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Saravanan A, Bajaj P, Matthews HL, Tell D, Starkweather A, Janusek L. Fatigue and Depressive Mood in Chronic Low Back Pain. Pain Manag Nurs 2024; 25:225-230. [PMID: 38492990 DOI: 10.1016/j.pmn.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/11/2024] [Accepted: 02/04/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Fatigue is prevalent, problematic, and co-occurs in chronic low back pain. When left untreated, fatigue can increase depressive mood, and intensify pain burden and disability in patients with chronic low back pain. The purpose of this study was to examine the relationship of fatigue to depressive mood, pain severity, and pain interference in patients with chronic low back pain. DESIGN AND METHODS A cross-sectional design was used to enroll and evaluate adults (n = 67) with chronic low back pain (>6 months) during their visit to an outpatient pain clinic. Participants completed psychometric instruments for fatigue, depressive mood, pain severity, and pain interference. RESULTS Participants were primarily women (73%), White (59%), with a median age of 59 years (range 22-70 years). Multiple regression models showed significant positive associations between fatigue and depressive mood (SD: 0.025 p = 0.017) with a coefficient of 0.069; fatigue and pain interference (SD: 0.123 p = 0.010) with a coefficient of 0.652; fatigue and pain severity (SD: 0.125 p-value <0.05) with a coefficient of 0.359. After adjusting for demographic factors (age, sex, and race/ethnicity) the associations remained significant. CONCLUSIONS The findings suggest that fatigue is associated with greater depressive mood, pain severity, and pain interference in adults with chronic low back pain. CLINICAL IMPLICATIONS Assessing the extent of fatigue and depressive mood as part of pain management may benefit patients with chronic low back, thereby reducing symptom burden.
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Affiliation(s)
- Anitha Saravanan
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois.
| | - Prempreet Bajaj
- Department of Orthopedic and Rehabilitation Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Herbert L Matthews
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago
| | - Dina Tell
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois
| | | | - Linda Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois
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Shin J, Hammer M, Cooley ME, Cooper BA, Paul SM, Cartwright F, Kober KM, Conley YP, Levine JD, Miaskowski C. Common and distinct risk factors that influence more severe and distressing shortness of breath profiles in oncology outpatients. Cancer Med 2024; 13:e7013. [PMID: 38400684 PMCID: PMC10891479 DOI: 10.1002/cam4.7013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/05/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Shortness of breath occurs in 10%-70% of oncology patients. Very little is known about interindividual variability in its severity and distress and associated risk factors. Using latent profile analyses (LPAs), purpose was to identify subgroups of patients with distinct severity and distress profiles for shortness of breath as single symptom dimensions. In addition, a joint LPA was done using patients' severity AND distress ratings. For each of the three LPAs, differences among the shortness of breath classes in demographic, clinical, symptom, stress, and resilience characteristics were evaluated. METHODS Patients completed ratings of severity and distress from shortness of breath a total of six times over two cycles of chemotherapy. All of the other measures were completed at enrollment (i.e., prior to the second or third cycle of chemotherapy). Separate LPAs were done using ratings of severity and distress, as well as a joint analysis using severity AND distress ratings. Differences among the latent classes were evaluated using parametric and nonparametric tests. RESULTS For severity, two classes were identified (Slight to Moderate [91.6%] and Moderate to Severe [8.4%]). For distress, two classes were identified (A Little Bit to Somewhat [83.9%] and Somewhat to Quite a Bit [16.1%]). For the joint LPA, two classes were identified (Lower Severity and Distress [79.9%] and Higher Severity and Distress [20.1%]). While distinct risk factors were associated with each of the LPAs, across the three LPAs, the common risk factors associated with membership in the worse class included: a past or current history of smoking, poorer functional status, and higher comorbidity burden. In addition, these patients had a higher symptom burden and higher levels of cancer-specific stress. CONCLUSIONS Clinicians can use the information provided in this study to identify high-risk patients and develop individualized interventions.
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Affiliation(s)
- Joosun Shin
- Dana‐Farber Cancer InstituteBostonMassachusettsUSA
| | | | | | - Bruce A. Cooper
- School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Steven M. Paul
- School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Kord M. Kober
- School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Yvette P. Conley
- School of NursingUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Jon D. Levine
- School of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Christine Miaskowski
- School of NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- School of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Lutgendorf SK, Telles RM, Whitney B, Thaker PH, Slavich GM, Goodheart MJ, Penedo FJ, Noble AE, Cole SW, Sood AK, Corn BW. The biology of hope: Inflammatory and neuroendocrine profiles in ovarian cancer patients. Brain Behav Immun 2024; 116:362-369. [PMID: 38081436 DOI: 10.1016/j.bbi.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/01/2024] Open
Abstract
INTRODUCTION Although the concept of hope is highly relevant for cancer patients, little is known about its association with cancer-relevant biomarkers. Here we examined how hope was related to diurnal cortisol and interleukin-6 (IL-6), a pro-inflammatory cytokine previously associated with tumor biology and survival in ovarian cancer. Secondly, we examined whether hope and hopelessness are distinctly associated with these biomarkers. METHOD Participants were 292 high-grade ovarian cancer patients who completed surveys and provided saliva samples 4x/daily for 3 days pre-surgery to assess diurnal cortisol. Blood (pre-surgery) and ascites were assessed for IL-6. Hope and hopelessness were assessed using standardized survey items from established scales (Center for Epidemiological Studies Depression Scale; Profile of Mood States, Functional Assessment of Cancer Therapy). Two hopeless items were z-scored and combined into a composite for analysis. Regression models related these variables to nocturnal cortisol, cortisol slope, plasma and ascites IL-6, adjusting for cancer stage, BMI, age, and depression. RESULTS Greater hope was significantly related to a steeper cortisol slope, β = -0.193, p = 0.046, and lower night cortisol, β = -0.227, p = 0.018, plasma IL-6, β = -0.142, p = 0.033, and ascites IL-6, β = -0.290, p = 0.002. Secondary analyses including both hope and hopelessness showed similar patterns, with distinct relationships of hope with significantly lower nocturnal cortisol β = -0.233,p = 0.017 and ascites IL-6, β = -0.282,p = 0.003, and between hopelessness and a flatter cortisol slope, β = 0.211, p = 0.031. CONCLUSIONS These data suggest a biological signature of hope associated with less inflammation and more normalized diurnal cortisol in ovarian cancer. These findings have potential clinical utility but need replication with more diverse samples and validated assessments of hope.
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Affiliation(s)
- Susan K Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States; Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States.
| | - Rachel M Telles
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Brendan Whitney
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Premal H Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, United States
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States
| | - Michael J Goodheart
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States; Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States
| | - Frank J Penedo
- Departments of Psychology and Medicine and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States
| | - Alyssa E Noble
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Steven W Cole
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States; Division of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Anil K Sood
- Departments of Gynecologic Oncology, Cancer Biology and Center for RNA Interference and Noncoding RNA, University of Texas M.D. Anderson Cancer Center, Houston, TX, United States
| | - Benjamin W Corn
- Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, Israel
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Xavier Hall CD, Okantey B, Meng Z, Sabuncu C, Lane B, Millender E, Queiroz A, Kim JH, Okada L, Gillespie A, Simoncini G, Barile J‘JP, Ma GX, Wong F‘FY. Examining biopsychosocial predictors of risk for cognitive impairment among a racially diverse sample of men who have sex with men living with HIV. Ther Adv Infect Dis 2024; 11:20499361241249657. [PMID: 38751756 PMCID: PMC11095190 DOI: 10.1177/20499361241249657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
Background Cognitive decline among people living with HIV (PLWH) is growing concern as world populations become increasing older including higher proportions of PLWH. It is vitally important to understand psychosocial predictors of age-related cognitive decline men who have sex with men (MSM) living with HIV. Objectives The current study seeks to examine psychosocial risk factors the contribute to the risk of age-related cognitive impairment as measured by Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score in a racially diverse sample of MSM living with HIV. Design The present analysis utilizes data from the baseline (n = 196) and 6-month follow-up (n = 135) time points of a longitudinal cohort study of PLWH. Methods Using a self-report survey, we examine the associations between psychosocial predictors (e.g. trauma, mental health, chronic pain, sleep disturbance, etc.) and risk of dementia using the CAIDE risk score. Analyses include linear and logistic regression. Results In adjusted model stress, chronic pain, Black racial identity, and having a sexual identity that is bisexual or another category are all positively associated with CAIDE scores. Childhood sexual abuse history was negatively associated with CAIDE scores indicating a protective effect. Sleep disorder has a positive association with CAIDE scores after adjusting for the baseline CAIDE scores. Conclusion These results indicate modifiable correlates of cognitive risk (stress and chronic pain). Interventions should seek to address these comorbid factors including the consideration of minority stress and stigma. Interventions should seek to reach Black and bisexual men living with HIV, including possible cultural tailoring to interventions and messaging. Lastly, future research should examine the impact of variation within childhood sexual abuse histories to better understand their association with cognitive impairment later in life. This may include considering the nature, severity, and potential treatment of trauma symptoms.
