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Shalaeva E, Bano A, Kasimov U, Atakov S, Mirakhmedova K, Dadabaeva N, Laimer M, Saner H. Depression and anxiety symptoms are underestimated risk factors for postoperative prognosis in patients with Type 2 diabetes and peripheral artery disease undergoing partial foot amputation: Results from a prospective cohort study. J Psychosom Res 2024; 183:111824. [PMID: 38865804 DOI: 10.1016/j.jpsychores.2024.111824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence and impact of depression and anxiety symptoms on post-operative prognosis and 1-year all-cause mortality in a large unique cohort of patients with Type 2 diabetes (T2D) and peripheral artery disease (PAD) after partial foot amputation (PFA). METHODS Prospective cohort study with 1-year follow-up of 785 consecutive patients (mean age 60.9 ± 9.1 years; 64.1% males) with T2D and PAD after PFA. Depressive symptoms were assessed by Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms by Hamilton Anxiety Rating Scale (HARS). We used multivariable Cox proportional hazard models to examine the association of depression and anxiety with all-cause mortality. RESULTS One-year all-cause mortality was 16.9% (n = 133). 331 (42.1%) patients had PHQ-9 score ≥ 10 indicating major depressive disorder. After adjusting for confounders, PHQ-9 score ≥ 10 was associated with an increased risk of 1-year all-cause mortality (HR = 1.68 (95%CI[1.16-2.44], p = 0.006). Depression dimensions of negative self-feeling and suicidal ideations were independently associated with 1-year mortality (HR = 1.26 (95%CI[1.24-1.55], p = 0.029 and HR = 2.37 (95%CI[1.89-2.96], p < 0.001, respectively). Compared to no depression, severe depressive symptoms (cut-off≥20) were associated with increased all-cause mortality (HR = 3.9 (95%CI [1.48-10.29], p = 0.006). Compared to no anxiety, severe anxiety symptoms (cut-off>30) were associated with increased 1-year mortality (HR = 2.25(95%CI [1.26-4.05], p = 0.006). CONCLUSION Depressive symptoms and severe anxiety have shown independently increased risk of 1-year all-cause mortality in patients with T2D and PAD requiring PFA. Our results indicate that screening for anxiety and depression should be considered under these circumstances to identify patients at increased risk to allow appropriate intervention.
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Affiliation(s)
- Evgeniya Shalaeva
- Graduate School for Health Sciences, University of Bern, Hochschulstrasse 4, 3012 Bern, Switzerland; School of Medicine, Central Asian University, 264, Milliy bog St, Mirzo Ulugbek dist, Tashkent 111221, Uzbekistan; Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan.
| | - Arjola Bano
- Institute for Social and Preventive Medicine, University of Bern, Hochschulstrasse 4, 3012 Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, University Hospital Bern: Inselspital, 3010 Bern, Switzerland.
| | - Ulugbek Kasimov
- Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan
| | - Sarvar Atakov
- Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan
| | | | - Nailya Dadabaeva
- Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan
| | - Markus Laimer
- Clinic for Diabetology, Endocrinology, Nutrition and Metabolism, University Hospital Bern: Inselspital, 3010 Bern, Switzerland.
| | - Hugo Saner
- Institute for Social and Preventive Medicine, University of Bern, Hochschulstrasse 4, 3012 Bern, Switzerland.
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Bouchard K, Gareau A, Sztajerowska K, Greenman PS, Lalande K, Tulloch H. Better together: Relationship quality and mental health among cardiac patients and spouses. FAMILY PROCESS 2023; 62:1624-1639. [PMID: 36404415 DOI: 10.1111/famp.12836] [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: 07/05/2021] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Reductions in marital relationship quality are pervasive post-cardiac event. It is not yet understood how relationship quality is linked to mental health outcomes in couples where one member has established cardiovascular disease (CVD) and the interdependence within dyads is seldom measured. This research is required as psychological distress has been independently linked to CVD incidence, morbidity, and mortality. This study assessed associations of relationship quality with depression and anxiety among patients with CVD and their spouses. Participants completed questionnaires measuring four dimensions of relationship quality and mental health. Data were analyzed using an Actor-Partner Interdependence Model with hierarchical moderation analyses. 181 dyads (N = 362 participants) comprised the study sample. Most patients had coronary artery disease (66.3%) and 25.9% were female. Patients reported higher relationship satisfaction and fewer anxiety symptoms than did spouses. Patients and spouses with high dyadic consensus and affectional expression reported fewer mental health symptoms, but only when the other partner also perceived high levels of consensus and affectional expression in the relationship. Patients and spouses with low dyadic cohesion reported worse mental health symptoms (actor effects), but those effects were no longer significant when both the patient and the spouse appraised the relationship as having high levels of dyadic cohesion. Taken together, relationship quality is linked to mental health symptoms in patients with CVD and their spouses. Longitudinal and experimental studies are now warranted to further substantiate the cross-sectional findings of this study.
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Affiliation(s)
- Karen Bouchard
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Paul S Greenman
- Université du Québec en Outaouais, Gatineau, Québec City, Canada
| | | | - Heather Tulloch
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
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von Below A, Hällström T, Sundh V, Björkelund C, Hange D. Association between anxiety and depression and all-cause mortality: a 50-year follow-up of the Population Study of Women in Gothenburg, Sweden. BMJ Open 2023; 13:e075471. [PMID: 37989363 PMCID: PMC10668159 DOI: 10.1136/bmjopen-2023-075471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES This study aimed to examine the association between anxiety disorders and/or major depression disorder (ADs/MDD) and all-cause mortality in a 50-year perspective and to examine specific risk and health factors that may influence such an association. DESIGN Observational population study, 1968-2019. SETTING The Population Study of Women in Gothenburg, Sweden (PSWG). PARTICIPANTS In 1968-1969, 899 (out of 1462) women from PSWG were selected according to date of birth for a psychiatric investigation, including diagnostic evaluation. Eight hundred (89%) were accepted. Twenty-two women were excluded. Of the 778 included, 135 participants (17.4 %) had solely ADs, 32 (4.1%) had solely MDD and 25 (3.2%) had comorbid AD/MDD. PRIMARY AND SECONDARY OUTCOME MEASURES Associations between ADs, MDD, comorbid AD/MDD and all-cause mortality with adjustments for potential confounding factors. Differences between the groups concerning health and risk factors and their association with mortality. RESULTS In a fully adjusted model, ADs were non-significantly associated with all-cause mortality (HR 1.17, 95% CI 0.98 to 1.41). When examining age during risk time as separate intervals, a significant association between mortality and AD was seen in the group of participants who died at the age of 65-80 years (HR 1.70, 95% CI 1.26 to 2.29). In the younger or older age interval, the association did not reach significance at the 95% level of confidence. Among confounding factors, smoking and physical activity were the strongest contributors. The association between smoking and mortality tended to be further increased in the group with ADs versus the group without such disorders (HR 2.10, 95% CI 1.60 to 2.75 and HR 1.82, 95% CI 1.56 to 2.12, respectively). CONCLUSIONS This study suggests potential links between ADs, age and mortality among women with 50 years of follow-up, but does not provide definitive conclusions due to the borderline significance of the results.
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Affiliation(s)
- Amanda von Below
- Primary Health Care/School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Tore Hällström
- Department of Psychiatry and Neurochemistry, Gothenburg University, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
| | - Valter Sundh
- Primary Health Care/School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Cecilia Björkelund
- Primary Health Care/School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Dominique Hange
- Primary Health Care/School of Public Health and Community Medicine, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
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Sarkar D, Tandon M, Pal DK. Comprehensive study of anxiety and depression in females with urinary incontinence. Urologia 2023; 90:757-762. [PMID: 37555561 DOI: 10.1177/03915603231191837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
BACKGROUND Anxiety and depression are commonly seen with urinary incontinence (UI) and its association is strongest for urgency and mixed UI. It affects the quality of life and functional status. AIMS To assess the prevalence and severity of anxiety and depression in SUI (Stress urinary incontinence) and UUI/MUI (Urge or mixed urinary incontinence), to assess the severity of SUI and UUI/MUI and its association with anxiety and depression and to identify various factors associated with anxiety and depression. MATERIALS AND METHODS An observational study using various tools as history regarding urinary incontinence, history of other prior events which can lead to anxiety or depression, age, educational level, BMI (Body mass index), HADS scale (Hospital anxiety and depression scale) for anxiety and depression and ICIQ-UI-SF score (International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form). RESULTS The Prevalence of anxiety and depression in UUI/MUI was higher. More women were overweight (BMI > 25) in the UUI/MUI group. Higher prevalence of anxiety and depression in the very severe urinary incontinence group. No association of the level of education with anxiety and depression in women with urinary incontinence. CONCLUSION Anxiety and depression are more in UUI/MUI patients compared to SUI. In obese ladies, UUI is more prevalent compared to SUI. Anxiety and depression are more with increasing severity of incontinence. Anxiety and depression have no association with the educational status of the patients.
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Affiliation(s)
- Debansu Sarkar
- Department of Urology, IPGME&R and SSKMH, Kolkata, West Bengal, India
| | - Mrinal Tandon
- Department of Urology, IPGME&R and SSKMH, Kolkata, West Bengal, India
| | - Dilip Kumar Pal
- Department of Urology, IPGME&R and SSKMH, Kolkata, West Bengal, India
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Padhy M, Hariharan M, Pandey P, Maryam R, Anand V. Chronic illness adjustment scale (CIAS): Development and validation. Chronic Illn 2023:17423953231205911. [PMID: 37801510 DOI: 10.1177/17423953231205911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
OBJECTIVES The objectives of this study were to (i) develop a self-report instrument to measure adjustment to chronic illness, (ii) evaluate its core structure and (iii) study various psychometric properties in the development of this instrument. METHOD The entire process of developing and validating the instrument is conducted in different phases: item writing and content validation; exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to extract dimensions of the instrument; reliability and validity testing. A total of 1095 participants were included in the study. The EFA was run using IBM SPSS 23 and CFA was done by AMOS 21. RESULTS The Cronbach alpha of the chronic illness adjustment scale was found to be .70. The instrument correlates positively with illness perception and well-being which supports the notion that the chronic illness adjustment scale has satisfactory convergent validity. DISCUSSION The multifaceted nature of the chronic illness adjustment scale can serve as a global indicator of adjustment to chronic illness, allowing various interventions to flow toward the healthcare arena.
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Affiliation(s)
| | | | | | - Riswana Maryam
- Centre for Health Psychology, School of Medical Science, University of Hyderabad, Hyderabad, India
| | - Varsha Anand
- Centre for Health Psychology, School of Medical Science, University of Hyderabad, Hyderabad, India
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Abu-Zaid A, Gari A, Alsharif SA, Alshahrani MS, Khadawardi K, Ahmed AM, Baradwan A, Bukhari IA, Alyousef A, Alharbi FS, Saleh SAK, Adly HM, Abuzaid M, Baradwan S. Exploring the impact of chronic medical conditions on maternal mental health: A National Inpatient Sample analysis. Eur J Obstet Gynecol Reprod Biol 2023; 289:42-47. [PMID: 37632994 DOI: 10.1016/j.ejogrb.2023.08.011] [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: 04/09/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Pregnancy and postpartum period are associated with stress and pain. Chronic medical conditions can aggravate depressive and psychotic mental illnesses in the peripartum period. AIM The study aimed to investigate the association between different chronic medical conditions and mental illnesses during pregnancy and the postpartum period using the National Inpatient Sample (NIS). METHODS Pregnant women or women in the postpartum period were retrieved from the NIS 2016-2019 database using the International Classification of Diseases (ICD)-10 and set as our targeted population. Postpartum depression, puerperal psychosis, and mental illnesses related to pregnancy were also retrieved as our outcomes of interest. STATA 15 was used to analyze the data and investigate the relationship between chronic medical conditions and pregnancy-related mental illnesses. RESULTS 2,854,149 admissions were retrieved from the database with a mean age of 29 ± 6 years old. Univariate and multivariate analyses showed a significant association between chronic medical conditions and postpartum depression, puerperal psychosis, and other mental illnesses. On univariate analysis, heart failure (odds ratio [OR] = 13.9; 95% confidence interval [CI] = 3.5-55.88; P < 0.001), alcohol misuse (OR = 5.3; 95% CI = 1.7-16.4; P = 0.004), and migraine (OR = 3.9; 95% CI = 2.8-5.3; P < 0.001) showed high association with postpartum depression. Epilepsy (OR = 54.37; 95% CI = 7.4-399.34; P < 0.001), systemic lupus erythematosus (OR = 24.66; 95% CI = 3.36-181.1; P = 0.002), and heart diseases (OR = 15.26; 95% CI = 3.6-64.5; P < 0.001) showed the highest association with puerperium psychosis. Alcohol misuse (OR = 8.21; 95% CI = 7.4-9.12; P < 0.001), osteoarthritis (OR = 6.02; 95% CI = 5.41-6.70; P < 0.001), and migraine (OR = 5.71; 95% CI = 5.56-5.86; P < 0.001) showed the highest association with other mental illnesses during pregnancy and the postpartum period. CONCLUSION Heart diseases, alcohol misuse, migraine, systemic lupus erythematosus, and epilepsy were the most important chronic medical conditions associated with mental diseases during pregnancy and the postpartum period. This investigation recommends integrating management of chronic diseases and mental health care together. Specifically, screening for mental illnesses should be a routine part of care for patients with chronic medical conditions, especially during pregnancy and early postpartum. By identifying and addressing mental health issues early on, healthcare providers can improve the overall health and well-being of these patients, ultimately leading to better maternal and fetal outcomes.
