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Jerković A, Proroković A, Matijaca M, Vuko J, Poljičanin A, Mastelić A, Ćurković Katić A, Košta V, Kustura L, Dolić K, Ðogaš Z, Rogić Vidaković M. Psychometric Properties of the HADS Measure of Anxiety and Depression Among Multiple Sclerosis Patients in Croatia. Front Psychol 2021; 12:794353. [PMID: 34917005 PMCID: PMC8670005 DOI: 10.3389/fpsyg.2021.794353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/12/2021] [Indexed: 12/04/2022] Open
Abstract
Depression and anxiety are common complaints in patients with multiple sclerosis (MS). The study objective was to investigate the factor structure, internal consistency, and correlates of the Croatian version of the Hospital Anxiety and Depression Scale (HADS) in patients with MS. A total of 179 patients with MS and 999 controls were included in the online survey. All subjects completed the HADS and self-administered questionnaires capturing information of demographic, education level, disease-related variables, and the Multiple Sclerosis Impact Scale-29 (MSIS-29). Psychometric properties were examined by estimating the validity, reliability, and factor structure of the HADS in patients with MS. The two HADS subscales (anxiety and depression) had excellent internal consistencies (Cronbach’s α value 0.82–0.83), and factor analysis confirmed a two-factor structure. The convergent validity of the HADS subscales appeared to be good due to the significant correlations between HADS and MSIS-29. Receiver operating characteristic (ROC) analysis indicates that the HADS subscales have a significant diagnostic validity for group differentiation. Hierarchical regression analysis using MSIS-29 subscales as criterion variables showed consistent evidence for the incremental validity of the HADS. The HADS is a reliable and valid self-assessment scale in patients with MS and is suggested to be used in clinical monitoring of the psychiatric and psychological status of patients with MS.
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Affiliation(s)
- Ana Jerković
- Laboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, Split, Croatia
| | - Ana Proroković
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Meri Matijaca
- Department of Neurology, University Hospital of Split, Split, Croatia
| | - Jelena Vuko
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Ana Poljičanin
- Institute of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, Split, Croatia.,Department for Health Studies, University of Split, Split, Croatia
| | - Angela Mastelić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | | | - Vana Košta
- Department of Neurology, University Hospital of Split, Split, Croatia
| | - Lea Kustura
- Department Psychiatry, University Hospital of Split, Split, Croatia
| | - Krešimir Dolić
- Department of Radiology, University Hospital of Split, Split, Croatia
| | - Zoran Ðogaš
- Laboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.,Sleep Medical Center, University of Split, Split, Croatia
| | - Maja Rogić Vidaković
- Laboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, Split, Croatia
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Differences in Dietary Habits, Physical Exercise, and Quality of Life between Male and Female Patients with Overweight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111255. [PMID: 34769772 PMCID: PMC8582794 DOI: 10.3390/ijerph182111255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 12/02/2022]
Abstract
Overweight can be an additional problem in patients admitted to hospital. Objective: To analyze gender differences in pre-admission dietary habits and physical exercise and in HRQoL at hospital discharge among hospitalized adults with overweight. Methods: Cross-sectional study in non-diabetic patients enrolled in a clinical trial with body mass index (BMI) ≥ 25 Kg/m2 at admission. Bivariate analyses used Pearson’s chi-square test and Fisher’s exact test for qualitative variables and the Mann–Whitney test for numerical variables. Results: The study included 148 males and 127 females. At admission, women had higher BMI (p = 0.016) than men and a larger percentage consumed drugs for depression (p = 0.030) and anxiety (p = 0.049), and followed a religion-based diet (p = 0.022). Pre-admission, women had healthier habits related to dietary caloric intake (p = 0.009) and greater adherence to recommendations for a healthy diet (p = 0.001). At discharge, women described worse self-perceived health (p = 0.044) and greater pain/discomfort (p = 0.004) in comparison to men. Conclusions: Pre-admission, women had better habits related to a healthy diet and did not differ from men in habits related to physical exercise but had a higher BMI. At discharge, women reported worse self-perceived health and greater pain/discomfort. These differences should be considered for the adequate clinical management of patients with overweight.
