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Kim SH, Kim H, Jeong SH, Park EC. Association of the Type of Public Pension With Mental Health Among South Korean Older Adults: Longitudinal Observational Study. JMIR Public Health Surveill 2024; 10:e49129. [PMID: 38696246 PMCID: PMC11099812 DOI: 10.2196/49129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 02/02/2024] [Accepted: 02/18/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND As income and health are closely related, retirement is considered undesirable for health. Many studies have shown the association between pension and health, but no research has considered the association between contribution-based public pensions or their types and health. OBJECTIVE This study investigates the association between the type of contributory public pension and depressive symptoms among older adults. METHODS We analyzed the data of 4541 older adults who participated in the South Korea Welfare Panel Study (2014-2020). Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression scale. Public pensions in South Korea are classified into specific corporate pensions and national pensions. For subgroup analyses, pensioners were categorized according to the amount of pension received and the proportion of public pension over gross income. Analyses using generalized estimating equations were conducted for longitudinal data. RESULTS Individuals receiving public pension, regardless of the pension type, demonstrated significantly decreased depressive symptoms (national pension: β=-.734; P<.001; specific corporate pension: β=-.775; P=.02). For both pension types, the higher the amount of benefits, the lower were the depression scores. However, this association was absent for those who received the smaller amount among the specific corporate pensioners. In low-income households, the decrease in the depressive symptoms based on the amount of public pension benefits was greater (fourth quartile of national pension: β=-1.472; P<.001; second and third quartiles of specific corporate pension: β=-3.646; P<.001). CONCLUSIONS Our study shows that contributory public pension is significantly associated with lower depressive symptoms, and this association is prominent in low-income households. Thus, contributory public pensions may be good income sources for improving the mental health of older adults after retirement.
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Affiliation(s)
- Seung Hoon Kim
- Department of Ophthalmology, Soonchunhyang University Hospital Cheonan, Soonchunhyang University College of Medicine, Chenonan, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Hoon Jeong
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yang J, Lee SG. Association between retirement age and depressive symptoms among Korean retirees: Results from Korean Retirement and Income Panel Study. J Affect Disord 2024; 352:454-459. [PMID: 38403136 DOI: 10.1016/j.jad.2024.02.082] [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: 10/09/2023] [Revised: 02/18/2024] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND The effective age of retirement in South Korea is higher than the average of Organization for Economic Co-operation and Development (OECD) countries. Early retirement in Asia may affect mental health differently compared to western countries. Thus, we examined the association between retirement age and depressive symptoms among South Korean retirees. METHODS We used data from the 2011, 2013, 2015, 2017, and 2019 Korean Retirement and Income Panel Study, including a total of 2998, 3152, 3203, 3154, and 3055 participants, respectively. We excluded those younger than 50 years, non-retirees, those without information on the Center for Epidemiological Studies-Depression (CES-D) scale, and those with other missing values. We used a generalized estimating equation model to identify the association between retirement age and depressive symptoms measured using the CES-D. RESULTS Participants who retired at age < 50 years had significantly higher CES-D scores (β = 1.764, P = 0.0003) compared to those who retired at age ≥ 70 years. The negative effects of early retirement on depressive symptoms were greater among male participants, heads of households, young involuntary retirees, those who retired within the past 20 years, and those who had no difficulties in activities of daily living. LIMITATIONS Since we evaluated the association between retirement age and depressive symptoms in one direction, there is a possibility of reverse causality. CONCLUSION Our findings highlight the importance of managing depressive symptoms in early retirees, especially young involuntary retirees and those burdened with family care.
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Affiliation(s)
- Jieun Yang
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Republic of Korea; Division of New Health Technology Assessment, National Evidence-based Healthcare Collaborating Agency, Seoul 04933, Republic of Korea
| | - Sang Gyu Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
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Raimo S, Trojano L, Gaita M, d'Onofrio F, Spitaleri D, Santangelo G. Relationship between apathy and cognitive dysfunctions in Multiple Sclerosis: a 4-year prospective longitudinal study. Mult Scler Relat Disord 2022; 63:103929. [DOI: 10.1016/j.msard.2022.103929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/10/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022]
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GONUL ONER O, TOTUK O, GUNGOR DOGAN İ, CELİK D, DEMİR S. Evaluation of neuropsychiatric symptoms in patients with multiple sclerosis. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1018632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kim SH, Kim H, Joo HJ, Jeong SH, Park EC, Jang SI. Impact of changes in housing tenure and affordability status on depressive symptoms: Evidence from a longitudinal study. J Affect Disord 2021; 295:40-49. [PMID: 34403933 DOI: 10.1016/j.jad.2021.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Housing is an important social determinant of health. We investigated effects of changes in housing tenure and affordability on depressive symptoms. METHODS Data of 9,956 individuals aged >20 years from the Korea Welfare Panel Study (2015-2020) were analyzed. Housing tenure was categorized as homeowners or tenants. Individuals with housing-related expenditures exceeding 30% of household income were defined as having housing unaffordability. Analyses using generalized estimating equations were conducted to evaluate the relationship between changes in housing tenure and affordability on depressive symptoms measured with the Center for Epidemiologic Studies Depression Scale. RESULTS Individuals who became tenants (β = 0.326, p = 0.027) or were persistent tenants (β = 0.542, p<0.001) demonstrated significantly more severe depressive symptoms than persistent homeowners. Individuals with new (β = 0.562, p < 0.001) or consistent housing unaffordability (β = 1.032, p = 0.036) showed increased depressive symptoms compared with those with persistent housing affordability. Depressive symptoms were reduced in new homeowners and those who left housing unaffordability status (β = -0.807, p = 0.031). The interaction between housing tenure and affordability on depressive symptoms differed by age and household composition. Housing tenure at post-retirement age and single-person households were associated with a decrease in depressive symptoms, respectively. LIMITATIONS All housing-related factors, especially different domains of housing insecurity including unstable neighborhoods or reasons for moving, have not been identified. CONCLUSIONS Changes in housing tenure, affordability, and the two combined were significantly associated with depressive symptoms. Furthermore, the degree of interactive effect varied among age groups and household composition. Housing welfare policies that can stabilize housing tenure and affordability might help prevent depression.
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Affiliation(s)
- Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Jin Joo
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sung Hoon Jeong
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
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Song J, Lee J, Lee YC, Chang AH, Semanik PA, Chang RW, Ehrlich-Jones L, Dunlop DD. Sleep Disturbance Trajectories in Osteoarthritis. J Clin Rheumatol 2021; 27:e440-e445. [PMID: 32815908 PMCID: PMC7887124 DOI: 10.1097/rhu.0000000000001512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE Sleep disturbance is common among adults with osteoarthritis (OA), but little is known about patterns over time. In this cohort study, we identified restless sleep trajectories and associated factors in adults with or at high risk for knee OA. METHODS Longitudinal (2004-2014) restless sleep (≥3 nights/week) annual reports over 8 years from 4359 Osteoarthritis Initiative participants were analyzed. Group-based trajectory modeling identified heterogeneous temporal patterns. Logistic regression identified baseline health and behavioral predictors of trajectory membership. RESULTS Four restless sleep trajectory groups were identified: good (69.7%, persistently low restless sleep probabilities), worsening (9.1%), improving (11.7%), and poor (9.5%, persistently high). Among 2 groups initially having low restless sleep prevalence, the worsening trajectory group had an increased likelihood of baseline cardiovascular disease (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.01-2.33), pulmonary disease (OR, 1.48; 95% CI, 1.07-2.05), lower physical activity (OR, 1.29; 95% CI, 1.03-1.61), knee pain (OR, 1.04; 95% CI, 1.00-1.07), depressive symptoms (OR, 1.03; 95% CI, 1.01-1.06), and a decreased likelihood of better mental health (OR, 0.97; 95% CI, 0.95-0.98) at baseline. Among 2 groups initially having high restless sleep prevalence, the poor group had an increased likelihood of baseline depressive symptoms (OR, 1.03; 95% CI, 1.00-1.05). CONCLUSIONS Four trajectories of restless sleep over 8 years were identified using data collected from over 4000 older adults aged 45 to 79 years with or at higher risk for knee OA. The presence of depressive symptoms, less physical activity, knee pain, poor mental health, cardiovascular disease, or pulmonary disease was each associated with unfavorable trajectories.
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Affiliation(s)
- Jing Song
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yvonne C. Lee
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alison H. Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pamela A. Semanik
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - Rowland W. Chang
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Linda Ehrlich-Jones
- Center for Rehabilitation Outcomes Research, Shirley Ryan Ability Lab, Chicago, IL, USA
| | - Dorothy D. Dunlop
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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The Impact of Epigallocatechin Gallate and Coconut Oil Treatment on Cortisol Activity and Depression in Multiple Sclerosis Patients. Life (Basel) 2021; 11:life11040353. [PMID: 33920655 PMCID: PMC8073508 DOI: 10.3390/life11040353] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 12/21/2022] Open
Abstract
(1) Background: Multiple sclerosis (MS) is pathogenically characterized by high oxidative stress and symptomatically by progressive muscle loss and increased body fat associated with the presence of depression. Epigallocatechin gallate (EGCG) (particularly present in green tea) and ketone bodies (in particular beta-hydroxybutyrate (BHB)), whose main source is coconut oil, have shown emotional benefits and body fat loss. The aim of this study was to assess the impact of EGCG and coconut oil on cortisol activity related to fat loss and depression in MS patients. (2) Methods: The study involved 51 MS patients who were randomly divided into an intervention group or a control group. The intervention group received 800 mg of EGCG and 60 mL of coconut oil, which were included in their daily diet for four months. The control group received placebo and all patients followed an isocaloric diet. A blood sample was collected before and after the four-month period, and levels of cortisol, albumin and BHB were measured in serum. In addition, immediately before and after the intervention, anthropometric variables were measured: waist-to-hip ratio (WHR), body fat mass percentage, fat weight, total weight, and muscle mass percentage. Depression was assessed with the Beck Depression Inventory II (BDI-II). (3) Results: No significant changes were obtained in cortisol levels in any of the groups, and there was a significant increase in albumin in the blood of the intervention group only that could lead to a decrease in serum free cortisol. In addition, it was observed a significant decrease in levels of depression and abdominal fat. (4) Conclusions: EGCG combined with coconut oil increase the concentration of albumin in blood and produce less depression in MS patients.
