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Holm A, Orenius T, Karttunen N, Ristolainen L, Kautiainen H, Hurri H. Impact of antidepressant medication on the analgetic effect of repetitive transcranial magnetic stimulation treatment of neuropathic pain. Preliminary findings from a registry study. Scand J Pain 2023; 23:670-676. [PMID: 37459208 DOI: 10.1515/sjpain-2023-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/05/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Repetitive transcranial magnetic stimulation (rTMS) has been found to be effective in chronic neuropathic pain conditions. However, information about the combined effects of rTMS and antidepressant treatment is scarce. We studied the outcome of rTMS and concurrent antidepressant treatment in patients with neuropathic pain. METHODS In this retrospective, real-world study, 34 patients with neuropathic pain, who were considered resistant or not benefitting from conventional treatment, received rTMS treatment between 2017 and 2020. Pain-related factors were measured using the Numerical Rating Scale (NRS), Global Impression of Change (GIC), and Beck Depression Inventory. RESULTS A decrease in pain intensity and pain interference assessed with NRS was observed after 10 treatment sessions in 16 patients. The impression of change was positive in 20 patients. Half of the patients (n=17) used antidepressant medication, while half (n=17) did not. A concurrent use of antidepressants with therapeutic rTMS was significantly linked with less pain intensity relief when compared with the nonuse of antidepressants (p=0.019). The impression of change was significantly in favor of the antidepressant nonuser group (p=0.002). No group differences in pain interference were found between the groups. CONCLUSIONS Therapeutic rTMS for neuropathic pain is plausibly sensitive to interference with antidepressant medication. The exact mechanism of our findings remains to be elucidated; confirmatory studies are warranted.
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Affiliation(s)
- Anu Holm
- Satakunta University of Applied Sciences (SAMK), Pori, Finland
- SataDiag, Hospital District of Satakunta, Pori, Finland
- Recuror Oy, Turku, Finland
| | | | - Nina Karttunen
- Satakunta University of Applied Sciences (SAMK), Pori, Finland
- SataDiag, Hospital District of Satakunta, Pori, Finland
| | | | - Hannu Kautiainen
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
- Department of General Practice, University of Helsinki, Helsinki, Finland
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Moon AS, Menendez ME, Moverman MA, Proal JD, Kim DH, Ohaegbulam C, Kwon B. Spine Surgeon Assessments of Patient Psychological Distress are Inaccurate and Bias Treatment Recommendations. Spine (Phila Pa 1976) 2023; 48:908-913. [PMID: 36728794 DOI: 10.1097/brs.0000000000004567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/12/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVE This study determined (1) the surgeon accuracy of psychological assessment in patients in spine clinic, (2) the impact of psychological distress on surgical recommendation, and (3) the correlation between patient-reported disability and psychological distress. SUMMARY OF BACKGROUND DATA Psychological distress is common among patients presenting for spine surgery. Surgeon estimations of patients' distress may influence treatment recommendations, but little is known as to whether these assessments accurately mirror patient-perceived psychological distress. MATERIALS AND METHODS A sample of new patients was recruited from an academic spine center. Prior to their initial consultation, patients completed the Modified Somatic Perception Questionnaire and Zung Depression Index to assess mental and physical manifestations of distress, which generated a Distress and Risk Assessment Method (DRAM) score of N (normal), R (at risk), or D (distressed). The Oswestry Disability Index and Neck Disability Index scores were also collected. Surgeons provided their estimates of the DRAM score after the visit and indicated their surgery recommendation. RESULTS Of 296 patients, 40.5% reported some level of psychological distress (DRAM=R) and 15.9% had a high level of distress (DRAM=D). All three surgeons' ability to accurately assess the participant DRAM score was poor, with an overall kappa of 0.13 (0.08-0.18), biased toward underestimating the patient's true level of psychological distress. Patients rated as normal (N) by the surgeon were 3.78 times more likely to be recommended for surgery compared to those assessed as distressed (D) ( P =0.007). Patients with higher DRAM scores had higher Oswestry Disability Index ( P =0.008) and Neck Disability Index ( P =0.005) scores compared to those with lower DRAM scores. CONCLUSIONS Spine surgeons have limited ability to detect psychological profiles in patients, with a tendency to underestimate levels of distress. The finding that these inaccurate assessments influence surgical recommendations underscores the importance of limiting surgeon bias in the decision-making process. LEVEL OF EVIDENCE Diagnostic Level 2.