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Affiliation(s)
- Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Abdulrahim Gari
- Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Saud Abdullah Alsharif
- Department of Obstetrics and Gynecology, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Majed Saeed Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Khalid Khadawardi
- Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Albagir Mahdi Ahmed
- Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Afnan Baradwan
- Department of Obstetrics and Gynecology, Mediclinic Almurjan Hospital, Jeddah, Saudi Arabia
| | - Ibtihal Abdulaziz Bukhari
- Department of Obstetrics and Gynecology, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | | | - Saleh A K Saleh
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba M Adly
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohammed Abuzaid
- Department of Obstetrics and Gynecology, Muhayil General Hospital, Muhayil, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
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Zhang Y, Chen J, Tang R, Deng J, Guo H, Wu X, Xu Q. Combined influence of depression and low-grade inflammation on mortality in peritoneal dialysis patients. BMC Nephrol 2023; 24:241. [PMID: 37587401 PMCID: PMC10433560 DOI: 10.1186/s12882-023-03291-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The relationship between depression and systemic inflammation as risk factors for mortality is not well understood and requires further investigation. METHODS Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) between July 01, 2015 to December 31, 2019, were analyzed and followed up until December 31, 2020. According to their status of depression (PHQ-9 score ≥ 5) and low-grade inflammation (hs-CRP level ≥ 3 mg/L), patients were divided into four groups (G1, without depression, nor inflammation; G2, with depression, without inflammation; G3, with inflammation, without depression; G4, with both depression and inflammation). We performed Kaplan-Meier and multivariable Cox proportional analyses of mortality for the combined influence of depression and systemic inflammation in this cohort. RESULTS During the mean follow-up of 36.3 ± 14.8 months, 73 deaths were recorded in 358 participants. Compared with patients in group G1, patients in group G2 and G3 carried 137% {hazard ratio (HR): 2.37, 95% confidence interval (CI): 1.06-5.23, p = 0.035} and 140% (HR: 2.40, 95% CI: 1.01-5.69, p = 0.048) higher risk of mortality. Patients in group G4 (with both depression and inflammation) showed the highest risks of all-cause mortality with 276% higher mortality risk (HR: 3.76, 95% CI: 1.73-8.15, p = 0.001), respectively. CONCLUSION The combined of depression and inflammation is associated with all-cause mortality in peritoneal dialysis patients, suggesting a need for further study of depression and low-grade inflammation in PD patients and potential relationship between them.
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Affiliation(s)
- Yanxia Zhang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jiexin Chen
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Ruiying Tang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jihong Deng
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Huankai Guo
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Xianfeng Wu
- Department of Nephrology, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Qingdong Xu
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China.
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Crowther G, Ninan S. Managing depression in frail older people; too little too late or pathologising loss? Future Healthc J 2023; 10:107-111. [PMID: 37786635 PMCID: PMC10540808 DOI: 10.7861/fhj.2023-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
It is testament to the advances of modern medicine that we have a population with more older people than ever before. While we are increasingly adept at managing their physical comorbidities, we have made relatively little progress in addressing the psychological impact of ageing. In this article we consider the prevalence and complex aetiology of depression in older people who often have to deal with profound loss, while simultaneously managing multiple comorbidities. We consider the challenges of diagnosing depression faced by healthcare professionals including access to resources and training, and what differentiates depression from socially appropriate low mood. Finally, we discuss treatment options and the difficulties that clinicians face when they have only limited resources and skills available, but a desire to help. We consider the role for antidepressants, and when not to prescribe, before addressing the challenges of providing talking therapies and social interventions.
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Affiliation(s)
- George Crowther
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK; consultant geriatrician, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sean Ninan
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK; consultant geriatrician, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Bitsika V, Elmose M, Mertika A, Sharpley CF, Ladopoulou K, Kampakos C, Syriopoulou-Delli CK. Occurrence and correlates of anxiety and depression in carers of autistic children across three nations. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2023; 69:362-370. [PMID: 37213595 PMCID: PMC10197999 DOI: 10.1080/20473869.2023.2196469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/23/2023]
Abstract
Purpose Caring for an autistic child is associated with elevated stress, anxiety and depression. Although some data suggest that 'child' or 'carer' factors may moderate the severity of carer distress, relatively few international comparisons have been made, limiting the generalizability of previous findings. This study aimed to address this issue. Method A survey-based comparison was made of carers from three nations (Australia, Denmark, Greece), and the effects of demographic, child, and carer variables upon carer anxiety and depression were investigated. Results Only limited cross-nation consistency was found for nation, child, or carer variables and their effects upon carer anxiety or depression. Conclusion The application of universal treatment models for carer anxiety and depression may be of differing value across nations.
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Affiliation(s)
- Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, Australia
| | - Mette Elmose
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Antigoni Mertika
- Specialized Unit for Autistic Children, General Children’s Hospital “Pan & Aglaia Kyriakou”, Athens, Greece
| | | | - Konstantia Ladopoulou
- Athens Child and Adolescent Mental Health Centre, General Children’s Hospital “Pan & Aglaia Kyriakou”, Athens, Greece
| | - Christos Kampakos
- Specialized Unit for Autistic Children, General Children’s Hospital “Pan & Aglaia Kyriakou”, Athens, Greece
| | - Christine K. Syriopoulou-Delli
- Laboratory of Autism-Developmental Spectrum Disorders and Behavior Difficulties, Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
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Gutiérrez F, Valdesoiro F. The evolution of personality disorders: A review of proposals. Front Psychiatry 2023; 14:1110420. [PMID: 36793943 PMCID: PMC9922784 DOI: 10.3389/fpsyt.2023.1110420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/12/2023] [Indexed: 02/02/2023] Open
Abstract
Personality disorders (PDs) are currently considered dysfunctions. However, personality differences are older than humanity and are ubiquitous in nature, from insects to higher primates. This suggests that a number of evolutionary mechanisms-other than dysfunctions-may be able to maintain stable behavioral variation in the gene pool. First of all, apparently maladaptive traits may actually improve fitness by enabling better survival or successful mating or reproduction, as exemplified by neuroticism, psychopathy, and narcissism. Furthermore, some PDs may harm important biological goals while facilitating others, or may be globally beneficial or detrimental depending on environmental circumstances or body condition. Alternatively, certain traits may form part of life history strategies: Coordinated suites of morphological, physiological and behavioral characters that optimize fitness through alternative routes and respond to selection as a whole. Still others may be vestigial adaptations that are no longer beneficial in present times. Finally, variation may be adaptative in and by itself, as it reduces competition for finite resources. These and other evolutionary mechanisms are reviewed and illustrated through human and non-human examples. Evolutionary theory is the best-substantiated explanatory framework across the life sciences, and may shed light on the question of why harmful personalities exist at all.
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Affiliation(s)
- Fernando Gutiérrez
- Hospital Clínic de Barcelona, Institute of Neuroscience, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Effects of predictable behavioral patterns on anxiety dynamics. Sci Rep 2022; 12:19240. [PMID: 36357536 PMCID: PMC9649661 DOI: 10.1038/s41598-022-23885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
People face stressors that are beyond their control and that maladaptively perpetuate anxiety. In these contexts, rituals emerge as a natural coping strategy helping decrease excessive anxiety. However, mechanisms facilitating these purported effects have rarely been studied. We hypothesized that repetitive and rigid ritual sequences help the human cognitive-behavioral system to return to low-entropy states and assuage anxiety. This study reports a pre-registered test of this hypothesis using a Czech student sample (n = 268). Participants were exposed to an anxiety induction and then randomly assigned to perform one of three actions: ritualized, control, and neutral (no-activity). We assessed the effects of this manipulation on cognitive and physiological anxiety, finding that ritualized action positively affected anxiety decrease, but this decrease was only slightly larger than in the other two conditions. Nevertheless, the between-condition differences in the reduction of physiological anxiety were well-estimated in participants more susceptible to anxiety induction.
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Effects of an internet-delivered insomnia intervention for older adults: A secondary analysis on symptoms of depression and anxiety. J Behav Med 2022; 45:728-738. [PMID: 35932397 PMCID: PMC9362578 DOI: 10.1007/s10865-022-00353-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
Objective To test whether an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) program for older adults attenuates symptoms of depression and anxiety. Methods Adults aged ≥ 55 with insomnia were randomized to SHUTi-OASIS (Sleep Healthy Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness; N = 207) or Patient Education (PE; N = 104). Depression and anxiety were assessed (HADS-D and HADS-A, respectively) at baseline, post-assessment, and 6- and 12-month follow-ups. Results Multilevel modeling of HADS-D showed a condition by time interaction (F[3,779] = 3.23, p = .02): SHUTi-OASIS participants reported lower symptoms than PE at post-assessment. There was no such interaction effect for HADS-A (F[3,779] = 2.12, p = .10). Generalized linear modeling showed no moderation of effects by baseline symptom severity. Conclusions Participants randomized to Internet-delivered CBT-I showed stable depression and anxiety across time, while control participants’ depressive symptoms briefly increased. CBT-I may help prevent development or worsening of psychological distress among older adults with insomnia. TRIAL REGISTRATION [Registered at ClinicalTrials.gov; identifier removed for anonymity]
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13
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Finlay S, Rudd D, McDermott B, Sarnyai Z. Allostatic load and systemic comorbidities in psychiatric disorders. Psychoneuroendocrinology 2022; 140:105726. [PMID: 35339811 DOI: 10.1016/j.psyneuen.2022.105726] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/16/2022] [Accepted: 03/11/2022] [Indexed: 12/11/2022]
Abstract
Psychiatric disorders are complex, disabling, and chronic conditions that are often accompanied by one or more systemic medical comorbidities. In this narrative review, we provide an overview of the allostatic load concept, which represents a multi-system dysregulation in response to chronic stress and link it to systemic comorbidities associated with psychiatric disorders. We synthesized published literature gathered using Medline (Ovid), Scopus, and PsychInfo and identified a high frequency of systemic comorbidities for both mood and psychotic disorders. The identified cardiovascular, metabolic, and immune comorbidities may represent the result of chronic wear and tear caused by a complex interaction between chronic psychosocial stress, health risk behaviors, pharmacological stressors, and the biological systems involved in the development of allostatic load. These findings support the notion that psychiatric disorders should be re-conceptualized as systemic disorders, affecting the brain and systemic biological pathways in an interconnected fashion to result in systemic comorbidities. We suggest that the multi-systemic and multi-dimensional approach that drives the allostatic load concept should be considered for understanding comorbidities in vulnerable psychiatric patients.
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Affiliation(s)
- Sabine Finlay
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Therapeutics, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland, Australia
| | - Donna Rudd
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Therapeutics, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland, Australia
| | - Brett McDermott
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Zoltán Sarnyai
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Therapeutics, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland, Australia.