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Kneebone II, Fife-Schaw C, Lam LT, das Nair R. The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis. F1000Res 2021; 9:1038. [PMID: 33564395 PMCID: PMC7851711 DOI: 10.12688/f1000research.25129.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation. This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS.
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Affiliation(s)
- Ian I Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Chris Fife-Schaw
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Lawrence T Lam
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.,Vice President (Academic), Tung Wah College, Hong Kong, Homantin, SAR, Hong Kong
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Lenton, Nottingham, Nottinghamshire, NG7 2RD, UK
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Galetta K, Deshpande C, Healy BC, Glanz B, Ziehn M, Saxena S, Paul A, Saleh F, Collins M, Gaitan-Walsh P, Castro-Mendoza P, Weiner HL, Chitnis T. Serum neurofilament levels and patient-reported outcomes in multiple sclerosis. Ann Clin Transl Neurol 2021; 8:631-638. [PMID: 33492760 PMCID: PMC7951092 DOI: 10.1002/acn3.51305] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/08/2020] [Accepted: 12/28/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Serum neurofilament light (sNfL) is a promising new biomarker in multiple sclerosis (MS). We explored the relationship between sNfL and health outcomes and resource use in MS patients. METHODS MS patients with serum samples and health-outcome measurements collected longitudinally between 2011 and 2016 were analyzed. sNfL values were evaluated across age and gender. Data were analyzed using correlation with log-transformed sNfL values. RESULTS A total of 304 MS patients with a mean age of 32.9 years, average EDSS of 1.6 (SD = 1.5) and baseline sNfL of 8.8 (range 1.23-78.3) pg/mL were studied. Baseline sNFL values increased with age and were higher in females. Baseline sNfL correlated with baseline Multiple Sclerosis Quality of Life physical composite (mean = 49.4 (9.1), P = 0.035) and baseline EDSS (P = 0.002). Other PRO measures at baseline did not show a significant relationship with baseline sNfL. Average of baseline and follow-up sNfL correlated with MSQoL physical-role limitations (mean = 48.9 (10.8), P = 0.043) and social-functioning (mean = 52.3 (7), P = 0.034) at 24-month follow-up. We found a trend for numerically higher sNfL levels in nonpersistent patients compared to those who were persistent to treatment (11.13 vs. 8.53 pg/mL, P = 0.093) measured as average of baseline and 24-month values. Baseline NfL was associated with number of intravenous steroid infusions (mean = 0.2; SD = 3.0, P = 0.013), whereas the average of baseline and 12 months NfL values related to inpatient stays at 12 months (mean = 0.2; SD = 3.0 P = 0.053). CONCLUSION Serum NfL is a patient-centric biomarker that correlated with MS patient health-outcomes and healthcare utilization measures in a real-world cohort.
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Affiliation(s)
- Kristin Galetta
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Brian C Healy
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bonnie Glanz
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Marina Ziehn
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Shrishti Saxena
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anu Paul
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Fermisk Saleh
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mikaela Collins
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Patricia Gaitan-Walsh
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Paola Castro-Mendoza
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Howard L Weiner
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Tanuja Chitnis
- Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Rahimlou M, Hosseini SA, Majdinasab N, Haghighizadeh MH, Husain D. Effects of long-term administration of Multi-Strain Probiotic on circulating levels of BDNF, NGF, IL-6 and mental health in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled trial. Nutr Neurosci 2020; 25:411-422. [PMID: 32500827 DOI: 10.1080/1028415x.2020.1758887] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Mental disorders is one of the main causes of disability and lower life expectancy among patients with Multiple Sclerosis (MS). The present trial aimed to examine the efficacy of multi-strain probiotic supplementation on circulating levels of BDNF, NGF, IL-6 and mental health in patients with MS.Methods: This trial was conducted among 70 patients with MS that referred to the MS Association. Patients were randomized into intervention and control groups to receive 2 multi-strain probiotic capsules or placebo, daily for six months. Serum BDNF, NGF and IL-6 was measured by ELISA kits. Mental health parameters were assessed by valid questionnaires in the baseline and end of the study.Results: Of the 70 patients enrolled in this study, 65 subjects were included in the final analysis. From baseline to 6 months, probiotic supplementation resulted in a significant increase in BDNF and a significant reduction in the IL-6 levels (P < 0.001). Our findings revealed that probiotic supplementation compared to placebo caused a significant improvement in the general health questionnaire-28 (GHQ-28) (-5.31 ± 4.62 vs. -1.81 ± 4.23; P = 0.002), Beck Depression Inventory-II (BDI-II) (-4.81 ± 0.79 vs. -1.90 ± 0.96; P = 0.001), Fatigue Severity Scale (FSS) (-3.81 ± 6.56 vs. 0.24 ± 5.44; P = 0.007) and Pain Rating Index (PRI) (-3.15 ± 4.51 vs. -0.09 ± 3.67; P = 0.004). However, we not found any significant difference between the two groups in other factors (P > 0.05).Conclusion: Overall, six months of probiotic supplementation resulted in greater improvement in mental health parameters.
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Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Nutrition & Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Nutrition & Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nastaran Majdinasab
- Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hosein Haghighizadeh
- Department of Biostatistics and Epidemiology, School of Health Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran
| | - Durdana Husain
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Nutrition & Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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11
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Song J, Dunlop DD, Semanik PA, Chang AH, Lee YC, Gilbert AL, Jackson RD, Chang RW, Lee J. Reallocating time spent in sleep, sedentary behavior and physical activity and its association with pain: a pilot sleep study from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2018; 26:1595-1603. [PMID: 30048683 PMCID: PMC7026908 DOI: 10.1016/j.joca.2018.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/11/2018] [Accepted: 07/02/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Being physically active has broad health benefits for people with osteoarthritis (OA), including pain relief. Increasing physical activity (PA) requires reducing time in other behaviors within a fixed 24-h day. We examined the potential benefits in relation to pain from trading time in one type of wake or sleep behavior for another. METHOD In this cross-sectional study, we used isotemporal logistic regression models to examine the estimated effect on pain from replacing time in one behavior with equal time in another, controlling for sociodemographic and health factors. Stratified analysis was conducted by the report of restless sleep. Sleep and wake behaviors [sedentary behavior (SB), light PA, moderate PA] were monitored by accelerometer in a pilot study of 185 Osteoarthritis Initiative (OAI) participants. Outcomes were bodily pain interference and knee pain. RESULTS Moderate PA substituted for an equivalent time in sleep or other types of wake behaviors was most strongly associated with lower odds of pain (bodily pain interference odds reduced 21-25%, knee pain odds reduced 17-20% per 10-min exchange). These beneficial associations were particularly pronounced in individuals without restless sleep, but not in those with restless sleep, especially for bodily pain interference. CONCLUSION Interventions promoting moderate physical activities may be most beneficial to address pain among people with or at high risk for knee OA. In addition to encouraging moderate-intensity PA, pain management strategies may also include the identification and treatment of sleep problems.
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Affiliation(s)
- Jing Song
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dorothy D. Dunlop
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pamela A. Semanik
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - Alison H. Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yvonne C. Lee
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Abigail L. Gilbert
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca D. Jackson
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Rowland W. Chang
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Perceived discrimination is associated with the inflammatory response to acute laboratory stress in women at risk for cardiovascular disease. Brain Behav Immun 2018; 73:625-632. [PMID: 30012518 PMCID: PMC6129426 DOI: 10.1016/j.bbi.2018.07.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/28/2018] [Accepted: 07/12/2018] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the United States and exacts a disproportionate toll on minorities. Growing evidence demonstrates that perceived discrimination is a significant contributing factor to psychological distress, chronic low-grade inflammation, and cardiovascular health. However, little is known regarding the extent to which perceived discrimination contributes to the inflammatory response to acute stress. Therefore, the purpose of this study was to examine the influence of perceived discrimination on the inflammatory response to a laboratory acute stress paradigm in women at risk for CVD. A cross-sectional sample of 99 postmenopausal women (50 African American and 49 non-Hispanic White) (mean age 60.2 years) with at least two risk factors for CVD underwent the Trier Social Stress Test (TSST). Subjects completed the Detroit Area Study Discrimination Scale (DAS-DS) Everyday Discrimination subscale and provided blood and saliva samples prior to the TSST and every 15 min up to 90 min post-TSST to measure a pro-inflammatory cytokine, interleukin-6 (IL-6). Perceived discrimination was significantly associated with the salivary IL-6 response to the TSST (b = 0.49, SE = 0.13, p = <0.001) controlling for age, race, marital status, household income, BMI, statin use, childhood maltreatment, depressive symptoms, and subjective social status. Women who reported higher levels of perceived discrimination had higher levels of salivary IL-6 at baseline and following the TSST as compared to women who reported lower levels of perceived discrimination. Results suggest that higher levels of perceived discrimination, regardless of race and socioeconomic status, may heighten levels of inflammation, prior to and following an acute stress exposure. The circulating Il-6 response was associated with BMI only and did not correlate with salivary IL-6. These data suggest that perceived discrimination may contribute to the salivary-IL-6 acute stress response. However, more research is needed to help clarify the complex relationships among stress and salivary proinflammatory cytokines.