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Affiliation(s)
- Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, 2010 Levy Avenue, Innovation Park, Building B, Suite 3600, Tallahassee, FL 32310, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Beth Okantey
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Zhuo Meng
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- Department of Statistics, Florida State University, Tallahassee, FL, USA
| | - Crim Sabuncu
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Brittany Lane
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Eugenia Millender
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Artur Queiroz
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Jung Hyo Kim
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Lorie Okada
- University of Hawaii, Manoa, Honolulu, HI, USA
| | - Avrum Gillespie
- Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Gina Simoncini
- Center of Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- AIDS Healthcare Foundation Healthcare Center, Philadelphia, PA, USA
| | | | - Grace X. Ma
- Center of Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Frank ‘Frankie’ Y. Wong
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
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El-Ammari A, El Malki H, Moutawakkil SG, El Hilaly J, El Houari F, El Gnaoui S, Ragala MEA, El Rhazi K, Zarrouq B. Validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a Moroccan sample with substance use disorder. BMC Psychiatry 2023; 23:723. [PMID: 37803359 PMCID: PMC10557308 DOI: 10.1186/s12888-023-05245-2] [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: 06/14/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Transcultural validation studies of depression scales are rare in Morocco. The Center for Epidemiologic Studies Depression Scale (CES-D) is commonly one of the most common and frequently used screening instruments for depressive symptoms, but the scale has not, up to date, been validated in dialect of Arabic in Moroccan contexts. Given the importance of assessing and preventing depressive symptoms in our Moroccan context, this study aims to validate the CES-D, translated, and adapted to the dialect of Arabic and Moroccan culture, in a sample with substance use disorder. METHODS The data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 140). Then, this structure was confirmed in the validation sample (N = 205) using confirmatory factor analysis (CFA). RESULTS Exploratory factor analysis extracted three factors different from the four factors in the original version. Confirmatory factor analysis confirmed the structure of three factors. The fit indices level showed acceptable to good performance of the measurement model. The instrument showed sufficient reliability and convergent validity, as demonstrated by acceptable values of composite reliability (CR = 0.89-0.93) and average variance extracted (AVE = 0.64-0.66), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio (HTMT) of correlations values was less than 0.85, indicating acceptable discriminant validity. CONCLUSIONS Overall reliability and both convergent and discriminant validity tests indicated that the Moroccan dialectal Arabic version of the CES-D had a good performance and may serve as a valid tool for measuring the severity of depression in people with substance use disorder.
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Affiliation(s)
- Abdelfettah El-Ammari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Hicham El Malki
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Salma Ghofrane Moutawakkil
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Jaouad El Hilaly
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRMEF) of Fez, Fez, Morocco
| | | | | | - Mohammed El Amine Ragala
- Department of Biology-Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
- Department of Biology-Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco.
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Shin J, Kober K, Yates P, Wong ML, Cooper BA, Paul SM, Hammer M, Conley Y, Levine JD, Wright F, Miaskowski C. Higher Lifetime Stress and Symptom Burden Contribute to the Occurrence of Shortness of Breath. Semin Oncol Nurs 2023; 39:151471. [PMID: 37500312 DOI: 10.1016/j.soncn.2023.151471] [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: 12/29/2022] [Revised: 06/10/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES Among four classes of patients with distinct shortness of breath profiles, evaluate for differences in levels of global, cancer-specific, and cumulative life stress, as well as resilience; evaluate for differences in the occurrence rates for various stressful life events, and evaluate for differences in the severity of common co-occurring symptoms. DATA SOURCES Outpatients (N = 1338) completed questionnaires six times over two cycles of chemotherapy. The occurrence of shortness of breath was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath profiles. Differences among the classes were evaluated using parametric and nonparametric tests. CONCLUSION Shortness of breath classes were labeled based on their distinct occurrence trajectories: None (70.5%), Decreasing (8.2%), Increasing (7.8%), and High (13.5%). Compared to None class, Decreasing and High classes had higher global and cancer-specific stress scores. The High class reported higher occurrence rates for several adverse childhood experiences. Compared to None class, Decreasing and High classes had higher depression, anxiety, and morning fatigue scores and lower morning energy and cognitive function scores. IMPLICATIONS FOR NURSING PRACTICE Given the additive or synergistic relationships between stress, co-occurring symptoms, and shortness of breath, multimodal interventions that include stress management, exercise training, and/or symptom management may decrease shortness of breath in oncology patients.
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Affiliation(s)
- Joosun Shin
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California
| | - Kord Kober
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California
| | - Patsy Yates
- Cancer & Palliative Outcomes Centre, Centre for Health Transformation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Melisa L Wong
- Department of Medicine, School of Medicine, University of California, San Francisco, California
| | - Bruce A Cooper
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California
| | - Marilyn Hammer
- The Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Yvette Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jon D Levine
- Department of Medicine, School of Medicine, University of California, San Francisco, California
| | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Christine Miaskowski
- Departments of Physiological Nursing and Anesthesia, School of Nursing and School of Medicine, University of California, San Francisco, California.
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Nelson AM, Erdmann AA, Coe CL, Juckett MB, Morris K, Knight JM, Hematti P, Costanzo ES. Inflammatory cytokines and depression symptoms following hematopoietic cell transplantation. Brain Behav Immun 2023; 112:11-17. [PMID: 37236325 PMCID: PMC10524437 DOI: 10.1016/j.bbi.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/21/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
Increased synthesis and release of inflammatory signalling proteins is common among individuals with hematologic malignancies undergoing hematopoietic cell transplantation (HCT) due to intensive conditioning regimens and complications such as graft-versus-host-disease and infections. Prior research indicates that inflammatory responses can activate central nervous system pathways that evoke changes in mood. This study examined relationships between markers of inflammatory activity and depression symptoms following HCT. Individuals undergoing allogeneic (n = 84) and autologous (n = 155) HCT completed measures of depression symptoms pre-HCT and 1, 3, and 6 months post-HCT. Proinflammatory (IL-6, TNF-α) and regulatory (IL-10) cytokines were assessed by ELISA in peripheral blood plasma. Mixed-effects linear regression models indicated that patients with elevated IL-6 and IL-10 reported more severe depression symptoms at the post-HCT assessments. These findings were replicated when examining both allogeneic and autologous samples. Follow-up analyses clarified that relationships were strongest for neurovegetative, rather than cognitive or affective, symptoms of depression. These findings suggest that anti-inflammatory therapeutics targeting an inflammatory mediator of depression could improve quality of life of HCT recipients.
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Affiliation(s)
- Ashley M Nelson
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
| | - Alexandra A Erdmann
- Department of Pediatrics, Division of Pediatric Cardiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Mark B Juckett
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Keayra Morris
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer M Knight
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Peiman Hematti
- Department of Medicine, Division of Hematology and Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Erin S Costanzo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, Division of Hematology and Oncology, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA.
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Çelik DÖ, Haney MÖ. The relationship between depression, healthy lifestyle behaviors and internet addiction: a cross-sectional study of the athlete university students in Turkey. Front Psychiatry 2023; 14:1222931. [PMID: 37484666 PMCID: PMC10359973 DOI: 10.3389/fpsyt.2023.1222931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Mental health research exists for university students in the areas of prevalence and association of depression, internet addiction and healthy lifestyle behaviors. However, the studies examining prevalence rates and these relationships in athlete university students are needed. This study aimed to evaluate the relationship between depression, healthy lifestyle behaviors and internet addiction among athlete university students in Turkey. Methods A cross-sectional design was conducted, measuring depression using the Center for Epidemiologic Studies Depression Scale, healthy lifestyle behaviors (HPLP-II), and internet addiction (YIAT-SF). Predictive factors associated with depressive symptoms were estimated using binary logistic regression. Results Of the 501 participants, 61.3% were male, with a mean age of 21.45 years (SD: 3.19). Student-athletes were at risk of depressive symptoms (76.4%), internet addiction (34.4%) and had moderate healthy lifestyle behaviors (130.41 ± 22.93). No significant differences were found for age, smoking, time spent on social network, number of sports days, number of social networks use for depressive symptoms (p > 0.05), however significant differences were found for depressive symptoms by sex and living with family status (p < 0.05). Pathological internet addiction (OR: 12.74, 95% CI: 2.91-55.77) and low spiritual growth (OR: 0.854, 95% CI: 0.79-0.92) were found to be predictors of depressive symptoms within the athlete university students (p < 0.001). Conclusion The athlete university students are at increased risk for depressive symptoms and internet addiction and decreased healthy lifestyle behaviors. It is essential to establish programs to improve the mental health of students in universities and to strengthen the psychological counseling services offered to students. These findings can assist universities in establishing effective measures to improve mental health outcomes.
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Affiliation(s)
- Demet Öztürk Çelik
- Department of Physical Education and Sports Teaching, Osmaniye Korkut Ata University, Osmaniye, Türkiye
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Mishra RK, Najafi B, Hamad A, Bara R, Lee M, Ibrahim R, Mathew M, Talal T, Al-Ali F. Intradialytic plantar electrical nerve stimulation to improve mobility and plantar sensation among adults with diabetes undergoing hemodialysis: a randomized double-blind trial. J Nephrol 2023:10.1007/s40620-023-01625-9. [PMID: 37326952 DOI: 10.1007/s40620-023-01625-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 03/08/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Impaired mobility is a debilitating consequence of hemodialysis. We examined the efficacy of intradialytic-plantar-electrical-nerve-stimulation (iPENS) to promote mobility among diabetes patients undergoing hemodialysis.. METHODS Adults with diabetes undergoing hemodialysis received either 1-h active iPENS, (Intervention-Group) or non-functional iPENS (Control-Group) during routine hemodialysis for 12 weeks (3 sessions/week). Participants and care-providers were blinded. Mobility (assessed using a validated pendant-sensor) and neuropathy (quantified by vibration-perception-threshold test) outcomes were assessed at baseline and 12 weeks. RESULTS Among 77 enrolled subjects (56.2 ± 2.6 years old), 39 were randomly assigned to the intervention group, while 38 were assigned to the control group. No study-related adverse events and dropouts were reported in the intervention group. Compared to the control group, significant improvements with medium to large effect sizes were observed in the intervention group at 12 weeks for mobility-performance metrics, including active-behavior, sedentary-behavior, daily step counts, and sit-to-stand duration variability (p < 0.05), Cohen's d effect size (d = 0.63-0.84). The magnitude of improvement in active-behavior was correlated with improvement in the vibration-perception-threshold test in the intervention group (r = - 0.33, p = 0.048). A subgroup with severe-neuropathy (vibration-perception-threshold > 25 V) showed a significant reduction in plantar numbness at 12 weeks compared to baseline (p = 0.03, d = 1.1). CONCLUSIONS This study supports feasibility, acceptability, and effectiveness of iPENS to improve mobility and potentially reduce plantar numbness in people with diabetes undergoing hemodialysis. Considering that exercise programs are not widely used in hemodialysis clinical practice, iPENS may serve as a practical, alternative solution to reduce hemodialysis-acquired weakness and promote mobility.