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14
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Burstein O, Shamir A, Abramovitz N, Doron R. Patients' attitudes toward conventional and herbal treatments for depression and anxiety: A cross-sectional Israeli survey. Int J Soc Psychiatry 2022; 68:589-599. [PMID: 33530827 PMCID: PMC8938990 DOI: 10.1177/0020764021992385] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND As many patients view conventional antidepressants and anxiolytics negatively, it is not surprising that the willingness to apply these treatments is far from ideal, thus posing a critical barrier in promoting an effective and durable treatment. AIM The present study aimed to explore patients' attitudes toward conventional and herbal treatments for depression and anxiety, while considering cultural and demographic factors, to further elucidate the antecedes that putatively determine the treatment's outcome. METHODS During June 2017, a cross-sectional survey was conducted using stratified sampling from a large-scale Israeli volunteer online panel. The final sample included 591 Jewish Israeli adults that reported they were suffering from depression or anxiety. RESULTS A heterogeneous range of attitudes toward treatment was found: for example, a large group of patients did not utilize prescription medications (39%), a professional consultation (12.9%), or any form of treatment (17.4%). Interestingly, these patients were significantly more likely to support naturally-derived treatments and were less concerned with scientific proof. Further, adverse effects were demonstrated as a prominent factor in the choice of treatment. A higher incidence of adverse effects was associated with an increased willingness to consider an alternative herbal treatment. Noteworthy attitudes were found in orthodox-Jewish individuals, who showed similar consultation rates, but utilized more psychological, rather than pharmacological treatments. CONCLUSIONS It is proposed that patients' perspectives and cultural backgrounds are needed to be taken into consideration during the clinical assessment and choice of treatment. The findings imply that a particular emphasis should be placed on patients that discard conventional pharmacological options and on distinct cultural aspects. Several recommendations for revising the current policy are advocated to promote more culturally-informed and patient-oriented care.
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Affiliation(s)
- Or Burstein
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Alon Shamir
- Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.,Mazor Mental Health Center, Akko, Israel
| | | | - Ravid Doron
- School of Behavioral Science, The Academic College Tel-Aviv-Yaffo, Yaffo, Israel.,Department of Education and Psychology, The Open University, Raanana, Israel
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15
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Siddiqui TG, Bjelkarøy MT, Cheng S, Kristoffersen ES, Grambaite R, Lundqvist C. The effect of cognitive function and central nervous system depressant use on mortality-A prospective observational study of previously hospitalised older patients. PLoS One 2022; 17:e0263024. [PMID: 35239678 PMCID: PMC8893618 DOI: 10.1371/journal.pone.0263024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Older patients are often users of prolonged Central Nervous System Depressants (CNSD) (Z-hypnotics, benzodiazepines and opioids), which may be associated with reduced cognition. The long-term effects of CNSD use and reduced cognitive function in older patients are unclear. The aim of this study was to examine whether cognitive function and CNSD use at baseline hospitalisation were associated with all-cause mortality two years after discharge. METHODS We conducted a prospective observational study, including baseline data (2017-2018) from previously hospitalised older patients (65-90 years), assessing all-cause mortality two years after discharge. We used logistic regression to assess the primary outcome, all-cause mortality two years after baseline hospitalisation. The primary predictors were cognitive function measured by The Mini Mental State Examination (MMSE) and prolonged CNSD use (continuous use ≥ 4 weeks). Adjustment variables: age, gender, education, the Hospital Anxiety and Depression Scale (HADS) and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G), using receiver operating characteristics (ROC) to compare the predictive power of the models. In a sub-analysis we used, the Neurobehavioural Cognitive State Examination (Cognistat) and the Clock Drawing Test. RESULTS Two years after discharge, out of 246 baseline patients, 43 were deceased at follow-up, among these 27 (63%) were CNSD users, and 16 (36%) were non-users at baseline, (p = 0.002). In the multivariable models cognitive function (MMSE score) was a predictor of mortality (OR 0.81 (95% CI 0.69; 0.96), p = 0.014). CNSD use was associated with mortality (OR 2.71 (95% CI 1.06; 6.95), p = 0.038), with ROC AUC: 0.74-0.77 for these models. Results using Cognistat supported the findings. The Clock Drawing Test was not significant predictor of mortality. CONCLUSION Two years after discharge from the hospital, older patients with reduced cognitive function and CNSD use during hospital stay had higher mortality. This underlines that inappropriate (prolonged and concurrent) use of CNSDs should be avoided by older patients, particularly in patients with reduced cognitive function. TRIAL REGISTRATION NCT03162081, 22 May 2017.
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Affiliation(s)
- Tahreem Ghazal Siddiqui
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maria Torheim Bjelkarøy
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Socheat Cheng
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Espen Saxhaug Kristoffersen
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ramune Grambaite
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christofer Lundqvist
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
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16
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Vikjord SAA, Brumpton BM, Mai XM, Romundstad S, Langhammer A, Vanfleteren L. The HUNT study: Association of comorbidity clusters with long-term survival and incidence of exacerbation in a population-based Norwegian COPD cohort. Respirology 2022; 27:277-285. [PMID: 35144315 DOI: 10.1111/resp.14222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/28/2021] [Accepted: 01/16/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease often viewed as part of a multimorbidity complex. There is a need for better phenotyping of the disease, characterization of its interplay with other comorbidities and its association with long-term outcomes. This study aims to examine how clusters of comorbidities are associated with severe exacerbations and mortality in COPD. METHODS Participants with potential COPD were recruited from the second (1995-1997) and third (2006-2008) survey of the HUNT Study and followed up until April 2020. Ten objectively identified comorbidities were clustered using self-organizing maps. Severe COPD exacerbations requiring hospitalization were assessed using hospital data. All-cause mortality was collected from national registries. Multivariable Cox regression was used to calculate hazard ratios (HRs) with 95% CIs for the association between comorbidity clusters and all-cause mortality. Poisson regression was used to calculate incidence rate ratios (IRRs) with 95% CI for the cumulative number of severe exacerbations for each cluster. RESULTS Five distinct clusters were identified, including 'less comorbidity', 'psychological', 'cardiovascular', 'metabolic' and 'cachectic' clusters. Using the less comorbidity cluster as reference, the psychological and cachectic clusters were associated with all-cause mortality (HR 1.23 [1.04-1.45] and HR 1.83 [1.52-2.20], adjusted for age and sex). The same clusters also had increased risk of exacerbations (unadjusted IRR of 1.24 [95% CI 1.04-1.48] and 1.50 [95% CI 1.23-1.83], respectively). CONCLUSION During 25 years of follow-up, individuals in the psychological and cachectic clusters had increased mortality. Furthermore, these clusters were associated with increased risk of severe COPD exacerbations.
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Affiliation(s)
- Sigrid Anna Aalberg Vikjord
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Levanger, Norway.,Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ben Michael Brumpton
- Clinic of Thoracic and Occupational Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Solfrid Romundstad
- Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Levanger, Norway.,Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Lowie Vanfleteren
- COPD Centre, Sahlgrenska University, Hospital and Institute of Medicine, Gothenburg University, Gothenburg, Sweden
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17
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Nyrønning LÅ, Hultgren R, Albrektsen G, Mattsson E, Stenman M. Prognostic impact of depressive symptoms on all-cause mortality in individuals with abdominal aortic aneurysm and in the general population: a population-based prospective HUNT study in Norway. BMJ Open 2022; 12:e049055. [PMID: 35039280 PMCID: PMC8765023 DOI: 10.1136/bmjopen-2021-049055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Abdominal aortic aneurysm (AAA) is a potentially life-threatening disease but the high mortality rate is linked to high age and comorbidity pattern. Depression is associated with increased mortality in the general population and individuals with cardiovascular diseases, but this is sparsely studied for AAA. The aim was to examine the prognostic impact of depressive symptoms on all-cause mortality in individuals with AAA and compare with findings in a general population of the same age and risk profile. METHODS Population-based prospective study including 36 616 participants (52.1% women) from the Trøndelag Health Study in Norway. A total of 9428 individuals died during a median follow-up of 10 years at ages 60-90 years. Depressive symptoms were defined by a Hospital Anxiety and Depression Scale-Depression score ≥8. Data on AAA diagnoses and death were obtained from medical records and national registers. HRs from Cox proportional hazard regression models are reported. RESULTS A total of 4832 (13.2%) individuals reported depressive symptoms, whereas 583 (1.6%) AAAs were identified. The adjusted hazard of death was 2.66 times higher in persons with AAA compared with the general population (95% CI 2.39 to 2.97). Overall, there was no significant adverse effect of depressive symptoms in individuals with AAA (HR 1.15;95% CI 0.88 to 1.51), whereas an increased risk was seen in the general population (HR 1.23;95% CI 1.17 to 1.30). CONCLUSION The overall risk of death was considerably higher in individuals with AAA compared with a general population of the same age and risk profile. Depressive symptoms did not significantly influence the risk of death in the AAA group.
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Affiliation(s)
- Linn Å Nyrønning
- Department of Surgery, Vascular Surgery, St Olav University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway
| | - Rebecka Hultgren
- Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Grethe Albrektsen
- Department of Public Health and Nursing, NTNU, Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Erney Mattsson
- Department of Surgery, Vascular Surgery, St Olav University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway
| | - Malin Stenman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Perioperative Medicine and Intensive Care function, Karolinska University Hospital, Stockholm, Sweden
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18
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Hockey M, Rocks T, Ruusunen A, Jacka FN, Huang W, Liao B, Aune D, Wang Y, Nie J, O’Neil A. Psychological distress as a risk factor for all-cause, chronic disease- and suicide-specific mortality: a prospective analysis using data from the National Health Interview Survey. Soc Psychiatry Psychiatr Epidemiol 2022; 57:541-552. [PMID: 34363488 PMCID: PMC8346782 DOI: 10.1007/s00127-021-02116-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 06/02/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The risk psychological distress (PD) confers on mortality due to specific chronic diseases compared to suicide is unclear. Using the National Health Interview Survey (NHIS), we investigated the association between PD levels and risk of all-cause and chronic disease-specific mortality and compared the contribution of chronic disease-related mortality to that of suicide. METHODS Data from 195, 531 adults, who participated in the NHIS between 1997 and 2004, were linked to the National Death Index records through to 2006. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) across four levels of PD, measured using the Kessler-6 scale. Outcomes included all-cause mortality, and mortality due to all CVDs and subtypes, all cancers and subtypes, diabetes mellitus, alcoholic liver disease and suicide. RESULTS During a mean follow-up time of 5.9 years, 7665 deaths occurred. We found a dose-response association between levels of PD and all-cause mortality, with the adjusted HRs (95% CI) elevated for all levels of PD, when compared to asymptomatic levels: subclinical 1.10 (1.03-1.16), symptomatic 1.36 (1.26-1.46) and highly symptomatic 1.57 (1.37-1.81). A similar association was found for all CVDs and certain CVD subtypes, but not for cancers, cerebrovascular diseases diabetes mellitus. Excess mortality attributable to suicide and alcoholic liver disease was evident among those with levels of PD only. CONCLUSION PD symptoms, of all levels, were associated with an increased risk of all-cause and CVD-specific mortality while higher PD only was associated with suicide. These findings emphasise the need for lifestyle interventions targeted towards improving physical health disparities among those with PD.