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Affiliation(s)
- Andrew S Moon
- Department of Orthopaedic Surgery, Tufts Medical Center
| | | | | | | | - David H Kim
- Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA
| | - Chima Ohaegbulam
- Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA
| | - Brian Kwon
- Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA
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Muzammel M, Salam H, Othmani A. End-to-end multimodal clinical depression recognition using deep neural networks: A comparative analysis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 211:106433. [PMID: 34614452 DOI: 10.1016/j.cmpb.2021.106433] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Major Depressive Disorder is a highly prevalent and disabling mental health condition. Numerous studies explored multimodal fusion systems combining visual, audio, and textual features via deep learning architectures for clinical depression recognition. Yet, no comparative analysis for multimodal depression analysis has been proposed in the literature. METHODS In this paper, an up-to-date literature overview of multimodal depression recognition is presented and an extensive comparative analysis of different deep learning architectures for depression recognition is performed. First, audio features based Convolutional Neural Networks (CNNs) and Long Short-Term Memory (LSTM) are studied. Then, early-level and model-level fusion of deep audio features with visual and textual features through LSTM and CNN architectures are investigated. RESULTS The performance of the proposed architectures using an hold-out strategy on the DAIC-WOZ dataset (80% training, 10% validation, 10% test split) for binary and severity levels of depression recognition is tested. Using this strategy, a set of experiments have been performed and they have demonstrated: (1) LSTM-based audio features perform slightly better than CNN ones with an accuracy of 66.25% versus 65.60% for binary depression classes. (2) the model level fusion of deep audio and visual features using LSTM network performed the best with an accuracy of 77.16%, a precision of 53% for the depressed class, and a precision of 83% for the non-depressed class. The given network obtained a normalized Root Mean Square Error (RMSE) of 0.15 for depression severity level prediction. Using a Leave-One-Subject-Out strategy, this network achieved an accuracy of 95.38% for binary depression detection, and a normalized RMSE of 0.1476 for depression severity level prediction. Our best-performing architecture outperforms all state-of-the-art approaches on DAIC-WOZ dataset. CONCLUSIONS The obtained results show that the proposed LSTM-based surpass the proposed CNN-based architectures allowing to learn temporal dynamics representations of multimodal features. Furthermore, model-level fusion of audio and visual features using an LSTM network leads to the best performance. Our best-performing architecture successfully detects depression using a speech segment of less than 8 seconds, and an average prediction computation time of less than 6ms; making it suitable for real-world clinical applications.
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Affiliation(s)
- Muhammad Muzammel
- Université Paris-Est Créteil (UPEC), LISSI, Vitry sur Seine 94400, France
| | - Hanan Salam
- New York University, SMART Lab, Saadiyat Island, Abu Dhabi
| | - Alice Othmani
- Université Paris-Est Créteil (UPEC), LISSI, Vitry sur Seine 94400, France.
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Rezapour T, Hatami J, Farhoudian A, Noroozi A, Daneshmand R, Sofuoglu M, Baldacchino A, Ekhtiari H. Baseline executive functions and receiving cognitive rehabilitation can predict treatment response in people with opioid use disorder. J Subst Abuse Treat 2021; 131:108558. [PMID: 34366202 DOI: 10.1016/j.jsat.2021.108558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 06/23/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Impaired cognitive functions, particularly executive function, predicts poor treatment success in people with substance use disorders. The current study investigated the effect of receiving adjunct cognitive rehabilitation and baseline executive function (EF) measures on treatment response among people with opioid use disorder (OUD). METHOD The analysis sample consisted of 113 participants with OUD who were discharged from a compulsory court-mandated methadone maintenance treatment (MMT) and followed for 3 months. We used the Backward digit span/Auditory verbal learning, Stroop, and Trail making tests to assess the three measures of EF, including working memory, inhibition, and shifting, respectively. Treatment response was operationalized as (1) treatment retention and (2) the number of positive urine tests for morphine during 3-month follow-up periods. The study used Cox's proportional hazards model and linear mixed model to identify predictive factors. RESULTS Lower Stroop interference scores predicted increased length of stay in treatment (χ2 = 33.15, P < 0.001). The linear mixed model showed that scores on auditory verbal learning test and group intervention predicted the number of positive urine tests during a 3-month follow-up. CONCLUSION Working memory and inhibitory control, as well as receiving cognitive rehabilitation, could be potentially considered as predictors of treatment response for newly MMT admitted patients with OUD. Assessment of EF before treatment initiation may inform treatment providers about patient's cognitive deficits that may interfere with therapeutic interventions.
