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Buckman TA, Sakyi SA, Yeboah-Mensah K, Antwi MH, Darban I, Owusu-Brenya L, Yorke J, Boateng AO, Senu E, Dompreh A, Addei AM, Boateng R, Yankey O, Tandoh S. Demographic, Clinical Profile of Rheumatoid Arthritis Patients and Their Association with Disease Severity in Ghana. Int J Rheumatol 2024; 2024:6639079. [PMID: 38249778 PMCID: PMC10798837 DOI: 10.1155/2024/6639079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/10/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Background Rheumatoid arthritis (RA) is one of the frequent chronic, systemic, inflammatory autoimmune disorders with an estimated global prevalence of 1%. RA leads to joint destruction and disability if left untreated. Ghana has seen very few studies on RA, and little is known about the disease's severity and related variables. This study sought to characterize the clinical presentation and determine disease severity and associated risk factors with disease severity among RA patients in a tertiary hospital in Ghana. Methods This cross-sectional study was conducted between September 2020 and August 2021. This study included 56 consecutively consenting RA patients from the Komfo Anokye Teaching Hospital orthopaedic unit. Diagnosis of RA was based on the updated American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2022 rheumatoid arthritis classification criteria by a rheumatologist. A study questionnaire was used to gather participant demographics and clinical features, and results from the laboratory were taken from the patients' charts and medical records. The patients' disease severity was evaluated based on the rheumatoid arthritis disease activity score, which is based on a 28-joint count (DAS28), and their functioning was evaluated using the modified health assessment questionnaire. Results The participants' mean age was 51.25 ± 13.22 years. Out of the total participants, 46 were females, and 10 were males (female-to-male ratio 4.6 : 1). Moreover, 37.50% had arthritis of the hand; 5.30% had severe disease, and 94.60% were not severe. A majority (76.80%) were on methotrexate medication. The most frequently involved joints were the knee (42.90%), wrist (32.10%), and elbow (12.50%). There was no statistically significant association with disease severity and a functional status score of >0.5 (cOR: 10.60, 95% CI (0.52-217.30); p = 0.124). In addition, marital status (p = 0.04), disease duration (p = 0.04), family complaints (p = 0.02), and ESR (p = 0.03) were significantly associated with disease severity. Conclusion RA is predominant among elder populations and females. Disease duration, family complaints, and ESR are associated with disease severity. The findings of this study call for interventions towards ensuring early diagnosis of RA among high-risk populations to enhance good management practices.
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Affiliation(s)
- Tonnies Abeku Buckman
- Department of Medical Laboratory Science, KAAF University College, Buduburam-Gomoa East District, Ghana
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Maxwell Hubert Antwi
- Department of Medical Laboratory Sciences, Koforidua Technical University, Koforidua, Ghana
| | - Isaac Darban
- Department of Medical Laboratory Sciences, Koforidua Technical University, Koforidua, Ghana
| | - Lawrence Owusu-Brenya
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Yorke
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Andy Opoku Boateng
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Albert Dompreh
- Department of Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Akwasi Minnah Addei
- Department of Biological Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Boateng
- Department of Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Ortis Yankey
- School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Samuel Tandoh
- University Clinic, University of Education, Winneba, Ghana
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Aqel O, Agu U, Almatruk Z, Axon DR. Association between pain burden and presence of any limitation among older adults (≥50 years of age) with pain who used opioids in the United States: Cross-sectional study using 2020 medical expenditure panel survey. Medicine (Baltimore) 2023; 102:e34863. [PMID: 37603524 PMCID: PMC10443775 DOI: 10.1097/md.0000000000034863] [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: 04/25/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
This study aimed to assess the association between pain burden and presence of any limitation among older adults (≥50 years of age) with pain who used opioids in the United States. This cross-sectional study used 2020 Medical Expenditure Panel Survey data and included all adults aged 50 or older, who were alive for the 2020 calendar year, used an opioid at least once in the calendar year, and reported having pain in the past 4 weeks. Unadjusted and adjusted logistic regression models were developed to assess the association between any limitation (AL) (yes or no), pain burden (extremely, quite a bit, moderately, or little bit) and the control variables among a nationally representative sample of United States adults. A total of 844 of the 27,805 participants included in the dataset were eligible for the study. Of these, 71.2% (95% confidence interval (CI) = 67.2, 75.1%) reported the presence of AL. The adjusted logistic regression analysis showed that having extreme, quite a bit, or moderate pain (vs little pain) was associated with 10.30 (95% CI = 3.87, 27.40), 5.07 (95% CI = 2.77, 9.30), and 2.49 (95% CI = 1.40, 4.45), respectively, times greater odds of having AL. Furthermore, being unemployed (vs employed; adjusted odds ratio (aOR) = 5.26, 95% CI = 2.94, 9.09%), unmarried (vs married; aOR = 1.92, 95% CI = 1.12, 3.33%), having poor overall health (vs good overall health; aOR = 2.08, 95% CI = 1.08, 4.17), and residing in the Midwest (vs West; aOR = 2.04, 95% CI = 1.10, 3.80) were associated with greater odds of having AL. Extreme, quite a bit, and moderate pain burden were significantly associated with greater odds of reporting AL compared to little pain burden. Developing effective pain management strategies that address not only pain relief but also functional improvement among this population is of importance. Future research could then be conducted to determine the most effective pain management strategies that will provide pain relief and improve their functional abilities.
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Affiliation(s)
- Osama Aqel
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ
| | - Uchechukwu Agu
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ
| | - Ziyad Almatruk
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ
| | - David R. Axon
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ
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Badreldin N, Ditosto JD, Grobman WA, Yee LM. Maternal psychosocial factors associated with postpartum pain. Am J Obstet Gynecol MFM 2023; 5:100908. [PMID: 36809840 PMCID: PMC10121962 DOI: 10.1016/j.ajogmf.2023.100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The experience of pain is shaped by a host of psychological, cultural, and social factors. Although pain is the most common postpartum complaint, data on its relationship with psychosocial factors and postpartum pain are limited. OBJECTIVE This study aimed to examine the relationship between self-reported postpartum pain scores and patient-level psychosocial factors, including relationship status, pregnancy intendedness, employment, education, and psychiatric diagnosis. STUDY DESIGN This was a secondary analysis of data from a prospective observational study of postpartum patients at 1 institution (May 2017 to July 2019) who used an oral opioid at least once during their postpartum hospitalization. Enrolled participants completed a survey, which included questions regarding their social situation (including relationship status), psychiatric diagnoses, and perceptions of their pain control during their postpartum hospitalization. The primary outcome was self-reported overall pain during the postpartum hospitalization (score of 0-100). Multivariable analyses accounted for age, body mass index, nulliparity, and mode of delivery. RESULTS In this cohort of 494 postpartum patients, most patients (84.0%) underwent cesarean delivery, and 41.3% of patients were nulliparous. In a pain score of 0 to 100, participants reported a median pain score of 47. On bivariable analyses, there was no significant difference in pain score between patients with and without an unplanned pregnancy or a psychiatric diagnosis. Patients who were unpartnered, those without a college education, and those who were unemployed reported significantly higher pain scores (57.5 vs 44.8 [P<.01], 52.6 vs 44.6 [P<.01], and 53.6 vs 44.6 [P<.01], respectively). In multivariable analyses, patients who were unpartnered and unemployed reported significantly higher adjusted pain scores than patients who were partnered and employed (adjusted beta coefficients: 7.93 [95% confidence interval, 2.29-13.57] vs 6.67 [95% confidence interval, 2.28-11.05]). CONCLUSION Psychosocial factors, such as relationship and employment statuses, which are indicators of social support, are associated with the experience of pain postpartum. These findings suggest that addressing social support, such as via enhanced support from the health care team, warrants exploration as a nonpharmacologic means of improving the postpartum pain experience.
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Affiliation(s)
- Nevert Badreldin
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee).
| | - Julia D Ditosto
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee)
| | - William A Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH (Dr Grobman)
| | - Lynn M Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee)
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Schäfer C, Keyßer G. Lifestyle Factors and Their Influence on Rheumatoid Arthritis: A Narrative Review. J Clin Med 2022; 11:jcm11237179. [PMID: 36498754 PMCID: PMC9736780 DOI: 10.3390/jcm11237179] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
In recent years, a possible association of lifestyle factors with rheumatoid arthritis (RA) has attracted increasing public interest. The aim of this review is to provide an overview of the extent and the limitations of current evidence regarding lifestyle factors and RA. The PubMed medical database was screened for epidemiological and prospective studies investigating the contribution of lifestyle factors to the development and the course of the disease. Large epidemiological studies have identified smoking, unhealthy diet and adiposity, as well as a low educational level and low socioeconomic status, as factors that increase the incidence of RA. In addition, several lifestyle habits influence the response of RA to antirheumatic drugs. Among others, smoking, obesity and poor physical activity are associated with a worse treatment outcome. Methodological problems often impair firm conclusions with respect to the causal role of these factors in the risk and the course of RA. However, current evidence is sufficient to recommend a healthy diet, the prevention of obesity, the cessation of smoking and the maintenance of a high level of physical activity to support the effectivity of modern antirheumatic medication.