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Affiliation(s)
- Meghan Hockey
- grid.1021.20000 0001 0526 7079IMPACT (The Institute for Mental and Physical Health and Clinical Translation), The Food and Mood Centre, Deakin University, Geelong, Australia
| | - Tetyana Rocks
- grid.1021.20000 0001 0526 7079IMPACT (The Institute for Mental and Physical Health and Clinical Translation), The Food and Mood Centre, Deakin University, Geelong, Australia
| | - Anu Ruusunen
- grid.1021.20000 0001 0526 7079IMPACT (The Institute for Mental and Physical Health and Clinical Translation), The Food and Mood Centre, Deakin University, Geelong, Australia ,grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland ,grid.410705.70000 0004 0628 207XDepartment of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Felice N. Jacka
- grid.1021.20000 0001 0526 7079IMPACT (The Institute for Mental and Physical Health and Clinical Translation), The Food and Mood Centre, Deakin University, Geelong, Australia
| | - Wentao Huang
- grid.411847.f0000 0004 1804 4300School of Nursing, Guangdong Pharmaceutical University, Haizhu District, Guangzhou, China
| | - Bing Liao
- grid.411847.f0000 0004 1804 4300School of Nursing, Guangdong Pharmaceutical University, Haizhu District, Guangzhou, China
| | - Dagfinn Aune
- grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK ,grid.510411.00000 0004 0578 6882Department of Nutrition, Bjørknes University College, Oslo, Norway ,grid.55325.340000 0004 0389 8485Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway ,grid.4714.60000 0004 1937 0626Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yafeng Wang
- grid.49470.3e0000 0001 2331 6153Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Jing Nie
- Department of Sociology, Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, 28 Xianning West Rd, Xi'an, 710049, Shaanxi, China.
| | - Adrienne O’Neil
- grid.1021.20000 0001 0526 7079IMPACT (The Institute for Mental and Physical Health and Clinical Translation), The Food and Mood Centre, Deakin University, Geelong, Australia
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19
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Salali GD, Uysal MS, Bevan A. Adaptive function and correlates of anxiety during a pandemic. Evol Med Public Health 2021; 9:393-405. [PMID: 34888056 PMCID: PMC8651168 DOI: 10.1093/emph/eoab037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 11/01/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Most studies to date have focused on the negative aspects of anxiety. Anxiety, however, is an evolved emotional response that can provide protection in the face of risk. Pandemics are characterized by increased mortality risk coupled with future uncertainties, which both cause heightened anxiety. Here, we examine the factors associated with anxiety levels and risk avoidance behaviours during the first wave of the COVID-19 pandemic. We asked how individual time perspectives (future-oriented consideration and attention to present moment experience) affect anxiety in uncertain times, and whether anxiety reduces mortality risk by promoting risk avoidance behaviour. METHODOLOGY We conducted an online survey in the UK (N = 1088) and Turkey (N = 3935) and measured participants' generalized and pandemic-related anxiety levels, future-oriented consideration, mindfulness, intolerance of uncertainty, risk perception and risk avoidance behaviours. RESULTS We found that people less tolerant of uncertainties had higher levels of pandemic anxiety. Those with higher pandemic anxiety exhibited risk avoidance behaviours more frequently. Mindfulness and increased financial satisfaction reduced pandemic anxiety. People in Turkey reported higher levels of generalized and pandemic anxiety and greater engagement in risk avoidance behaviours than people in the UK. CONCLUSIONS AND IMPLICATIONS Our study shows an elevated anxiety response can help mitigate infection risk during pandemics and emphasizes the importance of the underlying situation in understanding whether an anxiety response is adaptive or pathological. Maintaining a healthy level of anxiety can promote engagement in protective behaviours. Therapies addressing anxiety can focus on increasing tolerance to future uncertainties. LAY SUMMARY Anxiety is an emotional response triggered in the anticipation of a possible threat. We found that intolerance of uncertainty strongly predicted anxiety and that people with elevated anxiety levels engaged in protective behaviours more frequently during the COVID-19 pandemic, suggesting that anxiety can help mitigate mortality risk.
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Affiliation(s)
- Gul Deniz Salali
- Department of Anthropology, University College London, London WC1H 0BW, UK
| | - Mete Sefa Uysal
- Psychology Department, Dokuz Eylül University, Izmir, Turkey.,Department of Social Psychology, Friedrich-Schiller-Universität Jena, Jena, Germany
| | - Abi Bevan
- Department of Anthropology, University College London, London WC1H 0BW, UK
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21
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Explaining the association between frailty and mortality in older adults: The mediating role of lifestyle, social, psychological, cognitive, and physical factors. Prev Med Rep 2021; 24:101589. [PMID: 34976648 PMCID: PMC8683887 DOI: 10.1016/j.pmedr.2021.101589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/18/2021] [Accepted: 10/03/2021] [Indexed: 01/02/2023] Open
Abstract
Frailty in older adults is associated with adverse outcomes such as mortality. Not much is known about underlying pathways of the frailty-mortality association. We assessed the mediating role of a wide range of factors. In both men and women, only polypharmacy was identified as explanatory factor. Targeting polypharmacy in frail older adults could reduce their risk of mortality.
Frailty is associated with a higher risk of mortality, but not much is known about underlying pathways of the frailty-mortality association. In this study, we explore a wide range of possible mediators of the relation between frailty and mortality. Data were used from the Longitudinal Aging Study Amsterdam (LASA). We included 1477 older adults aged 65 years and over who participated in the study in 2008–2009 and linked their data to register data on mortality up to 2015. We examined a range of lifestyle, social, psychological, cognitive, and physical factors as potential mediators. All analyses were stratified by sex. We used causal mediation analyses to estimate the indirect effects in single-mediator analyses. Statistically significant mediators were then included in multiple-mediator analyses to examine their combined effect. The results showed that older men (OR = 2.79, 95% CI = 1.23;6.34) and women (OR = 2.31, 95% CI = 1.24;4.30) with frailty had higher odds of being deceased 6 years later compared to those without frailty. In men, polypharmacy (indirect effect OR = 1.21, 95% CI = 1.03;1.50) was a statistically significant mediator in this association. In women, polypharmacy, self-rated health, and multimorbidity were statistically significant mediators in the single-mediator models, but only the indirect effect of polypharmacy remained in the multiple-mediator model (OR = 1.16, 95% CI = 1.03;1.38). In conclusion, of many factors that were considered, we identified polypharmacy as explanatory factor of the association between frailty and mortality in older men and women. This finding has important clinical implications, as it suggests that targeting polypharmacy in frail older adults could reduce their risk of mortality.
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22
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Deidda G, Biazzo M. Gut and Brain: Investigating Physiological and Pathological Interactions Between Microbiota and Brain to Gain New Therapeutic Avenues for Brain Diseases. Front Neurosci 2021; 15:753915. [PMID: 34712115 PMCID: PMC8545893 DOI: 10.3389/fnins.2021.753915] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/16/2021] [Indexed: 12/12/2022] Open
Abstract
Brain physiological functions or pathological dysfunctions do surely depend on the activity of both neuronal and non-neuronal populations. Nevertheless, over the last decades, compelling and fast accumulating evidence showed that the brain is not alone. Indeed, the so-called "gut brain," composed of the microbial populations living in the gut, forms a symbiotic superorganism weighing as the human brain and strongly communicating with the latter via the gut-brain axis. The gut brain does exert a control on brain (dys)functions and it will eventually become a promising valuable therapeutic target for a number of brain pathologies. In the present review, we will first describe the role of gut microbiota in normal brain physiology from neurodevelopment till adulthood, and thereafter we will discuss evidence from the literature showing how gut microbiota alterations are a signature in a number of brain pathologies ranging from neurodevelopmental to neurodegenerative disorders, and how pre/probiotic supplement interventions aimed to correct the altered dysbiosis in pathological conditions may represent a valuable future therapeutic strategy.
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Affiliation(s)
- Gabriele Deidda
- The BioArte Limited, Life Sciences Park, San Gwann, Malta
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Manuele Biazzo
- The BioArte Limited, Life Sciences Park, San Gwann, Malta
- SienabioACTIVE, University of Siena, Siena, Italy
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23
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Towers AM, Smith N, Allan S, Vadean F, Collins G, Rand S, Bostock J, Ramsbottom H, Forder J, Lanza S, Cassell J. Care home residents’ quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2021. [DOI: 10.3310/hsdr09190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background
Care home staff have a critical bearing on quality. The staff employed, the training they receive and how well they identify and manage residents’ needs are likely to influence outcomes. The Care Act 2014 (Great Britain. The Care Act 2014. London: The Stationery Office; 2014) requires services to improve ‘well-being’, but many residents cannot self-report and are at risk of exclusion from giving their views. The Adult Social Care Outcomes Toolkit enables social care-related quality of life to be measured using a mixed-methods approach. There is currently no equivalent way of measuring aspects of residents’ health-related quality of life. We developed new tools for measuring pain, anxiety and depression using a mixed-methods approach. We also explored the relationship between care home quality, residents’ outcomes, and the skill mix and employment conditions of the workforce who support them.
Objectives
The objectives were to develop and test measures of pain, anxiety and depression for residents unable to self-report; to assess the extent to which regulator quality ratings reflect residents’ care-related quality of life; and to assess the relationship between aspects of the staffing of care homes and the quality of care homes.
Design
This was a mixed-methods study.
Setting
The setting was care homes for older adults in England.
Participants
Care home residents participated.
Results
Three measures of pain, anxiety and low mood were developed and tested, using a mixed-methods approach, with 182 care home residents in 20 care homes (nursing and residential). Psychometric testing found that the measures had good construct validity. The mixed-methods approach was both feasible and necessary with this population, as the majority of residents could not self-report. Using a combined data set (n = 475 residents in 54 homes) from this study and the Measuring Outcomes in Care Homes study (Towers AM, Palmer S, Smith N, Collins G, Allan S. A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England. Health Qual Life Outcomes 2019;17:22) we found a significant positive association between residents’ social care-related quality of life and regulator (i.e. Care Quality Commission) quality ratings. Multivariate regression revealed that homes rated ‘good/outstanding’ are associated with a 12% improvement in mean current social care-related quality of life among residents who have higher levels of dependency. Secondary data analysis of a large, national sample of care homes over time assessed the impact of staffing and employment conditions on Care Quality Commission quality ratings. Higher wages and a higher prevalence of training in both dementia and dignity-/person-centred care were positively associated with care quality, whereas high staff turnover and job vacancy rates had a significant negative association. A 10% increase in the average care worker wage increased the likelihood of a ‘good/outstanding’ rating by 7%.
Limitations
No care homes rated as inadequate were recruited to the study.
Conclusions
The most dependent residents gain the most from homes rated ‘good/outstanding’. However, measuring the needs and outcomes of these residents is challenging, as many cannot self-report. A mixed-methods approach can reduce methodological exclusion and an over-reliance on proxies. Improving working conditions and reducing staff turnover may be associated with better outcomes for residents.
Future work
Further work is required to explore the relationship between pain, anxiety and low mood and other indicators of care homes quality and to examine the relationship between wages, training and social care outcomes.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 19. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ann-Marie Towers
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Nick Smith
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Stephen Allan
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Florin Vadean
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Grace Collins
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Stacey Rand
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | | | | | - Julien Forder
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
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Grant S, Azhar G, Han E, Booth M, Motala A, Larkin J, Hempel S. Clinical interventions for adults with comorbid alcohol use and depressive disorders: A systematic review and network meta-analysis. PLoS Med 2021; 18:e1003822. [PMID: 34624018 PMCID: PMC8535380 DOI: 10.1371/journal.pmed.1003822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/22/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Uncertainty remains regarding the effectiveness of treatments for patients diagnosed with both an alcohol use disorder (AUD) and depressive disorder. This study aimed to compare the effectiveness of clinical interventions for improving symptoms of adults with co-occurring AUDs and depressive disorders. METHODS AND FINDINGS We searched CINAHL, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Excerpta Medica Database, International Clinical Trials Registry Platform (ICTRP), PubMed, PsycINFO, and Web of Science from inception to December 2020. We included randomized controlled trials (RCTs) evaluating clinical interventions for adults with co-occurring AUDs and depressive disorders. Two independent reviewers extracted study-level information and outcome data. We assessed risk of bias using the Cochrane Risk of Bias tool, used frequentist random effects models for network meta-analyses, and rated our confidence in effect estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Primary outcomes were remission from depression and alcohol use. Secondary outcomes were depressive symptoms, alcohol use, heavy drinking, health-related quality of life, functional status, and adverse events. We used standardized mean differences (SMDs) for continuous outcomes and odds ratios (ORs) for dichotomous outcomes to estimate intervention effects. Overall, 36 RCTs with 2,729 participants evaluated 14 pharmacological and 4 psychological interventions adjunctive to treatment as usual (TAU). Studies were published from 1971 to 2019, conducted in 13 countries, and had a median sample size of 50 participants (range: 14 to 350 participants). We have very low confidence in all estimates of intervention effects on our primary outcomes (i.e., remission from depression and remission from alcohol use). We have moderate confidence that cognitive behavioral therapies (CBTs) demonstrated greater benefit than no additional treatment (SMD = -0.84; 95% confidence interval [CI], -1.05 to -0.63; p < 0.001) for depressive symptoms and low confidence (SMD = -0.25; 95% CI, -0.47 to -0.04; p = 0.021) for alcohol use. We have low confidence that tricyclic antidepressants (TCAs) demonstrated greater benefit than placebo (SMD = -0.37; 95% CI, -0.72 to -0.02, p = 0.038) for depressive symptoms. Compared with placebo, we have moderate confidence that selective serotonin reuptake inhibitors (SSRIs) demonstrated greater benefit for functional status (SMD = -0.92; 95% CI, -1.36 to -0.47, p < 0.001) and low confidence for alcohol use (SMD = -0.30; 95% CI, -0.59 to -0.02, p = 0.039). However, we have moderate confidence that patients receiving SSRIs also were more likely to experience an adverse event (OR = 2.20; 95% CI, 0.94 to 5.16, p = 0.07). We have very low confidence in all other effect estimates, and we did not have high confidence in any effect estimates. Limitations include the sparsity of evidence on intervention effects over the long term, risks of attrition bias, and heterogeneous definitions of adverse events in the evidence base. CONCLUSIONS We are very uncertain about the existence (or not) of any non-null effects for our primary outcomes of remission from depression and remission from alcohol use. The available evidence does suggest that CBTs likely reduced, and TCAs may have resulted in a slight reduction of depressive symptoms. SSRIs likely increased functional status, and SSRIs and CBTs may have resulted in a slight reduction of alcohol use. However, patients receiving SSRIs also likely had an increased risk of experiencing an adverse event. In addition, these conclusions only apply to postintervention and are not against active comparators, limiting the understanding of the efficacy of interventions in the long term as well as the comparative effectiveness of active treatments. As we did not have high confidence in any outcomes, additional studies are warranted to provide more conclusive evidence.