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Affiliation(s)
- Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Javad Hatami
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reza Daneshmand
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehmet Sofuoglu
- Department of Psychiatry, School of Medicine, Yale University, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Alex Baldacchino
- University of St Andrews, School of Medicine, Division of Population and Behavioral Sciences, St Andrews, Scotland, UK
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA.
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Izquierdo-Alventosa R, Inglés M, Cortés-Amador S, Gimeno-Mallench L, Chirivella-Garrido J, Kropotov J, Serra-Añó P. Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103634. [PMID: 32455853 PMCID: PMC7277480 DOI: 10.3390/ijerph17103634] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/21/2022]
Abstract
Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain and other physical and psychological features. In this study, we aimed to analyze the effect of a low-intensity physical exercise (PE) program, combining endurance training and coordination, on psychological aspects (i.e., pain catastrophizing, anxiety, depression, stress), pain perception (i.e., pain acceptance, pressure pain threshold (PPT), and quality of life and physical conditioning (i.e., self-perceived functional capacity, endurance and functional capacity, power and velocity) in women with FM. For this purpose, a randomized controlled trial was carried out. Thirty-two women with FM were randomly allocated to a PE group (PEG, n = 16), performing an eight-week low-intensity PE program and a control group (CG, n = 16). Pain catastrophizing, anxiety, depression, stress, pain acceptance, PPT, quality of life, self-perceived functional capacity, endurance and functional capacity, power, and velocity were assessed before and after the intervention. We observed a significant improvement in all studied variables in the PEG after the intervention (p < 0.05). In contrast, the CG showed no improvements in any variable, which further displayed poorer values for PPT (p < 0.05). In conclusion, a low-intensity combined PE program, including endurance training and coordination, improves psychological variables, pain perception, quality of life, and physical conditioning in women with FM.
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Affiliation(s)
- Ruth Izquierdo-Alventosa
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 València, Spain; (R.I.-A.); (S.C.-A.); (P.S.-A.)
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES-ISCIII), Fundación Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), 46010 València, Spain
- Correspondence: ; Tel.: +34-963-98-38-55
| | - Sara Cortés-Amador
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 València, Spain; (R.I.-A.); (S.C.-A.); (P.S.-A.)
| | - Lucia Gimeno-Mallench
- Freshage Research Group, Department of Physiology, Faculty of Medicine, Universitat de València, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES-ISCIII), Fundación Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), 46010 València, Spain;
| | | | - Juri Kropotov
- N.P. Bechtereva Institute of Human Brain, Russian Academy of Science, 197022 St. Petersburg, Russia;
| | - Pilar Serra-Añó
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 València, Spain; (R.I.-A.); (S.C.-A.); (P.S.-A.)
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Rana R, Latif S, Gururajan R, Gray A, Mackenzie G, Humphris G, Dunn J. Automated screening for distress: A perspective for the future. Eur J Cancer Care (Engl) 2019; 28:e13033. [DOI: 10.1111/ecc.13033] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/05/2019] [Accepted: 02/18/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Rajib Rana
- University of Southern Queensland Springfield Queensland Australia
| | - Siddique Latif
- University of Southern Queensland Springfield Queensland Australia
| | - Raj Gururajan
- University of Southern Queensland Springfield Queensland Australia
| | - Anthony Gray
- University of Southern Queensland Springfield Queensland Australia
| | | | | | - Jeff Dunn
- University of Southern Queensland Springfield Queensland Australia
- Griffith University Brisbane Queensland Australia
- University of Technology Sydney Sydney New South Wales Australia
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Rebane K, Ristolainen L, Relas H, Orenius T, Kautiainen H, Luosujärvi R, Aalto K, Säilä H. Disability and health-related quality of life are associated with restricted social participation in young adults with juvenile idiopathic arthritis. Scand J Rheumatol 2018; 48:105-113. [PMID: 30270708 DOI: 10.1080/03009742.2018.1493140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To describe a cohort of Finnish juvenile idiopathic arthritis (JIA) patients, to recognize those young adults who are at risk of becoming socially restricted by their long-term rheumatic disease, and to assess which areas of self-rated health-related quality of life (HRQoL) are associated with the emergence of restricted social participation. METHODS A total of 195 young adults with JIA completed questionnaires addressing demographics, health behaviour, physical activity, functional ability, HRQoL, depressive symptoms, and self-esteem. Patients were classified as having non-restricted social participation if they were engaged in studying, working, maternity leave, or military service, and restricted social participation if they were unemployed or on disability pension. RESULTS Of the patients, 162 (83%) were considered as having non-restricted social participation and 33 (16%) restricted social participation. Among patients with restricted social participation, five (15%) were on disability pension and 28 (85%) were unemployed. Patients with restricted social participation participated less in leisure-time non-physical activities (p = 0.033), felt more disturbed during their leisure time (p = 0.010), had lower self-esteem (p = 0.005), and had higher disability scores (p = 0.024). HRQoL scores revealed statistically significant differences between the groups: physical functioning (p = 0.043), social functioning (p = 0.016), and emotional well-being (p = 0.049) were all lower in patients with restricted social participation. CONCLUSIONS Socially restricted patients showed a higher degree of disability, and lower levels of physical functioning, self-esteem, emotional well-being, and social functioning. These patients should be recognized earlier and interventions provided to enhance their social participation.
