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Romo-Nava F, Blom T, Cuellar-Barboza AB, Barrera FJ, Miola A, Mori NN, Prieto ML, Veldic M, Singh B, Gardea-Resendez M, Nunez NA, Ozerdem A, Biernacka JM, Frye MA, McElroy SL. Clinical characterization of patients with bipolar disorder and a history of asthma: An exploratory study. J Psychiatr Res 2023; 164:8-14. [PMID: 37290273 DOI: 10.1016/j.jpsychires.2023.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/07/2023] [Accepted: 05/16/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Bipolar disorder (BD) and asthma are leading causes of morbidity in the US and frequently co-occur. OBJECTIVES We evaluated the clinical features and comorbidities of patients with BD and a history of asthma. METHODS In a cross-sectional analysis from the Mayo Clinic Bipolar Biobank, we explored the clinical characteristics of the BD and an asthma phenotype and fitted a multivariable regression model to identify risk factors for asthma. RESULTS A total of 721 individuals with BD were included. From these, 140 (19%) had a history of asthma. In a multivariable model only sex and evening chronotype were significant predictors of asthma with the odds ratios and 95% confidence intervals being 1.65 (1.00, 2.72; p=0.05) and 1.99 (1.25, 3.17; p < 0.01), respectively. Individuals with asthma had higher odds of having other medical comorbidities after adjusting for age, sex, and site including hypertension (OR = 2.29 (95% CI 1.42, 3.71); p < 0.01), fibromyalgia (2.29 (1.16, 4.51); p=0.02), obstructive sleep apnea (2.03 (1.18, 3.50); p=0.01), migraine (1.98 (1.31, 3.00); p < 0.01), osteoarthritis (2.08 (1.20, 3.61); p < 0.01), and COPD (2.80 (1.14, 6.84); p=0.02). Finally, individuals currently on lithium were less likely to have a history of asthma (0.48 (0.32, 0.71); p < 0.01). CONCLUSION A history of asthma is common among patients with BD and is associated with being female and having an evening chronotype, as well as with increased odds of having other medical comorbidities. A lower likelihood of a history of asthma among those currently on lithium is an intriguing finding with potential clinical implications that warrants further study.
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Affiliation(s)
- Francisco Romo-Nava
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Thomas Blom
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alfredo B Cuellar-Barboza
- Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Francisco J Barrera
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alessandro Miola
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicole N Mori
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Miguel L Prieto
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; Center for Biomedical Research and Innovation, Universidad de los Andes, Santiago, Chile; Department of Psychiatry, Faculty of Medicine, Universidad de los Andes, Santiago, Chile; Mental Health Service, Clínica Universidad de los Andes, Santiago, Chile
| | - Marin Veldic
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Manuel Gardea-Resendez
- Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicolas A Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Joanna M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Susan L McElroy
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Nastri MMF, Lourenço B, Queiroz LB, Silva LEVD, Lourenço DMR, Castro APBM, Silva CA, Pastorino AC. Idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma. J Pediatr (Rio J) 2022; 98:270-275. [PMID: 34246587 PMCID: PMC9432169 DOI: 10.1016/j.jped.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma and healthy controls. METHODS Cross-sectional study was conducted on 150 asthmatic adolescents and 300 controls. Adolescents completed a self-administered questionnaire regarding painful symptoms, use of electronic devices, and physical activity. Seven musculoskeletal pain syndromes were evaluated, and Asthma Control Test (ACT) was assessed. RESULTS Musculoskeletal pain (42% vs. 61%, p = 0.0002) and musculoskeletal pain syndromes (2.7% vs. 15.7%, p = 0.0006) were significantly lower in asthmatic adolescents than in controls. The frequency of pain in the hands and wrists was reduced in asthmatic than in controls (12.6% vs. 31.1%, p = 0.004), in addition to cell phone use (80% vs. 93%, p < 0.0001), simultaneous use of at least two electronic media (47% vs. 91%, p < 0.0001), myofascial syndrome (0% vs. 7.1%, p = 0.043), and tendinitis (0% vs. 9.2%, p = 0.008). Logistic regression analysis, including asthma with musculoskeletal pain as the dependent variable, and female sex, ACT > 20, simultaneous use of at least two electronic devices, cell phone use, and weekends and weekdays of cell phone use, as independent variables, showed that female sex (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.929-6.316; p = 0.0009) and ACT ≥ 20 (OR, 0.194; 95% CI, 0.039-0.967; p = 0.045) were associated with asthma and musculoskeletal pain (Nagelkerke R2 = 0.206). CONCLUSIONS Musculoskeletal pain and musculoskeletal pain syndromes were lower in adolescents with asthma. Female sex was associated with musculoskeletal pain in asthmatic, whereas patients with asthma symptoms and well-controlled disease reported a lower prevalence of musculoskeletal pain.