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Affiliation(s)
- Sean Grant
- Department of Social & Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
- RAND Corporation, Santa Monica, California, United States of America
- * E-mail:
| | - Gulrez Azhar
- RAND Corporation, Santa Monica, California, United States of America
| | - Eugeniu Han
- RAND Corporation, Santa Monica, California, United States of America
| | - Marika Booth
- RAND Corporation, Santa Monica, California, United States of America
| | - Aneesa Motala
- RAND Corporation, Santa Monica, California, United States of America
| | - Jody Larkin
- RAND Corporation, Pittsburgh, Pennsylvania, United States of America
| | - Susanne Hempel
- RAND Corporation, Santa Monica, California, United States of America
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Martin EL, Strickland JC, Schlienz NJ, Munson J, Jackson H, Bonn-Miller MO, Vandrey R. Antidepressant and Anxiolytic Effects of Medicinal Cannabis Use in an Observational Trial. Front Psychiatry 2021; 12:729800. [PMID: 34566726 PMCID: PMC8458732 DOI: 10.3389/fpsyt.2021.729800] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/16/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Anxiety and depressive disorders are highly prevalent. Patients are increasingly using medicinal cannabis products to treat these disorders, but little is known about the effects of medicinal cannabis use on symptoms of anxiety and depression. The aim of the present observational study was to assess general health in medicinal cannabis users and non-using controls with anxiety and/or depression. Methods: Participants (368 Cannabis Users; 170 Controls) completed an online survey assessing anxiety and depressive symptoms, cannabis product use, sleep, quality of life, and comorbid chronic pain. Participants that completed this baseline survey were then invited to complete additional follow-up surveys at 3-month intervals. Baseline differences between Cannabis Users and Controls were assessed using independent-samples t-tests and generalized linear mixed effects models were used to assess the impact of initiating cannabis product use, sustained use, or discontinuation of use on anxiety and depressive symptoms at follow-up. Results: Medicinal cannabis use was associated with lower self-reported depression, but not anxiety, at baseline. Medicinal cannabis users also reported superior sleep, quality of life, and less pain on average. Initiation of medicinal cannabis during the follow-up period was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in Controls that never initiated cannabis use. Conclusions: Medicinal cannabis use may reduce anxiety and depressive symptoms in clinically anxious and depressed populations. Future placebo-controlled studies are necessary to replicate these findings and to determine the route of administration, dose, and product formulation characteristics to optimize clinical outcomes.
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Affiliation(s)
- Erin L. Martin
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Justin C. Strickland
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nicolas J. Schlienz
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
- Realm of Caring Foundation, Colorado Springs, CO, United States
| | - Joel Munson
- Realm of Caring Foundation, Colorado Springs, CO, United States
| | - Heather Jackson
- Realm of Caring Foundation, Colorado Springs, CO, United States
| | | | - Ryan Vandrey
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Evstifeeva SE, Shalnova SA, Makarova YK, Yarovaya EB, Balanova YA, Imaeva AE, Kapustina AV, Muromtseva GA, Maksimov SA, Karamnova NS, Artamonova GV, Belova OA, Grinshtein YI, Petrova МM, Duplyakov DV, Efanov AY, Kulakova NV, Libis RA, Chernykh TM, Rotar OP, Trubacheva IA, Shabunova AA, Konradi AO, Boytsov SA, Drapkina OM. Is the population level of anxiety and depression associated with mortality? Data from the ESSE-RF study. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-3009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study the associations of subclinical and clinical anxiety and depression, assesed by the Hospital Anxiety and Depression Scale (HADS), ≥8 points and ≥11 points, respectively, with all-cause mortality and cardiovascular mortality, as well as with the total number of nonfatal cardiovascular events (CVEs) in Russia.Material and methods. The study included male and female population aged 25-64 years from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study who signed an informed consent. The study included 16941 people (men, 6811 (40,2%)). To assess the anxiety and depression, HADS scale was used. The statistical analysis included individuals with subclinical/clinical (HADS ≥8) and clinical (HADS ≥11) anxiety and depression (HADS-A and HADS-D). The median of prospective follow-up was 5,5 years (from 2012 to 2019). The composite endpoint (CE) (cardiovascular death and nonfatal CVE occurred in 268 (4,2%) men and 203 (2,1%) women, while all-cause — in 220 (3,2%) men and 152 (1,5%) women.Results. The results obtained showed that the survival rate of men and women with varying degrees of anxiety (HADS-A ≥8 and ≥11) was associated with all-cause mortality and CE in women. However, this relationship has not been confirmed in multivariate models. In the multivariate Cox proportional hazards model 1 (M1), a significant association of depression with all-cause mortality in women was revealed — HADS-D ≥8: relative risk (RR), 2,22; 95% confidence interval (CI): 1,56-3,15 and ≥11: RR, 2,43; 95% CI: 1,65-3,59 (p<0,005), as well as in men — HADS-D ≥8: RR, 1,51; 95% CI: 1,10-2,08 (p=0,01). In model 2 (M2), when added to M1 as a predictor of prior cardiovascular disease (≥3), depression was significantly associated with all-cause mortality only in women — HADS-D ≥8: RR, 2,23; 95% CI: 1,53-3,24 (p<0,005); HADS-D ≥11: RR, 2,61; 95% CI: 1,74-3,92 (p=0,01). In addition, only in women, subclinical/clinical depression (HADS-D ≥8) was significantly associated with fatal and non-fatal CVE — HADS-D ≥8: RR, 1,46; 95% CI: 1,08-1,98 (p=0,02).Conclusion. Depression (HADS-D ≥8 and ≥11) in Russian women was significantly associated with all-cause mortality and CE (HADS-D ≥8). In men, depression (HADS-D ≥8) was significantly associated with allcause mortality when only conventional risk factors were included in the model, without taking into account prior cardiovascular disease. Anxiety in multivariate models was not associated with all-cause mortality and CE in both sex groups.
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Affiliation(s)
- S. E. Evstifeeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - Yu. K. Makarova
- National Medical Research Center for Therapy and Preventive Medicine; Lomonosov Moscow State University
| | - E. B. Yarovaya
- National Medical Research Center for Therapy and Preventive Medicine; Lomonosov Moscow State University
| | - Yu. A. Balanova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. E. Imaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kapustina
- National Medical Research Center for Therapy and Preventive Medicine
| | - G. A. Muromtseva
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Maksimov
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - G. V. Artamonova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | | | | | - М. M. Petrova
- V.F. Voino-Yasenetsky Krasnoyarsk State Medical University
| | - D. V. Duplyakov
- V.P. Polyakov Samara Regional Clinical Cardiology Dispensary
| | | | | | | | | | | | | | | | | | | | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Gimenez G, Gil-Lacruz AI, Gil-Lacruz M. Is Happiness Linked to Subjective Life Expectancy? A Study of Chilean Senior Citizens. MATHEMATICS 2021; 9:2050. [DOI: 10.3390/math9172050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The main goal of this research is to determine the link between happiness and individual subjective life expectancy (SLE) among Chilean senior citizens. We use data from the 2015 edition of the Chilean Social Protection Survey. Our sample consists of 1298 seniors: 700 aged 65–74, 421 aged 75–84, and 177 aged 85 and older. We provide a novel methodological approach that allows us to measure the relative contribution of happiness to SLE, by combining the Shapley–Owen–Shorrocks decomposition with contrasts of marginal linear predictions of the equality of the means by groups. Results reveal that happiness is the most important determinant of seniors’ SLE, and the effect is stronger the older the people are. Addressing varying levels of happiness is important because both happiness and unhappiness have a significant impact. In an ageing population, social agents should consider that these variables (happiness and SLE) are related to engagement in healthy lifestyles. If prevention programs integrated this interaction, welfare systems could save scarce resources. Therefore, governments should foster happiness to support active ageing.
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Liblik K, Mulvagh SL, Hindmarch CCT, Alavi N, Johri AM. Depression and anxiety following acute myocardial infarction in women. Trends Cardiovasc Med 2021; 32:341-347. [PMID: 34363978 DOI: 10.1016/j.tcm.2021.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease is the leading global cause of mortality, with ischemic heart disease causing the majority of cardiovascular deaths. Despite this, diagnostic delay commonly occurs in women experiencing acute myocardial infarction (AMI) who have a higher associated in-hospital mortality. Several studies have demonstrated that women are significantly more likely than men to experience depression and anxiety following AMI which is linked with increased morbidity, rehospitalization, and mortality, as well as decreased quality of life. Thus, it is imperative that future work aims to understand the factors that put women at higher risk for depression and anxiety following AMI, informing prevention and intervention. This narrative review will summarize the current literature on the association between AMI and mental health in women, including the impact on morbidity, mortality, and quality of life.
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Affiliation(s)
- Kiera Liblik
- School of Medicine, Queen's University, Kingston, ON, Canada
| | - Sharon L Mulvagh
- Department of Medicine, Division of Cardiology, Dalhousie University, Halifax, NS, Canada
| | - Charles C T Hindmarch
- Queen's Cardiopulmonary Unit, Translational Institute of Medicine, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Amer M Johri
- Department of Medicine, Cardiovascular Imaging Network at Queen's University, Kingston, ON, Canada.
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Prevalence and risk factors for anxiety symptoms during the outbreak of COVID-19: A large survey among 373216 junior and senior high school students in China. J Affect Disord 2021; 288:17-22. [PMID: 33839554 PMCID: PMC9754660 DOI: 10.1016/j.jad.2021.03.080] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The increasing menace of the COVID-19 epidemic led to an atmosphere of anxiety around the world, however the evidence among Chinese students aged 12 to 18 years has been limited. METHODS A total of 373216 junior and senior high school students were recruited using a cluster sampling method in Zhengzhou, Xinxiang, Xinyang city of Henan Province, China, during February 4-12, 2020. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the potential risk factors. RESULTS Among the participants, junior and senior high school students were found to have anxiety symptoms, producing an overall prevalence of 9.89%. The prevalence was lower in female than in male (9.66% vs. 10.11%) and the prevalence was higher for junior high school students than senior high school students (13.89% vs. 12.93%). The prevalence of anxiety symptoms was highest among rural students and lowest among urban students (11.33% vs. 8.77%). The cognitive level was negatively associated with the prevalence of anxiety symptoms. After adjusting for potential confounders, age, gender, residential location, worried level, fear level and behavior status were found to be associated with anxiety symptoms. LIMITATIONS Prevalence may be skewed by assessing anxiety symptoms using self-reported scales rather than clinical interviews. CONCLUSIONS This large-scale study assesses the prevalence of anxiety symptoms and its potential influencing factors in junior and senior high school students. These findings suggest that governments need to pay more attention to the mental health of young people in combating COVID-19.