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Affiliation(s)
- Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA.
| | - Abdullah Hamad
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Rasha Bara
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA
| | - Myeounggon Lee
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA
| | - Rania Ibrahim
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Mincy Mathew
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Talal Talal
- Diabetic Foot and Wound Clinic, Hamad Medical Co, Doha, Qatar
| | - Fadwa Al-Ali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
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10
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Mishra RK, Hamad A, Ibrahim R, Mathew M, Talal T, Al-Ali F, Park C, Davuluri V, Fernando ME, Najafi B. Objective assessment of mobility among adults with diabetes and end-stage renal disease using walking aid: A cross-sectional cohort study. Clin Biomech (Bristol, Avon) 2023; 107:106014. [PMID: 37290375 DOI: 10.1016/j.clinbiomech.2023.106014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND This cross-sectional study aimed to compare physical activity levels, plantar sensation, and fear of falling between individuals with diabetes undergoing hemodialysis, with or without walking aids. METHODS Sixty-four participants were recruited, with 37 not using walking aids (age = 65.8 ± 0.7 years, 46% female) and 27 using walking aids (age = 69.2 ± 1.2 years, 63% female). Physical activity was measured using validated pendant sensors over two consecutive days. Concern for falling and plantar numbness were assessed using the Falls Efficacy Scale-International and vibration perception threshold test, respectively. FINDINGS Participants using walking aids exhibited a greater fear of falling (84% vs. 38%, p < 0.01) and fewer walking bouts (p < 0.01, d = 0.67) and stand-to-walk transitions (p < 0.01, d = 0.72) compared to those not using walking aids. The number of walking bouts was negatively correlated with concern for falling scores (ρ = -0.35, p = 0.034) and vibration perception threshold (R = -0.411, p = 0.012) among individuals not using walking aids. However, these correlations were not significant among those using the walking aid. There was no significant group difference in active behavior (walking + standing %) and sedentary behavior (sitting + lying %). INTERPRETATION Those undergoing hemodialysis often lead sedentary lives, with mobility affected by fear of falling and plantar numbness. Using walking aids can help, but it doesn't guarantee more walking. A combined psychosocial and physical therapy approach is key for managing fall concerns and improving mobility.
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Affiliation(s)
- Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Abdullah Hamad
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Rania Ibrahim
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Mincy Mathew
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Talal Talal
- Diabetic Foot and Wound Clinic, Hamad Medical Co, Doha, Qatar
| | - Fadwa Al-Ali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Catherine Park
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Vyshnavi Davuluri
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Malindu E Fernando
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Ulcer and wound Healing consortium, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
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11
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Hsieh KL, Speiser JL, Neiberg RH, Marsh AP, Tooze JA, Houston DK. Factors associated with falls in older adults: A secondary analysis of a 12-month randomized controlled trial. Arch Gerontol Geriatr 2023; 108:104940. [PMID: 36709562 PMCID: PMC10068618 DOI: 10.1016/j.archger.2023.104940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/04/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE While identifying older adults at risk for falls is important, fall prediction models have had limited success, in part because of a poor understanding of which physical function measures to include. The purpose of this secondary analysis was to determine physical function measures that are associated with future falls in older adults. METHODS In a 12-month trial comparing Vitamin D3 supplementation versus placebo on neuromuscular function, 124 older adults completed physical function measures at baseline, including the Short Physical Performance Battery (SPPB), Timed Up and Go, tests of leg strength and power, standing balance on a force plate with firm and foam surfaces, and walking over an instrumented walkway. Falls were recorded with monthly diaries over 12 months and categorized as no falls vs. one or more falls. Univariate and multivariable logistic regression adjusting for demographics, treatment assignment, depression, and prescription medications were conducted to examine the association between each physical function measure and future falls. Models were additionally adjusted for fall history. RESULTS 61 participants sustained one or more falls. In univariate analysis, white race, depression, fall history, SPPB, and postural stability on foam were significantly associated with future falls. In multivariable analysis, fall history (OR (95% CI): 3.20 (1.42-7.43)), SPPB (0.80 (0.62-1.01)), and postural stability on foam (3.01 (1.18, 8.45)) were each significantly associated with future falls. After adjusting for fall history, only postural stability on foam was significantly associated with falls. CONCLUSIONS When developing fall prediction models, fall history, the SPPB, and postural stability when standing on foam should be considered.
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Affiliation(s)
- Katherine L Hsieh
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine; Department of Physical Therapy, Georgia State University.
| | - Jaime L Speiser
- Department of Biostatistics and Data Science, Division of Public Health Services, Wake Forest University School of Medicine
| | - Rebecca H Neiberg
- Department of Biostatistics and Data Science, Division of Public Health Services, Wake Forest University School of Medicine
| | - Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Division of Public Health Services, Wake Forest University School of Medicine
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine
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12
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Isselhard A, Lautz Z, Rhiem K, Stock S. Assessing Psychological Morbidity in Cancer-Unaffected BRCA1/2 Pathogenic Variant Carriers: A Systematic Review. Curr Oncol 2023; 30:3590-3608. [PMID: 37185387 PMCID: PMC10136916 DOI: 10.3390/curroncol30040274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Female BRCA1/2 pathogenic variant carriers have an increased lifetime risk for breast and ovarian cancer. Cancer-unaffected women who are newly diagnosed with this pathogenic variant may experience psychological distress because of imminent health threat. No comprehensible review on psychological morbidity in cancer-unaffected BRCA1/2 pathogenic variant carriers is currently available. This review aims to give an overview about all available the studies in which psychological outcomes have been assessed in cancer-unaffected BRCA1/2 pathogenic variant carriers, whether as a primary outcome or secondary measurement. A systematic search across four databases (Web of Science, PubMed, ScienceDirect, and EBSCO) was conducted. Studies had to report on cancer-unaffected pathogenic variant carriers (exclusively or separately) and use a validated measure of psychological morbidity to be eligible. Measures were only included if they were used in at least three studies. The final review consisted of 45 studies from 13 countries. Distress measures, including anxiety and cancer worry, were most often assessed. Most studies found a peak of distress immediately after genetic test result disclosure, with a subsequent decline over the following months. Only some studies found elevated distress in carriers compared to non-carriers in longer follow-ups. Depression was frequently investigated but largely not found to be of clinical significance. Quality of life seemed to be largely unaffected by a positive genetic test result, although there was some evidence that younger women, especially, were less satisfied with their role functioning in life. Body image has been infrequently assessed so far, but the evidence suggested that there may be a decrease in body image after genetic test result disclosure that may decrease further for women who opt for a prophylactic mastectomy. Across all the outcomes, various versions of instruments were used, often limiting the comparability among the studies. Hence, future research should consider using frequently used instruments, as outlined by this review. Finally, while many studies included cancer-unaffected carriers, they were often not reported on separately, which made it difficult to draw specific conclusions about this population.
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13
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Qureshi F, Guimond A, Tsao E, Delaney S, Boehm JK, Kubzansky LD. Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood: Implications for Health Equity. J Am Heart Assoc 2023; 12:e026173. [PMID: 36628968 PMCID: PMC9939070 DOI: 10.1161/jaha.122.026173] [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] [Indexed: 01/12/2023]
Abstract
Background Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals-particularly members of minoritized racial and ethnic groups-meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. Methods and Results Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994-1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self-esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0-5). In Waves 4 (2008; mean age=28 years) and 5 (2016-2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01-1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00-1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. Conclusions Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities.
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Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | - Anne‐Josee Guimond
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
| | - Elaine Tsao
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
| | - Scott Delaney
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
| | | | - Laura D. Kubzansky
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
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14
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Veronese N, Fazzari A, Caudal M, Polidori MC, Topinkova E, Mattace Raso F, Barbagelata M, Barbagallo M, Pilotto A. The role of comprehensive geriatric assessment in older patients affected by knee osteoarthritis: a systematic review. GERIATRIC CARE 2022. [DOI: 10.4081/gc.2022.11049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Osteoarthritis (OA) is one of the most common musculoskeletal diseases and highly prevalent in older people. Whilst the management of knee OA is usually multidisciplinary, the use of comprehensive geriatric assessment (CGA) for this condition is still limited. Given this background, with this systematic review, we summarized the current literature regarding the importance of CGA in people affected by knee OA. A systematic search across several databases was run until 10th April 2022 and updated on 21st November 2022 for any study investigating the use of CGA in patients with knee OA. The data were summarized descriptively. Among 295 articles initially included, three studies made in the context of the osteoarthritis initiative (OAI) were included. All the three studies used the OAI multidimensional prognostic index (MPI), a composite score derived from the CGA. Higher MPI values were associated with a higher risk of falls, cardiovascular conditions, and fractures across a follow-up period of 8 years and after adjusting for potential confounders. In conclusion, in this systematic review we summarized the current evidence of CGA in knee OA, finding that the MPI, a CGA derived tool, could be useful to early find people at higher risk of conditions that are associated with knee OA and therefore that can be the target of personalized interventions for preventing these conditions.
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15
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Explainable machine learning framework for predicting long-term cardiovascular disease risk among adolescents. Sci Rep 2022; 12:21905. [PMID: 36536006 PMCID: PMC9763353 DOI: 10.1038/s41598-022-25933-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Although cardiovascular disease (CVD) is the leading cause of death worldwide, over 80% of it is preventable through early intervention and lifestyle changes. Most cases of CVD are detected in adulthood, but the risk factors leading to CVD begin at a younger age. This research is the first to develop an explainable machine learning (ML)-based framework for long-term CVD risk prediction (low vs. high) among adolescents. This study uses longitudinal data from a nationally representative sample of individuals who participated in the Add Health study. A total of 14,083 participants who completed relevant survey questionnaires and health tests from adolescence to young adulthood were chosen. Four ML classifiers [decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), and deep neural networks (DNN)] and 36 adolescent predictors are used to predict adulthood CVD risk. While all ML models demonstrated good prediction capability, XGBoost achieved the best performance (AUC-ROC: 84.5% and AUC-PR: 96.9% on testing data). Besides, critical predictors of long-term CVD risk and its impact on risk prediction are obtained using an explainable technique for interpreting ML predictions. The results suggest that ML can be employed to detect adulthood CVD very early in life, and such an approach may facilitate primordial prevention and personalized intervention.