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Perceived cognitive deficits and depressive symptoms in patients with multiple sclerosis: Perceived stress and sleep quality as mediators. Mult Scler Relat Disord 2018; 25:150-155. [PMID: 30081314 DOI: 10.1016/j.msard.2018.07.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/11/2018] [Accepted: 07/10/2018] [Indexed: 11/24/2022]
Abstract
Multiple Sclerosis (MS), an autoimmune disorder marked by inflammation of the central nervous system, is associated with a myriad of symptoms. Individuals with MS are more likely to experience depressive symptoms, perhaps due to perceived cognitive impairments. Thus, we aimed to explore perceived stress and sleep deficits as potential mediators of the association between perceived cognitive deficits and depressive symptoms. We recruited a sample of 77 MS participants from an outpatient, university-based MS clinic in the United States. Participants ranged in age between 30 and 75 years old (M = 51.12; SD = 9.6), with more females than males (83% female; n = 64). Participants completed the Perceived Deficits Questionnaire, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, and the Center for Epidemiological Studies Depression Scale - Revised. Correlation analyses and mediation analyses were conducted with bootstrapping technique. Statistical analyses revealed that higher levels of perceived cognitive deficits were associated with lower quality of sleep, more perceived stress, and higher levels of depressive symptoms. Additionally, both perceived stress and sleep quality served as a significant mediator in the perceived cognitive impairments and depressive symptoms linkage. Our novel findings demonstrate the importance of underlying mechanisms (e.g., sleep quality and perceived stress) in the conceptualization of MS. Perceived stress and sleep quality are potentially modifiable factors, perhaps serving as a target for future treatment, to buffer risk of MS patients developing depression.
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Patients Less Likely to Lose Weight Following a Knee Replacement: Results From the Osteoarthritis Initiative. J Clin Rheumatol 2018; 23:355-360. [PMID: 28937470 DOI: 10.1097/rhu.0000000000000579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Knee replacement typically results in reduced pain and improved function, but it is unclear if these improvements lead to weight loss. OBJECTIVE The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. METHODS The study evaluated 210 overweight/obese patients from the Osteoarthritis Initiative who underwent a knee replacement during an 8-year longitudinal study. Average annual weight changes during 1- to 2-year intervals prior to, including, and subsequent to knee replacement were categorized as loss (≥-2.5%), maintain (>-2.5% to <2.5%), and gain (≥2.5%). Weight changes across time intervals were compared using logistic regression with generalized estimating equations, adjusting for demographic, health, and knee factors. RESULTS On average, patients lost -0.6 kg/y during the interval when the surgery was performed, but weight gain (0.9 kg/y) in the initial postoperative interval represented an overall net weight gain (0.3 kg/y) compared with presurgery. Continued weight gain (0.3 kg/y) was also seen among patients with additional follow-ups. Patients were significantly less likely to have a meaningful weight loss in the time interval immediately following the surgery compared with the interval in which the surgery took place (odds ratio, 0.37; 95% confidence interval, 0.18-0.79). CONCLUSIONS Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery. Knee replacement patients may benefit from weight management interventions both preoperatively and postoperatively.
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Abstract
Depressive disorders are common in patients with multiple sclerosis, influencing their quality of life and adherence to treatments, as well as becoming more frequent with the progression of the disease and in the secondary progressive form of multiple sclerosis. Patients with multiple sclerosis often experience a typical cluster of symptoms in association with depression, such as fatigue, pain and cognitive impairment. However, the pathogenesis of multiple sclerosis-related depression remains partially unclear, even though genetic, immune-inflammatory and psychosocial factors might be seen to play a role, in addition to the brain structural alterations documented by magnetic resonance imaging studies. The high incidence and burden of depression in people affected with multiple sclerosis are matters of crucial importance. Despite such importance, the efficacy of pharmacologic treatments has been poorly studied and, for the most part, the access to non-pharmacological treatments is partially dependent on the local health system availability. It has been determined that interferon-beta and glatiramer acetate do not cause depressive symptoms; however, no definitive data in this regard are avaible for the newer disease-modifyng medications. In this review, we discuss the diagnosis, prevalence, pathogenesis, clinical aspects, magnetic resonance imaging findings and treatments available in patients experiencing multiple sclerosis-related depression.
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Song J, Chang AH, Chang RW, Lee J, Pinto D, Hawker G, Nevitt M, Dunlop DD. Relationship of knee pain to time in moderate and light physical activities: Data from Osteoarthritis Initiative. Semin Arthritis Rheum 2017; 47:683-688. [PMID: 29103557 DOI: 10.1016/j.semarthrit.2017.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/15/2017] [Accepted: 10/04/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION While OA literature indicates greater pain is related to less time being physically active, it is not known if time curtailment occurs primarily for moderate intensity activities or for light activities or in both. We examine the cross-sectional association of knee pain with physical activity using data from 1874 Osteoarthritis Initiative participants. METHODS Knee pain characteristics of constant and intermittent pain were each scored by the Intermittent and Constant Osteoarthritis Pain instrument and categorized into four pain levels (no pain, intermittent pain below and above median level, and constant pain). The relationships between knee pain levels and objectively measured physical activity (average weekly moderate or light intensity minutes) were assessed by quantile regression adjusted for socio-demographics and health factors. RESULTS Knee pain levels had a strong negative relationship with moderate intensity physical activities (p-value for trend =0.029). Compared to the no pain group, persons with more severe knee pain, particularly those reporting higher intermittent or constant pain spent less time in moderate activity. In contrast, there was no notable trend related to pain with time spent in light intensity activity. These patterns remained when restricted to persons with clinical evidence (symptoms and/or radiographic) of knee OA and among persons not using medications for knee symptoms. CONCLUSION Greater knee pain levels were strongly related to less moderate intensity activity time, but not time spent in light intensity physical activity. This relationship suggests that light activity may be a more acceptable way to increase physical activity than moderate activity for people with symptomatic knee pain.
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Affiliation(s)
- Jing Song
- Institute for Public Health and Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 633 St. Clair St, 20th Floor, Chicago, IL.
| | - Alison H Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Rowland W Chang
- Institute for Public Health and Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 633 St. Clair St, 20th Floor, Chicago, IL; Northwestern University Feinberg School of Medicine, Division of Rheumatology, Department of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jungwha Lee
- Northwestern University Feinberg School of Medicine, Division of Rheumatology, Department of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Daniel Pinto
- Institute for Public Health and Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 633 St. Clair St, 20th Floor, Chicago, IL; Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gillian Hawker
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Michael Nevitt
- Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, CA
| | - Dorothy D Dunlop
- Institute for Public Health and Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 633 St. Clair St, 20th Floor, Chicago, IL; Northwestern University Feinberg School of Medicine, Division of Rheumatology, Department of Medicine, Chicago, IL
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Zettl UK, Schreiber H, Bauer-Steinhusen U, Glaser T, Hechenbichler K, Hecker M. Baseline predictors of persistence to first disease-modifying treatment in multiple sclerosis. Acta Neurol Scand 2017; 136:116-121. [PMID: 27796033 DOI: 10.1111/ane.12705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Patients with multiple sclerosis (MS) require lifelong therapy. However, success of disease-modifying therapies is dependent on patients' persistence and adherence to treatment schedules. In the setting of a large multicenter observational study, we aimed at assessing multiple parameters for their predictive power with respect to discontinuation of therapy. MATERIALS AND METHODS We analyzed 13 parameters to predict discontinuation of interferon beta-1b treatment during a 2-year follow-up period based on data from 395 patients with MS who were treatment-naïve at study onset. Besides clinical characteristics, patient-related psychosocial outcomes were assessed as well. RESULTS Among patients without clinically relevant fatigue, males showed a higher persistence rate than females (80.3% vs 64.7%). Clinically relevant fatigue scores decreased the persistence rate in men and especially in women (71.4% and 51.2%). Besides gender and fatigue, univariable and multivariable analyses revealed further factors associated with interferon beta-1b therapy discontinuation, namely lower quality of life, depressiveness, and higher relapse rate before therapy initiation, while higher education, living without a partner, and higher age improved persistence. CONCLUSIONS Patients with higher grades of fatigue and depressiveness are at higher risk to prematurely discontinue MS treatment; especially, women suffering from fatigue have an increased discontinuation rate.
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Affiliation(s)
- U. K. Zettl
- Department of Neurology; Neuroimmunology Section; University of Rostock; Rostock Germany
| | | | - U. Bauer-Steinhusen
- Neurology, Immunology, and Ophthalmology; Bayer Vital GmbH; Leverkusen Germany
| | - T. Glaser
- Neurology, Immunology, and Ophthalmology; Bayer Vital GmbH; Leverkusen Germany
| | | | - M. Hecker
- Department of Neurology; Neuroimmunology Section; University of Rostock; Rostock Germany
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Song J, Gilbert AL, Chang RW, Pellegrini CA, Ehrlich-Jones LS, Lee J, Pinto D, Semanik PA, Sharma L, Kwoh CK, Jackson RD, Dunlop DD. Do Inactive Older Adults Who Increase Physical Activity Experience Less Disability: Evidence From the Osteoarthritis Initiative. J Clin Rheumatol 2017; 23:26-32. [PMID: 28002153 PMCID: PMC5180208 DOI: 10.1097/rhu.0000000000000473] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Physical inactivity is a leading risk factor for developing disability. Although randomized clinical trials have demonstrated improving physical activity can reduce this risk in older adults with arthritis, these studies did not specifically evaluate inactive adults. OBJECTIVES The aim of this study was to evaluate the relationship of changes in physical activity with disability changes among initially inactive adults with or at high risk of knee osteoarthritis from Osteoarthritis Initiative. METHODS Inactive persons were identified at baseline based on the US Department of Health and Human Services classification (no [zero] 10-minute session of moderate-to-vigorous [MV] activity over 1 week) from objective accelerometer monitoring. Two years later, physical activity change status was classified as follows: (1) met Federal physical activity guidelines (≥150 MV minutes/week acquired in bouts ≥10 minutes), (2) insufficiently increased activity (some but <150 MV bout minutes/week), or (3) remained inactive. Disability at baseline and 2 years was assessed by Late Life Disability Instrument limitation and frequency scores. Multiple regression evaluated the relationship of physical activity change status with baseline-to-2-year changes in disability scores adjusting for socioeconomics, health factors, and baseline disability score. RESULTS Increased physical activity showed a graded relationship with improved disability scores in Late Life Disability Instrument limitation (P < 0.001) and frequency scores (P = 0.027). While increasing MV activity to guideline levels showed the greatest reduction, even insufficiently increased physical activity was related to reduced disability. CONCLUSIONS Findings support advice to increase MV physical activity to reduce disability among inactive adults with or at high risk of knee osteoarthritis, even when guidelines are not met.