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Myers S, Emmott EH. Communication Across Maternal Social Networks During England's First National Lockdown and Its Association With Postnatal Depressive Symptoms. Front Psychol 2021; 12:648002. [PMID: 34045995 PMCID: PMC8144711 DOI: 10.3389/fpsyg.2021.648002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/12/2021] [Indexed: 01/28/2023] Open
Abstract
Postnatal/postpartum depression (PND/PPD) had a pre-COVID-19 estimated prevalence ranging up to 23% in Europe, 33% in Australia, and 64% in America, and is detrimental to both mothers and their infants. Low social support is a key risk factor for developing PND. From an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers, inherently reliant on social support to raise children. The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is likely to be even more important to new mothers, as it poses risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support. Using data from 162 mothers living in London with infants aged ≤6 months, we explore how communication with members of a mother's social network related to her experience of postnatal depressive symptoms during the first "lockdown" in England. Levels of depressive symptoms, as assessed via the Edinburgh Postnatal Depression Scale, were high, with 47.5% of the participants meeting a ≥11 cut-off for PND. Quasi-Poisson regression modelling found that the number of network members seen in-person, and remote communication with a higher proportion of those not seen, was negatively associated with depressive symptoms; however, contact with a higher proportion of relatives was positively associated with symptoms, suggesting kin risked seeing mothers in need. Thematic qualitative analysis of open text responses found that mothers experienced a burden of constant mothering, inadequacy of virtual contact, and sadness and worries about lost social opportunities, while support from partners facilitated family bonding. While Western childrearing norms focus on intensive parenting, and fathers are key caregivers, our results highlight that it still "takes a village" to raise children in high-income populations and mothers are struggling in its absence.
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Affiliation(s)
- Sarah Myers
- UCL Anthropology, University College London, London, United Kingdom
- BirthRites Independent Max Planck Research Group, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Emily H. Emmott
- UCL Anthropology, University College London, London, United Kingdom
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A Systematic Review of the Effectiveness of Self-Compassion-Related Interventions for Individuals With Chronic Physical Health Conditions. Behav Ther 2021; 52:607-625. [PMID: 33990237 DOI: 10.1016/j.beth.2020.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022]
Abstract
Self-compassion, defined as a mindful way of coping with pain and suffering by showing kindness, care, and concern towards the self, may improve psychological adjustment in people living with a chronic physical health condition (CPHC). Various studies illustrate that self-compassion is associated with positive outcomes in general. The aim of this systematic review is to establish the effect of compassion-related therapies on self-compassion specifically in people with CPHCs. Secondary aims are to (a) establish the effect on other psychological and physiological outcomes and (b) explore the relative effectiveness of different therapy types among those identified. Cochrane, Embase, Medline, PsycINFO, and CINAHL databases were searched using "compassion" AND "chronic disease" AND "psychological outcomes" and their synonyms, from 2004 to March 2019. Eligible studies had an experimental design using a self-compassion scale with an adult population. Risk of bias (RoB) was assessed using the Cochrane RoB tool. Effect sizes were calculated for study outcomes. Fifteen studies, including a total of 1,190 participants, 7 different CPHCs, and 11 types of therapies, were included in the review. Nearly all included therapies significantly increased self-compassion with medium to large effect sizes, and reported positive outcomes, such as decreased depression. None of the therapy types appeared clearly superior to the others. Findings from this review show that included therapies increased self-compassion and improved various outcomes, which may represent clinically significant benefits for patients. However, there is a need to further understand how self-compassion exerts its benefits and determine the best methods to increase self-compassion.
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Bitsika V, Sharpley CF. Symptom profiles and correlates of anxiety and depression among parents of autistic girls and boys. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103874. [PMID: 33524737 DOI: 10.1016/j.ridd.2021.103874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 12/01/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although it has been reported for some time that parenting an autistic child is associated with elevated anxiety and depression, no direct comparison has been published regarding the relative anxiety and depressive states of parents of an autistic son versus an autistic daughter. AIMS To investigate the presence of differences in anxiety and depression in parents of autistic girls and boys, and to identify if there were any meaningful child-based correlates of those states. METHODS AND PROCEDURES A sample of 51 parents of young autistic males (M age = 10.2 yr, SD = 2.8 yr, range to 6-17 yr) and 51 parents of autistic females (M age = 10.1 yr, SD = 2.7 yr, range to 6-17 yr) completed the GAD7 and PHQ9. Autistic children were assessed for IQ and autism severity. OUTCOMES AND RESULTS Although there were no significant differences between the two sets of parents' GAD7 or PHQ9 total scores, there were significant and meaningful differences at the individual GAD7 and PHQ9 item level. Moreover, when examined at the within-child-sex subgroup level, different aspects of the autistic sons' and daughters' age and IQ were correlated with specific items from the GAD7 and PHQ9. CONCLUSIONS AND IMPLICATIONS Because these items were somatic in nature, implications are discussed for possible treatment strategies with these parents.
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Affiliation(s)
- Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, 2350, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, 2350, Australia.
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Sharpley CF, Murcell N, Anderson M, Bitsika V, Fourie PJ, Agnew LL. An exploration of recent life stress, psychological resilience, purpose in life, and optimism as correlates of depression in social housing residents in rural Australia. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1896079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Christopher F. Sharpley
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, Australia
| | | | - Mark Anderson
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, Australia
| | - Phillip J. Fourie
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, Australia
| | - Linda L. Agnew
- Brain-Behaviour Research Group, School of Science and Technology, University of New England, Armidale, Australia
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The Predictive Value of Health Anxiety for Cancer Incidence and All-Cause Mortality: A 44-Year Observational Population Study of Women. Psychosom Med 2021; 83:157-163. [PMID: 33534434 DOI: 10.1097/psy.0000000000000894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Long-term data concerning mortality and serious illness as a function of health anxiety are scarce. We aimed to study health anxiety in relation to long-term mortality and cancer morbidity among women. METHODS A Swedish population sample of women (n = 770; ages, 38-54 years) took part in a general medical and psychiatric examination in 1968 to 1969 and were followed up until 2013 in national Swedish registries for all-cause mortality and first diagnosis of cancer. A modified version of the Whiteley Index questionnaire (maximum score, 12) was used to measure health anxiety. Scores were trichotomized based on quartiles as no (score 0, lowest quartile), mild-moderate (score 1-2, middle quartiles), and high (score ≥3, highest quartile) health anxiety. Risks of death and cancer were evaluated with Cox regression models. RESULTS Compared with women with mild-moderate health anxiety levels, women with no health anxiety had a higher risk of death (age-adjusted hazard ratio [HR] = 1.22, 95% confidence interval [CI] = 1.00-1.49; fully adjusted for baseline sociodemographic, mental, and physical health variables: HR, 1.44, 95% CI = 1.17-1.76). Women with high health anxiety levels had a greater risk of death in age-adjusted analysis (HR = 1.26, 95% CI = 1.04-1.54; fully adjusted HR = 1.21, 95% CI = 0.98-1.49). For both groups, the mortality risk was time dependent and declined during follow-up. We observed no between-group differences in the risk of cancer. CONCLUSIONS In this population-based cohort of midlife women, health anxiety was moderately associated with mortality in a U-shaped fashion. Absence of health anxiety entailed the greatest risk when other factors were taken into account.
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Pardhan S, Smith L, Bourne R, Davis A, Leveziel N, Jacob L, Koyanagi A, López-Sánchez GF. Combined Vision and Hearing Difficulties Results in Higher Levels of Depression and Chronic Anxiety: Data From a Large Sample of Spanish Adults. Front Psychol 2021; 11:627980. [PMID: 33536989 PMCID: PMC7848112 DOI: 10.3389/fpsyg.2020.627980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Individually, vision and hearing impairments have been linked to higher levels of anxiety and depression. We investigated the effect of dual sensory impairment (difficulty seeing and hearing) in a large representative sample of Spanish adults. METHODS Data from a total of 23,089 adults (age range: 15-103 years, 45.9% men) from the Spanish National Health Survey 2017 were analyzed. Self-reported difficulty of seeing and hearing (exposures), and depression and chronic anxiety (outcomes) were analyzed. Multivariable logistic regression was assessed for difficulty with vision alone, hearing alone and with difficulty with both, adjusting for gender, age, marital status, living as a couple, education, smoking, alcohol consumption, BMI, physical activity, use of glasses/contact lenses, and hearing aid. RESULTS Visual difficulty, hearing difficulty, and dual difficulties were all associated with significantly higher odds for depression (ORs 2.367, 2.098, and 3.852, respectively) and for chronic anxiety (ORs 1.983, 1.942, and 3.385, respectively). Dual sensory difficulty was associated with higher odds ratios for depression and anxiety when compared to either impairment alone. CONCLUSION Dual sensory difficulty is associated with significantly higher odds of anxiety and depression when compared to either vision or hearing difficulty alone. Appropriate interventions are needed to address any reversible causes of vision and hearing as well as anxiety and depression in people in these specific groups.
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Affiliation(s)
- Shahina Pardhan
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Rupert Bourne
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Adrian Davis
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
- ENT and Audiology, Imperial College London, London, United Kingdom
| | - Nicolas Leveziel
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Guillermo F. López-Sánchez
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
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Different independent associations of depression and anxiety with survival in patients with cancer. J Psychosom Res 2020; 138:110218. [PMID: 32911441 PMCID: PMC7614809 DOI: 10.1016/j.jpsychores.2020.110218] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Depression and anxiety have both been reported to predict worse subsequent survival in people with cancer. However, depression and anxiety are mutually associated and we lack understanding of their independent associations with survival. We therefore aimed to investigate these in a large sample of patients with common cancers. METHODS We analysed data on 19,966 patients with common cancers (breast, colorectal, gynaecological, lung and prostate) who had attended specialist NHS outpatient clinics in Scotland, UK. Hospital Anxiety and Depression Scale (HADS) data were linked with demographic, cancer and mortality data. We estimated the independent associations of depression (HADS depression score) and anxiety (HADS anxiety score) with survival by fitting (separately for each cancer) Cox proportional hazards models which incorporated cubic splines to allow for non-linear associations. We also adjusted for potential confounders. RESULTS The median time from HADS completion to death or censoring was 1.9 years. Greater depression was found to be strongly associated with worse survival from all cancers. When adjusted for anxiety, this association remained in males and increased in females. Greater anxiety was also associated with worse survival in nearly all cancers. However, when adjusted for depression, the association of anxiety with worse survival was lost. In females the association reversed direction so that greater anxiety was associated with better survival. CONCLUSION Although often considered together as aspects of 'emotional distress', depression and anxiety have different independent associations with survival in patients with cancer and should therefore be considered separately.
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The association of anxiety and depression with mortality in a COPD cohort. The HUNT study, Norway. Respir Med 2020; 171:106089. [DOI: 10.1016/j.rmed.2020.106089] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/05/2020] [Accepted: 07/10/2020] [Indexed: 02/07/2023]
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Underlying domains of anxiety trait in a Costa Rican sample: preliminary results. ACTA ACUST UNITED AC 2020; 35:38-41. [PMID: 32863597 DOI: 10.1016/j.npbr.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Imprecision of the psychiatric phenotype might partially explain the failure of genetic research to identify genes that contribute to susceptibility of anxiety disorders. Previous research concluded two underlying constructs, worry and rumination, might explain anxiety sub-syndromic symptoms in Costa Rican patients with history of mania. The goal of the current study is to explore the presence of latent constructs for quantitative anxiety in a group of subjects with a wide diagnostic phenotype and non-affected individuals. Methods We conducted an exploratory factor analysis of anxiety trait in 709 subjects. Our sample was comprised by 419 subjects with psychiatric disorders and 290 non-affected individuals. We used principal factors extraction method with squared multiple correlations of the STAI (trait subscale). Results We found the following preliminary results: a three-factor solution with a good simple structure and statistical adequacy was obtained with a KMO of 0.92 (>0.6) and Bartlett's Test of Sphericity of 5644,44 (p<0.05). The STAI items were grouped into three factors: anxiety-absent, worry and rumination based on the characteristics of the symptoms. Conclusion Two underlying constructs, worry and rumination may explain anxiety sub-syndromic symptoms in Costa Rican subjects. Our proposed underlying structure of subsyndromal anxiety in individuals should be considered as an important factor in defining better phenotypic characterizations on a broader diagnostic concept. Worry and rumination as a phenotypic characterization may assist in genotyping; however, its predictive value on actual illness outcome still requires more research. The Genome-Wide QTL analysis for anxiety trait in the same sample is ongoing.