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Affiliation(s)
- Mariana Machado Forti Nastri
- Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Benito Lourenço
- Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ligia Bruni Queiroz
- Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luiz Eduardo Vargas da Silva
- Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Clovis Artur Silva
- Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Antonio Carlos Pastorino
- Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, SP, Brazil
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de Felice G, Hyland ME, Lanario JW, Antonacci Y, Jones RC, Masoli M. Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma. BMC Pulm Med 2021; 21:369. [PMID: 34775957 PMCID: PMC8591792 DOI: 10.1186/s12890-021-01730-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022] Open
Abstract
Background Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced.
Methods Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma. Results 100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and − 0.34 (p = 0.001) with the two principal components. Conclusion The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01730-0.
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Affiliation(s)
- Giulio de Felice
- Sapienza University of Rome, Rome, Italy.,NC IUL University, London, UK
| | - Michael E Hyland
- Plymouth Marjon University, Plymouth, UK. .,Plymouth University, Plymouth, UK.
| | | | | | | | - Matthew Masoli
- Royal Devon and Exeter Hospital, Exeter, UK.,University of Exeter, Exeter, UK
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Nishimura K, Nakayasu K, Mori M, Sanda R, Shibayama A, Kusunose M. Are Fatigue and Pain Overlooked in Subjects with Stable Chronic Obstructive Pulmonary Disease? Diagnostics (Basel) 2021; 11:diagnostics11112029. [PMID: 34829376 PMCID: PMC8620334 DOI: 10.3390/diagnostics11112029] [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: 10/06/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/19/2022] Open
Abstract
Although there have been many published reports on fatigue and pain in patients with chronic obstructive pulmonary disease (COPD), it is considered that these symptoms are seldom, if ever, asked about during consultations in Japanese clinical practice. To bridge this gap between the literature and daily clinical experience, the authors attempted to gain a better understanding of fatigue and pain in Japanese subjects with COPD. The Brief Fatigue Inventory (BFI) to analyse and quantify the degree of fatigue, the revised Short–Form McGill Pain Questionnaire 2 (SF-MPQ-2) for measuring pain and the Kihon Checklist to judge whether a participant is frail and elderly were administered to 89 subjects with stable COPD. The median BFI and SF-MPQ-2 Total scores were 1.00 [IQR: 0.11–2.78] and 0.00 [IQR: 0.00–0.27], respectively. They were all skewed toward the milder end of the respective scales. A floor effect was noted in around a quarter on the BFI and over half on the SF-MPQ-2. The BFI scores were significantly different between groups regarding frailty determined by the Kihon Checklist but not between groups classified by the severity of airflow limitation. Compared to the literature, neither fatigue nor pain are considered to be frequent, important problems in a real-world Japanese clinical setting, especially among subjects with mild to moderate COPD. In addition, our results might suggest that fatigue is more closely related to frailty than COPD.
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Affiliation(s)
- Koichi Nishimura
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.M.); (R.S.); (M.K.)
- Correspondence: ; Tel.: +81-562-46-2311
| | - Kazuhito Nakayasu
- Data Research Section, Kondo Photo Process Co., Ltd., Osaka 543-0011, Japan;
| | - Mio Mori
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.M.); (R.S.); (M.K.)
| | - Ryo Sanda
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.M.); (R.S.); (M.K.)
| | - Ayumi Shibayama
- Department of Nursing, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan;
| | - Masaaki Kusunose
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.M.); (R.S.); (M.K.)