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Meneguzzo P, Todisco P, Calonaci S, Mancini C, Dal Brun D, Collantoni E, Donini LM, Tenconi E, Favaro A. Health-related quality of life assessment in eating disorders: adjustment and validation of a specific scale with the inclusion of an interpersonal domain. Eat Weight Disord 2021; 26:2251-2262. [PMID: 33315213 PMCID: PMC8437832 DOI: 10.1007/s40519-020-01081-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/18/2020] [Accepted: 11/22/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Quality of life is a fundamental aspect of both clinical practice and research on eating disorders (ED) due to the significant impacts these disorders have on everyday life. Disorder-specific scales can improve the quality of research and findings and offer greater sensitivity and responsiveness. However, no specific instrument is available in Italian for ED. The aim of this paper is to adjust and to validate a reliable scale with specific items regarding physical and interpersonal well-being. METHODS The Italian version of the Eating Disorder Quality of Life (IEDQOL) scale was developed, on the basis of the original English scale, with the addition of items pertaining to physical well-being and interpersonal interactions. In this study, 180 ED patients and 190 healthy controls from the community were enrolled both from inpatient units and outpatient services. A statistical analysis with an exploratory factorial approach was performed in order to validate the tool. RESULTS The results showed that the IEDQOL has very good psychometric properties with test-retest validity and sensitivity between patients and controls (d = 2.17 for total score). Moreover, the interpersonal domain showed excellent psychometric values (Cronbach's α > 0.70 in all the subgroups) and a robust correlation with other quality of life constructs. CONCLUSION Future studies on the Italian population should use IEDQOL as outcome element that can be useful also with other disorder-specific psychopathological constructs and corroborate the reliability of the data. Future research in the ED field should only use this specific tool. LEVEL OF EVIDENCE Case-control analytic study, Level III.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy. .,Eating Disorders Unit, Casa Di Cura "Villa Margherita", Arcugnano, VI, Italy.
| | - Patrizia Todisco
- Eating Disorders Unit, Casa Di Cura "Villa Margherita", Arcugnano, VI, Italy
| | - Sofia Calonaci
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy
| | - Cecilia Mancini
- Experimental Medicine Department, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Rome, Italy
| | - David Dal Brun
- Department of Linguistic and Literary Studies, University of Padova, Padua, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy
| | - Lorenzo Maria Donini
- Experimental Medicine Department, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Rome, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy.,Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy.,Padova Neuroscience Center, University of Padova, Padua, Italy
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Pavlova N, Kioskli K, Smith C, Picariello F, Rayner L, Moss‐Morris R. Psychosocial aspects of obesity in adults with psoriasis: A systematic review. SKIN HEALTH AND DISEASE 2021; 1:e33. [PMID: 35664982 PMCID: PMC9060108 DOI: 10.1002/ski2.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/08/2021] [Accepted: 03/28/2021] [Indexed: 02/04/2023]
Abstract
Background Excess weight is a common (30%–40%) multifactorial concern that remains understudied in adults with psoriasis. Objectives This systematic review aimed to synthesise the evidence on the psychosocial factors associated with body weight in psoriasis and to use these findings to inform clinical practice. The review was registered with PROSPERO (registration number: CRD42020201138). Methods Electronic databases, related reviews and associated reference lists were searched. Observational and experimental studies reporting on the relationship of psychosocial factors to weight‐related outcomes in adults with body mass index (BMI) of ≥30 kg/m2 and psoriasis were eligible. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP). Results Eighteen studies were included in the review, the majority of which (n = 16) examined cross‐sectional associations between psychosocial factors and weight outcomes. Although the strengths of the associations were heterogeneous, most studies confirmed the positive association between high BMI and increased reports of depression and anxiety, impaired quality of life, deteriorated sleep quality, sexual dysfunction, and daily functioning issues. Only four studies were rated as high quality. Conclusions The current evidence of the association between psychosocial factors and weight‐related outcomes is largely cross‐sectional with unclear directionality of causality. Longitudinal studies are needed to examine the replicability and generalisability of the examined obesity‐related psychosocial factors in psoriasis. Theoretical exploration of subgroup differences and similarities may pave the way towards intervention personalisation, and ultimately, improved patient outcomes.