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Affiliation(s)
- Jing Song
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Rowland W. Chang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Jungwha Lee
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel Pinto
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Leena Sharma
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, Tucson, Arizona
| | | | - Dorothy D. Dunlop
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Rayan A, Obiedate K. The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia. J Am Psychiatr Nurses Assoc 2017; 23:404-413. [PMID: 28569084 DOI: 10.1177/1078390317710498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. AIMS The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. METHOD In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. RESULTS Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. CONCLUSIONS Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.
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Affiliation(s)
- Ahmad Rayan
- 1 Ahmad Rayan, PhD, Zarqa University, Zarqa, Jordan
| | - Khaldoon Obiedate
- 2 Khaldoon Obiedate, RN, MSN, CNS, Jordan University Hospital, Amman, Jordan
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Hind D, Kaklamanou D, Beever D, Webster R, Lee E, Barkham M, Cooper C. The assessment of depression in people with multiple sclerosis: a systematic review of psychometric validation studies. BMC Psychiatry 2016; 16:278. [PMID: 27491674 PMCID: PMC4973535 DOI: 10.1186/s12888-016-0931-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 06/15/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The prevalence of depression in people with multiple sclerosis (PwMS) is high; however, symptoms common to both conditions makes measurement difficult. There is no high quality overview of validation studies to guide the choice of depression inventory for this population. METHODS A systematic review of studies validating the use of generic depression inventories in people with MS was conducted using MEDLINE and PsycINFO. Studies validating the use of depression inventories in PwMS and published in English were included; validation studies of tests for cognitive function and general mental health were excluded. Eligible studies were then quality assessed using the COSMIN checklist and findings synthesised narratively by instrument and validity domain. RESULTS Twenty-one studies (N = 5,991 PwMS) evaluating 12 instruments were included in the review. Risk of bias varied greatly between instrument and validity domain. CONCLUSIONS The review of validation studies was constrained by poor quality reporting and outcome reporting bias. Well-conducted evaluations of some instruments are unavailable for some validity domains. This systematic review provides an evidence base for trade-offs in the selection of an instrument for assessing self-reported symptoms of depression in research or clinical practice involving people with MS. We make detailed and specific recommendations for where further research is needed. TRIAL REGISTRATION PROSPERO CRD42014010597.
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Affiliation(s)
- Daniel Hind
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Daphne Kaklamanou
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Heart of the Campus, 42 Collegiate Crescent, Sheffield, S10 2BQ, UK.
| | - Dan Beever
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Ellen Lee
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Michael Barkham
- Centre for Psychological Services Research, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
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Caban ME, Freeman JL, Zhang DD, Jansen C, Ostir G, Hatch SS, Goodwin JS. The relationship between depressive symptoms and shoulder mobility among older women: assessment at one year after breast cancer diagnosis. Clin Rehabil 2016; 20:513-22. [PMID: 16892933 DOI: 10.1191/0269215506cr966oa] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the association between depressive symptoms and shoulder range of motion at one year after breast cancer diagnosis, controlling for patient characteristics, tumour stage and cancer therapy (surgery, axillary node dissection and radiation). Design: Prospective trial of nurse case management involving 187 older women with complete data, age 60 years and older, newly diagnosed with breast cancer, from 1 November, 1993 to 31 October, 1996 in south-eastern Texas. Depressive symptoms, sociodemographic characteristics and breast cancer treatment were measured at two months and shoulder range of motion at 12 months. The relationship among the variables was evaluated with bivariate chi-square statistics and logistic regression analysis. All logistic models also included a variable indicating whether or not the woman received nurse case management, to control for intervention status. Results: Increasing depressive symptoms at baseline were associated with lower arm mobility at 12 months following breast cancer diagnosis. Each unit increase in depressive symptoms at baseline was associated with an 8% decreased odds of having full range of motion of the shoulder (odds ratio (OR) 0.92, 95% confidence interval (CI) 0.87, 0.97), after controlling for relevant patient and treatment factors. Conclusion(s): Older women with depressive symptoms have an elevated risk of not fully recovering shoulder mobility after being treated for breast cancer. Future studies are needed to assess benefits from early intervention with psychological and or physical interventions in the presence of depressive symptoms on shoulder mobility.
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Affiliation(s)
- Mabel E Caban
- Department of Orthopedics and Rehabilitation, Route 0165, University of Texas Medical Branch, Galveston, TX 77555, USA.
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Yoo KB, Park EC, Jang SY, Kwon JA, Kim SJ, Cho KH, Choi JW, Kim JH, Park S. Association between employment status change and depression in Korean adults. BMJ Open 2016; 6:e008570. [PMID: 26932136 PMCID: PMC4785295 DOI: 10.1136/bmjopen-2015-008570] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES This study investigated the association between employment status and depression. METHODS Data from the Korea Welfare Panel Study (KOWEPS) collected from 2008 to 2011 were used. A total of 7368 subjects were included in this study after exclusion of subjects with missing data and those who were self-employed or could not work. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Employment status, age, sex, region, education, marital status, income, head of household, self-rated health, smoking status, drinking habits, and the current year's and the previous year's CES-D scores were included in the model as independent variables. A generalised linear mixed-effects model for longitudinal binary data was used. RESULTS Compared with those who were permanently employed, individuals who moved from permanent to precarious employment (OR 1.45, 95% CI 1.23 to 1.70) or to unemployment (OR 1.78, 95% CI 1.30 to 2.43) and from precarious employment to unemployment (OR 1.65, 95% CI 1.32 to 2.06) showed a significantly increased the odds of having depression. Continuing precarious employment (OR 1.54, 95% CI 1.30 to 1.83) or unemployment (OR 1.45, 95% CI 1.23 to 1.70) also significantly increased the odds of having depression. These results were particularly identified in men and head of household women. The effects were not significant among non-head of household women. CONCLUSIONS Precarious employment and unemployment were clearly associated with having depression. In addition, in view of our findings, policy makers should consider sex and head of household status when developing welfare policies. The inequity between precarious jobs and permanent jobs should be tackled.
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Affiliation(s)
- Ki-Bong Yoo
- Department of Healthcare Management, Eulji University, Sungnam, Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, College of Medicine Yonsei University, Seoul, Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, College of Medicine Yonsei University, Seoul, Korea
| | - Jeoung A Kwon
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Sun Jung Kim
- Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Korea
| | - Kyoung-hee Cho
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Jae-Woo Choi
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Jae-Hyun Kim
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Sohee Park
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Graduate School of Public Health, Yonsei University, Seoul, Korea
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Amtmann D, Bamer AM, Johnson KL, Ehde DM, Beier ML, Elzea JL, Bombardier CH. A comparison of multiple patient reported outcome measures in identifying major depressive disorder in people with multiple sclerosis. J Psychosom Res 2015; 79:550-7. [PMID: 26363679 DOI: 10.1016/j.jpsychores.2015.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 08/20/2015] [Accepted: 08/26/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depression is one of the most prominent and debilitating symptoms in individuals with multiple sclerosis (MS), yet there is currently no consensus on the best instruments for depression screening in MS. More head to head comparisons of available screening instruments are needed to advise MS researchers and clinicians. METHODS A cross-sectional comparison of the effectiveness of screening for MDD using multiple patient reported outcome (PRO) screeners against a modified SCID telephone interview was completed in 164 individuals with MS. Stratum goals were set for depression levels to ensure participation by people with borderline and higher levels of depression. Criterion standard was a modified SCID MDD module. PRO measures included the PHQ-9, BDI-FS, PROMIS depression, Neuro-QOL depression, M-PHQ-2, PHQ-2, and CESD. RESULTS 48 (29%) individuals met the modified SCID criteria for MDD. The sensitivity of the PRO measures ranged from 60% to 100% while specificity ranged from 46% to 86%. The ROC area for the PRO measures ranged from 0.79 to 0.83. Revised (higher) cutoff scores were suggested by the ROC analyses for most self-reported screeners. LIMITATIONS Enrollment was stopped early because of difficulties with recruitment. Several SCID recording could not be reviewed and diagnosis confirmed. CONCLUSIONS CESD-10 and PHQ9 had the best diagnostic performance using optimal cutoffs, but no one PRO measure stood out as significantly better than any other. Even when revised cutoff scores were used, none of the self-reported screeners identified people with MDD with adequate accuracy. More accurate self-reported screeners would facilitate diagnosing of MDD for both research and clinical purposes.
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Affiliation(s)
- Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | - Alyssa M Bamer
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Kurt L Johnson
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Meghan L Beier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Jamie L Elzea
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Change in Physical Activity and Sedentary Time Associated With 2-Year Weight Loss in Obese Adults With Osteoarthritis. J Phys Act Health 2015; 13:461-6. [PMID: 26552064 DOI: 10.1123/jpah.2015-0404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND We examined if changes in moderate-to-vigorous physical activity (MVPA), light activity, and sedentary behavior are related to weight change over a 2-year period in obese adults with/elevated risk for knee osteoarthritis. METHODS Weight, physical activity, and sedentary time at baseline and 2 years were obtained from 459 obese participants from the Osteoarthritis Initiative. Weight change was categorized as ≥ 10 lbs, 5.0 to 9.9 lbs, 4.9 to -4.9 lbs, -5.0 to -9.9 lbs, and ≤ -10 lbs. We examined the association between 2-year weight change categories and changes in activity/sedentary time from accelerometer monitoring by multiple linear regression adjusted for baseline weight, demographic, and health factors. RESULTS Across the 5 weight categories (loss to gain), average 2-year change ranged from -7.4 to 28.0 sedentary minutes/ day, 4.2 to -23.1 light activity minutes/day, and 3.2 to -4.9 MVPA minutes/day, respectively. Higher weight loss categories were separately associated with increased MVPA (P for trend < 0.001) and less sedentary gain (P for trend = 0.01). Weight loss categories had a strong trend with light activity gain but not statistically significant (P for trend = 0.06). CONCLUSIONS Small increases in MVPA and decreases in sedentary time over 2 years were associated with weight loss among adults with obesity and with or at elevated risk for knee osteoarthritis.