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Affiliation(s)
- K Rebane
- a Children's Hospital , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - L Ristolainen
- b Research Institute Orton , Orton, Helsinki , Finland
| | - H Relas
- c Department of Medicine, Division of Rheumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - T Orenius
- d Orton Orthopaedic Hospital , Orton, Helsinki , Finland
| | - H Kautiainen
- e Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - R Luosujärvi
- c Department of Medicine, Division of Rheumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - K Aalto
- a Children's Hospital , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - H Säilä
- d Orton Orthopaedic Hospital , Orton, Helsinki , Finland
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Svebak S, Halvari H. Sickness Absence due to Chronic Musculoskeletal Pain: The Exploration of a Predictive Psychological Model Including Negative Moods, Subjective Health and Work Efficacy in an Adult County Population (The HUNT Study). EUROPES JOURNAL OF PSYCHOLOGY 2018; 14:373-385. [PMID: 30008952 PMCID: PMC6016039 DOI: 10.5964/ejop.v14i2.1470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 01/09/2018] [Indexed: 12/01/2022]
Abstract
The relation between musculoskeletal pain and sickness absence was tested in an adult county population. Maximal explained variance in absence from work due to chronic musculoskeletal pain (sickness absence) was tested in a model in which subjective health was expected to mediate the associations between such pain and dysphoria, respectively, and work efficacy. In turn, work efficacy was expected to mediate the link between subjective health and sickness absence. All the residents in the County of Nord-Trøndelag, Norway, aged 20 and older, were invited to take part in a public health survey during 1995-97 (HUNT-2), and 66,140 (71.2%) participated. Prevalence of musculoskeletal pain, dysphoria, subjective health and work efficacy were assessed, as well as sickness absence last year due to musculoskeletal pain. The model test was performed by use of the LISREL procedure based upon data from 30,158 employees reporting chronic musculoskeletal pain last year. The measurement model fitted the data well: χ2 = 9075, df = 52, p < .0004, Critical N = 1041, RMSEA = 0.038, CFI = 0.99, SRMR = 0.020. The structural model fitted the data equally well, and the best prediction of sickness absence was obtained with lower back pain, upper and lower extremity pain, as well as dysphoria as the primary variables affecting subjective health that, in turn, was the convergent predictor of work efficacy that, finally, best explained the variance in sickness absence (56%). The data supported an indirect sequence of complaint-health-efficacy (CHE-model) as the best predictor of sickness absence due to musculoskeletal pain.
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Affiliation(s)
- Sven Svebak
- Norwegian University of Science and Technology, Department of Mental Health, Trondheim, Norway
| | - Hallgeir Halvari
- University College Southeast Norway, School of Business and Social Sciences, Hønefoss, Norway
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Preventing Sickness Absence With Career Management Intervention: A Randomized Controlled Field Trial. J Occup Environ Med 2018; 58:1202-1206. [PMID: 27930479 PMCID: PMC5172807 DOI: 10.1097/jom.0000000000000887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence. Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a randomized controlled trial. Sickness absence data were collected covering a period from 1 year before (baseline) to approximately 2 years after the intervention (follow-up). The data were analyzed using zero-inflated negative binomial models. After controlling for baseline absence, age, gender, and organization, the intervention was effective in decreasing the number of longer sickness absences (lasting longer than > 2 weeks), but no other significant effects were found. These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations.