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Ashton-James CE, Anderson SR, Mackey SC, Darnall BD. Beyond pain, distress, and disability: the importance of social outcomes in pain management research and practice. Pain 2022; 163:e426-e431. [PMID: 34252908 PMCID: PMC8742845 DOI: 10.1097/j.pain.0000000000002404] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Claire E Ashton-James
- School of Medicine, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Steven R Anderson
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, United States
| | - Sean C Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, United States
| | - Beth D Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, United States
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Simkin J, Valentino J, Cao W, McCarthy C, Schuon J, Davis J, Marrero L, Dasa V, Leonardi C, Yu Q. Quantifying Mediators of Racial Disparities in Knee Osteoarthritis Outcome Scores: A Cross-Sectional Analysis. JB JS Open Access 2021; 6:JBJSOA-D-21-00004. [PMID: 34337283 PMCID: PMC8318640 DOI: 10.2106/jbjs.oa.21.00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Studies on symptomatic osteoarthritis suggest that Black patients report worse pain and symptoms compared with White patients with osteoarthritis. In this study, we aimed to quantify the relationship among variables such as overall health and socioeconomic status that may contribute to disparities in patient-reported outcomes.
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Affiliation(s)
- Jennifer Simkin
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - John Valentino
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Wentao Cao
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Christina McCarthy
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Jonathan Schuon
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Jacob Davis
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Luis Marrero
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Vinod Dasa
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Claudia Leonardi
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
| | - Qingzhao Yu
- Department of Orthopaedic Surgery, School of Medicine, LSUHSC-New Orleans, New Orleans, Louisiana
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Kumaradev S, Roux C, Sellam J, Perrot S, Pham T, Dugravot A, Molto A. Sociodemographic determinants in the evolution of pain in inflammatory rheumatic diseases: results from ESPOIR and DESIR cohorts. Rheumatology (Oxford) 2021; 61:1496-1509. [PMID: 34270700 PMCID: PMC8996788 DOI: 10.1093/rheumatology/keab562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/30/2021] [Indexed: 11/21/2022] Open
Abstract
Objective To determine whether socio-demographic factors are associated with heterogeneity in pain evolution in inflammatory rheumatic diseases (IRDs) after accounting for disease-specific characteristics in a system with universal health care. Methods This analysis included the data from two prospective observational cohorts of early IRDs (ESPOIR for early RA and DESIR for early SpA). Data on pain was measured, respectively, on 13 and 9 occasions spanning 10 and 6 years of follow-up using the Short-Form 36 bodily pain score for 810 participants of ESPOIR, and 679 participants of DESIR. Linear mixed models were used to characterize differences in pain evolution as a function of age (tertiles), sex, ethnicity, education, marital, and professional status, after accounting for disease-related, treatment, lifestyle, and health factors. Results While transitioning from early (disease duration ≤6 months for RA and ≤3 years for SpA) to long-standing disease, differences in pain evolution emerged as a function of age (P < 0.001), sex (P = 0.050), and ethnicity (P = 0.001) in RA, and as a function of age (P = 0.048) in SpA; younger age, males, and Caucasians exhibited lower pain in the latter phases of both diseases. Highly educated participants (RA, β = −3.8, P = 0.007; SpA, β = −6.0, P < 0.001) for both diseases, and Caucasians (β = −5.6, P = 0.021) for SpA presented with low pain early in the disease, with no changes throughout disease course. Conclusion Being older, female, non-Caucasian and having lower education was found to be associated with worse pain in early and/or long-standing IRDs, despite universally accessible health-care. Early identification of at-risk populations and implementation of multidisciplinary strategies may reduce patient-reported health outcome disparities. Trial registration registrations ESPOIR: ClinicalTrials.gov, www.clinicaltrials.gov, NCT03666091. DESIR: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01648907.
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Affiliation(s)
- Sushmithadev Kumaradev
- Clinical epidemiology applied to rheumatic and musculoskeletal diseases, Inserm 1153, Université de Paris, Paris, France.,Epidemiology of Ageing and Neurodegenerative diseases, Inserm 1153, Université de Paris, Paris, France
| | - Christian Roux
- Clinical epidemiology applied to rheumatic and musculoskeletal diseases, Inserm 1153, Université de Paris, Paris, France.,Department of Rheumatology, APHP-Centre, Cochin Hospital, Paris, France
| | - Jérémie Sellam
- Department of Rheumatology, APHP-Centre, Saint-Antoine Hospital, Paris, France
| | - Serge Perrot
- Pain clinic, APHP-Centre, INSERM U897, Cochin Hospital, Paris, France
| | - Thao Pham
- Department of Rheumatology, APHM, Sainte-Marguerite Hospital, Aix-Marseille Univ, Marseille, France
| | - Aline Dugravot
- Epidemiology of Ageing and Neurodegenerative diseases, Inserm 1153, Université de Paris, Paris, France
| | - Anna Molto
- Clinical epidemiology applied to rheumatic and musculoskeletal diseases, Inserm 1153, Université de Paris, Paris, France.,Department of Rheumatology, APHP-Centre, Cochin Hospital, Paris, France
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Morf H, da Rocha Castelar-Pinheiro G, Vargas-Santos AB, Baerwald C, Seifert O. Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil. Clin Rheumatol 2021; 40:1779-1787. [PMID: 33104946 PMCID: PMC8102442 DOI: 10.1007/s10067-020-05470-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the prevalence of depressive symptoms and its association with clinical and psychological factors in patients with rheumatoid arthritis (RA) in Germany and in Brazil. METHOD A convenience sample of 267 RA patients, 176 from Germany (age 62.4 ± 12.3 years) and 91 from Brazil (age 56.3 ± 12.6 years), was used in this cross-sectional study. The following questionnaires were used: Beck Depression Inventory (BDI), painDETECT test, Perceived Stress Questionnaire, fatigue questionnaire (FACIT), Health Assessment Questionnaire Disability Index (HAQ-DI), and the SF-36 questionnaires (Short-Form 36 Health Survey). Disease activity score (DAS 28-CRP) and visual analogue scale (VAS) for pain were also evaluated. Statistical analysis is based on comparison of means and proportions. Statistical significance for non-normal data was evaluated by non-parametrical tests. RESULTS Depressive symptoms were more prevalent in the Brazilian sample (44% vs 22.9%, p = 0.025). Compared to German patients, the Brazilian ones also experienced more pain (current pain status on VAS: 4.67 ± 3.4 vs 3.67 ± 2.31 respectively, p < 0.01), were physically more limited (1.89 ± 1.85 vs 1.01 ± 0.75, p = 0.012), and had higher C-reactive protein levels (7.78 ± 18.3 vs 5.82 ± 10.45, p = 0.028). Despite receiving a more intensive treatment, German patients presented similar disease activity when compared to Brazilian patients (DAS28-CRP: Brazil 3.4 ± 1.5 vs Germany 3.3 ± 1.3, p = 0.307). CONCLUSION Depressive symptoms are frequent in RA patients from different countries and interact with psychological disorders and the experience of pain. They contribute negatively to their well-being suggesting the need for psychoeducational strategies. Key Points • New psychoeducational strategies for RA management.• Higher inflammation marker in rheumatoid arthritis patients is associated with depression.• Medical treatment in RA influences depressive symptoms.• Depressive symptoms are dependent on population group.• High disease activity is related to depression.
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Affiliation(s)
- Harriet Morf
- Department of Rheumatology, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, Germany
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University Hospital Erlangen, Maximilianspl. 2, 91054 Erlangen, Germany
| | - Geraldo da Rocha Castelar-Pinheiro
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University Hospital Erlangen, Maximilianspl. 2, 91054 Erlangen, Germany
- Department of Internal Medicine, Rheumatology Unit, Universidade do Estado do Rio de Janeiro, R. São Francisco Xavier, 524-Maracanã, Rio de Janeiro, Brazil
| | - Ana Beatriz Vargas-Santos
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University Hospital Erlangen, Maximilianspl. 2, 91054 Erlangen, Germany
- Department of Internal Medicine, Rheumatology Unit, Universidade do Estado do Rio de Janeiro, R. São Francisco Xavier, 524-Maracanã, Rio de Janeiro, Brazil
| | - Christoph Baerwald
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University Hospital Erlangen, Maximilianspl. 2, 91054 Erlangen, Germany
- Department of Rheumatology, University Hospital Leipzig, Liebigstraße 20, 04104 Leipzig, Germany
| | - Olga Seifert
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University Hospital Erlangen, Maximilianspl. 2, 91054 Erlangen, Germany
- Department of Rheumatology, University Hospital Leipzig, Liebigstraße 20, 04104 Leipzig, Germany
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Axon DR, Le D. Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study. J Clin Med 2021; 10:1836. [PMID: 33922574 PMCID: PMC8122955 DOI: 10.3390/jcm10091836] [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: 03/10/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 01/01/2023] Open
Abstract
The characteristics of self-reported functional limitations among older United States (US) adults with pain are currently unknown. This cross-sectional study aimed to determine the characteristics associated with functional limitations among non-institutionalized older (≥50 years) US adults with pain using 2017 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive for the calendar year, aged ≥50 years, and experienced pain within the past four weeks. Hierarchical logistic regression models were utilized to determine significant characteristics associated with functional limitations (outcome variable; yes, no). Functional limitations included difficulty with bending, stooping, climbing stairs, grasping objects, lifting, reaching overhead, standing for long periods of time, or walking. Extrapolation of national data values was possible by adjusting for the complex MEPS design. We found approximately 22 million of the 57 million older US adults (≥50 years) who reported pain had a functional limitation in 2017. Characteristics associated with functional limitations included: gender, race, ethnicity, employment status, marital status, pain intensity, physical health, number of chronic conditions, and frequent exercise status. Knowledge of characteristics associated with functional limitations may provide an opportunity to identify and resolve gaps in patient care among this population.