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Affiliation(s)
- N.T. Pavlova
- Health Psychology Section, Psychology Department King's College London Institute of Psychiatry Psychology and Neuroscience London UK
| | - K. Kioskli
- Department of Computer Science, Centre for Adaptive Computing Systems University of London London UK
- Gruppo Maggioli, Research and Development Lab Athens Greece
| | - C. Smith
- Health Psychology Section, Psychology Department King's College London Institute of Psychiatry Psychology and Neuroscience London UK
- St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust London UK
| | - F. Picariello
- Health Psychology Section, Psychology Department King's College London Institute of Psychiatry Psychology and Neuroscience London UK
| | - L. Rayner
- Department of Psychological Medicine King's College London Institute of Psychiatry Psychology and Neuroscience London UK
| | - R. Moss‐Morris
- Health Psychology Section, Psychology Department King's College London Institute of Psychiatry Psychology and Neuroscience London UK
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Family Physicians' Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic-A Nationwide Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042093. [PMID: 33669982 PMCID: PMC7924834 DOI: 10.3390/ijerph18042093] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 12/23/2022]
Abstract
During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = -0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = -0.33, p = 0.023) and anxiety (β = -0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs' knowledge. Thus lowering anxiety and improving patient care.
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Galić M, Mustapić L, Šimunić A, Sić L, Cipolletta S. COVID-19 Related Knowledge and Mental Health: Case of Croatia. Front Psychol 2020; 11:567368. [PMID: 33324280 PMCID: PMC7726852 DOI: 10.3389/fpsyg.2020.567368] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Abstract
Background and Aims: The COVID-19 pandemic has led to radical and unexpected changes in everyday life, and it is plausible that people's psychophysical health has been affected. This study examined the relationship between COVID-19 related knowledge and mental health in a Croatian sample of participants. METHODS An online survey was conducted from March 18 until March 23, 2020, and a total of 1244 participant responses were collected (85.5% were women and 58.4% completed secondary education). Measures included eight questions regarding biological features of the virus, symptoms, and prevention, the Hospital Anxiety and Depression Scale, and Optimism-Pessimism Scale. According to the answers given on the questions on COVID-19 related knowledge, participants were divided in two groups: (1) informed and (2) uninformed on each question. They were then compared in the expressed levels of anxiety, depression, pessimism, and optimism. Full vs. partial mediation models with optimism/pessimism as a mediator in the relationship between anxiety/depression and the accuracy of responses for questions about handwashing and ways of transmission were estimated. RESULTS Participants who responded correctly on the question about handwashing had higher levels of anxiety, depression, and pessimism than those participants whose answer was incorrect, while participants who answered correctly on the question about the percentage of patients who develop serious breathing problems had higher levels of depression than those who answered incorrectly. Lower levels of anxiety and pessimism were observed in the participants who answered correctly about ways of transmission. Higher levels of pessimism were found in participants who scored incorrectly on questions about the efficiency of antibiotics, most common symptoms, and the possibility of being infected by asymptomatic carriers. Higher levels of knowledge about handwashing were predicted by higher levels of anxiety and pessimism. Higher levels of knowledge about ways of transmission were predicted by lower levels of anxiety and lower levels of pessimism. The examined relationships between anxiety/depression and knowledge were mediated by pessimism. CONCLUSION The findings of this study suggest that knowledge about COVID-19 may be useful to reduce anxiety and depression, but it must be directed to the promotion of health behaviors and to the recognition of fake news.
