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Poole L, Frost R, Rowlands H, Black G. Experience of depression in older adults with and without a physical long-term condition: findings from a qualitative interview study. BMJ Open 2022; 12:e056566. [PMID: 35210344 PMCID: PMC8883274 DOI: 10.1136/bmjopen-2021-056566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To understand how the lived experience of depression differs among patients with a long-term condition (LTC) compared with those without an LTC, and how the experience differs across different types of LTC. DESIGN Face-to-face, semistructured interviews. SETTING Primary care; General Practitioner (GP) surgeries in and around North London. PARTICIPANTS 41 primary care patients with depression were recruited. Our sample comprised participants aged 55-75 years with depression only (n=12), depression and coronary heart disease (n=5), depression and type 2 diabetes (n=10) and depression and arthritis (n=14). RESULTS Interviews were conducted, audio recorded, transcribed and analysed using thematic analysis. The results revealed that the cardinal diagnostic symptoms of depression (anhedonia, sadness) were experienced by all our participants regardless of LTC. However, the LTC did interact with depression by compounding somatic, cognitive and emotional symptoms, increasing disability and reducing independence, and hindering attempts at coping with mental illness. Our findings demonstrate common experiences across patients as well as key differences based on LTC. CONCLUSIONS We suggest four key implications for future care practices of these patients: (1) not all participants with depression and LTC view their mental and physical health as interconnected; there should be allowances in care plans for separate treatment pathways; (2) key features of depression that affect LTC management are social withdrawal and lack of motivation to self-manage or access healthcare; (3) key features of LTCs that worsen depression are pain, the unpredictability of future health and progressive disability; (4) positive self-management of LTC could improve self-efficacy and therefore mood, and should be encouraged.
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Affiliation(s)
- Lydia Poole
- Institute of Health Informatics, UCL, London, UK
| | - Rachael Frost
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Hannah Rowlands
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Georgia Black
- Applied Health Research, University College London, London, UK
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Tarabeih N, Kalinkovich A, Shalata A, Cherny SS, Livshits G. Deciphering the Causal Relationships Between Low Back Pain Complications, Metabolic Factors, and Comorbidities. J Pain Res 2022; 15:215-227. [PMID: 35125889 PMCID: PMC8809521 DOI: 10.2147/jpr.s349251] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/23/2021] [Indexed: 01/09/2023] Open
Affiliation(s)
- Nader Tarabeih
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Maale HaCarmel Mental Health Center, Affiliated to Rappaport Faculty of Medicine Technion, Israel Institute of Technology, Haifa, Israel
| | - Alexander Kalinkovich
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adel Shalata
- The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Stacey S Cherny
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gregory Livshits
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Correspondence: Gregory Livshits, Department of Morphological Studies, Adelson School of Medicine, Ariel University, Ariel, 40700, Israel, Tel +972-3-6409494, Fax +972-3-6408287, Email
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Seecheran N, Jagdeo CL, Seecheran R, Seecheran V, Persad S, Peram L, Evans M, Edwards J, Thackoorcharan S, Davis B, Davis S, Dawkins B, Dayaram A, De Freitas M, Deonarinesingh T, Dhanai J, Didier C, Motilal S, Baboolal N. Screening for depressive symptoms in cardiovascular patients at a tertiary centre in Trinidad and Tobago: investigation of correlates in the SAD CAT study. BMC Psychiatry 2020; 20:498. [PMID: 33032571 PMCID: PMC7545556 DOI: 10.1186/s12888-020-02909-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study aimed to screen cardiovascular patients for depressive symptoms at a tertiary centre in Trinidad and Tobago; and to determine any significant associations amongst patients' demographics, comorbidities, and cardiovascular medications with depressive symptoms. METHODS In this observational, cross-sectional study, patients (n = 1203) were randomly selected from the cardiology outpatient clinics at the Eric Williams Medical Sciences Complex. After meeting selection criteria, informed consent was obtained, and patients were administered a case report form, which included the Patient Health Questionnaire-9 (PHQ-9). Descriptive analyses included frequency, percentage and summary statistics. Inferential analyses included 95% confidence intervals (CIs), independent sample t-test, Fisher's exact test, Chi-square test, and multivariate logistic regression. RESULTS The study had a 96% respondent rate, whereby the average age was 62 years old. Slightly less than half were male, and 52.5% were female. Over 90 % of the sample had cardiovascular disease (CVD). One-quarter of the sample had a PHQ-9 score of ≥10, with almost one-fifth having no depressive symptoms. Females, lower levels of education and income were all found to be statistically significant at risk for depressive symptoms (all p-values < 0.001). Comorbidities associated with depressive symptoms included hypertension, prior cerebrovascular events, chronic kidney disease, and chronic obstructive pulmonary disease with odds ratios (ORs) and 95% confidence intervals (CIs) of OR 1.988 (CI 1.414-2.797), OR 1.847 (CI 1.251-2.728), OR 1.872 (CI 1.207-2.902) and OR 1.703 (CI 1.009-2.876) respectively. Only the cardiovascular medication of ticagrelor was found to be significantly associated with depressive symptoms (p-value < 0.001). CONCLUSIONS Twenty-five percent of screened cardiovascular patients displayed significant depressive symptoms with a PHQ-9 ≥ 10. This study also highlights the importance of implementing a multidisciplinary approach to managing cardiovascular disease and screening for depressive symptoms in this subpopulation. Further studies are required to validate these findings. TRIAL REGISTRATION ClinicalTrials.gov number, NCT03863262 . This trial was retrospectively registered on 20th February 2019.
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Affiliation(s)
- Naveen Seecheran
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI, Trinidad and Tobago.
| | - Cathy-Lee Jagdeo
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Rajeev Seecheran
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Valmiki Seecheran
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Sangeeta Persad
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Lakshmipatty Peram
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Matthew Evans
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Justine Edwards
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Sheri Thackoorcharan
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Britney Davis
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Shari Davis
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Barbrianna Dawkins
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Anisha Dayaram
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Michelle De Freitas
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Tsarina Deonarinesingh
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Jiovanna Dhanai
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Cherelle Didier
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Shastri Motilal
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
| | - Nelleen Baboolal
- grid.430529.9Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, 2nd Floor, Building #67, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, St. Augustine, WI Trinidad and Tobago
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