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Affiliation(s)
- David R. Axon
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ 85721, USA;
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10
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Martínez-Borba V, Ripoll-Server P, Yakobov E, Suso-Ribera C. Predicting the Physical and Mental Health Status of Individuals With Chronic Musculoskeletal Pain From a Biopsychosocial Perspective: A Multivariate Approach. Clin J Pain 2021; 37:211-218. [PMID: 33399397 DOI: 10.1097/ajp.0000000000000913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/12/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chronic pain is theoretically conceptualized from a biopsychosocial perspective. However, research into chronic pain still tends to focus on isolated, biological, psychological, or social variables. Simultaneous examination of these variables in the prediction of outcomes is important because communalities between predictors exist. Examination of unique contributions might help guide research and interventions in a more effective way. METHODS The participants were 114 individuals with chronic pain (mean age=58.81, SD=11.85; 58.8% women and 41.2% men) who responded to demographics (age and sex), pain characteristics (duration and sensory qualities), psychological (catastrophizing and perceived injustice), and social (marital adjustment) measures. Multivariate analyses were conducted to investigate their unique contributions to pain-related health variables pain severity, pain interference, disability, anxiety, and depressive symptoms. RESULTS Bivariate analyses evidenced significant associations between pain sensory qualities, catastrophizing, perceived injustice, and all health variables. In multivariate analyses, pain sensory qualities were associated with pain severity (β=0.10; 95% confidence interval [CI]=0.05, 0.14; t=4.28, P<0.001), while perceived injustice was associated with pain interference (β=0.08; 95% CI=0.03, 0.12; t=3.59, P<0.001), disability (β=0.25; 95% CI=0.08, 0.42; t=2.92, P=0.004), anxiety (β=0.18; 95% CI=0.08, 0.27; t=3.65, P<0.001), and depressive symptoms (β=0.14; 95% CI=0.05, 0.23; t=2.92, P=0.004). Age, sex, pain duration, and marital adjustment were not associated with health variables either in bivariate or in multivariate analyses (all P>0.010). DISCUSSION As expected, communalities between biopsychosocial variables exist, which resulted in a reduced number of unique contributions in multivariate analyses. Perceived injustice emerged as a unique contributor to variables, which points to this psychological construct as a potentially important therapeutic target in multidisciplinary treatment of pain.
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Affiliation(s)
- Verónica Martínez-Borba
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Paula Ripoll-Server
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Esther Yakobov
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
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11
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Damsgård E, Thrane G, Fleten N, Bagge J, Sørlie T, Anke A, Broderstad AR. Persistent pain associated with socioeconomic and personal factors in a Sami and Non-Sami population in Norway: an analysis of SAMINOR 2 survey data. Int J Circumpolar Health 2020; 79:1787022. [PMID: 32780007 PMCID: PMC7480428 DOI: 10.1080/22423982.2020.1787022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/12/2022] Open
Abstract
In international studies, higher prevalence of persistent pain has been reported in indigenous populations compared to majority populations. The present study aimed to determine the prevalence of persistent pain within a Sami and a non-Sami population in northern Norway, with adjustment for the confounding factors of age, sex, marital status, education, income, mental health, smoking status and ethnic background. Using SAMINOR 2 survey data including Sami and non-Sami populations, we analysed 5,546 responses, from individuals aged 40-79 years, to questions concerning persistent pain (≥ 3 months). In total, 2,426 (43.7%) participants reported persistent pain with differences between Sami women and non-Sami women (44.1% versus 51.1%, respectively), but none between Sami men and non-Sami men (38.7% versus 38.2%, respectively). Elderly Sami women were less likely to report persistent pain than were elderly non-Sami women. In men, no ethnic differences in pain were observed according to age-group. Marital status, education levels, household income, psychological distress, and smoking status did not influence the association between ethnicity and pain. Pain severity and location did not differ between Sami and non-Sami participants. In this study, we found only minor ethnic differences in persistent pain. Similar living conditions and cultural features may explain these findings.
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Affiliation(s)
- Elin Damsgård
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Nils Fleten
- Department of Community Medicine, UiT the Arctic University of Norway , Tromsø, Norway
| | - Johan Bagge
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Tore Sørlie
- UiT the Arctic University of Norway , Tromsø, Norway
| | - Audny Anke
- UiT the Arctic University of Norway , Tromsø, Norway
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12
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Validation of CARE Scale-7 in treatment-seeking patients with chronic pain: measurement of sex invariance. Pain Rep 2020; 5:e862. [PMID: 33204930 PMCID: PMC7665255 DOI: 10.1097/pr9.0000000000000862] [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: 07/28/2020] [Revised: 08/31/2020] [Accepted: 09/06/2020] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. The CARE Scale-7 is the first validated instrument to assess self-care difficulty in both sexes and may promote individualized care planning among chronic pain patients. Objectives: Social and interpersonal factors impact the trajectory of chronic pain. We previously developed and validated a 2-factor, 7-item measure to assess interpersonal factors, including relationship guilt and worry and difficulty prioritizing self-care in chronic pain. Here, we confirm the factor structure and examine the sex invariance of the two-factor structure of the CARE Scale-7. Methods: Data were collected as part of routine clinical care at a tertiary pain clinic using the Collaborative Health Outcomes Information Registry. Patient participants (67% women) were predominantly middle-aged (M = 50.9 years, SD = 17.8), married (55.2%), and White/non-Hispanic (55.7%). Data included demographics, pain characteristics, CARE Scale-7, pain catastrophizing, and Patient-Reported Outcomes Measurement Information System psychological and physical function measures. Confirmatory factor analysis was conducted to validate the factor structure of the CARE Scale, and a stepwise approach to measurement invariances by sex examined configural, metric, and scalar invariance. Results: Internal consistency of the scale items ensured suitability for factor analyses. Confirmatory factor analysis findings revealed an overall good fit of the 2-factor model among males and females and that CARE Scale-7 is in fact sex invariant. Finally, CARE Scale-7 showed convergent validity with pain-related outcomes. Discussion: The CARE Scale is the first validated instrument to assess self-care in both sexes among patients with chronic pain. The subscale of difficulty prioritizing self-care emerged as a potentially unique factor that should be integrated in clinical assessment. CARE Scale may facilitate standardized measurement in research and clinical contexts, which may inform a comprehensive treatment focus that integrates individualized self-care planning.
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Rezaei S, Mohammadhossini S, Karimi Z, Yazdanpanah P, Zarei Nezhad M, Ghafarian Shirazi HR. Effect of 8-Week Aerobic Walking Program on Sexual Function in Women with Rheumatoid Arthritis. Int J Gen Med 2020; 13:169-176. [PMID: 32494186 PMCID: PMC7231853 DOI: 10.2147/ijgm.s252591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/30/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Sexual dysfunction is a little-addressed condition in patients with rheumatoid arthritis. Aerobic exercises, including walking, can help alleviate this dysfunction. This study aimed to determine the effect of an 8-week aerobic walking program on sexual function ine patients with rheumatoid arthritis. Methodology This clinical trial was conducted on 51 patients with rheumatoid arthritis. At first, patients were selected through nonprobability sampling. They were then allocated into intervention and control groups using block randomization. The walking intervention was performed based on the frequency–intensity–time–type principle forg 8 consecutive weeks. Rosen’s Female Sexual Function Index was used for data collection before, immediately after, and 4 weeks after the intervention. Data collected were analyzed with SPSS 22 using descriptive and inferential statistics and 95% CI. Findings Mean sexual function scores before, after, and 4 weeks after intervention were 17.66±4, 22.88±4.7, and 24.39±5.1 in the intervention group and 17.60±4.24, 17.27±4.66, and 17.39±4.39 in the control group, respectively. Test results showed a significant intergroup difference in mean sexual function score (p<0.05). Conclusion Based on our results, an 8-week aerobic walking program is recommended as an effective way to improve sexual function in women with rheumatoid arthritis.
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Affiliation(s)
- Sara Rezaei
- Department of Nursing, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Sima Mohammadhossini
- Department of Nursing, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Zohreh Karimi
- Department of Operating Room, School of Paramedicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Parviz Yazdanpanah
- Physical Medicine and Rehabilitation, Yasuj University of Medical Sciences, Yasuj, Iran
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14
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The Relationship Between Anxiety, Depression, Suicidal Ideation and Quality of Life in Patients with Rheumatoid Arthritis. Psychiatr Q 2020; 91:53-64. [PMID: 31768910 DOI: 10.1007/s11126-019-09680-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic disease and many patients with RA experience lifelong anxiety and depression. The aim of this study is to provide an assessment of anxiety, depression, suicidal ideation, disease activity and quality of life in patients with RA. Fifty patients were included in the study. Hospital Anxiety and Depression Scale (HADS), Short Form Health Survey (SF-36), Beck Scale for Suicide Ideation (BSSI) and Disease Activity Score (DAS-28) were applied. A statistically negative correlation was found between HADS-A and HADS-D scores and all subscales of SF-36. There was a statistically negative correlation between the DAS-28 score and the subscales of the SF-36 except mental health and bodily pain. Suicidal ideation was associated with anxiety and depression and BSSI scores of patients suffering from anxiety and depression are higher than the patients not suffering from anxiety and depression. There was a statistically negative correlation between BSSI and the subscales of SF-36 excepting physical role. This study indicated that anxiety, depression, quality of life, disease activity and suicidal ideation are related to each other in patients with RA. The presence of concomitant anxiety and depression may lead to suicide and poor quality of life and may worsen the prognosis of the RA.