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16
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Lee KS, Yang Y. Educational attainment and emotional well-being in adolescence and adulthood. SSM - MENTAL HEALTH 2022; 2:100138. [PMID: 36704067 PMCID: PMC9875584 DOI: 10.1016/j.ssmmh.2022.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Education has been conceptualized as a causal factor leading to emotional well-being. However, it is also possible that some of the effect of education may be due to selection factors. Analyzing data from the National Longitudinal Study of Adolescent to Adult Health (n = 10,908), we asked: to what extent does educational attainment increase emotional well-being once stable observed and unobserved individual characteristics are accounted for? Findings from fixed effects models showed that attaining a college degree was associated with greater emotional well-being. However, interactions with gender indicate that the positive association with emotional well-being is primarily for women, although a small negative association between completing college and depressive affect was found for men. These findings point to unmeasured confounding factors as motivating some of the association between educational attainment and emotional well-being among adolescents and adults.
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Affiliation(s)
- Kristen Schultz Lee
- Department of Sociology, University at Buffalo, SUNY, United States,Corresponding author. 430 Park Hall, Buffalo, NY, 14260, United States, (K.S. Lee)
| | - Yulin Yang
- University of California, San Francisco, United States
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17
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Ferrari M, Allan S, Arnold C, Eleftheriadis D, Alvarez-Jimenez M, Gumley A, Gleeson JF. Digital Interventions for Psychological Well-Being in University Students: A Systematic Review and Meta-Analysis (Preprint). J Med Internet Res 2022; 24:e39686. [PMID: 36169988 PMCID: PMC9557766 DOI: 10.2196/39686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Life at university provides important opportunities for personal growth; however, this developmental phase also coincides with the peak period of risk for the onset of mental health disorders. In addition, specific university lifestyle factors, including impaired sleep and academic and financial stress, are known to exacerbate psychological distress in students. As a result, university students have been identified as a vulnerable population who often experience significant barriers to accessing psychological treatment. Digital psychological interventions are emerging as a promising solution for this population, but their effectiveness remains unclear. Objective This systematic review and meta-analysis aimed to assess digital interventions targeting psychological well-being among university students. Methods Database searches were conducted on December 2, 2021, via Embase, MEDLINE, PsycINFO, and Web of Science. Results A total of 13 eligible studies were identified, 10 (77%) of which were included in the meta-analysis. Mean pre-post effect sizes indicated that such interventions led to small and significant improvement in psychological well-being (Hedges g=0.32, 95% CI 0.23-0.4; P<.001). These effects remained, albeit smaller, when studies that included a wait-list control group were excluded (Hedges g=0.22, 95% CI 0.08-0.35; P=.002). An analysis of acceptance and commitment therapy approaches revealed small and significant effects (k=6; Hedges g=0.35, 95% CI 0.25-0.45; P<.001). Conclusions Digital psychological interventions hold considerable promise for university students, although features that optimize service delivery and outcomes require further assessment. Trial Registration PROSPERO CRD42020196654; https:/www.crd.york.ac.uk/prospero/display_record.php?RecordID=196654
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Affiliation(s)
- Madeleine Ferrari
- Healthy Brain and Mind Research Centre, Australian Catholic University, Sydney, Australia
| | - Stephanie Allan
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Chelsea Arnold
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
| | - Dina Eleftheriadis
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Andrew Gumley
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - John F Gleeson
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
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18
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Tong B, Devendorf A, Panaite V, Miller R, Kashdan TB, Joiner T, Twenge J, Karver M, Janakiraman R, Rottenberg J. Future Well-Being Among U.S. Youth Who Attempted Suicide and Survived. Behav Ther 2022; 53:481-491. [PMID: 35473651 PMCID: PMC9046683 DOI: 10.1016/j.beth.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/02/2022]
Abstract
To what extent does a suicide attempt impair a person's future well-being? We estimated the prevalence of future well-being (FWB) among suicide attempt survivors using a nationally representative sample of 15,170 youths. Suicide attempt survivors were classified as having high FWB if they reported (a) a suicide attempt at Wave I, (b) no suicidal ideation or attempts over the past year at Wave III (7 years after), and (c) a well-being profile at or above the top quartile of nonsuicidal peers. Seventy-five of 574 suicide attempt survivors (∼13%) met criteria for FWB at Wave III, compared to 26% of nonsuicidal peers. Wave I well-being levels, not depressive symptoms, predicted the likelihood of FWB at Wave III (OR = 1.23, 95% CI [1.05, 1.44], p < .05). In conclusion, a nonfatal suicide attempt reduced but did not preclude FWB in a large national sample. The observation that a segment of the population of suicide attempt survivors achieves FWB carries implications for the prognosis of suicidal behavior and the value of incorporating well-being into investigations of suicide-related phenomena.
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Affiliation(s)
| | | | - Vanessa Panaite
- University of South Florida;,James A. Haley Veterans’ Hospital
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19
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Distinct Cognitive Function Profiles Are Associated With a Higher Presurgery Symptom Burden in Patients With Breast Cancer. Cancer Nurs 2022:00002820-990000000-00020. [PMID: 35439196 DOI: 10.1097/ncc.0000000000001114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) is a common symptom in patients with breast cancer. In our previous study of 397 women with breast cancer, we identified 3 groups of patients with distinct CRCI profiles (ie, high, moderate, and low-moderate attentional function). Compared with the other 2 classes, the low-moderate class was younger, had more comorbidities, and with lower functional status. OBJECTIVES In this study, we expand on this work and evaluate for differences among these latent classes in the severity of psychological (depression and anxiety) and physical (fatigue, decrements in energy, sleep disturbance, and pain) symptoms before surgery. METHODS Cancer-related cognitive impairment was assessed using the Attentional Functional Index from before through 6 months after surgery. Lower Attentional Functional Index scores indicate higher levels of CRCI. Psychological and physical symptoms were assessed with valid instruments. Parametric and nonparametric tests were used to evaluate for differences in symptom severity scores among the latent classes. RESULTS Approximately 60% of patients experienced CRCI (ie, moderate and low-moderate classes). Significant differences were found among the 3 classes in the severity of trait and state anxiety, depressive symptoms, fatigue, and sleep disturbance (ie, high < moderate < low-moderate). In addition, compared with the other 2 classes, the low-moderate class reported higher pain interference scores. CONCLUSIONS These findings suggest that women with clinically meaningful levels of persistent CRCI have a relatively high symptom burden before surgery. IMPLICATIONS FOR PRACTICE Clinicians need to routinely perform preoperative assessments of CRCI and associated symptoms and initiate therapeutic interventions.
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20
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Shin J, Harris C, Oppegaard K, Kober KM, Paul SM, Cooper BA, Hammer M, Conley Y, Levine JD, Miaskowski C. Worst Pain Severity Profiles of Oncology Patients Are Associated With Significant Stress and Multiple Co-Occurring Symptoms. THE JOURNAL OF PAIN 2022; 23:74-88. [PMID: 34298161 PMCID: PMC10788964 DOI: 10.1016/j.jpain.2021.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/27/2021] [Accepted: 07/07/2021] [Indexed: 12/27/2022]
Abstract
Little is known about the associations between pain, stress, and co-occurring symptoms in oncology patients. Purpose was to identify subgroups of patients with distinct worst pain profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, as well as stress and symptom scores. Oncology outpatients (n = 1305) completed questionnaires prior to their second or third chemotherapy cycle. Worst pain intensity was assessed 6 times over 2 chemotherapy cycles using a 0 to 10 numeric rating scale. The 371 patients (28.4%) who had ≤1 occurrence of pain over the 6 assessments were classified as the None class. For the remaining 934 patients whose data were entered into the latent profile analysis, 3 distinct worst pain profiles were identified (ie Mild [12.5%], Moderate [28.6%], Severe [30.5%]). Compared to None class, Severe class had fewer years of education and a lower annual income; were less likely to be employed and married; less likely to exercise on a regular basis, had a higher comorbidity burden, and a worse functional status. Compared to None class, Severe class reported higher levels of general, disease-specific, and cumulative life stress and lower levels of resilience, as well as higher levels of depressive symptoms, anxiety, fatigue, sleep disturbance, and cognitive dysfunction. This study is the first to identify distinct worst pain profiles in a large sample of oncology patients receiving chemotherapy and associated risk factors. PERSPECTIVE: Unrelieved pain remains a significant problem for oncology patients receiving chemotherapy. High levels of stress and co-occurring symptoms contribute to a more severe pain profile in these patients.
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Affiliation(s)
- Joosun Shin
- School of Nursing, University of California, San Francisco, California
| | - Carolyn Harris
- School of Nursing, University of California, San Francisco, California
| | - Kate Oppegaard
- School of Nursing, University of California, San Francisco, California
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California
| | | | - Yvette Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, California; School of Medicine, University of California, San Francisco, California.
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21
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The impact of the COVID-19 pandemic on the mental health of medical students. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1061178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Chan RJ, Cooper B, Koczwara B, Chan A, Tan CJ, Gordon L, Paul SM, Dunn LB, Conley YP, Kober KM, Abrams G, Levine JD, Miaskowski C. Characteristics associated with inter-individual variability in financial distress in patients with breast cancer prior to and for 12 months following surgery. Support Care Cancer 2021; 30:1293-1302. [PMID: 34477973 DOI: 10.1007/s00520-021-06524-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate for inter-individual differences in financial distress and identify demographic, clinical, and symptom characteristics associated with higher levels of financial distress. METHODS Patients (n = 387) were enrolled prior to breast cancer surgery and followed for 12 months. Financial distress was measured using a 0 (no problem) to 10 (severe problem) numeric rating scale. Hierarchical linear modeling was used to evaluate for inter-individual differences in trajectories of financial distress and characteristics associated with financial distress at enrollment and over 12 months. RESULTS Patients' mean age was 55.0 (± 11.7) years and the majority underwent breast conservation surgery (80.6%). Mean financial distress score prior to surgery was 3.3 (± 3.4; range 0 to 10). Unconditional model for financial distress demonstrated no significant changes over time (-0.006/month). Younger age, lower income, receipt of an axillary lymph node dissection and adjuvant chemotherapy, and lower attentional function were associated with higher preoperative levels of financial distress. CONCLUSION Risk factors identified in this study can be used to inform clinicians regarding the need to initiate financial discussions and social work referrals for some patients. Additional clinical or system level interventions should be considered for vulnerable groups with these risk factors.