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Affiliation(s)
- Marko Galić
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Luka Mustapić
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Ana Šimunić
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Leon Sić
- Department of Psychology, University of Zadar, Zadar, Croatia
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Panduro A, Rivera-Iñiguez I, Sepulveda-Villegas M, Roman S. Genes, emotions and gut microbiota: The next frontier for the gastroenterologist. World J Gastroenterol 2017; 23:3030-3042. [PMID: 28533660 PMCID: PMC5423040 DOI: 10.3748/wjg.v23.i17.3030] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/10/2017] [Accepted: 04/12/2017] [Indexed: 02/06/2023] Open
Abstract
Most medical specialties including the field of gastroenterology are mainly aimed at treating diseases rather than preventing them. Genomic medicine studies the health/disease process based on the interaction of the human genes with the environment. The gastrointestinal (GI) system is an ideal model to analyze the interaction between our genes, emotions and the gut microbiota. Based on the current knowledge, this mini-review aims to provide an integrated synopsis of this interaction to achieve a better understanding of the GI disorders related to bad eating habits and stress-related disease. Since human beings are the result of an evolutionary process, many biological processes such as instincts, emotions and behavior are interconnected to guarantee survival. Nourishment is a physiological need triggered by the instinct of survival to satisfy the body’s energy demands. The brain-gut axis comprises a tightly connected neural-neuroendocrine circuitry between the hunger-satiety center, the dopaminergic reward system involved in the pleasure of eating and the gut microbiota that regulates which food we eat and emotions. However, genetic variations and the consumption of high-sugar and high-fat diets have overridden this energy/pleasure neurocircuitry to the point of addiction of several foodstuffs. Consequently, a gut dysbiosis generates inflammation and a negative emotional state may lead to chronic diseases. Balancing this altered processes to regain health may involve personalized-medicine and genome-based strategies. Thus, an integrated approach based on the understanding of the gene-emotions-gut microbiota interaction is the next frontier that awaits the gastroenterologist to prevent and treat GI disorders associated with obesity and negative emotions.
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Ágh T, Kovács G, Supina D, Pawaskar M, Herman BK, Vokó Z, Sheehan DV. A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder. Eat Weight Disord 2016; 21:353-364. [PMID: 26942768 PMCID: PMC5010619 DOI: 10.1007/s40519-016-0264-x] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/17/2016] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To perform a systematic review of the health-related quality of life (HRQoL) and economic burdens of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). METHODS A systematic literature search of English-language studies was performed in Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier, and Cochrane Library. Cost data were converted to 2014 Euro. RESULTS Sixty-nine studies were included. Data on HRQoL were reported in 41 studies (18 for AN, 17 for BN, and 18 for BED), on healthcare utilization in 20 studies (14 for AN, 12 for BN, and 8 for BED), and on healthcare costs in 17 studies (9 for AN, 11 for BN, and only 2 for BED). Patients' HRQoL was significantly worse with AN, BN, and BED compared with healthy populations. AN, BN, and BED were associated with a high rate of hospitalization, outpatient care, and emergency department visits. However, patients rarely received specific treatment for their eating disorder. The annual healthcare costs for AN, BN, and BED were €2993 to €55,270, €888 to €18,823, and €1762 to €2902, respectively. CONCLUSIONS AN, BN, and BED have a serious impact on patient's HRQoL and are also associated with increased healthcare utilization and healthcare costs. The burden of BED should be examined separately from that of BN. The limited evidence suggests that further research is warranted to better understand the differences in long-term HRQoL and economic burdens of AN, BN, and BED.
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Affiliation(s)
- Tamás Ágh
- Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary.
| | - Gábor Kovács
- Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary
| | - Dylan Supina
- Formerly of Shire, 300 Shire Way, Lexington, MA, 02421, USA
| | | | | | - Zoltán Vokó
- Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary.,Department of Health Policy and Health Economics, Faculty of Social Sciences, Eötvös Loránd University, 1/a Pázmány Péter Street, 1117, Budapest, Hungary
| | - David V Sheehan
- University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL, 33612, USA
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