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Stewart R, Fosså SD, Hotopf M, Mykletun A. Extent of disease at first cancer presentation and previous anxiety and depressive symptoms: the HUNT study. Br J Psychiatry 2020; 217:427-433. [PMID: 31587671 DOI: 10.1192/bjp.2019.211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Depressive symptoms are associated with higher cancer mortality, whereas anxiety symptoms are associated with lower than expected risk. AIMS This study aimed to investigate the prospective association between depressive/anxiety symptoms and the extent of disease (EOD) of first cancer at diagnosis. METHOD Prospective population-based study conducted from the second wave of the Nord-Trøndelag Health (HUNT) study. Of 65 000 residents comprehensively interviewed and examined for health status, 407 received first lifetime cancer diagnoses 1-3 years later, ascertained from the Cancer Registry of Norway, and had EOD recorded. Patients with localised disease or regional/distant spread at cancer diagnosis were analysed for earlier depressive/anxiety symptoms ascertained by the Hospital Anxiety and Depression Scale in HUNT. RESULTS Beyond-local EOD was present in 59.8% of those with neither anxiety nor depression, in 76.6% of those with depression alone (odds ratio, 2.20; 1.08-4.49), in 39.3% of those with anxiety alone (odds ratio, 0.44; 0.20-0.96) and in 57.7% of those with both anxiety and depression (odds ratio, 0.92; 0.41-2.06). After adjustment for demographic and health status, and cancer type, these associations were marginally stronger, but no longer statistically significant (odds ratios, 2.26; 0.84-6.11; 0.43; 0.15-1.26; and 1.00; 0.98-1.03, respectively). CONCLUSIONS In people who develop cancer, beyond-local EOD at diagnosis was more common in people with previous depression and less common in people with previous anxiety; however, independence from confounding factors could not be concluded.
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Affiliation(s)
- Robert Stewart
- Researcher, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and The National Institute for Health Research (NIHR), South London and Maudsley NHS Foundation Trust, UK
| | - Sophie Dorothea Fosså
- Researcher, Department of Oncology and University of Oslo, Institute of Clinical Medicine, Oslo University Hospital, Norway
| | - Matthew Hotopf
- Researcher, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and South London and Maudsley NHS Foundation Trust, UK
| | - Arnstein Mykletun
- Researcher, Division of Mental Health, Norwegian Institute of Public Health; Department of Community Medicine, University of Tromsø; Center for Work and Mental Health, Nordland Hospital Trust; and Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Norway
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Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Lang M, Krátký J, Xygalatas D. The role of ritual behaviour in anxiety reduction: an investigation of Marathi religious practices in Mauritius. Philos Trans R Soc Lond B Biol Sci 2020; 375:20190431. [PMID: 32594878 DOI: 10.1098/rstb.2019.0431] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
While the occurrence of rituals in anxiogenic contexts has been long noted and supported by ethnographic, quantitative and experimental studies, the purported effects of ritual behaviour on anxiety reduction have rarely been examined. In the present study, we investigate the anxiolytic effects of religious practices among the Marathi Hindu community in Mauritius and test whether these effects are facilitated by the degree of ritualization present in these practices. Seventy-five participants first experienced anxiety induction through the public speaking paradigm and were subsequently asked to either perform their habitual ritual in a local temple (ritual condition) or sit and relax (control condition). The results revealed that participants in the ritual condition reported lower perceived anxiety after the ritual treatment and displayed lower physiological anxiety, which was assessed as heart-rate variability. The degree of ritualization in the ritual condition showed suggestive albeit variable effects, and thus further investigation is needed. We conclude the paper with a discussion of various mechanisms that may facilitate the observed anxiolytic effects of ritual behaviour and should be investigated in the future. This article is part of the theme issue 'Ritual renaissance: new insights into the most human of behaviours'.
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Affiliation(s)
- M Lang
- LEVYNA Laboratory for the Experimental Research of Religion, Masaryk University, Brno, Czech Republic
| | - J Krátký
- LEVYNA Laboratory for the Experimental Research of Religion, Masaryk University, Brno, Czech Republic
| | - D Xygalatas
- Department of Anthropology, University of Connecticut, Storrs, CT, USA
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Turiano NA, Graham EK, Weston SJ, Booth T, Harrison F, James BD, Lewis NA, Makkar SR, Mueller S, Wisniewski KM, Zhaoyang R, Spiro A, Willis S, Schaie KW, Lipton RB, Katz M, Sliwinski M, Deary IJ, Zelinski EM, Bennett DA, Sachdev PS, Brodaty H, Trollor JN, Ames D, Wright MJ, Gerstorf D, Muniz-Terrera G, Piccinin AM, Hofer SM, Mroczek DK. Is Healthy Neuroticism Associated with Longevity? A Coordinated Integrative Data Analysis. COLLABRA. PSYCHOLOGY 2020; 6:33. [PMID: 33354648 PMCID: PMC7751763 DOI: 10.1525/collabra.268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Individual differences in the Big Five personality traits have emerged as predictors of health and longevity. Although there are robust protective effects for higher levels of conscientiousness, results are mixed for other personality traits. In particular, higher levels of neuroticism have significantly predicted an increased risk of mortality, no-risk at all, and even a reduced risk of dying. The current study hypothesizes that one potential reason for the discrepancy in these findings for neuroticism is that interactions among neuroticism and other key personality traits have largely been ignored. Thus, in the current study we focus on testing whether the personality traits neuroticism and conscientiousness interact to predict mortality. Specifically, we borrow from recent evidence of "healthy neuroticism" to explore whether higher levels of neuroticism are only a risk factor for increased mortality risk when conscientiousness levels are low. We conducted a pre-registered integrative data analysis using 12 different cohort studies (total N = 44,702). Although a consistent pattern emerged of higher levels of conscientiousness predicting a reduced hazard of dying, neuroticism did not show a consistent pattern of prediction. Moreover, no study provided statistical evidence of a neuroticism by conscientiousness interaction. The current findings do not support the idea that the combination of high conscientiousness and high neuroticism can be protective for longevity. Future work is needed to explore different protective factors that may buffer the negative effects of higher levels of neuroticism on health, as well as other behaviors and outcomes that may support the construct of healthy neuroticism.
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Affiliation(s)
- Nicholas A. Turiano
- West Virginia University, Department of Psychology and the West Virginia Prevention Research Center, Morgantown, WV, USA
| | - Eileen K. Graham
- Northwestern University, Department of Medical Social Sciences, Chicago, IL, USA
| | - Sara J. Weston
- University of Oregon, Department of Psychology, Eugene, OR, USA
| | - Tom Booth
- Centre for Cognitive Aging and Cognitive Epidemiology, Department of Psychology The University of Edinburgh, Edinburgh, Scotland
| | - Fleur Harrison
- The University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Sydney NSW, Australia
| | - Bryan D. James
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Nathan A. Lewis
- The University of Victoria, Department of Psychology, Victoria, BC, Canada
| | - Steven R. Makkar
- The University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Sydney NSW, Australia
| | - Swantje Mueller
- Hamburg University, Berlin, Germany, Department of Psychology, Berlin, Germany
- Humboldt University Berlin, Germany, Department of Psychology, Berlin, Germany
| | - Kristi M. Wisniewski
- University of Southern California, Department of Gerontology, Los Angeles, CA, USA
| | - Ruixue Zhaoyang
- Center for Healthy Aging, Pennsylvania State University, State College, PA, USA
| | - Avron Spiro
- VA Boston Healthcare System, Boston, MA, USA
- Boston University, Boston, MA, USA
| | - Sherry Willis
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - K. Warner Schaie
- Pennsylvania State University, Department of Human Development and Psychology, State College, PA, USA
| | | | - Mindy Katz
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martin Sliwinski
- Center for Healthy Aging, Pennsylvania State University, State College, PA, USA
| | - Ian J. Deary
- University of New South Wales, Department of Developmental Disability Neuropsychiatry, Sydney, Australia
| | | | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Perminder S. Sachdev
- The University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Sydney NSW, Australia
| | - Henry Brodaty
- The University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Sydney NSW, Australia
| | - Julian N. Trollor
- The University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Sydney NSW, Australia
- University of New South Wales, Department of Developmental Disability Neuropsychiatry, Sydney, Australia
| | - David Ames
- University of Melbourne Academic Unit for Psychiatry of Old Age and National Ageing Research Institute, Kew & Parkville, Australia
| | | | - Denis Gerstorf
- Humboldt University Berlin, Germany, Department of Psychology, Berlin, Germany
| | | | - Andrea M. Piccinin
- The University of Victoria, Department of Psychology, Victoria, BC, Canada
| | - Scott M. Hofer
- The University of Victoria, Department of Psychology, Victoria, BC, Canada
| | - Daniel K. Mroczek
- Northwestern University, Department of Medical Social Sciences, Chicago, IL, USA
- Northwestern University, Department of Psychology, Evanston, IL, USA
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Li J, Ji F, Song J, Gao X, Jiang D, Chen G, Chen S, Lin X, Zhuo C. Anxiety and clinical outcomes of patients with acute coronary syndrome: a meta-analysis. BMJ Open 2020; 10:e034135. [PMID: 32647021 PMCID: PMC7351295 DOI: 10.1136/bmjopen-2019-034135] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Anxiety has been suggested to be associated with poor outcomes in patients with acute coronary syndrome (ACS). However, results of previous follow-up studies were inconsistent. The aim of this meta-analysis was to evaluate the association between anxiety and clinical outcomes in patients with ACS, and to investigate the potential role of depression underlying the above association. DESIGN A meta-analysis of prospective follow-up studies. SETTING Hospitals. PARTICIPANTS Patients with ACS. INTERVENTIONS We included related prospective follow-up studies up through 20 July 2019 that were identified by searching PubMed and Embase databases. A random-effect model was used for the meta-analysis. Anxiety was evaluated by validated instruments at baseline. PRIMARY AND SECONDARY OUTCOME MEASURES We determined the association between anxiety and risks of mortality and adverse cardiovascular events (MACEs) in patients with ACS. RESULTS Our analysis included 17 studies involving 39 038 patients wqith ACS. Anxiety was independently associated with increased mortality risk (adjusted risk ratio (RR) 1.21, 95% CI 1.07 to 1.37, p=0.002) and MACEs (adjusted RR 1.47, 95% CI 1.24 to 1.74, p<0.001) in patients with ACS. Subgroup analyses showed that depression may at least partly confound the association between anxiety and poor outcomes in patients with ACS. Adjustment of depression significantly attenuated the association between anxiety and MACEs (adjusted RR 1.25, 95% CI 1.04 to 1.52, p=0.02). Moreover, anxiety was not significantly associated with mortality risk after adjusting for depression (adjusted RR 0.88, 95% CI 0.66 to 1.17, p=0.37). CONCLUSIONS Anxiety is associated with increased risk of mortality and MACEs in patients with ACS. However, at least part of the association may be confounded by concurrent depressive symptoms in these patients.
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Affiliation(s)
- Jie Li
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Feng Ji
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, School of Mental of Jining Medical University, Jining, China
| | - Junxian Song
- Department of Cardiology, Center for Cardiovascular Translational Research, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Peking University People's Hospital, Beijing, China
| | - Xiangyang Gao
- Health Management Institute, Medical Data Statistical Analysis Center, Medical Big Data Analysis Center, Chinese PLA General Hospital, Beijing, China
| | - Deguo Jiang
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Guangdong Chen
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Suling Chen
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Chuanjun Zhuo
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, School of Mental of Jining Medical University, Jining, China
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
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Long J, Ouyang Y, Duan H, Xiang Z, Ma H, Ju M, Sun D. Multiple Factor Analysis of Depression and/or Anxiety in Patients with Acute Exacerbation Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:1449-1464. [PMID: 32606653 PMCID: PMC7310996 DOI: 10.2147/copd.s245842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/30/2020] [Indexed: 01/05/2023] Open
Abstract
Objective To reveal the risk factors, the symptom distribution characteristics, the clinical values of white blood cell counts (WBC counts), red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with depression and/or anxiety. Methods The study included prospective cross-sectional and case-control studies, and was executed in the Affiliated Hospital of Zunyi Medical University, Guizhou, China. Previously diagnosed chronic obstructive pulmonary disease (COPD) patients who admitted to the hospital with AECOPD, patients with depression and/or anxiety, and healthy people were enrolled in the study. The Hamilton Rating Scales were used to assess all subjects, and the complete blood counts (CBC) were collected. Baseline data and clinical measurement data [spirometry, arterial blood gas analysis, and COPD evaluation test (the CAT scale)] from patients with AECOPD were collected. Results Of the 307 patients with AECOPD included, 63.5% (N=195) had depressive and/or anxiety symptoms, and 36.5% (N=112) had no symptoms. Sex, respiratory failure, number of comorbidities, number of acute exacerbations in the previous year and the CAT score were closely related to AECOPD combined with depression and/or anxiety (p<0.05). The CAT scale score were the independent risk factor (OR=6.576, 95% CI 3.812-11.342) and significant predictor of AECOPD with depression and/or anxiety (AUC=0.790,95% CI 0.740-0.834); the patients with depression and/or anxiety were more severe and characteristic than the patients with AECOPD combined with depression and/or anxiety; RDW was associated with AECOPD with depression and/or anxiety (p=0.020, OR1.212,95% CI1.03-1.426), and had certain clinical diagnostic value (AUC=0.570,95% CI 0.531-0.626). Conclusion Depression and anxiety should not be ignored in patients with AECOPD. The severity and quality of life of COPD were closely related to the occurrence of depression and/or anxiety symptoms. In most cases, perhaps depression and anxiety in AECOPD are only symptoms and not to the extents of the diseases. RDW had clinical diagnostic value in AECOPD combined with depression and/or anxiety. NLR, PLR, MLR, and RDW may become the novel indicators for evaluating the degree of inflammation of AECOPD and deserve further research.