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Affiliation(s)
- Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA5042, Australia.
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, QLD, Australia.
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Flinders University, Bedford Park, Australia
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
| | - Chia Jie Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, National Cancer Centre, Singapore, Singapore
| | - Louisa Gordon
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Laura B Dunn
- School of Medicine, Stanford University, Stanford, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Gary Abrams
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
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Chan RJ, Cooper B, Gordon L, Hart N, Tan CJ, Koczwara B, Kober KM, Chan A, Conley YP, Paul SM, Miaskowski C. Distinct employment interference profiles in patients with breast cancer prior to and for 12 months following surgery. BMC Cancer 2021; 21:883. [PMID: 34340680 PMCID: PMC8327049 DOI: 10.1186/s12885-021-08583-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership. METHODS Women with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles. RESULTS Three distinct EI profiles (i.e., None - 26.2% (n = 101), Low - 42.6% (n = 164), High - 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function. CONCLUSIONS This study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.
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Affiliation(s)
- Raymond Javan Chan
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.,Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, Australia
| | - Bruce Cooper
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Louisa Gordon
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nicolas Hart
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.,Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Chia Jie Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, National Cancer Centre, Singapore, Singapore, Singapore
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer, Flinders Medical Centre and Flinders University, Bedford Park, Australia
| | - Kord M Kober
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California, Irvine, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
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Mitochondria in epithelial ovarian carcinoma exhibit abnormal phenotypes and blunted associations with biobehavioral factors. Sci Rep 2021; 11:11595. [PMID: 34078919 PMCID: PMC8172869 DOI: 10.1038/s41598-021-89934-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/04/2021] [Indexed: 12/19/2022] Open
Abstract
Malignant tumor cells exhibit mitochondrial alterations and are also influenced by biobehavioral processes, but the intersection of biobehavioral factors and mitochondria in malignant tumors remains unexplored. Here we examined multiple biochemical and molecular markers of mitochondrial content and function in benign tissue and in high-grade epithelial ovarian carcinoma (EOC) in parallel with exploratory analyses of biobehavioral factors. First, analysis of a publicly-available database (n = 1435) showed that gene expression of specific mitochondrial proteins in EOC is associated with survival. Quantifying multiple biochemical and molecular markers of mitochondrial content and function in tissue from 51 patients with benign ovarian masses and 128 patients with high-grade EOC revealed that compared to benign tissue, EOCs exhibit 3.3-8.4-fold higher mitochondrial content and respiratory chain enzymatic activities (P < 0.001) but similar mitochondrial DNA (mtDNA) levels (- 3.1%), documenting abnormal mitochondrial phenotypes in EOC. Mitochondrial respiratory chain activity was also associated with interleukin-6 (IL-6) levels in ascites. In benign tissue, negative biobehavioral factors were inversely correlated with mitochondrial content and respiratory chain activities, whereas positive biobehavioral factors tended to be positively correlated with mitochondrial measures, although effect sizes were small to medium (r = - 0.43 to 0.47). In contrast, serous EOCs showed less pronounced biobehavioral-mitochondrial correlations. These results document abnormal mitochondrial functional phenotypes in EOC and warrant further research on the link between biobehavioral factors and mitochondria in cancer.
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25
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Behavioral Symptom Clusters, Inflammation, and Quality of Life in Chronic Low Back Pain. Pain Manag Nurs 2021; 22:361-368. [PMID: 33478899 DOI: 10.1016/j.pmn.2020.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/22/2020] [Accepted: 11/29/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Chronic low back pain is a prevalent condition, often involving an inflammatory process. Behavioral symptoms, including depressed mood, fatigue, and sleep disturbance, intensifies pain and reduces quality of life. AIMS The objectives of this pilot study were to identify behavioral symptom clusters (depressive mood, fatigue, poor sleep) in individuals with chronic low back pain, and to determine whether there are differences in pain, quality of life and inflammation (plasma IL-6) based on cluster membership. DESIGN AND SETTINGS A cross-sectional study was conducted in a pain clinic. PARTICIPANTS/ SUBJECTS Participants between ages 21 to 70 years (N=69) were enrolled if they had chronic low back pain for at least six months. METHODS Participants completed instruments measuring, pain, depressive mood, fatigue, sleep, and demographic form. Blood (10ml) was obtained. Latent class analysis was used to identify clusters. RESULTS AND CONCLUSIONS Findings revealed a two-class model, with Class 1 characterized by more depressive mood, fatigue, and sleep disturbance compared to Class 2. Class 1 participants reported worse quality of life than those in Class 2. Pain severity and pain interference were not significantly different between the classes. Levels of IL-6 were significantly greater in Class 1 participants compared to Class 2 with higher levels of IL-6 correlating with greater pain severity and sleep disturbances. Logistic regression revealed higher levels of IL-6 predicted Class 1 membership. Behavioral symptoms cluster exist in chronic low back pain patients and impact quality of life. Inflammation may contribute to relationship between behavioral symptoms and pain severity.
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Peng W, Liu Z, Liu Q, Chu J, Zheng K, Wang J, Wei H, Zhong M, Ling Y, Yi J. Insecure attachment and maladaptive emotion regulation mediating the relationship between childhood trauma and borderline personality features. Depress Anxiety 2021; 38:28-39. [PMID: 32720464 DOI: 10.1002/da.23082] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/02/2020] [Accepted: 07/12/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previous studies suggested that childhood trauma is an important etiologic factor for the development of borderline personality disorder (BPD). Moreover, insecure attachment and maladaptive emotion regulation (ER) might be related to childhood trauma and BPD. This study was aimed to explore the relationships among childhood trauma, insecure attachment, maladaptive ER, and BPD features. METHODS A cohort of 637 patients with psychological disorders completed a series of psychometric instruments such as the Personality Diagnostic Questionnaire-4+ (PDQ-4+), the 23-Item Borderline Symptom List, the Childhood Trauma Questionnaire, the Attachment Style Questionnaire, and the Cognitive Emotion Regulation Questionnaire. The path analyses were conducted to investigate the experience-driven model that whether insecure attachment and maladaptive ER could mediate the relationship between childhood trauma and BPD features. The random forest regression was performed to select variables that contribute significantly to BPD features, which variables would be incorporated into the data-driven model to further confirm the experience-driven model. RESULTS Both the experience-driven model and the data-driven model verified that there were three significant mediation pathways (childhood trauma → insecure attachment/maladaptive ER → BPD features, childhood trauma → insecure attachment → maladaptive ER → BPD features; all p < .05), and the most weighted mediation pathway by which childhood trauma influencing the BPD features was through insecure attachment and then through maladaptive ER (weighted 53.16%). CONCLUSION The influence of childhood trauma on BPD features was mainly mediated by the combination of insecure attachment and maladaptive emotion regulation.
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Affiliation(s)
- Wanrong Peng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute, Central South University, Changsha, China
| | - Zhaoxia Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute, Central South University, Changsha, China
| | - Qian Liu
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Jun Chu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute, Central South University, Changsha, China
| | - Kaili Zheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute, Central South University, Changsha, China
| | - Jingwei Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Hao Wei
- School of Computer Science and Engineering, Central South University, Changsha, China
| | - Mingtian Zhong
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Yu Ling
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
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Bernard C, Font H, Diallo Z, Ahonon R, Tine JM, N’guessan Abouo F, Tanon A, Messou E, Seydi M, Dabis F, de Rekeneire N. Prevalence and factors associated with severe depressive symptoms in older west African people living with HIV. BMC Psychiatry 2020; 20:442. [PMID: 32912173 PMCID: PMC7481548 DOI: 10.1186/s12888-020-02837-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Depression is one of the most common psychiatric disorders in people living with HIV (PLHIV). Depression has a negative impact on both mental and physical health and is mainly associated with suboptimal HIV treatment outcomes. To encourage successful aging and the achievement of the 3 × 90 objectives in older PLHIV, the psychological domain must not be neglected. In this context and as data are scarce in West Africa, this study aimed to evaluate the prevalence and the factors associated with severe depressive symptoms in older PLHIV living in this region of the world. METHODS Data from PLHIV aged ≥50 years and on ART since ≥6 months were collected in three clinics (two in Côte d'Ivoire, one in Senegal) participating in the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. The severity of depressive symptoms was measured using the Center for Epidemiological Studies Depression scale (CES-D), and associated factors were identified using logistic regressions. RESULTS The median age of the 334 PLHIV included in the study was 56.7 (53.5-61.1), 57.8% were female, and 87.1% had an undetectable viral load. The prevalence of severe depressive symptoms was 17.9% [95% Confidence Interval (95% CI): 13.8-22.0]. PLHIV with severe depressive symptoms were more likely to be unemployed (adjusted Odd Ratio (aOR) = 2.8; 95% CI: 1.4-5.7), and to be current or former tobacco smokers (aOR = 2.6; 95% CI: 1.3-5.4) but were less likely to be overweight or obese (aOR = 0.4; 95% CI: 0.2-0.8). CONCLUSIONS The prevalence of severe depressive symptoms is high among older PLHIV living in West Africa. Unemployed PLHIV and tobacco smokers should be seen as vulnerable and in need of additional support. Further studies are needed to describe in more details the reality of the aging experience for PLHIV living in SSA. The integration of screening and management of depression in the standard of care of PLHIV is crucial.