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15
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C Evans M, Bazargan M, Cobb S, Assari S. Pain Intensity among Community-Dwelling African American Older Adults in an Economically Disadvantaged Area of Los Angeles: Social, Behavioral, and Health Determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3894. [PMID: 31615105 PMCID: PMC6843192 DOI: 10.3390/ijerph16203894] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although social, behavioral, and health factors influence prevalence and intensity of pain, very few studies have investigated correlates of pain among economically disadvantaged older African American (AA) adults. OBJECTIVE This study explored social, behavioral, and health correlates of pain intensity among community-dwelling AA older adults in an economically disadvantaged area of Los Angeles. METHODS A cross-sectional study on 740 AA older adults (age ≥ 55 years) was conducted in South Los Angeles between 2015 and 2018. Exploratory variables were age, gender, educational attainment, financial difficulties, living alone, marital status, smoking, drinking, pain-related chronic medical conditions (CMCs), and depressive symptoms. Dependent variable was pain intensity. Linear regression was used for data analysis. RESULTS Age, financial difficulties, living alone, smoking, pain-related chronic medical conditions, and depressive symptoms were associated with pain intensity. Individuals with lower age, higher financial difficulties, those who lived alone, those with a higher number of pain-related chronic medical conditions, more depressive symptoms, and nonsmokers reported more pain intensity. Gender, educational attainment, marital status, and drinking were not associated with pain intensity. CONCLUSION The results may help with the health promotion of economically disadvantaged AA older adults in urban areas.
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Affiliation(s)
- Meghan C Evans
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
| | - Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
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16
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Woods SB, Priest JB, Kuhn V, Signs T. Close relationships as a contributor to chronic pain pathogenesis: Predicting pain etiology and persistence. Soc Sci Med 2019; 237:112452. [PMID: 31398508 DOI: 10.1016/j.socscimed.2019.112452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 07/09/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
RATIONALE Chronic stress contributes to the pathogenesis of chronic pain. Yet, the role of close relationship stress in these pathways to pain is not fully understood. OBJECTIVE To delineate specific psychosocial pathways associated with chronic pain, specifically emphasizing close relationships for midlife adults. We tested whether relationship strain, relationship support, social integration, depression, anxiety, and pain severity predict chronic pain etiology and persistence over 10 years, highlighting specific associations for acute versus chronic pain. METHOD Using data from the National Survey of Midlife in the U.S. (MIDUS 2 and 3, collected in 2004-2006 and 2013-2014, respectively), we used logistic regression to test the etiology of new chronic pain (n = 1591) and persistence of pain for adults with acute (n = 352) and chronic pain (n = 367) conditions at baseline. RESULTS Of participants who reported they did not have chronic pain at baseline, the development of chronic pain 10 years later was significantly associated with baseline family strain (OR = 1.38, p < .01). For participants with acute pain at baseline, the transition of this pain to chronic a decade later was significantly associated with initial reports of pain interference (OR = 1.24, p < .001), family support (OR = 0.60, p < .05), and depression (OR = 1.20, p < .05). Persistent chronic pain was solely associated with baseline pain interference (OR = 1.21, p < .01). CONCLUSIONS Family strain is an important part of the chronic stress profile associated with chronic pain etiology, whereas family support is associated with a reduced risk of acute pain transitioning to chronic pain over time. Prioritizing family relationships in treatment approaches to pain may be an indicated, innovative approach to preventing pain development and escalation and requires systems training in healthcare.
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Affiliation(s)
- Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5920 Forest Park Rd, Suite 651, Dallas, TX 75390, USA.
| | - Jacob B Priest
- Department of Psychological and Quantitative Foundations, University of Iowa, N372 Lindquist Center, Iowa City, IA 52242, USA.
| | - Veronica Kuhn
- Graduate School of Education & Psychology, Pepperdine University, 6100 Center Dr., Los Angeles, CA 90045, USA.
| | - Tara Signs
- College of Humanities and Social Sciences, Oklahoma Baptist University, 500 West University, Shawnee, OK, 74804, USA.
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17
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Nyrop KA, Deal AM, Reeder-Hayes KE, Shachar SS, Reeve BB, Basch E, Choi SK, Lee JT, Wood WA, Anders CK, Carey LA, Dees EC, Jolly TA, Kimmick GG, Karuturi MS, Reinbolt RE, Speca JC, Muss HB. Patient-reported and clinician-reported chemotherapy-induced peripheral neuropathy in patients with early breast cancer: Current clinical practice. Cancer 2019; 125:2945-2954. [PMID: 31090930 DOI: 10.1002/cncr.32175] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/01/2019] [Accepted: 04/11/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND In the current study, the authors investigated the incidence of moderate to severe chemotherapy-induced peripheral neuropathy (CIPN) for chemotherapy regimens commonly used in current clinical practice for the treatment of patients with early breast cancer. Patient-reported and clinician-assessed CIPN severity scores were compared, and risk factors for CIPN severity were identified. METHODS Patients completed a Patient-Reported Symptom Monitoring form and oncologists completed a Common Terminology Criteria for Adverse Events form. CIPN reports were collected prospectively during regularly scheduled infusion visits throughout the duration of chemotherapy. RESULTS The sample included 184 women with a mean age of 55 years; approximately 73% were white. The 4 chemotherapy regimens used were doxorubicin and cyclophosphamide plus paclitaxel (60 patients); docetaxel and cyclophosphamide (50 patients); docetaxel, carboplatin, and anti-human epidermal growth factor receptor 2 (HER2) (24 patients); and doxorubicin and cyclophosphamide plus paclitaxel and carboplatin (18 patients). All patients treated with doxorubicin and cyclophosphamide plus paclitaxel and doxorubicin and cyclophosphamide plus paclitaxel and carboplatin received paclitaxel; all patients treated with docetaxel and cyclophosphamide and docetaxel, carboplatin, and anti-HER2 received docetaxel. The chemotherapy dose was reduced in 52 patients (28%); in 15 patients (29%), this reduction was due to CIPN. Chemotherapy was discontinued in 26 patients (14%), 8 because of CIPN. Agreement between patient-reported and clinician-assessed CIPN severity scores was minimal (weighted Cohen kappa, P = .34). Patient-reported moderate to severe CIPN was higher for paclitaxel (50%) compared with docetaxel (17.7%) (P < .001). Pretreatment arthritis and/or rheumatism (relative risk [RR], 1.58; 95% CI, 1.06-2.35 [P = .023]) and regimens containing paclitaxel (RR, 2.88; 95% CI, 1.72-4.83 [P < .0001]) were associated with higher CIPN severity. Being married (RR, 0.57; 95% CI, 0.37-0.887 [P = .01]) was found to be associated with lower CIPN severity. CONCLUSIONS The discrepancy between patient-reported and clinician-assessed CIPN underscores the need for both patient and clinician perspectives regarding this common, dose-limiting, and potentially disabling side effect of chemotherapy.
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Affiliation(s)
- Kirsten A Nyrop
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn E Reeder-Hayes
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Ethan Basch
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Seul Ki Choi
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jordan T Lee
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina
| | - William A Wood
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carey K Anders
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Lisa A Carey
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Elizabeth C Dees
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Trevor A Jolly
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gretchen G Kimmick
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Meghan S Karuturi
- Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, Texas
| | - Raquel E Reinbolt
- Department of Internal Medicine, Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - JoEllen C Speca
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Hyman B Muss
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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18
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Tate AM, Martire LM, Zhaoyang R. Spousal understanding and marital satisfaction in pain patients and their spouses. PERSONAL RELATIONSHIPS 2019; 26:42-53. [PMID: 34335070 PMCID: PMC8323495 DOI: 10.1111/pere.12264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The current study tested the hypotheses that knee osteoarthritis (OA) patients and spouses who report more spousal understanding of patient's pain would report greater marital satisfaction. A total of 124 couples completed interviews at three time points across 18 months. Results from dyadic analyses showed that patients who felt more understood by their spouse report, and have spouses who report, higher marital satisfaction concurrently. In addition, patients who felt more understood by their spouse reported higher marital satisfaction over time. Spouses' reports of understanding also had a significant influence on the patients' and their own marital satisfaction concurrently. Results highlight the importance of spouses understanding knee OA patients' pain for both dyad members' marital satisfaction.