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Mousa A, Naderpoor N, de Courten MPJ, de Courten B. Vitamin D and symptoms of depression in overweight or obese adults: A cross-sectional study and randomized placebo-controlled trial. J Steroid Biochem Mol Biol 2018; 177:200-208. [PMID: 28803880 DOI: 10.1016/j.jsbmb.2017.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 07/26/2017] [Accepted: 08/03/2017] [Indexed: 12/26/2022]
Abstract
Recent evidence suggests that vitamin D deficiency may contribute to increased risk of depression. However, previous studies are limited by variability in participant characteristics including vitamin D deficiency status and presence of existing diseases, use of low doses of vitamin D supplementation for short durations, and use of co-interventions or psychotropic drugs. We examined whether 25-hydroxyvitamin D (25(OH)D) concentrations were associated with symptoms of depression, as well as whether vitamin D supplementation reduced symptoms of depression in overweight or obese and vitamin D-deficient, but otherwise healthy adults. Cross-sectional analyses were performed on baseline data from 63 (39M/24F) overweight or obese (body mass index (BMI) ≥25kg/m2) and vitamin D-deficient (25(OH)D ≤50 nmol/l) adults (mean age=31.3±8.5), without clinical depression. Participants were randomized to either a bolus oral dose of 100,000 IU followed by 4000 IU daily of cholecalciferol, or matching placebo for 16 weeks. Interventional analyses were performed on data from 48 participants (30M/18F) who completed the trial. We measured serum 25(OH)D concentrations; anthropometry: BMI, waist-to-hip ratio (WHR), % body fat (dual X-ray absorptiometry); and depressive symptoms using the Beck Depression Inventory (BDI) before and after intervention. Data on dietary vitamin D intake (3-day food record), physical activity (international physical activity questionnaire), and sun exposure habits were collected using questionnaires. At baseline, mean 25(OH)D concentration was 32.9±11.3 nmol/l and total BDI score was 6.6±6.3 (range=0-33). There were no associations between 25(OH)D concentrations and total BDI scores or BDI subscales (all p>0.1). After the 16-week intervention, 25(OH)D concentrations increased in the vitamin D group compared to placebo (56.0±20.8 versus 2.7±13.9 nmol/L, respectively; p <0.0001). Change in total BDI scores did not differ between vitamin D and placebo groups (-2.0±4.5 versus -1.5±2.9, respectively; p=0.7). There were no differences in BDI subscales between groups (both p>0.1). Results remained non-significant after adjusting for multiple covariates including sun exposure, physical activity, and dietary vitamin D intake (all p>0.1). Our findings suggest that vitamin D deficiency may not be related to increased risk of depression in individuals without clinically significant depression and that the use of vitamin D supplementation may not be warranted for reducing depressive symptoms in this population. Further large-scale studies are needed to establish whether vitamin D supplementation may be beneficial for improving depressive symptoms in other population groups, including in those with existing depressive or psychiatric disorders.
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Affiliation(s)
- Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia.
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia.
| | - Maximilian P J de Courten
- Centre for Chronic Disease, Victoria University, 176 Furlong Road, St. Albans, Melbourne, VIC 3021, Australia.
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia.