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Affiliation(s)
- Charlotte Bernard
- Bordeaux Population Health Research Center, Univ. Bordeaux, Inserm, UMR 1219, F-33000, Bordeaux, France. .,Bordeaux Population Health Research Center, Univ. Bordeaux, ISPED, UMR 1219, F-33000, Bordeaux, France.
| | - Hélène Font
- grid.412041.20000 0001 2106 639XBordeaux Population Health Research Center, Univ. Bordeaux, Inserm, UMR 1219, F-33000 Bordeaux, France ,grid.412041.20000 0001 2106 639XBordeaux Population Health Research Center, Univ. Bordeaux, ISPED, UMR 1219, F-33000 Bordeaux, France
| | - Zélica Diallo
- grid.411387.80000 0004 7664 5497Service de maladies infectieuses et tropicales, CHU Treichville, Abidjan, Côte d’Ivoire
| | - Richard Ahonon
- Centre de prise en charge de recherche et de formation (CePReF), Yopougon Attié Hospital, Abidjan, Côte d’Ivoire
| | - Judicaël Malick Tine
- Service de maladies infectieuses et tropicales, CRCF, CHNU de Fann, Dakar, Senegal
| | - Franklin N’guessan Abouo
- grid.411387.80000 0004 7664 5497Service de maladies infectieuses et tropicales, CHU Treichville, Abidjan, Côte d’Ivoire
| | - Aristophane Tanon
- grid.411387.80000 0004 7664 5497Service de maladies infectieuses et tropicales, CHU Treichville, Abidjan, Côte d’Ivoire
| | - Eugène Messou
- Centre de prise en charge de recherche et de formation (CePReF), Yopougon Attié Hospital, Abidjan, Côte d’Ivoire
| | - Moussa Seydi
- Service de maladies infectieuses et tropicales, CRCF, CHNU de Fann, Dakar, Senegal
| | - François Dabis
- grid.412041.20000 0001 2106 639XBordeaux Population Health Research Center, Univ. Bordeaux, Inserm, UMR 1219, F-33000 Bordeaux, France ,grid.412041.20000 0001 2106 639XBordeaux Population Health Research Center, Univ. Bordeaux, ISPED, UMR 1219, F-33000 Bordeaux, France
| | - Nathalie de Rekeneire
- grid.412041.20000 0001 2106 639XBordeaux Population Health Research Center, Univ. Bordeaux, Inserm, UMR 1219, F-33000 Bordeaux, France ,grid.412041.20000 0001 2106 639XBordeaux Population Health Research Center, Univ. Bordeaux, ISPED, UMR 1219, F-33000 Bordeaux, France
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28
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Boehm JK, Chen Y, Qureshi F, Soo J, Umukoro P, Hernandez R, Lloyd-Jones D, Kubzansky LD. Positive emotions and favorable cardiovascular health: A 20-year longitudinal study. Prev Med 2020; 136:106103. [PMID: 32348855 PMCID: PMC7246158 DOI: 10.1016/j.ypmed.2020.106103] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/07/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022]
Abstract
No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. We also considered whether baseline CVH was associated with subsequent positive emotions during the same period. Participants included 4196 Black and White men and women from the Coronary Artery Risk Development in Young Adults Study. Positive emotions and cardiovascular-related parameters were each assessed in 1990 (this study's baseline), with repeated assessment through 2010. CVH was defined by blood pressure, lipids, body mass index, diabetes, and smoking status. Primary analyses used linear mixed effects models adjusting for potential confounders; secondary analyses stratified by race and sex. Controlling for sociodemographic factors, greater baseline positive emotions were associated with better CVH across time (β = 0.03, 95% confidence interval = 0.007-0.06). However, positive emotions were unrelated to rate of change in CVH across time. Baseline CVH was also associated with greater average positive emotions across time (β = 0.09, 95% confidence interval = 0.02-0.15), but not rate of change. Positive emotions' association with CVH was stronger for women than men, but race did not modify associations. Positive emotions in early to middle adulthood were associated with better CVH across several decades. Baseline CVH was also associated with greater positive emotions during follow-up. Future research may be able to disentangle these relationships by assessing positive emotions and CVH earlier in life.
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Affiliation(s)
- Julia K Boehm
- Department of Psychology, Chapman University, 1 University Drive, Orange, CA 92866, USA.
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Farah Qureshi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Jackie Soo
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Peter Umukoro
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada Street, Urbana, IL 61801, USA.
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 E. Superior Street, Chicago, IL 60611, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
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Kohler C, Chang M, Allemann-Su YY, Vetter M, Jung M, Jung M, Conley Y, Paul S, Kober KM, Cooper BA, Smoot B, Levine JD, Miaskowski C, Katapodi MC. Changes in Attentional Function in Patients From Before Through 12 Months After Breast Cancer Surgery. J Pain Symptom Manage 2020; 59:1172-1185. [PMID: 31953207 PMCID: PMC7239765 DOI: 10.1016/j.jpainsymman.2020.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Although approximately 75% of patients with breast cancer report changes in attentional function, little is known about how demographic, clinical, symptom, and psychosocial adjustment (e.g., coping) characteristics influence changes in the trajectories of attentional function over time. OBJECTIVES This study evaluated interindividual variability in the trajectories of self-reported attentional function and determined which demographic, clinical, symptom, and psychosocial adjustment characteristics were associated with initial levels and with changes in attentional function from before through 12 months after breast cancer surgery. METHODS Before surgery, 396 women were enrolled. Attentional Function Index (AFI) was completed before and nine times within the first 12 months after surgery. Hierarchical linear modeling was used to determine which characteristics were associated with initial levels and trajectories of attentional function. RESULTS Given an estimated preoperative AFI score of 6.53, for each additional month, the estimated linear rate of change in AFI score was an increase of 0.054 (P < 0.001). Higher levels of comorbidity, receipt of adjuvant chemotherapy, higher levels of trait anxiety, fatigue, and sleep disturbance, and lower levels of energy and less sense of control were associated with lower levels of attentional function before surgery. Patients who had less improvements in attentional function over time were nonwhite, did not have a lymph node biopsy, had received hormonal therapy, and had less difficulty coping with their disease. CONCLUSION Findings can be used to identify patients with breast cancer at higher risk for impaired self-reported cognitive function and to guide the prescription of more personalized interventions.
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Affiliation(s)
- Carmen Kohler
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Ming Chang
- Department of Clinical Research, Nursing Science, University of Basel, Basel, Switzerland
| | - Yu-Yin Allemann-Su
- Department of Clinical Research, Nursing Science, University of Basel, Basel, Switzerland
| | - Marcus Vetter
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Miyeon Jung
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Misook Jung
- School of Nursing, Indiana University, Indianapolis, Indiana, USA
| | - Yvette Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Steven Paul
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Betty Smoot
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco, San Francisco, California, USA.
| | - Maria C Katapodi
- Department of Clinical Research, Nursing Science, University of Basel, Basel, Switzerland; School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Benoit AC, Burchell AN, O'Brien KK, Raboud J, Gardner S, Light L, Beaver K, Cotnam J, Conway T, Price C, Rourke SB, Rueda S, Hart TA, Loutfy M. Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario. HIV Res Clin Pract 2020; 21:45-55. [PMID: 32419657 DOI: 10.1080/25787489.2020.1763711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012. MATERIALS AND METHODS We conducted cross-sectional analyses with women on ART completing the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire. Data closest to, or at the last completed interview, were collected from medical charts, through record linkage with Public Health Ontario Laboratories, and from a standardized self-reported questionnaire comprised of socio-demographic and psycho-socio-behavioral measures (Center for Epidemiologic Studies Depression Scale (CES-D), Alcohol Use Disorders Identification Test (AUDIT)), and stress measures (National Population Health Survey). Logistic regression was used to quantify associations with optimal adherence (≥95% adherence defined as missing ≤ one dose of ART in the past 4 weeks). RESULTS Among 307 women, 65.5% had optimal adherence. Women with suboptimal compared to optimal adherence had higher median total stress scores (6.0 [interquartile range (IQR): 3.0-8.1] vs. 4.1 [IQR: 2.0-7.1], p = 0.001), CES-D scores (16 [IQR: 6-28] vs. 12 [IQR: 3-22], p = 0.008) and reports of hazardous and harmful alcohol use (31.1% vs. 17.9%, p = 0.008). In our multivariable model, we found an increased likelihood of optimal adherence with the absence of hazardous and harmful alcohol use (Adjusted Odds Ratio (AOR)=2.20, 95% confidence interval (CI): 1.12-4.32) and a decreased likelihood of optimal adherence with more self-reported stress (AOR = 0.56, 95% CI: 0.33-0.94). CONCLUSIONS Interventions supporting optimal ART adherence should address stress and include strategies to reduce or eliminate hazardous and harmful alcohol use for women living with HIV.
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Affiliation(s)
- Anita C Benoit
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ann N Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Family and Community Medicine, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Janet Raboud
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Sandra Gardner
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Baycrest Health Sciences, Kunin-Lunenfeld Centre for Applied Research and Evaluation (KL-CARE), Toronto, ON, Canada
| | - Lucia Light
- Ontario HIV Treatment Network, Toronto, ON, Canada
| | - Kerrigan Beaver
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - Jasmine Cotnam
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - Tracey Conway
- Project Community Advisory Committee, Ontario HIV Treatment Network Cohort Study, Ontario, Canada
| | - Colleen Price
- Project Community Advisory Committee, Ontario HIV Treatment Network Cohort Study, Ontario, Canada
| | - Sean B Rourke
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sergio Rueda
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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Tejada M, Viele C, Kober KM, Cooper BA, Paul SM, Dunn LB, Hammer MJ, Wright F, Conley YP, Levine JD, Miaskowski C. Identification of subgroups of chemotherapy patients with distinct sleep disturbance profiles and associated co-occurring symptoms. Sleep 2020; 42:5541565. [PMID: 31361899 DOI: 10.1093/sleep/zsz151] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/31/2019] [Indexed: 01/09/2023] Open
Abstract
STUDY OBJECTIVES Purposes of this study were to identify subgroups of patients with distinct sleep disturbance profiles and to evaluate for differences in demographic, clinical, and various sleep characteristics, as well for differences in the severity of co-occurring symptoms among these subgroups. METHODS Outpatients with breast, gynecological, gastrointestinal, or lung cancer (n = 1331) completed questionnaires six times over two chemotherapy cycles. Self-reported sleep disturbance was evaluated using the General Sleep Disturbance Scale (GSDS). Latent profile analysis was used to identify distinct subgroups. RESULTS Three latent classes with distinct sleep disturbance profiles were identified (Low [25.5%], High [50.8%], Very High [24.0%]) across the six assessments. Approximately 75% of the patients had a mean total GSDS score that was above the clinically meaningful cutoff score of at least 43 across all six assessments. Compared to the Low class, patients in High and Very High classes were significantly younger, had a lower functional status, had higher levels of comorbidity, and were more likely to be female, more likely to have childcare responsibilities, less likely to be employed, and less likely to have gastrointestinal cancer. For all of the GSDS subscale and total scores, significant differences among the latent classes followed the expected pattern (Low < High < Very High). For trait and state anxiety, depressive symptoms, morning and evening fatigue, decrements in attentional function, and decrements in morning and evening energy, significant differences among the latent classes followed the expected pattern (Low < High < Very High). CONCLUSIONS Clinicians need to perform in-depth assessments of sleep disturbance and co-occurring symptoms to identify high-risk patients and recommend appropriate interventions.