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Houston E, Tatum AK, Guy A, Mikrut C, Yoder W. Goal Setting and Treatment Adherence Among Patients With Chronic Illness and Depressive Symptoms: Applying a Patient-Centered Approach. Glob J Health Sci 2015; 8:128-38. [PMID: 26755463 PMCID: PMC4954903 DOI: 10.5539/gjhs.v8n6p128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/17/2015] [Accepted: 07/26/2015] [Indexed: 11/29/2022] Open
Abstract
Objective: Poor treatment adherence is a major problem among individuals with chronic illness. Research indicates that adherence is worsened when accompanied by depressive symptoms. In this preliminary study, we aimed to describe how a patient-centered approach could be employed to aid patients with depressive symptoms in following their treatment regimens. Methods: The sample consisted of 14 patients undergoing antiretroviral therapy (ART) for HIV who reported clinically-significant depressive symptoms. Participant ratings of 23 treatment-related statements were examined using two assessment and analytic techniques. Interviews were conducted with participants to determine their views of information based on the technique. Results: Results indicate that while participants with optimal adherence focused on views of treatment associated with side effects to a greater extent than participants with poor adherence, they tended to relate these side effects to sources of intrinsic motivation. Conclusion: The study provides examples of how practitioners could employ the assessment techniques outlined to better understand how patients think about treatment and aid them in effectively framing their health-related goals.
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Fischer A, Fischer M, Nicholls RA, Lau S, Poettgen J, Patas K, Heesen C, Gold SM. Diagnostic accuracy for major depression in multiple sclerosis using self-report questionnaires. Brain Behav 2015; 5:e00365. [PMID: 26445703 PMCID: PMC4589811 DOI: 10.1002/brb3.365] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/31/2015] [Accepted: 06/07/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Multiple sclerosis and major depressive disorder frequently co-occur but depression often remains undiagnosed in this population. Self-rated depression questionnaires are a good option where clinician-based standardized diagnostics are not feasible. However, there is a paucity of data on diagnostic accuracy of self-report measures for depression in multiple sclerosis (MS). Moreover, head-to-head comparisons of common questionnaires are largely lacking. This could be particularly relevant for high-risk patients with depressive symptoms. Here, we compare the diagnostic accuracy of the Beck Depression Inventory (BDI) and 30-item version of the Inventory of Depressive Symptomatology Self-Rated (IDS-SR30) for major depressive disorder (MSS) against diagnosis by a structured clinical interview. METHODS Patients reporting depressive symptoms completed the BDI, the IDS-SR30 and underwent diagnostic assessment (Mini International Neuropsychiatric Interview, M.I.N.I.). Receiver-Operating Characteristic analyses were performed, providing error estimates and false-positive/negative rates of suggested thresholds. RESULTS Data from n = 31 MS patients were available. BDI and IDS-SR30 total score were significantly correlated (r = 0.82). The IDS-SR30total score, cognitive subscore, and BDI showed excellent to good accuracy (area under the curve (AUC) 0.86, 0.91, and 0.85, respectively). CONCLUSION Both the IDS-SR30 and the BDI are useful to quantify depressive symptoms showing good sensitivity and specificity. The IDS-SR30 cognitive subscale may be useful as a screening tool and to quantify affective/cognitive depressive symptomatology.
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Affiliation(s)
- Anja Fischer
- Department of Health Psychology, King's College London SE1 9RT, London, UK ; Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Marcus Fischer
- Department of Pharmaceutical Chemistry, University of California San Francisco San Francisco, California, 94158
| | - Robert A Nicholls
- Structural Studies Division, MRC Laboratory of Molecular Biology Cambridge, CB2 0QH, UK
| | - Stephanie Lau
- Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Jana Poettgen
- Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Kostas Patas
- Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Christoph Heesen
- Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Neurology, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Stefan M Gold
- Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin (CBF), Charité Universitätsmedizin Berlin, Germany
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Song J, Lindquist LA, Chang RW, Semanik PA, Ehrlich-Jones LS, Lee J, Sohn MW, Dunlop DD. Sedentary Behavior as a Risk Factor for Physical Frailty Independent of Moderate Activity: Results From the Osteoarthritis Initiative. Am J Public Health 2015; 105:1439-45. [PMID: 25973826 DOI: 10.2105/ajph.2014.302540] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This prospective longitudinal study investigated the association between baseline objectively measured sedentary time and 2-year onset of physical frailty. METHODS We studied 1333 Osteoarthritis Initiative participants 55 to 83 years of age who were at risk for physical frailty, as assessed via low gait speed (< 0.6 m per second) or inability to perform a single chair stand. Baseline sedentary time was assessed through accelerometer monitoring. Hazard ratios (HRs) for physical frailty onset were estimated with discrete survival methods that controlled for moderate physical activity, sociodemographic characteristics, baseline gait and chair stand functioning, and health factors. RESULTS The incidence of physical frailty in this high-risk group was 20.7 per 1000 person-years. Greater baseline sedentary time (adjusted HR = 1.36 per sedentary hour; 95% confidence interval [CI] = 1.02, 1.79) was significantly related to incident physical frailty after control for time spent in moderate-intensity activities and other covariates. CONCLUSIONS Our prospective data demonstrated a strong relationship between daily sedentary time and development of physical frailty distinct from insufficient moderate activity. Interventions that promote reductions in sedentary behaviors in addition to increases in physical activity may help decrease physical frailty onset.
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Affiliation(s)
- Jing Song
- Jing Song, Lee A. Lindquist, Rowland W. Chang, Jungwha Lee, and Dorothy D. Dunlop are with the Northwestern University Feinberg School of Medicine, Chicago, IL. Pamela A. Semanik is with the Rush University School of Medicine, Chicago. Linda S. Ehrlich-Jones is with the Center for Rehabilitation Outcome Research, Rehabilitation Institute of Chicago. Min-Woong Sohn is with the University of Virginia School of Medicine, Charlottesville
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Houston E, Osborn A. THE USE OF SELF-MANAGED TREATMENT STRATEGIES IN A PREDOMINANTLY LOW-INCOME, AFRICAN-AMERICAN SAMPLE OF WOMEN LIVING WITH HIV. Psychol Rep 2015; 116:861-9. [PMID: 25933048 DOI: 10.2466/13.pr0.116k27w8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While low-income and ethnic minority women represent a growing proportion of new HIV cases in the United States, little is known about how they manage their antiretroviral medication regimens. Using a predominantly low-income, African-American sample (N = 85), this study examined medication self-management strategies among HIV seropositive women undergoing antiretroviral therapy in a major metropolitan area. Most study participants (95%; n = 81) reported employing a specific medication management strategy during the previous week. Pillboxes, use of daily activities, and receiving reminders from another person were the most common strategies. Most participants (80.2%) employed two or more strategies. Age, education, and motivation were associated with alarm, pillbox, and visual aid usage.
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Affiliation(s)
- Eric Houston
- 1 Illinois Institute of Technology, Chicago, Illinois
| | - Amanda Osborn
- 1 Illinois Institute of Technology, Chicago, Illinois
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Houston E, Mikrut C, Guy A, Fominaya AW, Tatum AK, Kim JH, Brown A. Another look at depressive symptoms and antiretroviral therapy adherence: The role of treatment self-efficacy. J Health Psychol 2015; 21:2138-47. [PMID: 25712489 DOI: 10.1177/1359105315571976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Depression has been strongly associated with poor HIV treatment adherence, but little research has explored how individuals manage to follow their regimens despite symptoms of major depression. Using a sample of antiretroviral therapy patients with clinically significant depressive symptoms (n = 84), we examined whether patients with optimal adherence differed from those with suboptimal adherence in terms of the types of depressive symptoms experienced and treatment self-efficacy. There were no significant differences between participants with regard to types of depressive symptoms. Findings indicate that patients with high treatment self-efficacy were more likely to report optimal levels of adherence than patients with low self-efficacy.
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Affiliation(s)
| | | | - Arryn Guy
- Illinois Institute of Technology, USA
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Saban KL, Mathews HL, Collins EG, Hogan NS, Tell D, Bryant FB, Pape TLB, Griffin JM, Janusek LW. The Man I Once Knew. Biol Res Nurs 2015; 18:50-9. [DOI: 10.1177/1099800414568661] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI. Participants completed written measures of grief, perceived stress, and depressive symptoms and provided morning saliva samples for TNF-α analysis. Participants reported levels of grief comparable to those reported in studies evaluating individuals grieving the death of a loved one. Path analysis revealed that grief was not associated with TNF-α; however, participants reporting high levels of blame/anger, a subscale of the grief scale, had higher levels of TNF-α. In addition, both grief and blame/anger were related to increased perceived stress and depressive symptoms; however, path analysis demonstrated that perceived stress and depressive symptoms did not mediate the influence of blame/anger on TNF-α. These findings suggest that blame/anger associated with grief may be related to the elevations in TNF-α exhibited by individuals caring for a loved one with TBI.