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Affiliation(s)
- Ashley M. Tate
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Lynn M. Martire
- Department of Human Development and Family Studies and the Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
| | - Ruixue Zhaoyang
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
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19
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Brooks JM, Umucu E, Huck GE, Fortuna K, Sánchez J, Chiu C, Bartels SJ. Sociodemographic characteristics, health conditions, and functional impairment among older adults with serious mental illness reporting moderate-to-severe pain. Psychiatr Rehabil J 2018; 41:224-233. [PMID: 30160508 PMCID: PMC6123826 DOI: 10.1037/prj0000316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare adults aged ≥50 years with serious mental illness reporting moderate-to-severe pain to older adults with serious mental illness without pain with respect to sociodemographic characteristics, health conditions, and functional impairment. METHOD Secondary data analyses were conducted using baseline assessments of 183 participants recruited for the Helping Older People Experience Success (HOPES) study from three community mental health centers. The primary outcome was self-reported, nonexperimentally induced, moderate-to-severe pain (referent = no-to-mild pain). Predictor variables consisted of sociodemographic characteristics, health conditions, and functional impairment. We conducted univariable and multivariable logistic regression analyses to examine the associations between these variables. RESULTS Sixty-one participants (33.3%) from our sample reported pain. Pain was associated with all of the sociodemographic and health-related factors in univariable analyses. In the multivariable model, only older age, pain-related activity interference, and physical and emotional health-related social limitations were significantly associated with pain. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The presence of moderate-to-severe pain in older adults with serious mental illness is associated with pain-attributable impairment of activities and social problems above and beyond the substantial functional limitations routinely experienced by this high-risk, high-need group. Given the high rates of preexisting conditions and persistent social impairment among these older adults, our findings suggest that pain may contribute to worse overall functional outcomes. Future research and clinical interventions focused on improving outcomes should include an evaluation of pain as a contributor to decreased functioning and assess the need for early intervention, nonpharmacological pain management, or other health promotion services in psychiatric rehabilitation. (PsycINFO Database Record
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Affiliation(s)
- Jessica M Brooks
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso
| | - Garrett E Huck
- Department of Rehabilitation and Human Services, Penn State Hazleton
| | - Karen Fortuna
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College
| | - Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa
| | - Chungyi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign
| | - Stephen J Bartels
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College
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Sharif K, Watad A, Coplan L, Lichtbroun B, Krosser A, Lichtbroun M, Bragazzi NL, Amital H, Afek A, Shoenfeld Y. The role of stress in the mosaic of autoimmunity: An overlooked association. Autoimmun Rev 2018; 17:967-983. [PMID: 30118900 DOI: 10.1016/j.autrev.2018.04.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 12/22/2022]
Abstract
Stress is defined as the pscyophysiological reaction in which the steady state is disturbed or threatened. Stress is not always perceived as a negative response. Stress results when environmental demands exceed an individuals' adaptive capacities. Autoimmune diseases are heterogeneous group of chronic diseases which occur secondary to loss of self antigen tolerance. The etiopathogenesis of autoimmune disease is uncertain. Genetic factors as well as environmental factors appear to interplay, leading to a cascade of events resulting in disease onset. Stress has been postulated to play a role in disease onset in the genetically susceptible patients. During the stress response, catecholamines and glucocorticoids are released from locus coeruleus and adrenal gland. These biomolecules exert control over various immune cells in the innate and adaptive arms of the immune system, thereby altering the cytokine profile released. The increase of IL-4 promotes T-helper 2 (Th2) cell differentiation, while the decrease in IL-12 and the increased IL-10 production reduce the number of T-helper 1 (Th1) cells. The relationship between stress and autoimmune diseases is intricate. Stress has been shown to be associated with disease onset, and disease exacerbations in rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, multiple sclerosis, Graves' disease as well as other autoimmune conditions. In certain conditions such as psoriasis, stress has been implicated in delaying lesion clearance upon the application of standard treatment regimes. Finally, psychological therapy and cognitive behavioral therapy aimed to reduce stress levels was shown to be effective in influencing better outcomes in many autoimmune diseases. The purpose of this paper is to closer inspect the clinical evidence regarding the role of stress on influencing the various aspects of disease entities.
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Affiliation(s)
- Kassem Sharif
- Department of Medicine 'B', Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abdulla Watad
- Department of Medicine 'B', Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Louis Coplan
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Alec Krosser
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Howard Amital
- Department of Medicine 'B', Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Arnon Afek
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Tel-Aviv University, Head of The Mosaic of Autoimmunity Project, Saint Petersburg State University, Israel; Head of The Mosaic of Autoimmunity Project, Saint Petersburg State University, Russia.
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21
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Dinh KT, Aizer AA, Muralidhar V, Mahal BA, Chen YW, Beard CJ, Choueiri TK, Hoffman KE, Hu JC, Martin NE, Sweeney CJ, Trinh QD, Nguyen PL. Increased Vulnerability to Poorer Cancer-Specific Outcomes Following Recent Divorce. Am J Med 2018; 131:517-523. [PMID: 29555248 DOI: 10.1016/j.amjmed.2017.11.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 11/16/2017] [Accepted: 11/21/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prior studies have only considered the association between static marital status and cancer-specific outcomes. We aim to measure the effect of recent divorce on cancer-specific outcomes. METHODS There were 83,804 patients with 2 malignancies, diagnosed 12 to 60 months apart, from 1973-2006 from the Surveillance, Epidemiology, and End Results database. Patients were identified as newly divorced if married at their first diagnosis and single/divorced at their second. Multivariable logistic regression and competing-risks regression were used to analyze the association of becoming newly divorced or newly married with cancer-specific outcomes from the second malignancy, including advanced diagnosis (T4 or N1 or M1), receipt of treatment, and cancer-specific survival. RESULTS Four percent became newly divorced and 3.4% became newly married. Compared with long-term married, newly divorced patients were most likely to be diagnosed with advanced disease (adjusted odds ratio [AOR] 1.31; 95% confidence interval [CI], 1.19-1.43), followed by long-term divorced (AOR 1.18; 95% CI, 1.11-1.25), and were least likely to receive curative treatment (AOR 0.74; 95% CI, 0.67-0.81). Newly divorced patients had the worst cancer-specific survival (adjusted hazard ratio [AHR] 1.17; 95% CI, 1.05-1.30, P = .005), followed by long-term divorced (AHR 1.08; 95% CI, 1.01-1.16, P = .032), while newly married patients had similar cancer-specific survival to long-term married (AHR 0.96; 95% CI, 0.85-1.08, P = .46). CONCLUSION Recent divorce, which represents an acute disruption of a patient's social support network, was associated with the worst cancer outcomes, followed by long-term divorce. Clinicians should consider recent divorce as a risk factor for worse cancer outcomes, and encourage appropriate screening, treatment, and access to social and financial supports for recently divorced patients.
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Affiliation(s)
| | - Ayal A Aizer
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Mass
| | | | | | - Yu-Wei Chen
- Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Clair J Beard
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Mass
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Karen E Hoffman
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Jim C Hu
- Department of Urology, Weill Cornell Medical College, James Buchanan Brady Foundation, New York City, NY
| | - Neil E Martin
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Mass
| | - Christopher J Sweeney
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Quoc-Dien Trinh
- Division of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Brigham and Women's Hospital, Boston, Mass
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
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Elrashidi MY, Philpot LM, Ramar P, Leasure WB, Ebbert JO. Depression and Anxiety Among Patients on Chronic Opioid Therapy. Health Serv Res Manag Epidemiol 2018; 5:2333392818771243. [PMID: 29761131 PMCID: PMC5946357 DOI: 10.1177/2333392818771243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 03/26/2018] [Indexed: 01/25/2023] Open
Abstract
Background: Chronic noncancer pain (CNCP) and chronic opioid therapy (COT) commonly coexist with comorbid depression and anxiety. We investigated the prevalence of depression and anxiety and their correlates at the time of controlled substance agreement (CSA) enrollment among patients with CNCP and a history of depression or anxiety on COT. Methods: Retrospective analysis of 1066 patients in a Midwest primary care practice enrolled in CSAs for COT between May 9, 2013, and August 15, 2016. Patients with self-reported symptoms or a clinical history of depression or anxiety were screened at CSA enrollment using the Patient Health Questionnaire–9 item scale and the Generalized Anxiety Disorder–7 item scale. Results: The percentage of patients screening positive for depression and anxiety at CSA enrollment was 15.4% and 14.4%, respectively. Patients screening positive for depression or anxiety were more likely to be younger, unmarried, unemployed, and live alone compared to patients not screening positive. Patients screening positive for depression or anxiety were more likely to smoke cigarettes and report concern from friends or relatives regarding alcohol consumption. Compared to patients screening negative, patients screening positive for depression had higher odds of receiving opioid doses of ≥50 morphine milligram equivalents per day (adjusted odds ratio: 1.62; 95% confidence interval: 1.01-2.58). Conclusion: Anxiety and depression are prevalent at enrollment in CSAs among patients receiving COT. Future research is needed to determine whether recognition of anxiety and depression leads to improved management and outcomes for this population.