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Affiliation(s)
- Maria Tejada
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Carol Viele
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Kord M Kober
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Bruce A Cooper
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Laura B Dunn
- Department of Physiological Nursing, School of Medicine, Stanford University, Stanford, CA
| | | | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, NY
| | | | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
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Abstract
SummaryMajor depression is one of the medical disorders in which quality of life instruments have most often been applied. It is important to distinguish between disease-dependent scales (ie, scales measuring the symptoms of major depression, such as the Beck Depression Inventory) and generic scales (ie, scales measuring self-reported states without reference to a specific disorder, such as the WHO well-being scale). The empirical use of generic scales for quality of life major depression has indicated that they can predict relapse and compliance. In the future, more trials comparing the different treatments with cost-effectiveness vs quality of life in major depression are required.
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Hou J, Dodd K, Nair VA, Rajan S, Beniwal-Patel P, Saha S, Prabhakaran V. Alterations in brain white matter microstructural properties in patients with Crohn's disease in remission. Sci Rep 2020; 10:2145. [PMID: 32034257 PMCID: PMC7005825 DOI: 10.1038/s41598-020-59098-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022] Open
Abstract
Patients with inflammatory bowel disease have been shown to have abnormal brain morphometry or function, which are associated with psychological symptoms such as stress, depression or anxiety. The present work recruited 20 Crohn’s disease patients in remission (CDs) and 20 age-gender-handedness-education matched healthy controls (HCs) and compared their brain white matter microstructural properties using Diffusion Tensor Imaging (DTI). Additionally, we examined the correlations between the microstructural properties and cognition (verbal fluency language task, VF) and affect (anxiety) in both groups as well as disease duration in CDs. Results showed that CDs exhibited significant alterations in microstructural properties compared to HCs in various white matter tracts relevant to language function despite no significant difference in VF scores. Furthermore, CDs’ microstructural changes exhibited correlations with anxiety level and disease duration. These findings suggest that CD patients may experience changes in white matter microstructural properties which may be a biomarker of neuropsychiatric comorbidities of CD.
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Affiliation(s)
- Jiancheng Hou
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Keith Dodd
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Veena A Nair
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Shruti Rajan
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Poonam Beniwal-Patel
- Department of Medicine, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, USA
| | - Sumona Saha
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Vivek Prabhakaran
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA.
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Hugoy T, Lerdal A, Rustoen T, Oksholm T. Predicting postoperative fatigue in surgically treated lung cancer patients in Norway: a longitudinal 5-month follow-up study. BMJ Open 2019; 9:e028192. [PMID: 31562144 PMCID: PMC6773303 DOI: 10.1136/bmjopen-2018-028192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Despite the negative influence of fatigue on quality of life in patients who undergo lung cancer surgery, little is known about the possible predictors of postoperative fatigue. The aim of this study was to examine demographic and clinical characteristics that might predict postoperative fatigue 5 months after lung cancer surgery. DESIGN A prospective longitudinal follow-up study comprising preoperative and postoperative questionnaires, including Lee Fatigue Scale, and sociodemographic and clinical data. SETTING Three university hospitals in Norway (eg, Oslo University Hospital, St. Olav University Hospital and Haukeland University Hospital). PARTICIPANTS In total, 196 surgically treated patients who answered the questionnaires both preoperatively and at 5-month follow-up with valid fatigue scores. RESULTS Bivariate analyses showed that preoperative fatigue was associated with comorbidities and the symptoms of shortness of breath, cough, depression, anxiety, sleep disturbance and pain. Only cough was directly associated with preoperative fatigue in a regression model. Comorbidities and the symptoms of shortness of breath, cough, depression and sleep disturbance were associated with postoperative fatigue in the bivariate analyses, but only shortness of breath was associated with postoperative fatigue in the regression model. We did not find any significant correlations between fatigue and any treatment variable. CONCLUSION Clinicians should pay special attention to lung symptoms and be aware that these may lead to long-term postoperative fatigue. Further research should examine whether interventions reducing lung symptoms, such as shortness of breath and coughing, may prevent development of fatigue in patients undergoing lung cancer surgery.
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Affiliation(s)
- Therese Hugoy
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diakonale Hogskole, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Tone Rustoen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo universitetssykehus Ulleval, Oslo, Norway
| | - Trine Oksholm
- Faculty of Health Studies, Campus Haraldsplass, VID Vitenskapelige Hogskole, Bergen, Norway
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Rice KG, Slaney RB. Clusters of Perfectionists: Two Studies of Emotional Adjustment and Academic Achievement. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1080/07481756.2002.12069046] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kenneth G. Rice
- Kenneth G. Rice is an associate professor in the Department of Counseling, Educational Psychology and Special Education at Michigan State University in East Lansing
| | - Robert B. Slaney
- Robert B. Slaney is a professor in the Department of Counselor Education, Counseling Psychology, and Rehabilitation Services at The Pennsylvania State University in University Park
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Rice KG, Dellwo JP. Within-Semester Stability and Adjustment Correlates of the Multidimensional Perfectionism Scale. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1080/07481756.2002.12069031] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kenneth G. Rice
- Kenneth G. Rice is an associate professor, and Jacqueline P. Dellwo is a doctoral student, both in the Department of Counseling, Educational Psychology, and Special Education at Michigan State University, East Lansing
| | - Jacqueline P. Dellwo
- Kenneth G. Rice is an associate professor, and Jacqueline P. Dellwo is a doctoral student, both in the Department of Counseling, Educational Psychology, and Special Education at Michigan State University, East Lansing
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Hernandez R, Lash JP, Burrows B, Wilund KR, Mattix-Kramer HJ, Peralta C, Durazo-Arvizu RA, Talavera GA, Penedo FJ, Khambaty T, Moncrieft AE, Chen J, Daviglus ML. The association of positive affect and cardiovascular health in Hispanics/Latinos with chronic kidney disease: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med Rep 2019; 15:100916. [PMID: 31293880 PMCID: PMC6595078 DOI: 10.1016/j.pmedr.2019.100916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/01/2019] [Accepted: 06/04/2019] [Indexed: 11/19/2022] Open
Abstract
The beneficial influence of positive affect (e.g., joy) remains unexplored in relation to heart health in adults with chronic kidney disease (CKD)-a population at increased risk for poor cardiovascular health (CVH). Therefore, we evaluated the association of positive affect and CVH in a diverse U.S. population of Hispanics/Latinos with CKD. We analyzed cross-sectional data of adults ages 18-74 enrolled between 2008 and 2011 in the Hispanic Community Health Study/Study of Latinos with prevalent CKD (N = 1712). Positively worded items from the Center for Epidemiologic Studies Depression Scale were used to create a composite positive affect score (0-6; higher scores indicate greater positive affect). Prevalent CKD was defined as estimated glomerular filtration <60 ml/min/1.73 m2 or urine albumin-to-creatinine ratio ≥30 mg/g. A composite CVH score was calculated using diet, body mass index, physical activity, cholesterol, blood pressure, fasting glucose, and smoking status. Each metric was defined as ideal, intermediate, or poor to compute an additive score. Linear regression was used for continuous scores of CVH and logistic regression for binary treatment (e.g., ≥4 Ideal). In participants with CKD, each unit increase in the positive affect score was associated with higher CVH scores when modeling CVH as a continuous outcome (β = 0.06, 95% CI = 0.01, 0.11). Similarly, a 1-unit increase in positive affect was associated with 1.15 times the odds of having >4 (vs. <4) ideal CVH indicators. Positive affect is associated with favorable CVH profiles in Hispanics/Latinos with CKD. Replication and prospective studies are needed to elucidate whether emotional well-being is a potential therapeutic target for intervention.
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Affiliation(s)
- Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
- Corresponding author at: School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada Street, Urbana, IL, United States of America.
| | - James P. Lash
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Brett Burrows
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - Kenneth R. Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | | | - Carmen Peralta
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Ramon A. Durazo-Arvizu
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- Public Health Sciences, Loyola University, Chicago, IL, United States of America
| | - Gregory A. Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Frank J. Penedo
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Tasneem Khambaty
- Department of Psychology, University of Miami, Miami, FL, United States of America
| | - Ashley E. Moncrieft
- Department of Psychology, University of Miami, Miami, FL, United States of America
| | - Jinsong Chen
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Martha L. Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
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Reliability and Validity of the Center for Epidemiologic Studies Depression Scale in a Population-Based Cohort of Middle-Aged U.S. Adults. J Nurs Meas 2019; 25:476-485. [PMID: 29268830 DOI: 10.1891/1061-3749.25.3.476] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Globally, depressive symptoms are a leading contributor to years lived with disability. The Center for Epidemiological Studies-Depression (CES-D) scale has been used extensively to quantify depression; yet, its psychometric properties remain contentious. This study examined the reliability and factor structure of the CES-D in the MacArthur Foundation's Midlife in the United States Study (MIDUS), a nationally representative cohort study of noninstitutionalized, English-speaking adults aged 24-74 years. METHODS Internal consistency (Cronbach's alpha) and confirmatory factor analysis (CFA) were used to examine the reliability and factor structure of the CES-D. RESULTS There were 1,233 participants who were included in the analysis (mean age = 57.3 years [SD = 11.5], 56.7% female). Cronbach's alpha of .90 was observed. The 4-factor model had the best model fit. CONCLUSIONS High internal consistency was demonstrated alongside a replication of the original 4-factor structure. Continued use of the CES-D in noninstitutionalized populations is warranted.