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Affiliation(s)
- Karen L. Saban
- Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | | | - Eileen G. Collins
- Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Nancy S. Hogan
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Dina Tell
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Fred B. Bryant
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Theresa Louise Bender Pape
- Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Joan M. Griffin
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
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Marrie RA, Cohen J, Stuve O, Trojano M, Sørensen PS, Reingold S, Cutter G, Reider N. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: overview. Mult Scler 2015; 21:263-81. [PMID: 25623244 PMCID: PMC4361468 DOI: 10.1177/1352458514564491] [Citation(s) in RCA: 237] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Comorbidity is an area of increasing interest in multiple sclerosis (MS). Objective: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. Methods: We searched the PubMed, SCOPUS, EMBASE and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles. Two reviewers independently screened abstracts. One reviewer abstracted data using a standardized form and the abstraction was verified by a second reviewer. We assessed study quality using a standardized approach. We quantitatively assessed population-based studies using the I2 statistic, and conducted random-effects meta-analyses. Results: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting findings. Prevalence was reported more frequently than incidence; estimates for prevalence and incidence varied substantially for all conditions. Heterogeneity was high. Conclusion: This review highlights substantial gaps in the epidemiological knowledge of comorbidity in MS worldwide. Little is known about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, University of Manitoba, Canada/Department of Community Health Sciences, University of Manitoba, Health Sciences Center, Canada
| | - Jeffrey Cohen
- Mellen Center for MS Treatment and Research, Cleveland Clinic, USA
| | - Olaf Stuve
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern, USA
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy
| | | | | | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, USA
| | - Nadia Reider
- Department of Internal Medicine, University of Manitoba, Canada
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Semanik PA, Lee J, Song J, Chang RW, Sohn MW, Ehrlich-Jones LS, Ainsworth BE, Nevitt MM, Kwoh CK, Dunlop DD. Accelerometer-monitored sedentary behavior and observed physical function loss. Am J Public Health 2015; 105:560-6. [PMID: 25602883 DOI: 10.2105/ajph.2014.302270] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether objectively measured sedentary behavior is related to subsequent functional loss among community-dwelling adults with or at high risk for knee osteoarthritis. METHODS We analyzed longitudinal data (2008-2012) from 1659 Osteoarthritis Initiative participants aged 49 to 83 years in 4 cities. Baseline sedentary time was assessed by accelerometer monitoring. Functional loss (gait speed and chair stand testing) was regressed on baseline sedentary time and covariates (baseline function; socioeconomics [age, gender, race/ethnicity, income, education], health factors [obesity, depression, comorbidities, knee symptoms, knee osteoarthritis severity, prior knee injury, other lower extremity pain, smoking], and moderate-to-vigorous activity). RESULTS This cohort spent almost two thirds of their waking hours (average=9.8 h) in sedentary behaviors. Sedentary time was significantly positively associated with subsequent functional loss in both gait speed (-1.66 ft/min decrease per 10% increment sedentary percentage waking hours) and chair stand rate (-0.75 repetitions/min decrease), controlling for covariates. CONCLUSIONS Being less sedentary was related to less future decline in function, independent of time spent in moderate-to-vigorous activity. Both limiting sedentary activities and promoting physical activity in adults with knee osteoarthritis may be important in maintaining function.
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Affiliation(s)
- Pamela A Semanik
- Pamela A. Semanik is with the College of Nursing, Rush University, Chicago, IL. Barbara E. Ainsworth is with the School of Nutrition and Health Promotion, College of Health Solutions, Phoenix, Arizona. Jungwha Lee, Jing Song, Rowland W. Chang, and Dorothy D. Dunlop are with the Feinberg School of Medicine, Northwestern University, Chicago. Min-Woong Sohn is with the School of Medicine, University of Virginia, Charlottesville. Linda S. Ehrlich-Jones is with the Center for Rehabilitation Outcome Research, Rehabilitation Institute of Chicago. Michael M. Nevitt is with the Coordinating Center, University of California, San Francisco. C. Kent Kwoh is with University of Arizona Medical Center, Tucson
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Marrie RA, Reingold S, Cohen J, Stuve O, Trojano M, Sorensen PS, Cutter G, Reider N. The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review. Mult Scler 2015; 21:305-17. [PMID: 25583845 PMCID: PMC4429164 DOI: 10.1177/1352458514564487] [Citation(s) in RCA: 310] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). OBJECTIVES The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies. METHODS We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I² statistic, and conducted meta-analyses. RESULTS We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, University of Manitoba, Canada/Department of Community Health Sciences, University of Manitoba, Canada
| | | | - Jeffrey Cohen
- Mellen Center for MS Treatment and Research, Cleveland Clinic, USA
| | - Olaf Stuve
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern, USA
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Italy
| | | | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, USA
| | - Nadia Reider
- Department of Community Health Sciences, University of Manitoba, Canada
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Houston E, Fominaya AW. Antiretroviral therapy adherence in a sample of men with low socioeconomic status: The role of task-specific treatment self-efficacy. PSYCHOL HEALTH MED 2014; 20:896-905. [PMID: 25439192 DOI: 10.1080/13548506.2014.986137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Disparities continue to persist in HIV care and treatment outcomes among racial/ethnic minorities, men who have sex with men (MSM), and individuals with low socioeconomic status. Much research has identified treatment self-efficacy as a key factor in antiretroviral therapy adherence and subsequent treatment outcomes. Few studies, however, have elaborated on these links and their potential in reducing HIV treatment disparities by examining the role of task-specific types of treatment self-efficacy. In this study, we examined the effect of four types of task-specific treatment self-efficacy on antiretroviral adherence among patients in a predominantly racial/ethnic minority sample of HIV-seropositive MSM with low socioeconomic status. We grouped participants by duration of treatment to determine whether certain types of self-efficacy were more salient based on treatment experience. We found that participants with optimal adherence tended to have higher levels of task-specific self-efficacy related to medication management and mood management than participants with suboptimal adherence. After a Bonferroni correction for multiple comparisons, only task-specific self-efficacy for medication management showed significant effects on adherence. Findings suggest that using focused, task-specific measures of treatment self-efficacy could strengthen our ability to aid patients at risk for adherence difficulties and tailor interventions to more effectively meet their needs.
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Affiliation(s)
- Eric Houston
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL 60616 , USA
| | - Adam W Fominaya
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL 60616 , USA
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Sun K, Song J, Lee J, Chang RW, Eaton CB, Ehrlich-Jones L, Kwoh KC, Manheim LM, Semanik PA, Sharma L, Sohn MW, Dunlop DD. Relationship of meeting physical activity guidelines with health-related utility. Arthritis Care Res (Hoboken) 2014; 66:1041-7. [PMID: 24339324 DOI: 10.1002/acr.22262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 12/03/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Health-related utility measures overall health status and quality of life and is commonly incorporated into cost-effectiveness analyses. This study investigates whether attainment of federal physical activity guidelines translates into better health-related utility in adults with or at risk for knee osteoarthritis (OA). METHODS Cross-sectional data from 1,908 adults with or at risk for knee OA participating in the accelerometer ancillary study of the Osteoarthritis Initiative were assessed. Physical activity was measured using 7 days of accelerometer monitoring and was classified as 1) meeting guidelines (≥150 bouted moderate-to-vigorous [MV] minutes per week); 2) insufficiently active (≥1 MV bout[s] per week but below guidelines); or 3) inactive (zero MV bouts per week). A Short Form 6D health-related utility score was derived from patient-reported health status. Relationship of physical activity levels to median health-related utility adjusted for socioeconomic and health factors was tested using quantile regression. RESULTS Only 13% of participants met physical activity guidelines, and 45% were inactive. Relative to the inactive group, median health-related utility scores were significantly greater for the meeting guidelines group (0.063; 95% confidence interval [95% CI] 0.055, 0.071) and the insufficiently active group (0.059; 95% CI 0.054, 0.064). These differences showed a statistically significant linear trend and strong cross-sectional relationship with physical activity level even after adjusting for socioeconomic and health factors. CONCLUSION We found a significant positive relationship between physical activity level and health-related utility. Interventions that encourage adults, including persons with knee OA, to increase physical activity even if recommended levels are not attained may improve their quality of life.
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Affiliation(s)
- Kai Sun
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Gomez R, McLaren S. The center for epidemiologic studies depression scale: support for a bifactor model with a dominant general factor and a specific factor for positive affect. Assessment 2014; 22:351-60. [PMID: 25085880 DOI: 10.1177/1073191114545357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES For the Center for Epidemiologic Studies Depression Scale (CES-D) ratings, the study examined support for a bifactor model, and also the internal consistency reliability and external validity of the factors in this model. METHOD Participants (N = 1,178) were older adults from the general community who completed the CES-D. RESULTS Confirmatory factor analysis of their ratings indicated support for the bifactor model. For this model, the general factor explained most of the covariance in the scores of the CES-D items for Depressed Affect, Somatic Symptoms and Retarded Activity, and Interpersonal Difficulties items. Most of the covariance in the scores of the Positive Affect (PA) scale was explained by its own specific factor. Additional analyses showed support for internal consistencies and external validities of general factors based on all the CES-D items, and when PA items were excluded, and also the PA-specific factor. DISCUSSION The findings support the use of a total CES-D score without the PA items and also the concurrent use of the PA scale score.
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Affiliation(s)
- Rapson Gomez
- Federation University Australia, Ballarat, Victoria, Australia
| | - Suzanne McLaren
- Federation University Australia, Ballarat, Victoria, Australia
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Dunlop DD, Song J, Semanik PA, Sharma L, Bathon JM, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Mysiw WJ, Nevitt MC, Chang RW. Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study. BMJ 2014; 348:g2472. [PMID: 24782514 PMCID: PMC4004786 DOI: 10.1136/bmj.g2472] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. DESIGN Prospective multisite cohort study from September 2008 to December 2012. SETTING Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. PARTICIPANTS Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. MAIN OUTCOME MEASURES Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. RESULTS Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. CONCLUSION These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of the knee or risk factors for knee osteoarthritis. An increase in daily physical activity time may reduce the risk of disability, even if the intensity of that additional activity is not increased.