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Affiliation(s)
- Jian Long
- Department of Respiratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou, People’s Republic of China
- Zunyi Fifth People’s Hospital (Zunyi Mental Health Center), Zunyi City, Guizhou, People’s Republic of China
| | - Yao Ouyang
- Department of Respiratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou, People’s Republic of China
| | - Haizhen Duan
- Department of Emergency Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou, People’s Republic of China
| | - Zhongyong Xiang
- Zunyi Fifth People’s Hospital (Zunyi Mental Health Center), Zunyi City, Guizhou, People’s Republic of China
| | - Hongchang Ma
- Zunyi Fifth People’s Hospital (Zunyi Mental Health Center), Zunyi City, Guizhou, People’s Republic of China
| | - Mingliang Ju
- Shanghai Mental Health Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai City, People’s Republic of China
| | - Desheng Sun
- Department of Respiratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou, People’s Republic of China
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Nuggerud-Galeas S, Sáez-Benito Suescun L, Berenguer Torrijo N, Sáez-Benito Suescun A, Aguilar-Latorre A, Magallón Botaya R, Oliván Blázquez B. Analysis of depressive episodes, their recurrence and pharmacologic treatment in primary care patients: A retrospective descriptive study. PLoS One 2020; 15:e0233454. [PMID: 32437398 PMCID: PMC7241802 DOI: 10.1371/journal.pone.0233454] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/05/2020] [Indexed: 11/29/2022] Open
Abstract
Background Depression is one of the most prevalent health problems, frequently being a medium- and long-term condition, with a high comorbidity rate and with frequent relapses and recurrences. Although numerous studies have compared the effectiveness of specific antidepressant therapy drugs and have assessed relapses, scientific evidence on the relationship between pharmacologic treatments and recurrence is scarce. The objective of this study is to describe depressive episodes in a primary care patient cohort, the percentage of depression recurrences and the administered pharmacologic treatment, from a naturalistic perspective. Methods Retrospective descriptive study. 957 subjects were included. The dependent variable was a depression diagnosis and independent variables were: gender, age at time of data collection; age of onset, first-episode treatment, number of recurrences, age at recurrences, treatment prescribed for recurrences using therapeutic groups categorization. Results Recurrences are frequent, affecting more than 40% of the population. In the first episode, 13.69% of the patients were not prescribed pharmacological treatment, but this percentage decreased over the following depression episodes. 80.9% of the patients who did not receive drug treatment in the first depression episode did not experience subsequent episodes. Monotherapy, and specifically, SSRIs were the most frequently prescribed treatment option for all depressive episodes. Regards the combined pharmacologic treatment, the most frequent drug combinations were SSRIs and benzodiazepines. Limitations In order to increase the power of results, the statistical analysis was performed using therapeutic groups categorization, not individually analyzing each drug and dose. Conclusions Depressive episode recurrence is frequent in primary care patients. Further studies having a prospective design are needed in order to expand on this issue.
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Affiliation(s)
| | | | | | | | | | - Rosa Magallón Botaya
- Institute for Health Research Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- * E-mail: ,
| | - Bárbara Oliván Blázquez
- Institute for Health Research Aragón, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Pascale A, Marchesi N, Govoni S, Barbieri A. Targeting the microbiota in pharmacology of psychiatric disorders. Pharmacol Res 2020; 157:104856. [PMID: 32389857 DOI: 10.1016/j.phrs.2020.104856] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 02/07/2023]
Abstract
There is increasing interest in the role of the gut microbiota in health and disease. In particular, gut microbiota influences the Central Nervous System (CNS) development and homeostasis through neural pathways or routes involving the immune and circulatory systems. The CNS, in turn, shapes the intestinal flora through endocrine or stress-mediated responses. These overall bidirectional interactions, known as gut microbiota-brain axis, profoundly affect some brain functions, such as neurogenesis and the production of neurotransmitters, up to influence behavioral aspects of healthy subjects. Consequently, a dysfunction within this axis, as observed in case of dysbiosis, can have an impact on the behavior of a given individual (e.g. anxiety and depression) or on the development of pathologies affecting the CNS, such as autism spectrum disorders and neurodegenerative diseases (e.g. Alzheimer's disease and Parkinson's disease). It should be considered that the whole microbiota has a significant role not only on aspects concerning human physiology, such as harvesting of nutrients and energy from the ingested food or production of a wide range of bioactive compounds, but also has positive effects on the gastrointestinal barrier function and actively contributes to the pharmacokinetics of several compounds including neuropsychiatric drugs. Indeed, the microbiota is able to affect drug absorption and metabolism up to have an impact on drug activity and/or toxicity. On the other hand, drugs are able to shape the human gut microbiota itself, where these changes may contribute to their pharmacologic profile. Therefore, the emerging picture on the complex drug-microbiota bidirectional interplay will have considerable implications in the future not only in terms of clinical practice but also, upstream, on drug development.
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Affiliation(s)
- Alessia Pascale
- Department of Drug Sciences, Pharmacology Section, University of Pavia, Viale Taramelli 14, 27100 Pavia, Italy.
| | - Nicoletta Marchesi
- Department of Drug Sciences, Pharmacology Section, University of Pavia, Viale Taramelli 14, 27100 Pavia, Italy
| | - Stefano Govoni
- Department of Drug Sciences, Pharmacology Section, University of Pavia, Viale Taramelli 14, 27100 Pavia, Italy
| | - Annalisa Barbieri
- Department of Drug Sciences, Pharmacology Section, University of Pavia, Viale Taramelli 14, 27100 Pavia, Italy
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Bitsika V, Sharpley CF. Age-related differences in the association between autistic sons’ challenging behaviour and maternal anxiety and depression: implications for counsellors. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2020. [DOI: 10.1080/03069885.2020.1750561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, Australia
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European Psychiatric Association (EPA) guidance on prevention of mental disorders. Eur Psychiatry 2020; 27:68-80. [DOI: 10.1016/j.eurpsy.2011.10.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 10/11/2011] [Accepted: 10/19/2011] [Indexed: 12/18/2022] Open
Abstract
AbstractThere is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions. Since a large proportion of lifetime mental illness starts before adulthood, such interventions are particularly important during childhood and adolescence. Prevention is important for the sustainable reduction of the burden of mental disorder since once it has arisen, treatment can only reduce a relatively small proportion of such burden. The challenge for clinicians is to incorporate such interventions into non-clinical and clinical practice as well as engaging with a range of other service providers including public health. Similar strategies can be employed in both the European and global contexts. Promotion of mental well-being can prevent mental disorder but is also important in the recovery from mental disorder. This guidance should be read in conjunction with the EPA Guidance on Mental Health Promotion. This guidance draws on preparatory work for the development of England policy on prevention of mental disorder which used a wide range of sources.
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Steffen A, Nübel J, Jacobi F, Bätzing J, Holstiege J. Mental and somatic comorbidity of depression: a comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data. BMC Psychiatry 2020; 20:142. [PMID: 32228541 PMCID: PMC7106695 DOI: 10.1186/s12888-020-02546-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depression is frequently accompanied by other mental disorders and various somatic diseases; however, previous comorbidity studies often relied on self-reported data and have not simultaneously assessed the entire spectrum of mental and somatic diagnoses. The aim is to provide a complete picture of mental and somatic comorbidity of depression in routine outpatient care in a high income country with a relatively well equipped health care system. METHODS Using ambulatory claims data covering 87% of the German population (age 15+), we designed a cross-sectional study by identifying persons diagnosed with mild, moderate and severe depression in 2017 (N = 6.3 million) and a control group matched 4:1 on sex, 5-year age group and region of residence (N = 25.2 million). Stratified by severity, we calculated the prevalence of 202 diagnosis groups included in the ICD-10 in persons with depression as compared to matched controls using prevalence ratios (PR). RESULTS Nearly all mental disorders were at least twice as prevalent in persons with depression relative to controls, showing a dose-response relationship with depression severity. Irrespective of severity, the three most prevalent somatic comorbid diagnosis groups were 'other dorsopathies' (M50-M54), 'hypertensive diseases' (I10-I15) and 'metabolic disorders' (E70-E90), exhibiting PRs in moderate depression of 1.56, 1.23 and 1.33, respectively. Strong associations were revealed with diseases of the central nervous system (i.e. multiple sclerosis) and several neurological diseases, among them sleep disorders, migraine and epilepsy, most of them exhibiting at least 2- to 3-fold higher prevalences in depression relative to controls. Utilization of health care was higher among depression cases compared to controls. CONCLUSIONS The present study based on data from nearly the complete adolescent and adult population in Germany comprehensively illustrates the comorbidity status of persons diagnosed with depression as coded in routine health care. Our study should contribute to increasing the awareness of the strong interconnection of depression with all other mental and the vast majority of somatic diseases. Our findings underscore clinical and health-economic relevance and the necessity of systematically addressing the high comorbidity of depression and somatic as well as other mental diseases through prevention, early identification and adequate management of depressive symptoms.
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Affiliation(s)
- Annika Steffen
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Berlin, Germany.
| | - Julia Nübel
- Department of Epidemiology and Health Monitoring, Unit 26 Mental Health, Robert Koch Institute, Berlin, Germany
| | - Frank Jacobi
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Jörg Bätzing
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Berlin, Germany
| | - Jakob Holstiege
- Central Research Institute of Ambulatory Health Care in Germany (Zi), Berlin, Germany
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Rahman MS, Rahman MA, Ali M, Rahman MS, Maniruzzaman M, Yeasmin MA, Ahmed NAMF, Abedin MM, Islam SMS. Determinants of depressive symptoms among older people in Bangladesh. J Affect Disord 2020; 264:157-162. [PMID: 32056745 DOI: 10.1016/j.jad.2019.12.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/08/2019] [Accepted: 12/13/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depressive symptoms are common among older people which are associated with disability, morbidity and mortality. The aim of this study was to determine the associated risk factors for depressive symptoms among older people in Bangladesh. METHODS A cross-sectional survey was conducted among 400 people aged ≥65 years from the Meherpur district in Bangladesh. Depressive symptoms were measured by the 15-item Geriatric Depression Scale and categorized into: no depressive symptoms, mild, moderate and severe depressive symptoms. Information was also collected on socio-economic and demographic characteristics, health problems, feeling of loneliness, history of falls and concern about falling. Chi-square test of association and multinomial logistic regression was performed to reveal the determinants of depressive symptoms. RESULTS Just over half of the sample were female, aged 70+ years, and lived in rural areas. The prevalence of depressive symptoms was 55.5%, and 23.0% mild, 19.0% moderate, and 13.5% having severe levels of depressive symptoms. Older age, sex, residence, marital status, presence of co-morbidities, visual impairment, previous falls, loneliness, and fear of falling were the significant determinants for developing depressive symptoms. LIMITATIONS A convenience sampling method was used for data collection among older people from selected communities in a district of Bangladesh. The results do not represent the entire population of Bangladesh. Besides, it was a cross-sectional study, and causality cannot be determined. CONCLUSION Depressive symptoms among older people in Bangladesh is prevalent, and needs to be addressed. Public health programs and strategies are needed to reduce depressive symptoms among older adults in Bangladesh.
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Affiliation(s)
| | - Md Ashfikur Rahman
- Development Studies Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Mohammad Ali
- Statistics Discipline, Khulna University, Khulna, 9208, Bangladesh.
| | - Md Saidur Rahman
- Department of Management, Islamic University, Kustia, 7003, Bangladesh
| | - Md Maniruzzaman
- Statistics Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Mst Anamika Yeasmin
- Department of Clinical Psychology, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | | | | | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Victoria, 3125, Australia
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