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Fibromyalgia in Iraqi patients with asthma and its impact on asthma severity and control. Ann Med Surg (Lond) 2020; 60:22-26. [PMID: 33101668 PMCID: PMC7575834 DOI: 10.1016/j.amsu.2020.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 11/21/2022] Open
Abstract
Background Fibromyalgia (FM) is common with significant impact on patients quality of life. Limited reports on coexistence of FM with asthma. Objectives To assess the prevalence of FM in asthmatic patients and its impact on asthma severity and control. Patients and methods This case-control study included 103 patients with asthma and 102 apparently healthy controls matched in age and sex. Sociodemographic and clinical characteristics of FM and controls were recorded. FM was diagnosed according to the 2016 revision of American College of Rheumatology criteria. Asthma diagnosis and severity were performed by the pulmonologist according to Global Initiative for Asthma (GINA) guidelines and asthma control was assessed by Asthma Control Test (ACT) score. Results The mean age of asthmatic patients was 41.1 ± 12.7 years and for controls was 39.8 ± 12 years (p = 0.453). Females were more prevalent in asthmatic patients and controls although statistically were not significant (p-value = 0.532). Prevalence of FM was significantly more in asthmatic patients compared to controls [18 (17.6%) vs 7 (6.8%), p = 0.018] and asthmatic patients had three folds risk of having FM (ranging from 1.2 to 7.4 times. FM increased the risk of severe asthma by 4.91 folds (P < 0.005). Also, only FMS and glucocorticoids were significant independent predictor of having poor asthma control. FM was significantly and negatively correlated with low ACT score (β standardized regression coefficient = −0.291, p = 0.005). Conclusions fibromyalgia was common in asthmatic patients and was significantly associated with more severe and poorly controlled asthma. Fibromyalgia (FM) was more common in asthmatic patients compared with controls. FM was significantly associated with more severe and poorly controlled asthma. Breathing training programs may be useful management in asthmatic patients with FM.
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Hyland ME, Lanario JW, Wei Y, Jones RC, Masoli M. Evidence for similarity in symptoms and mechanism: The extra-pulmonary symptoms of severe asthma and the polysymptomatic presentation of fibromyalgia. IMMUNITY INFLAMMATION AND DISEASE 2019; 7:239-249. [PMID: 31441602 PMCID: PMC6842811 DOI: 10.1002/iid3.263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/03/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Asthma is a disease of the lung and a systemic disease. Functional disorders are associated with multiple systemic abnormalities that have been explained by complexity models. The aim was to test the similarity in type and aetiology between the extra-pulmonary symptoms of severe asthma and the symptoms of fibromyalgia. METHODS One Hundred patients recruited from a specialist severe asthma clinic and 1751 people reporting different functional disorder diagnoses recruited via the internet completed the same 60-item questionnaire. Symptom patterns were compared between groups using a new measure, the symptom pattern similarity index where 0 = no relationship, 1 = identical patterns between groups. RESULTS Severe asthma patients report numerous extra-pulmonary symptoms. The similarity index between the symptom pattern of the asthma patients with other groups was irritable bowel syndrome = 0.54, chronic fatigue syndrome = 0.69, and fibromyalgia = 0.75. The index between fibromyalgia and asthma patients with the most and least frequent extra-pulmonary symptoms was 0.81 and 0.55 respectively. CONCLUSIONS Patients with severe asthma have numerous extra-pulmonary symptoms similar in type and pattern to the symptoms of fibromyalgia. The similarity of the symptom pattern between asthma and fibromyalgia increases as the number of extra-pulmonary symptoms increases as predicted by network theory and previously shown to be the case with other functional disorders. These findings support the hypothesis that functional disorders and extra-pulmonary asthma symptoms have a common complexity or network aetiology. Evidence based behavioural interventions for fibromyalgia may be helpful for patients with severe asthma reporting extra-pulmonary symptoms.
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Affiliation(s)
- Michael E Hyland
- School of Psychology, University of Plymouth of Plymouth, Plymouth, UK.,University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Joseph W Lanario
- School of Psychology, University of Plymouth of Plymouth, Plymouth, UK.,University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Yinghui Wei
- School of Computing, Electronics and Mathematics, University of Plymouth, Plymouth, UK
| | - Rupert C Jones
- Department of Respiratory Medicine, Peninsula School of Medicine and Dentistry, University of Plymouth, Plymouth, UK
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