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Prevalence of Symptoms of Depression, Anxiety, and Posttraumatic Stress Disorder in Workers With Upper Extremity Complaints. J Orthop Sports Phys Ther 2016; 46:590-5. [PMID: 27170526 DOI: 10.2519/jospt.2016.6265] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional cohort study. Background Symptoms of depression, panic disorder (PD), and posttraumatic stress disorder (PTSD) have been associated with musculoskeletal complaints and could represent barriers to recovery in injured workers. Objectives To determine the prevalence of symptoms of depression, PD, and PTSD utilizing the Patient Health Questionnaire (PHQ) in a cohort of patients presenting to an upper extremity injured-worker clinic; secondarily, to identify any relationships between patients screening positive and patient-reported outcome measures. Methods In 2010, 418 patients completed the PHQ during their initial evaluation. Patients with PHQ scores exceeding threshold values for symptoms of depression, PD, or PTSD were compared based on patient-reported outcome scores, including the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The prevalence of symptoms, and their relationship with presenting complaints and patient-reported outcomes, were calculated. Results Thirty-one percent of patients scored above thresholds for symptoms of at least 1 mental health disorder. Of those who screened positive, 67% screened positive for depression, 44% for PTSD, and 50% for PD, with 43% of patients positive for multiple symptoms. Patients experiencing neck pain had significantly higher screening rates of depressive symptoms (62.5% versus 20.1%, P = .004) and PD (37.5% versus 12.9%, P = .044) compared with other presenting complaints. Similarly, patients with chronic pain had higher rates of depression (54.5% versus 20.1%, P = .006), PD (63.6% versus 12%, P<.001), and PTSD (36.4% versus 14.8%, P = .05) compared with other presenting complaints. Patients endorsing depressive symptoms had significantly lower SF-36 mental component summary scores (26.3 ± 10.7 versus 37.6 ± 9.9, P<.001) and higher shortened-version DASH (72.3 ± 16.7 versus 61.5 ± 11.1, P = .003) and DASH work scores (86.5 ± 19.2 versus 82.1 ± 20.1, P = .007) compared to patients endorsing other items on the PHQ. Conclusion In this prospective cohort study of injured workers, we identified a relatively high prevalence of symptoms of psychological disorders utilizing the PHQ, with one third of injured workers screening positive for symptoms of depression, PD, or PTSD. Further longitudinal follow-up is necessary to determine the impact on treatment outcomes. Level of Evidence Symptom prevalence, level 1b. J Orthop Sports Phys Ther 2016;46(7):590-595. Epub 12 May 2016. doi:10.2519/jospt.2016.6265.
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Blümel JE, Chedraui P, Baron G, Belzares E, Bencosme A, Calle A, Danckers L, Espinoza MT, Flores D, Gomez G, Hernandez-Bueno JA, Izaguirre H, Leon-Leon P, Lima S, Mezones-Holguin E, Monterrosa A, Mostajo D, Navarro D, Ojeda E, Onatra W, Royer M, Soto E, Tserotas K, Vallejo MS. Menopause could be involved in the pathogenesis of muscle and joint aches in mid-aged women. Maturitas 2013; 75:94-100. [DOI: 10.1016/j.maturitas.2013.02.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 01/01/2023]
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13
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Wicksell RK, Kemani M, Jensen K, Kosek E, Kadetoff D, Sorjonen K, Ingvar M, Olsson GL. Acceptance and commitment therapy for fibromyalgia: A randomized controlled trial. Eur J Pain 2012; 17:599-611. [DOI: 10.1002/j.1532-2149.2012.00224.x] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2012] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | | | - K. Sorjonen
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm; Sweden
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Soegaard HJ. Undetected common mental disorders in long-term sickness absence. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2012; 2012:474989. [PMID: 22666588 PMCID: PMC3361179 DOI: 10.1155/2012/474989] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 01/24/2012] [Accepted: 02/20/2012] [Indexed: 05/22/2023]
Abstract
Background. Undetected Common Mental Disorders (CMDs) amongst people on sick leave complicate rehabilitation and return to work because appropriate treatments are not initiated. Aims. The aim of this study is to estimate (1) the frequencies of CMD, (2) the predictors of undetected CMD, and (3) the rate of return to work among sick listed individuals without a psychiatric disorder, who are registered on long-term sickness absence (LSA). Methods. A total of 2,414 incident individuals on LSA with a response rate of 46.4%, were identified for a two-phase study. The subsample of this study involved individuals registered on LSA who were sick-listed without a psychiatric sick leave diagnosis. In this respect, Phase 1 included 831 individuals, who were screened for mental disorders. In Phase 2, following the screening of Phase 1, 227 individuals were thoroughly examined by a psychiatrist applying Present State Examination. The analyses of the study were carried out based on the 227 individuals from Phase 2 and, subsequently, weighted to be representative of the 831 individuals in Phase 1. Results. The frequencies of undetected mental disorders among all sick-listed individuals were for any psychiatric diagnosis 21%, depression 14%, anxiety 4%, and somatoform disorder 6%. Conclusions. Undetected CMD may delay the initiation of appropriate treatment and complicate the rehabilitation and return to work.
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Affiliation(s)
- Hans Joergen Soegaard
- Regional Psychiatric Services Central Denmark Region, Research Unit West and Centre for Psychiatric Research, 7400 Herning, Denmark
- *Hans Joergen Soegaard:
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