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Affiliation(s)
- Muhamad Y Elrashidi
- Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Lindsey M Philpot
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Priya Ramar
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - William B Leasure
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Jon O Ebbert
- Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
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23
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Levis B, Rice DB, Kwakkenbos L, Steele RJ, Hagedoorn M, Hudson M, Baron M, Thombs BD. Using Marital Status and Continuous Marital Satisfaction Ratings to Predict Depressive Symptoms in Married and Unmarried Women With Systemic Sclerosis: A Canadian Scleroderma Research Group Study. Arthritis Care Res (Hoboken) 2017; 68:1143-9. [PMID: 26605870 DOI: 10.1002/acr.22802] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 10/27/2015] [Accepted: 11/17/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Married persons have, on average, better mental health than nonmarried persons. Among married persons, marital satisfaction is associated with better mental health. Studies on mental health in married and nonmarried persons that consider marital satisfaction have categorized patients as satisfied versus unsatisfied, which reduces statistical power and does not generate clinically useful information on mental health across the satisfaction spectrum. Our objective was to demonstrate a novel regression approach to evaluate mental health in women with systemic sclerosis (SSc), comparing married and unmarried women, accounting for continuously measured marital satisfaction. METHODS Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and marital satisfaction with the Dyadic Adjustment Scale-7. A single multiple linear regression model was used to predict CES-D scores from marital status and, among married women, continuously measured marital satisfaction, controlling for demographic and clinical characteristics. RESULTS Of 725 women, 494 (68%) were married or living as married. On average, married women had mean CES-D scores that were 2.0 points (0.19 SDs) lower than unmarried women (P = 0.013). Among married women, a 1.0 SD increase in marital satisfaction was associated with a 2.2 point (0.21 SDs) decrease in CES-D scores (P < 0.001). Married women whose marital satisfaction scores were below the 19th percentile had greater predicted depressive symptoms than unmarried women. Married women's predicted CES-D scores ranged from 6.7 points lower to 6.9 points higher than those of unmarried women, depending on marital satisfaction. CONCLUSION Comparisons of mental health in married and unmarried patients with rheumatic diseases should include continuously measured marital satisfaction.
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Affiliation(s)
- Brooke Levis
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Linda Kwakkenbos
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Russell J Steele
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Mariët Hagedoorn
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marie Hudson
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Murray Baron
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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24
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Soósová MS, Macejová Ž, Zamboriová M, Dimunová L. Anxiety and depression in Slovak patients with rheumatoid arthritis. J Ment Health 2016; 26:21-27. [PMID: 27809630 DOI: 10.1080/09638237.2016.1244719] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is significantly associated with psychiatric morbidity. Mental health conditions are often unrecognized and untreated in primary care. AIMS To assess prevalence of anxiety and depression and their impact on arthritis pain and functional disability in Slovak patients with rheumatoid arthritis. METHODS Anxiety was assessed by the Beck Anxiety Inventory (BAI), depression by the Zung self-rating depression scale (SDS), pain by the visual analog scale (VAS) and functional disability by the health assessment questionnaire - disability index (HAQ-DI) in 142 patients with rheumatoid arthritis. Spearman's rho was calculated to assess relations between variables. Stepwise linear regression analysis was used to assess impact of anxiety and depression on arthritis pain and functional disability. RESULTS High prevalence of anxiety and depression was observed in arthritis patients. Anxiety and depression were significant predictors of arthritis pain and functional disability. Sex, education, marital status, disease duration and comorbidity had no impact on arthritis pain and functional disability. CONCLUSION These findings support the notions that psychological negative affect can influence subjective perception of arthritis pain and disability. The regular screening of anxiety and depression and the psychological approaches can be useful for managing arthritis patients.
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Affiliation(s)
| | - Želmíra Macejová
- b 1st Department of Internal Medicine, Faculty of Medicine , Pavol Jozef Šafárik University in Košice , Košice , Slovakia
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25
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Campi LB, Jordani PC, Tenan HL, Camparis CM, Gonçalves DAG. Painful temporomandibular disorders and central sensitization: implications for management-a pilot study. Int J Oral Maxillofac Surg 2016; 46:104-110. [PMID: 27553896 DOI: 10.1016/j.ijom.2016.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 05/12/2016] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
The objective was to investigate the presence of cutaneous allodynia and hyperalgesia in the trigeminal and extra-trigeminal areas, as a surrogate for central sensitization (CS), in women with a painful temporomandibular disorder (TMD) and without other painful conditions. Painful TMDs, depression, and non-specific physical symptoms (NSPS) were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The amount of pain in the trigeminal and extra-trigeminal areas was determined using a visual analogue scale (0-100mm) after the application of a vibrotactile stimulus and assessment of the pressure pain threshold (PPT). Statistical tests (Fisher's, χ2, and Mann-Whitney) were performed, with a significance level of 5%. The sample comprised 45 women (mean age 37.5 years; 16 with a painful TMD) who were free of any headache, fibromyalgia, or other painful condition. Painful TMD was associated with higher pain sensitivity and lower PPT values in the trigeminal (P<0.01) and extra-trigeminal regions (P<0.01). The presence of depression contributed significantly to increased pain sensitivity. The presence of hyperalgesia and allodynia in both the trigeminal and extra-trigeminal regions among women with a painful TMD indicated the presence of CS. Changes involving the central nervous system should be considered during the evaluation and management of patients with a painful TMD.
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Affiliation(s)
- L B Campi
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil.
| | - P C Jordani
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
| | - H L Tenan
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
| | - C M Camparis
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
| | - D A G Gonçalves
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
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26
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Burns W, Péloquin K, Sultan S, Moghrabi A, Marcoux S, Krajinovic M, Sinnett D, Laverdière C, Robaey P. A 2-year dyadic longitudinal study of mothers' and fathers' marital adjustment when caring for a child with cancer. Psychooncology 2016; 26:1660-1666. [PMID: 27278682 DOI: 10.1002/pon.4189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 05/02/2016] [Accepted: 06/06/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Studies examining interrelationships within parental couples confronted with pediatric cancer are scarce. This study explored dyadic longitudinal associations between both partners' family functioning and mood at diagnosis, and marital adjustment 2 years later. METHOD Parents of children (n = 47 couples) with acute lymphoblastic leukemia (ALL) completed the Family Well-Being Assessment and Profile of Mood States-Bipolar Form at diagnosis, and the Locke-Wallace Marital Adjustment Test 2 years post diagnosis. Multilevel linear models using the actor-partner interdependence model (APIM) and controlling for baseline marital adjustment were conducted to evaluate within subject and dyadic longitudinal effects. RESULTS For mothers, better marital adjustment 2 years post diagnosis was associated with perception of greater family support and less role conflict and role overload at diagnosis. For fathers, better marital adjustment 2 years post-diagnosis was associated with perception of less role conflict, greater role ambiguity, and being more tired at diagnosis, as well as their partner's perception of less role conflict at diagnosis. CONCLUSIONS These findings highlight the importance of considering both partners' perspectives in understanding marital adjustment across treatment phases in parents of children with ALL. Early interventions for couples should be tailored to meet each partner's needs in order to foster resilience within the couple.
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Affiliation(s)
- W Burns
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - K Péloquin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - S Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - A Moghrabi
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - S Marcoux
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - M Krajinovic
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - D Sinnett
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - C Laverdière
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - P Robaey
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
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27
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McGeary CA, Blount TH, Peterson AL, Gatchel RJ, Hale WJ, McGeary DD. Interpersonal Responses and Pain Management Within the US Military. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:216-228. [PMID: 26330300 DOI: 10.1007/s10926-015-9605-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose Chronic pain poses a significant problem for the US military. The benefits of self-management treatments for chronic pain are well-documented, but interpersonal responses also influence physical and psychological health and may not be addressed through self-management treatments alone. The current study examines whether perceived interpersonal responses to pain, as measured by the Multidimensional Pain Inventory (MPI), change as a result of participation in an intensive pain management program. It was hypothesized that interpersonal responses to pain would be significantly correlated to psychosocial and physical pain outcomes and that interpersonal responses to pain would change significantly for completers of a functional restoration (FR) program compared to those who were randomized to treatment-as-usual in the military medical system. Methods Forty-four participants were randomly assigned to one of two treatment groups. One treatment group received FR (n = 26) and the other group received treatment-as-usual (n = 18). Significant other responses to chronic pain were measured by the MPI (Pain 23(4):345-356, 1985). Participants also completed measures of impacted quality of life, reported disability, psychological distress, fear avoidance, pain interference, and physical activity. Results Perceived higher punishing responses from a significant other were significantly related to worse physical health-related quality of life (p = .037), work-related fear avoidance (p = .008), pain interference (p = .026), affective distress (p = .039), and pain while lifting (p = .017). Perceived higher solicitous responses from significant others were significantly associated with lower mental health-related quality of life (p = .011), household activity (p = 017), general activity (p = .042), self-reported disability (p = .030), lifting capacity (p = .005), and aerobic capacity (p = .009). Conclusions While findings are preliminary and of limited scope, it appears that the perception of significant others' responses may be impacted by psychosocial and physical pain outcomes and may change after treatment. More work in this area is needed to uncover the benefits one might achieve when a significant other is included within the FR treatment framework.
