease status, treatment, and comorbidity were obtained from the Danish Cancer Cooperative Group and surgical departments, and information on sociodemographic factors and psychiatric history was obtained from Danish national longitudinal registries.

RESULTS

More than half (57.9%) of the women reported clinically significant sleep difficulty (PSQI >5). Multiple logistic regression identified seven significant predictors of sleep difficulty in the full sample. In order of strength, these were the following: more depressive symptoms, poorer physical functioning, older age, higher levels of trait anxiety, consuming more cigarettes, having undergone lumpectomy, and lower levels of physical activity. Subgroup analysis found that more depressive symptoms and poorer physical functioning were the only two predictors that were significant in both pre- and postmenopausal women.

CONCLUSION

These findings indicate that a high proportion of women with breast cancer experience sleep difficulty. Depression and poorer physical functioning appear to be robust predictors of sleep difficulty, whereas other predictors may depend on sample characteristics, including menopausal status.

Stress and prevalence of hearing problems in the Swedish working population

Background

Current human and experimental studies are indicating an association between stress and hearing problems; however potential risk factors have not been established. Hearing problems are projected to become among the top ten disabilities according to the WHO in the near future. Therefore a better understanding of the relationships between stress and hearing is warranted. Here we describe the prevalence of two common hearing problems, i.e. hearing complaints and tinnitus, in relation to different work-and health-related stressors.

Methods

A total of 18,734 individuals were invited to participate in the study, out of which 9,756 (52%) enrolled.

Results

The results demonstrate a clear and mostly linear relationship between higher prevalence of hearing problems (tinnitus or hearing loss or both) and different stressors, e.g. occupational, poorer self-rated health, long-term illness, poorer sleep quality, and higher burnout scores.

Conclusions

The present study unambiguously demonstrates associations between hearing problems and various stressors that have not been previously described for the auditory system. These findings will open new avenues for future investigations.

A population-based study of associations between current posttraumatic stress symptoms and current fatigue

This study explores current experience with posttraumatic stress disorder (PTSD) symptoms and other variables (sociodemographic, mental distress, somatic morbidity, self-rated health, and quality of life [QoL]) in relation to fatigue. A representative sample of the Norwegian population (N = 3,944) was invited to participate in a mailed survey, and 1,857 (47%) returned valid responses on the questionnaire that included the Fatigue Severity Scale and the Posttraumatic Symptom Scale-10. Posttraumatic stress disorder symptoms showed a strong association with fatigue in univariate (β = .41) and multivariate analyses (β = .33). Associations between psychosocial health variables, QoL, and fatigue were confirmed. However, PTSD symptoms showed the strongest association with fatigue in the analyses. Findings need to be replicated in other population samples and in clinical samples with PTSD and fatigue.