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Affiliation(s)
- Dorothy D Dunlop
- Institute for Public Health and Medicine Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, 750 Lakeshore Drive, Chicago, IL 60611, USA
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Zettl UK, Bauer-Steinhusen U, Glaser T, Hechenbichler K, Limmroth V. Evaluation of an electronic diary for improvement of adherence to interferon beta-1b in patients with multiple sclerosis: design and baseline results of an observational cohort study. BMC Neurol 2013; 13:117. [PMID: 24011220 PMCID: PMC3849232 DOI: 10.1186/1471-2377-13-117] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 08/21/2013] [Indexed: 11/15/2022] Open
Abstract
Background Multiple sclerosis is a chronic, incurable, demyelinating disease that requires long-term treatment. Rates of non-adherence to prescribed therapy of up to 50% have been reported for chronic diseases. Strategies to improve treatment adherence are therefore of the utmost importance. This study will evaluate the effect of using electronic and paper diaries on treatment adherence to interferon beta-1b in patients with a first clinical isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS). Here we report on the study design and results of baseline assessments. Methods Patients were recruited into a prospective national multicenter cohort study for an observational period of 2 years. At the start of the study, patients opted to use a digital (DiD) or paper diary (PD) to document self-administered injections of interferon beta-1b. Adherence to treatment will be assessed on the dropout rate at the end of the observation period and on the regularity of injections every other day at 6-month intervals. Patient-related health outcomes will also be evaluated. Results 700 patients with a mean age of 38.3 (SD 10.3) years and a mean duration of disease since diagnosis of 3.6 (SD 5.9) years were enrolled. 383 patients opted for the digital diary, 192 of which included an injection reminder. Significantly more male than female patients opted for the DiD. Only gender was identified as a factor influencing the decision for DiD or PD. Based on rating scales, a significantly higher proportion of women had depressive comorbidities at baseline. Conclusions Demographic characteristics of the two cohorts were similar at baseline. More women chose a paper diary, and more had depression at baseline. These imbalances will be addressed in the analysis of the study as possible confounders influencing long-term treatment adherence in the digital and paper diary cohorts. Trial Registration ClinicalTrials.gov Identifier: NCT00902135.
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Affiliation(s)
- Uwe K Zettl
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock, Rostock, Germany.
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Ma Y, Balasubramanian R, Pagoto SL, Schneider KL, Hébert JR, Phillips LS, Goveas JS, Culver AL, Olendzki BC, Beck J, Smoller JW, Sepavich DM, Ockene JK, Uebelacker L, Zorn M, Liu S. Relations of depressive symptoms and antidepressant use to body mass index and selected biomarkers for diabetes and cardiovascular disease. Am J Public Health 2013; 103:e34-43. [PMID: 23763394 PMCID: PMC3791588 DOI: 10.2105/ajph.2013.301394] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated whether depressive symptoms and antidepressant use are associated with biomarkers for glucose dysregulation and inflammation, body mass index (BMI), and waist circumference. METHODS Postmenopausal women were recruited into the Women's Health Initiative from 1993 to 1998, and data were collected at regular intervals through 2005. We used multiple linear regression models to examine whether depressive symptoms and antidepressant use are associated with BMI, waist circumference, and biomarkers. RESULTS Analysis of data from 71, 809 women who completed all relevant baseline and year 3 assessments showed that both elevated depressive symptoms and antidepressant use were significantly associated with higher BMI and waist circumference. Among 1950 women, elevated depressive symptoms were significantly associated with increased insulin levels and measures of insulin resistance. Analyses of baseline data from 2242 women showed that both elevated depressive symptoms and antidepressant use were associated with higher C-reactive protein levels. CONCLUSIONS Monitoring body habitus and other biomarkers among women with elevated depression symptoms or taking antidepressant medication may be prudent to prevent diabetes and cardiovascular disease.
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Affiliation(s)
- Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Song J, Hochberg MC, Chang RW, Hootman JM, Manheim LM, Lee J, Semanik PA, Sharma L, Dunlop DD. Racial and ethnic differences in physical activity guidelines attainment among people at high risk of or having knee osteoarthritis. Arthritis Care Res (Hoboken) 2013; 65:195-202. [PMID: 22807352 DOI: 10.1002/acr.21803] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/09/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This cross-sectional study examined racial/ethnic differences in meeting the 2008 United States Department of Health and Human Services Physical Activity Guidelines aerobic component (≥150 moderate-to-vigorous minutes/week in bouts of ≥10 minutes) among persons with or at risk of radiographic knee osteoarthritis (RKOA). METHODS We evaluated African American versus white differences in guideline attainment using multiple logistic regression, adjusting for sociodemographic (age, sex, site, income, and education) and health factors (comorbidity, depressive symptoms, overweight/obesity, and knee pain). Our analyses included adults ages 49-84 years who participated in accelerometer monitoring at the Osteoarthritis Initiative 48-month visit (n = 1,142 with RKOA and n = 747 at risk of RKOA). RESULTS Two percent of African Americans and 13.0% of whites met the guidelines. For adults with and at risk of RKOA, significantly lower rates of guidelines attainment among African Americans compared to whites were partially attenuated by health factor differences, particularly overweight/obesity and knee pain (with RKOA: adjusted odds ratio [OR] 0.24, 95% confidence interval [95% CI] 0.08-0.72; at risk of RKOA: OR 0.28, 95% CI 0.07-1.05). CONCLUSION Despite known benefits from physical activity, attainment of the physical activity guidelines among persons with and at risk of RKOA was low. African Americans were 72-76% less likely than whites to meet the guidelines. Culturally relevant interventions and environmental strategies in the African American community targeting overweight/obesity and knee pain may reduce future racial/ethnic differences in physical activity and improve health outcomes.
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Affiliation(s)
- Jing Song
- Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Lee J, Song J, Hootman JM, Semanik PA, Chang RW, Sharma L, van Horn L, Bathon JM, Eaton CB, Hochberg MC, Jackson R, Kwoh CK, Mysiw WJ, Nevitt M, Dunlop DD. Obesity and other modifiable factors for physical inactivity measured by accelerometer in adults with knee osteoarthritis. Arthritis Care Res (Hoboken) 2013; 65:53-61. [PMID: 22674911 DOI: 10.1002/acr.21754] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/25/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the public health impact of obesity and other modifiable risk factors related to physical inactivity in adults with knee osteoarthritis (OA). METHODS The frequency of inactivity as defined by the US Department of Health and Human Services was assessed from objective accelerometer monitoring of 1,089 participants (ages 49-84 years) with radiographic knee OA during the Osteoarthritis Initiative 48-month visit (2008-2010). The relationship between modifiable factors (weight status, dietary fat, fiber, smoking, depressive symptoms, knee function, knee pain, and knee confidence) with inactivity was assessed using odds ratios (ORs) and attributable fractions (AFs), controlling for descriptive factors (age, sex, race, education, lives alone, employment, frequent knee symptoms, and comorbidity). RESULTS Almost half (48.9%) of participants with knee OA were inactive. Being overweight (OR 1.8, 95% confidence interval [95% CI] 1.2-2.5) or obese (OR 3.9, 95% CI 2.6-5.7), having inadequate dietary fiber intake (OR 1.6, 95% CI 1.2-2.2), severe knee dysfunction (OR 1.9, 95% CI 1.3-2.8), and severe pain (OR 1.7, 95% CI 1.1-2.5) were significantly related to inactivity, controlling for descriptive factors. Modifiable factors with significant average AFs were being overweight or obese (AF 23.8%, 95% CI 10.5-38.6%) and inadequate dietary fiber (AF 12.1%, 95% CI 0.1-24.5%), controlling for all factors. CONCLUSION Being obese or overweight, the quality of the diet, severe pain, and severe dysfunction are significantly associated with physical inactivity in adults with knee OA. All components should be considered in designing physical activity interventions that target arthritis populations with low activity levels.
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Affiliation(s)
- Jungwha Lee
- Northwestern University, Chicago, IL 60611, USA.
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Marrie RA, Cutter G, Tyry T, Campagnolo D, Vollmer T. Effect of Physical Comorbidities on Risk of Depression in Multiple Sclerosis. Int J MS Care 2013. [DOI: 10.7224/1537-2073-15.s1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Jonassaint CR, Haywood C, Korthuis PT, Cooper LA, Saha S, Sharp V, Cohn J, Moore RD, Beach MC. The impact of depressive symptoms on patient-provider communication in HIV care. AIDS Care 2013; 25:1185-92. [PMID: 23320529 DOI: 10.1080/09540121.2012.752788] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Persons with HIV who develop depression have worse medical adherence and outcomes. Poor patient-provider communication may play a role in these outcomes. This cross-sectional study evaluated the influence of patient depression on the quality of patient-provider communication. Patient-provider visits (n=406) at four HIV care sites were audio-recorded and coded with the Roter Interaction Analysis System (RIAS). Negative binomial and linear regressions using generalized estimating equations tested the association of depressive symptoms, as measured by the Center for Epidemiology Studies Depression scale (CES-D), with RIAS measures and postvisit patient-rated quality of care and provider-reported regard for his or her patient. The patients, averaged 45 years of age (range =20-77), were predominately male (n=286, 68.5%), of black race (n=250, 60%), and on antiretroviral medications (n=334, 80%). Women had greater mean CES-D depression scores (12.0) than men (10.6; p=0.03). There were no age, race, or education differences in depression scores. Visits with patients reporting severe depressive symptoms compared to those reporting none/mild depressive symptoms were longer and speech speed was slower. Patients with severe depressive symptoms did more emotional rapport building but less social rapport building, and their providers did more data gathering/counseling (ps<0.05). In postvisit questionnaires, providers reported lower levels of positive regard for, and rated more negatively patients reporting more depressive symptoms (p<0.01). In turn, patients reporting more depressive symptoms felt less respected and were less likely to report that their provider knows them as a person than none/mild depressive symptoms patients (ps<0.05). Greater psychosocial needs of patients presenting with depressive symptoms and limited time/resources to address these needs may partially contribute to providers' negative attitudes regarding their patients with depressive symptoms. These negative attitudes may ultimately serve to adversely impact patient-provider communication and quality of HIV care.