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Affiliation(s)
- Cindy A McGeary
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, STRONG STAR, 7550 IH-10 West, Suite 1325, San Antonio, TX, 78229, USA.
| | - Tabatha H Blount
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, STRONG STAR, 7550 IH-10 West, Suite 1325, San Antonio, TX, 78229, USA
| | - Alan L Peterson
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, STRONG STAR, 7550 IH-10 West, Suite 1325, San Antonio, TX, 78229, USA
| | - Robert J Gatchel
- Department of Psychology, The University of Texas at Arlington, Arlington, TX, USA
| | - Willie J Hale
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, STRONG STAR, 7550 IH-10 West, Suite 1325, San Antonio, TX, 78229, USA
| | - Donald D McGeary
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, STRONG STAR, 7550 IH-10 West, Suite 1325, San Antonio, TX, 78229, USA
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28
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Maasoumi R, Moridi M, Farhadi F, Moshfeghi Z. Sexual Function in Women With Rheumatoid Arthritis. WOMEN’S HEALTH BULLETIN 2014. [DOI: 10.17795/whb-20098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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29
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Walsh DA, McWilliams DF. Mechanisms, impact and management of pain in rheumatoid arthritis. Nat Rev Rheumatol 2014; 10:581-92. [PMID: 24861185 DOI: 10.1038/nrrheum.2014.64] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
People with rheumatoid arthritis (RA) identify pain as their most important symptom, one that often persists despite optimal control of inflammatory disease. RA pain arises from multiple mechanisms, involving inflammation, peripheral and central pain processing and, with disease progression, structural change within the joint. Consequently, RA pain has a wide range of characteristics-constant or intermittent, localized or widespread-and is often associated with psychological distress and fatigue. Dominant pain mechanisms in an individual are identified by critical evaluation of clinical symptoms and signs, and by laboratory and imaging tests. Understanding these mechanisms is essential for effective management, although evidence from preclinical models should be interpreted with caution. A range of pharmacological analgesic and immunomodulatory agents, psychological interventions and surgery may help manage RA pain. Pain contributes importantly to the clinical assessment of inflammatory disease activity, and noninflammatory components of RA pain should be considered when gauging eligibility for or response to biologic agents. Further randomized controlled trials are required to determine the optimal usage of analgesics in RA, and novel agents with greater efficacy and lower propensity for adverse events are urgently needed. Meanwhile, targeted use of existing treatments could reduce pain in people with RA.
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Affiliation(s)
- David A Walsh
- Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - Daniel F McWilliams
- Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
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30
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Stephenson E, DeLongis A, Esdaile JM, Lehman AJ. Depressive Symptoms and Rheumatoid Arthritis: Spouse Empathic Responding as a Buffer. Arthritis Care Res (Hoboken) 2014; 66:532-41. [DOI: 10.1002/acr.22161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 09/03/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Ellen Stephenson
- University of British Columbia; Vancouver, British Columbia Canada
| | - Anita DeLongis
- University of British Columbia; Vancouver, British Columbia Canada
| | - John M. Esdaile
- Arthritis Research Centre of Canada and University of British Columbia; Vancouver, British Columbia Canada
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31
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Robles TF, Slatcher RB, Trombello JM, McGinn MM. Marital quality and health: a meta-analytic review. Psychol Bull 2014; 140:140-187. [PMID: 23527470 PMCID: PMC3872512 DOI: 10.1037/a0031859] [Citation(s) in RCA: 633] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in more than 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was related to better health, with mean effect sizes from r = .07 to .21, including lower risk of mortality (r = .11) and lower cardiovascular reactivity during marital conflict (r = -.13), but not daily cortisol slopes or cortisol reactivity during conflict. The small effect sizes were similar in magnitude to previously found associations between health behaviors (e.g., diet) and health outcomes. Effect sizes for a small subset of clinical outcomes were susceptible to publication bias. In some studies, effect sizes remained significant after accounting for confounds such as age and socioeconomic status. Studies with a higher proportion of women in the sample demonstrated larger effect sizes, but we found little evidence for gender differences in studies that explicitly tested gender moderation, with the exception of surrogate endpoint studies. Our conclusions are limited by small numbers of studies for specific health outcomes, unexplained heterogeneity, and designs that limit causal inferences. These findings highlight the need to explicitly test affective, health behavior, and biological mechanisms in future research, and focus on moderating factors that may alter the relationship between marital quality and health.
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Affiliation(s)
| | | | | | - Meghan M McGinn
- Mental Illness Research, Education, and Clinical Care, Veterans Affairs Puget Sound Healthcare System
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32
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Newton-John TRO. How significant is the Significant Other in patient coping in chronic pain? Pain Manag 2013; 3:485-93. [DOI: 10.2217/pmt.13.52] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY While healthcare is most commonly focused at the individual level, considerable research has demonstrated that the presence and nature of the relationship with a significant other can play an important role in both mortality and morbidity. In the case of chronic pain, studies have shown that patient disability, mood and overall adjustment can be strongly influenced by the partner. The partner’s responses to patient overt communications of pain have been examined in detail, with support for operant behavioral models of chronic pain generally found. However, more recent studies have extended the behavioral paradigm by exploring issues such as empathy, relationship intimacy and the cognitive patterns of patients and their partners, to better understand dyadic adjustment to chronic pain. Future work will broaden the investigation of the determinants of partner helping behaviors, by looking at pre-illness variables and their expression in a chronic pain relationship.
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Affiliation(s)
- Toby RO Newton-John
- School of Psychology, Australian Catholic University, Locked Bag 2002, Strathfield, New South Wales 2135, Australia
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The Relationship between Marital Status and Psychological Resilience in Chronic Pain. PAIN RESEARCH AND TREATMENT 2013; 2013:928473. [PMID: 24167728 PMCID: PMC3791801 DOI: 10.1155/2013/928473] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/18/2013] [Accepted: 08/08/2013] [Indexed: 11/18/2022]
Abstract
We examined the relationship between marital status and a 2-stage model of pain-related effect, consisting of pain unpleasantness and suffering. We studied 1914 chronic pain patients using multivariate analysis of covariance (MANCOVA) to clarify whether marital status was a determinant factor in the emotional or ideational suffering associated with chronic pain after controlling for pain sensation intensity, age, and ethnicity. Marital status was unrelated to immediate unpleasantness (P = 0.08). We found a strong association with emotional suffering (P < 0.0001) but not with negative illness beliefs (P = 0.44). Interestingly, widowed subjects experienced significantly less frustration, fear, and anger than all other groups (married, divorced, separated, or single). A final MANCOVA including sex as a covariate revealed that the emotional response to pain was the same for both widow and widower. Only those individuals whose spouse died experienced less emotional turmoil in the face of a condition threatening their lifestyle. These data suggest that after experiencing the death of a spouse, an individual may derive some “emotional inoculation” against future lifestyle threat.
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Couple perceptions of fibromyalgia symptoms: the role of communication. Pain 2013; 154:2417-2426. [PMID: 23872105 DOI: 10.1016/j.pain.2013.07.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 07/09/2013] [Accepted: 07/15/2013] [Indexed: 11/23/2022]
Abstract
The objectives of the current study were to describe fibromyalgia patient-spouse incongruence regarding patient pain, fatigue, and physical function; and to examine the associations of individual and interpersonal factors with patient-spouse incongruence. Two hundred four fibromyalgia patients and their coresiding partners rated the patient's symptoms and function. Multilevel modeling revealed that spouses, on average, rated patient fatigue significantly lower than patients. Couple incongruence was not significantly different from zero, on average, for pain severity, interference, or physical function. However, there was significant variability across couples in how they rated the severity of symptoms and function, and how much incongruence existed within couples. Controlling for individual factors, patient and spouse reports of communication problems were significantly associated with levels of couple incongruence regarding patient fatigue and physical function, albeit in opposing directions. Across couples, incongruence was high when patients rated communication problems as high; incongruence was low when spouses rated communication problems as high. An important within-couple interaction was found for pain interference, suggesting that couples who are similar on level of communication problems experience low incongruence; those with disparate ratings of communication problems experience high incongruence. Findings suggest the important roles of spouse response and the patient's perception of how well the couple is communicating. Couple-level interventions targeting communication or other interpersonal factors may help to decrease incongruence and lead to better patient outcomes.
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35
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Taylor SS, Davis MC, Zautra AJ. Relationship status and quality moderate daily pain-related changes in physical disability, affect, and cognitions in women with chronic pain. Pain 2012. [PMID: 23200258 DOI: 10.1016/j.pain.2012.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objectives of this study were to examine whether (1) daily pain-related changes in physical functioning differed between happily partnered, unhappily partnered, and unpartnered female chronic pain patients, and (2) affect and pain cognitions mediated the partner status effect on pain-related changes in physical functioning. Two hundred fifty-one women with chronic pain due to osteoarthritis and/or fibromyalgia completed 30 daily electronic diaries assessing pain, affect, pain-related cognitions, and physical functioning. Patients living with a romantic partner also completed a modified version of the Locke-Wallace Marital Adjustment Scale to assess relationship satisfaction. Multilevel modeling revealed that patients in satisfying unions showed more adaptive daily pain-related changes in physical functioning, pain coping difficulty, and catastrophizing compared to those in unsatisfying unions and those who were unpartnered. Both partnered groups also showed more adaptive pain-related changes in positive affect compared to the unpartnered group. The impact of relationship status on pain-related changes in physical functioning was partly mediated by the pain cognitions catastrophizing and coping difficulty. These results indicate that happily partnered pain patients show less pain-related physical disability and more adaptive affective and cognitive responses to daily pain changes than do unhappily partnered and unpartnered patients. Living in a happy union may bolster the capacity of patients to sustain a sense of pain coping efficacy during pain episodes, which in turn, minimizes pain-related physical activity limitations.