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Affiliation(s)
- Charles R Jonassaint
- a Division of General Internal Medicine , Johns Hopkins University , Baltimore , MD , USA
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Evans-Polce R, Hulbert A, Latkin C. The Association of Multiple Neighborhood Perceptions with Depression among a Highly Impoverished Urban Sample. JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 41:52-64. [PMID: 25378764 PMCID: PMC4219739 DOI: 10.1002/jcop.21510] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Rebecca Evans-Polce
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
| | | | - Carl Latkin
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
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Storholm ED, Halkitis PN, Kupprat SA, Hampton MC, Palamar JJ, Brennan-Ing M, Karpiak S. HIV-Related Stigma as a Mediator of the Relation Between Multiple-Minority Status and Mental Health Burden in an Aging HIV-Positive Population. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2013; 12:9-25. [PMID: 36919144 PMCID: PMC10010679 DOI: 10.1080/15381501.2013.767557] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Cross-sectional analyses of 904 diverse men and women aged 50 years and older living with HIV in New York City were conducted to examine the unique experiences and needs of aging HIV-positive individuals. Using Minority Stress Theory and Syndemic Theory as guiding paradigms, the authors documented the mental health burdens of the sample with regard to depression, loneliness, and diminished psychological well-being and examined how multiple-minority status and HIV-related stigma explained these burdens. Mediation modeling demonstrated that the effects of minority stressors on mental health burden were mediated by HIV-related stigma. The mediation was significant for the overall sample and for the male subsample. Results suggest that to fully address the mental health burdens experienced by aging HIV-positive individuals, we must continue to address mental health burdens directly, and at the same time, look beyond the psychiatric symptoms to address the structural inequities faced by individuals based on their multiple-minority status.
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Affiliation(s)
- Erik David Storholm
- Center for Health, Identity, Behavior & Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Sandra A Kupprat
- Center for Health, Identity, Behavior & Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Melvin C Hampton
- Center for Health, Identity, Behavior & Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Joseph J Palamar
- Center for Health, Identity, Behavior & Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Mark Brennan-Ing
- AIDS Community Research Initiative of America, New York, New York, USA, and New York University College of Nursing, New York, New York, USA
| | - Stephen Karpiak
- AIDS Community Research Initiative of America, New York, New York, USA, and New York University College of Nursing, New York, New York, USA
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Aisenberg Romano G, Ravid H, Zaig I, Schreiber S, Azem F, Shachar I, Bloch M. The psychological profile and affective response of women diagnosed with unexplained infertility undergoing in vitro fertilization. Arch Womens Ment Health 2012; 15:403-11. [PMID: 22847827 DOI: 10.1007/s00737-012-0299-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 07/18/2012] [Indexed: 11/24/2022]
Abstract
It has been hypothesized that unexplained infertility may be related to specific personality and coping styles. We studied two groups of women with explained infertility (EIF, n = 63) and unexplained infertility (UIF, n = 42) undergoing an in vitro fertilization (IVF) cycle. Women completed personality and coping style questionnaires prior to the onset of the cycle, and state depression and anxiety scales before and at two additional time points during the cycle. Almost no in-between group differences were found at any of the measured time points in regards to the Minnesota Multiphasic Personality Inventory-2 validity and clinical scales, Illness Cognitions and Life Orientation Test, or for the situational measures. The few differences found suggest a more adaptive, better coping, and functioning defensive system in women with EIF. In conclusion, we did not find any clinically significant personality differences or differences in depression or anxiety levels between women with EIF and UIF during an IVF cycle. Minor differences found are probably a reaction to the ambiguous medical situation with its uncertain prognosis, amplifying certain traits which are not specific to one psychological structure but rather to the common experience shared by the group. The results of this study do not support the possibility that personality traits are involved in the pathophysiology of unexplained infertility.
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Ruiz-Grosso P, Loret de Mola C, Vega-Dienstmaier JM, Arevalo JM, Chavez K, Vilela A, Lazo M, Huapaya J. Validation of the Spanish Center for Epidemiological Studies Depression and Zung Self-Rating Depression Scales: a comparative validation study. PLoS One 2012; 7:e45413. [PMID: 23056202 PMCID: PMC3466285 DOI: 10.1371/journal.pone.0045413] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 08/22/2012] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Depressive disorders are leading contributors to burden of disease in developing countries. Research aiming to improve their diagnosis and treatment is fundamental in these settings, and psychometric tools are widely used instruments to support mental health research. Our aim is to validate and compare the psychometric properties of the Spanish versions of the Center for Epidemiological Studies Depression Scale (CES-D) and the Zung Self-Rating Depression Scale (ZSDS). METHODOLOGY/PRINCIPAL FINDINGS A Spanish version of the CES-D was revised by 5 native Spanish speaking psychiatrists using as reference the English version. A locally standardized Spanish version of the ZSDS was used. These Spanish versions were administered to 70 patients with a clinical diagnosis of DSM-IV Major Depressive Episode (MDE), 63 without major depression but with clinical diagnosis of other psychiatric disorders (OPD), and 61 with no evidence of psychiatric disorders (NEP). For both scales, Cronbach's alpha (C-α) and Hierarchical McDonald Omega for polychoric variables (MD-Ω) were estimated; and receiver operating characteristics (ROC) analysis performed. For the CES-D and ZSDS scales, C-α was 0.93 and 0.89 respectively, while MD-Ω was 0.90 and 0.75 respectively. The area under the ROC curve in MDE+OPD was 0.83 for CES-D and 0.84 for ZSDS; and in MDE+NEP was 0.98 for CES-D and 0.96 for ZSDS. Cut-off scores (co) for the highest proportions of correctly classified (cc) individuals among MDE+OPD were ≥29 for CES-D (sensitivity (ss) = 77.1/specificity (sp) = 79.4%/(cc) = 78.2%) and ≥47 for ZSDS (ss = 85.7%/sp = 71.4%/cc = 78.9%). In the MDE+NEP, co were ≥24 for the CES-D (ss = 91.4%/sp = 96.7%/cc = 93.9%) and ≥45 for the ZSDS (ss = 91.4%/sp = 91.8%/cc = 91.6%). CONCLUSION Spanish versions of the CES-D and ZSDS are valid instruments to detect depression in clinical settings and could be useful for both epidemiological research and primary clinical settings in settings similar as those of public hospitals in Lima, Peru.
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Affiliation(s)
- Paulo Ruiz-Grosso
- Mental Health Working Group, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Zaig I, Azem F, Schreiber S, Gottlieb-Litvin Y, Meiboom H, Bloch M. Women's psychological profile and psychiatric diagnoses and the outcome of in vitro fertilization: is there an association? Arch Womens Ment Health 2012; 15:353-9. [PMID: 22767032 DOI: 10.1007/s00737-012-0293-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 06/23/2012] [Indexed: 11/29/2022]
Abstract
The influence of psychological processes and psychiatric syndromes on the outcome of fertility treatments is not well understood. In this prospective study, we investigated the effect of baseline psychiatric diagnosis and situational psychiatric symptoms on several biological outcome factors of in vitro fertilization treatments (IVF). Women undergoing their first IVF treatment (n = 108) were interviewed before treatment for the presence of a lifetime DSM-IV-TR disorder. Questionnaires measuring state depression (Center for Epidemiologic Studies Depression scale), anxiety (State Trait Anxiety Inventory), and psychiatric symptomatology (Brief Symptom Inventory) were administered at ovulation induction. Outcome variables were number of retrieved and fertilized oocytes, chemical pregnancy, and a take home baby. Situational anxiety, depression, or other psychiatric symptoms had no effect on any of the outcome measures. Women diagnosed with mood or anxiety disorder prior to the onset of the IVF treatment showed a higher, though not statistically significant, pregnancy success rate compared to women without a diagnosis (57 % compared to 38 %). We speculate that in women with such psychopathology, chronic stress results in biological effects that impede successful implantation, thus impairing fertility. Fertility treatment using the IVF paradigm may bypass this negative effect, resulting in high success rates. This hypothesis should be further explored.
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Affiliation(s)
- Inbar Zaig
- Department of Psychiatry, Tel Aviv Souraski Medical Center, Tel Aviv, Israel
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Bayón C, Ribera E, Cabrero E, Griffa L, Burgos Á. Prevalence of depressive and other central nervous system symptoms in HIV-infected patients treated with HAART in Spain. ACTA ACUST UNITED AC 2012; 11:321-8. [PMID: 22713685 DOI: 10.1177/1545109712448217] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was conducted to assess the prevalence of depressive symptoms, sleep disturbances, and subjective cognitive complaints in patients with HIV receiving highly active antiretroviral therapy. Participants completed the "Center for Epidemiological Studies Depression Scale" (CES-D) and a questionnaire on sleep disturbances and subjective cognitive complaints. Mean age of the 799 participants was 43.7 years and 67% were men. Adjusted prevalence of CES-D was 35.4% (95% confidence interval [CI]: 32.0-38.7), with no significant differences between gender and age groups. Sleep disturbances were more prevalent in older versus younger participants (74.0% [95% CI: 70.4-77.7] versus 63.3% [95% CI: 56.8-69.8]). Cognitive complaints were more prevalent in women (52.3% [95% CI: 46.4-58.2]) when compared with men (48.2% [95% CI: 44.7-51.6]). Hepatitis C virus coinfection was a strong predictor of depressive symptoms. Male gender and detectable viral load were independent risk factors for sleep disturbance. A higher CES-D score was an independent risk factor for sleep disturbance and cognitive complaints.
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Nolan MS, Hause AM, Murray KO. Findings of long-term depression up to 8 years post infection from West Nile virus. J Clin Psychol 2012; 68:801-8. [PMID: 23929558 DOI: 10.1002/jclp.21871] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the psychological sequelae following West Nile virus (WNV) infection among a large cohort of participants over an 8-year period. DESIGN We conducted a longitudinal study to assess mental health outcomes among a cohort of 171 WNV-positive participants in Houston, Texas. RESULTS We found 35% of participants met the Center for Epidemiologic Studies Depression scale definition for new onset clinical depression. Multivariate analysis found that severe depression was significantly associated with gender and physical disability (Barthel index score <100) at 5 years post-WNV infection. CONCLUSIONS Practitioners should be aware of depression as a possible outcome in patients who were infected with WNV and include this as a part of their routine assessment.
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