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36
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Park S, Cho MJ, Seong S, Shin SY, Sohn J, Hahm BJ, Hong JP. Psychiatric morbidities, sleep disturbances, suicidality, and quality-of-life in a community population with medically unexplained pain in Korea. Psychiatry Res 2012; 198:509-15. [PMID: 22424895 DOI: 10.1016/j.psychres.2012.01.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 11/16/2011] [Accepted: 01/26/2012] [Indexed: 11/26/2022]
Abstract
We examined the psychiatric morbidities, sleep disturbances, suicidality, quality-of-life, and psychological distress of community-dwelling subjects in Korea who had medically unexplained pain. A total of 6510 subjects (age 18-65 years) participated in this study. A medically unexplained pain symptom (MUS-pain) was defined as pain lasting for 6 months or longer that was sufficiently severe to cause significant distress or to materially interfere with normal activities in the previous year, and that could not be explained by a medical condition or substance use/abuse. Diagnostic assessments were based on responses to the Composite International Diagnostic Interview, which was administered by lay colleagues. The presence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) disorders, sleep disturbances, suicidal tendency, quality-of-life issues, and psychological distress was determined in subjects with and without MUS-pain. There were significant positive associations between MUS-pain and nicotine dependence and withdrawal, alcohol dependence, major depressive disorder, dysthymic disorder, bipolar disorder, post-traumatic stress disorder, social phobia, generalized anxiety disorder, and psychotic disorder. In addition, subjects with MUS-pain reported more sleep disturbances, suicidality, psychological distress, and a poorer quality-of-life than did subjects without MUS-pain. The results of this study suggest that clinicians should carefully evaluate and treat comorbid psychiatric problems in individuals with MUS-pain.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
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Fishbain DA, Bruns D, Meyer LJ, Lewis JE, Gao J, Disorbio JM. Exploration of the relationship between disability perception, preference for death over disability, and suicidality in patients with acute and chronic pain. PAIN MEDICINE 2012; 13:552-61. [PMID: 22487542 DOI: 10.1111/j.1526-4637.2012.01358.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
HYPOTHESIS Passive, active, and historical suicidality are associated with preference for death over disability. DESIGN Community nonpatients without pain, community patients with pain, and patients with acute and chronic pain were compared for endorsement of disability perception and preference for death over disability. Phi correlations and chi-square analyses were calculated between preference for death over disability and six suicidality items representing passive, active, and historical suicidality. Logistic regression was used to predict preference for death over disability in patients with acute and chronic pain. RESULTS For patients with acute and chronic pain, endorsement of preference for death over disability correlated significantly with all six suicidality items. The logistic regression models identified the following variables as predictors for preference for death over disability in patients with acute pain: the Behavior Health Inventory (BHI 2) family dysfunction scale, history of wanting to die, and disability perception. For patients with chronic pain, predictors were the BHI 2 Borderline scale, history of wanting to die, treated fairly by family item, frequent suicide ideation, people I trust turn on me item, and disability perception. Preference for death over disability was a statistically significant predictor in patients with chronic pain for disability perception, recent suicide ideation, having a suicidal plan, and a history of wanting to die but was not a significant predictor for any suicide items in patients with acute pain. CONCLUSION Preference for death over disability is associated with passive and active suicide ideation and historical suicidality in patients with chronic pain.
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Affiliation(s)
- David A Fishbain
- Department of Psychiatry, Miller School of Medicine at University of Miami, Miami, Florida 33136, USA.
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TERRILL ALEXANDRAL, GAROFALO JOHNP, SOLIDAY ELIZABETH, CRAFT REBECCA. Multiple Roles and Stress Burden in Women: A Conceptual Model of Heart Disease Risk. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1751-9861.2011.00071.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bahk WM, Park S, Jon DI, Yoon BH, Min KJ, Hong JP. Relationship between painful physical symptoms and severity of depressive symptomatology and suicidality. Psychiatry Res 2011; 189:357-61. [PMID: 21329990 DOI: 10.1016/j.psychres.2011.01.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Revised: 12/27/2010] [Accepted: 01/11/2011] [Indexed: 10/18/2022]
Abstract
We examined the prevalence of painful physical symptoms in patients with major depressive disorder (MDD), clinical correlations therewith, and associations between painful symptoms and depression severity, quality of life, and suicidality, in a clinical sample in Korea. A total of 414 psychiatric outpatients at least 18years of age, with a primary diagnosis of MDD based on the DSM-IV-TR, were enrolled at the discretion of their treating psychiatrist. Patients were assessed for the presence or absence of painful physical symptoms (PPS+ and PPS-, respectively), defined by a total score ≥5 on the pain subscale (PS) of the Depression and Somatic Symptoms Scale (DSSS). DSSS and the Clinical Global Impressions-Severity of Illness scale (CGI-S) determined depression severity, and the EuroQoL Questionnaire-5 dimensions (EQ-5D) determined perceived quality of life. Questions about suicidality during current depressive episode were also asked to the participants. Overall, 30.4% of patients were classified as PPS+. PPS+ patients were older, less educated, less frequently unmarried, and more frequently widowed/divorced/separated compared to PPS- patients. PPS+ patients showed a significantly greater depression severity (CGI-S mean difference 0.92; 95% CI=0.68 to 1.16; DSSS mean difference 18.39; 95% CI=16.28 to 20.50), a significantly lower quality of life (EQ-5D VAS mean difference -18.15; 95% CI=-22.68 to -13.62), and significantly higher suicidal ideation (OR 1.73; 95% CI 1.04-2.86) during the current depressive episode. This study suggests that assessment of depressive patients should include detailed questions about painful physical symptoms, and treatment of MDD should involve management targeting painful physical symptoms as well as emotional and non-painful physical symptoms.
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Affiliation(s)
- Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Psychological advances in chronic pain: a concise selective review of research from 2010. Curr Opin Support Palliat Care 2011; 5:122-6. [PMID: 21430540 DOI: 10.1097/spc.0b013e328345a3ff] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW It is difficult to hold an organized view of psychological research related to chronic pain. There are many different theories and variables and the volume of literature is vast. The purpose of this review is to highlight some key trends in this research in 2010. RECENT FINDINGS We conducted a search of the output of four prominent scientific journals in the field of chronic pain management. Five research topics from among those identified are summarized. Identified topics include psychological factors related to analgesic use, efficacy of cognitive behavioral treatments, and contextual approaches (including acceptance and mindfulness). SUMMARY The largest number of psychological studies categorized for this review focused on psychological factors in relation to opioid use. These studies include ones to identify risk factors for aberrant drug behavior. This result seems to reflect that the dominant approach to chronic pain remains a pharmacological one. At the same time treatment from within a broadly cognitive behavioral approach seems to have reached a level of relative maturity with questions frequently being addressed with meta-analysis. Otherwise, there are developing and promising trends, such as in new treatment models and uses of information technology.
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Yacoub YI, Amine B, Laatiris A, Hajjaj-Hassouni N. Spinsterhood and its impact on disease features in women with rheumatoid arthritis. Health Qual Life Outcomes 2011; 9:58. [PMID: 21806812 PMCID: PMC3161835 DOI: 10.1186/1477-7525-9-58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 08/01/2011] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the impact of spinsterhood on disease characteristics and quality of life (QoL) in Moroccan women with rheumatoid arthritis (RA). Methods 185 women with RA were recruited in this study. Marital status was specified as follow: 1. Spinsterhood (never-married woman aged 38 or over), 2. Distressed marriage; 3. Nondistressed marriage and 4. Divorced or widowed. Marital distress was assessed by a self-report concerning coping efficacy and burden caring of husbands. Assessment criteria included the evaluation of: age at onset (years), diagnosis delay (months), disease duration (years), disease activity (evaluated by physical examination, biological inflammatory tests; and disease activity score (DAS 28)), pain intensity (measured with a visual analogue scale (VAS)); and radiographic damage (evaluated by the Sharp's method as modified by van der Heijde). Treatments (doses and duration) were specified. The Health Assessment Questionnaire (HAQ) was used to evaluate functional disability. QoL was measured using the Arabic version of the generic instrument SF-36. Results In our data, spinsterhood was detected in 42 (22.7%) patients vs. 88 (47.5%) with distressed marriage, 28 (15.1%) with nondistressed marriage and 27 (14.6%) divorced or widowed. Comparing the 4 groups, we found that QoL in never-married women was damaged in a significant way comparing to the other groups. Mental as well as physical aspects were affected. Also, we found that spinsterhood was associated to an early age at onset (p = 0.009), pain intensity (p < 0.001); clinical (p < 0.001) and biological disease activity (C-reactive protein; p = 0.02) and functional disability (p < 0.001). Logistic regression analysis revealed a significant relationship between spinsterhood and early age at onset and severe functional disability (for all p ≤ 0.01). Conclusion This study suggests that spinsterhood in our RA patients was associated with an altered QoL even compared with distressed married women. Also, we state that spinsterhood was associated with an early age at onset, severe joint pain; higher disease activity and with altered functional ability. It seems important to consider not only disease-related parameters but also social status as a determinant factor of poor course in RA.
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Affiliation(s)
- Yousra Ibn Yacoub
- Department of Rheumatology, El Ayachi Hospital, University Hospital of Rabat-Sale, Morocco.
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