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Maguire R, Lewis L, Kotronoulas G, McPhelim J, Milroy R, Cataldo J. Lung cancer stigma: A concept with consequences for patients. Cancer Rep (Hoboken) 2019; 2:e1201. [PMID: 32721137 DOI: 10.1002/cnr2.1201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patients with lung cancer (LC) report lower quality of life (QoL) and higher levels of psychological distress compared with other cancer populations. Lung cancer stigma (LCS) may in part explain these findings. AIM We investigated the prevalence of patient-perceived lung cancer stigma (LCS) and its relationships to symptom burden/severity, depression, and deficits in health-related quality of life (HR-QoL). METHODS In this descriptive, observational, and cross-sectional study, 201 participants were sent questionnaires. These included the Cataldo Lung Cancer Stigma Scale (CLCSS), the Lung Cancer Symptom Scale, the Centre for Epidemiologic Studies-Depression Scale, and the Quality of Life Inventory. RESULTS Participants were on average 69 years old, 52% women, 95% ever smokers, and 18.5% current smokers. The mean total CLCSS score was 53.1 (SD = 14.1; range = 31-94). LCS was significantly correlated with younger age (P < .001), greater social deprivation (P < .05), being unemployed (P < .001), depression (P < .001), symptom burden (P < .001), and HR-QoL deficits (P < .001). Symptom burden explained 18% of variance in LCS (P < .001). LCS explained 8.5% and 14.3% of the variance in depression (P < .001) and HR-QoL (P < .001), respectively. CONCLUSION Patients with lung cancer are vulnerable to LCS. Symptom burden can directly contribute to greater perceived LCS. Greater perceived LCS can be directly related to greater levels of depression and lower HR-QoL. A tailored approach is required to screen for LCS and implement interventions to enhance the psychosocial well-being of patients with perceived LCS.
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Affiliation(s)
- Roma Maguire
- Department of Computing and Information Science, University of Strathclyde, Glasgow, UK
| | - Liane Lewis
- Department of Computing and Information Science, University of Strathclyde, Glasgow, UK
| | | | | | | | - Janine Cataldo
- Department of Physiological Nursing, University of California San Francisco, San Francisco, California
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Hou J, Mohanty R, Nair VA, Dodd K, Beniwal-Patel P, Saha S, Prabhakaran V. Alterations in resting-state functional connectivity in patients with Crohn's disease in remission. Sci Rep 2019; 9:7412. [PMID: 31092855 PMCID: PMC6520362 DOI: 10.1038/s41598-019-43878-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 04/04/2019] [Indexed: 01/19/2023] Open
Abstract
Previous studies have found neural alterations in regions involved in cognitive and affective functions among Crohn's disease (CD) patients. The present work recruited 18 CD patients and 18 age-gender matched healthy controls (HC) and specifically compared differences in resting-state functional connectivity (RSFC) within the executive control network (ECN) which has been implicated in cognitive function and default mode network (DMN), which has been implicated in affective function. Additionally, we examined the correlations between RSFC in ECN and verbal fluency (VF) in both groups as well as RSFC in DMN and anxiety level in the CD group. Results showed significantly increased RSFC between the right middle frontal gyrus and right inferior parietal lobule in ECN, as well as increased RSFC between the right precuneus and right posterior cingulate cortex in DMN, among CD patients compared to HC. However, the correlations between ECN/DMN and behavioral scores in each group were not significant, which was possibility due to the limited sample size. These findings suggest that CD patients may experience changes in the connectivity patterns in ECN and DMN. Increased connectivity observed on these networks could be a potential biomarker of a neuropsychiatric manifestation of CD.
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Affiliation(s)
- Jiancheng Hou
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Rosaleena Mohanty
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Veena A Nair
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Keith Dodd
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Poonam Beniwal-Patel
- Department of Medicine, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, USA
| | - Sumona Saha
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Vivek Prabhakaran
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA.
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Papachristou N, Puschmann D, Barnaghi P, Cooper B, Hu X, Maguire R, Apostolidis K, P. Conley Y, Hammer M, Katsaragakis S, M. Kober K, D. Levine J, McCann L, Patiraki E, P. Furlong E, A. Fox P, M. Paul S, Ream E, Wright F, Miaskowski C. Learning from data to predict future symptoms of oncology patients. PLoS One 2018; 13:e0208808. [PMID: 30596658 PMCID: PMC6312306 DOI: 10.1371/journal.pone.0208808] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 11/24/2018] [Indexed: 01/04/2023] Open
Abstract
Effective symptom management is a critical component of cancer treatment. Computational tools that predict the course and severity of these symptoms have the potential to assist oncology clinicians to personalize the patient's treatment regimen more efficiently and provide more aggressive and timely interventions. Three common and inter-related symptoms in cancer patients are depression, anxiety, and sleep disturbance. In this paper, we elaborate on the efficiency of Support Vector Regression (SVR) and Non-linear Canonical Correlation Analysis by Neural Networks (n-CCA) to predict the severity of the aforementioned symptoms between two different time points during a cycle of chemotherapy (CTX). Our results demonstrate that these two methods produced equivalent results for all three symptoms. These types of predictive models can be used to identify high risk patients, educate patients about their symptom experience, and improve the timing of pre-emptive and personalized symptom management interventions.
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Affiliation(s)
- Nikolaos Papachristou
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford, United Kingdom
| | - Daniel Puschmann
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford, United Kingdom
| | - Payam Barnaghi
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford, United Kingdom
| | - Bruce Cooper
- University of California, San Francisco, United States of America
| | - Xiao Hu
- University of California, San Francisco, United States of America
| | | | | | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, United States of America
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Medical Center, New York, United States of America
| | | | - Kord M. Kober
- University of California, San Francisco, United States of America
| | - Jon D. Levine
- University of California, San Francisco, United States of America
| | - Lisa McCann
- University of Strathclyde, Glasgow, Scotland
| | | | - Eileen P. Furlong
- UCD School of Nursing, Midwifery and Health Systems, Dublin, Ireland
| | - Patricia A. Fox
- UCD School of Nursing, Midwifery and Health Systems, Dublin, Ireland
| | - Steven M. Paul
- University of California, San Francisco, United States of America
| | - Emma Ream
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford, United Kingdom
| | - Fay Wright
- School of Nursing, Yale University, New Haven, United States of America
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Ingram KM, Cohen-Filipic J. Benefits, challenges, and needs of people living with cancer and their companion dogs: An exploratory study. J Psychosoc Oncol 2018; 37:110-126. [DOI: 10.1080/07347332.2018.1529010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kathleen M. Ingram
- Department of Psychology, Department of Gender, Sexuality and Women's Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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Allen SH, Leslie LA. Considering the Role of Nativity in the Health and Psychological Wellbeing of Black LGBT Adults. JOURNAL OF HOMOSEXUALITY 2018; 66:1769-1796. [PMID: 30222074 DOI: 10.1080/00918369.2018.1511134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Recent scholars have underscored how the experiences of LGBT people of color cannot be fully understood by considering only the independent contributions of race and sexual orientation. Framed by an intersectional lens, the current study seeks to address this gap in understanding by considering the role of nativity on the health and wellbeing of Black sexual minority adults; we also examined the moderating effects of family support and racial community climate on this relationship. Using national data from the Social Justice Sexuality Project (N = 2,166), we discovered that foreign-born Black LGBT adults had similar levels of psychological wellbeing and physical health as their native counterparts; family support and racial community climate did not moderate this relationship. Our findings did, however, substantiate the importance of family and community support for all Black LGBT adults, regardless of immigration status. Implications of this finding, in addition to directions for future intersectional work on racial minority LGBT people, are discussed.
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Affiliation(s)
- Samuel H Allen
- Department of Family Science, University of Maryland , College Park , Maryland , USA
| | - Leigh A Leslie
- Department of Family Science, University of Maryland , College Park , Maryland , USA
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Pérez-Pedrogo C, Martínez-Taboas A, González RA, Caraballo JN, Albizu-García CE. Sex differences in traumatic events and psychiatric morbidity associated to probable posttraumatic stress disorder among Latino prisoners. Psychiatry Res 2018; 265:208-214. [PMID: 29738944 PMCID: PMC6016368 DOI: 10.1016/j.psychres.2018.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 03/01/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
Latinos comprised 17.1% of the U.S. population and 33.1% of US prisoners, yet they are underrepresented in the psychopathology literature. Despite higher rates of trauma among incarcerated individuals than in the general population, most of the previous research in this area focused primarily on women samples, and very few studies examined sex differences in PTSD and traumatic experiences. In addition, there is a need for research assessing traumatic experiences and probable PTSD in men and women Latino inmates to inform culturally competent care and sex sensitive care for this vulnerable and underserved population. Our study examined whether men and women Latino inmates with probable Posttraumatic Stress Disorder (PTSD), based on the cut off 40 or more symptoms on the Davidson Trauma Scale (DTS), differed significantly by the number of event types experienced, the type of potentially traumatizing event, and in co-occurring psychiatric conditions. A multi-stage sample design was used to select a probabilistic sample of 1,331 inmates from 26 penal institutions in PR of which 1179 participated in the study. Bivariate associations were calculated for each type of traumatic event and probable PTSD. Mean number of types of potentially traumatizing event experienced was comparable for both sexes (F = 3.83, M = 3.74) yet sex differences were found in the nature of the event. Women with probable PTSD had higher rates of experiencing rape and sexual abuse. Men had higher rates of experiencing combat in war, a life-threatening accident, of witnessing violence, and being threatened with a weapon. Men with significant ADHD symptoms in childhood and with Generalized Anxiety Disorder (GAD) during adulthood were almost 5 and 7 times as likely to score above threshold on the DTS whereas women were >3 times as likely in the presence of ADHD symptoms in childhood or depression during adulthood. This study underscores the need to improve understanding of the clinical manifestations of trauma and co-occurring psychiatric conditions for appropriate sex sensitive interventions targeting Latinos living in prisons.
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Affiliation(s)
- Coralee Pérez-Pedrogo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico; Carlos Albizu University, San Juan Campus, San Juan, Puerto Rico.
| | | | - Rafael A González
- East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS), London, UK; Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - José N Caraballo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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Alexandrowicz RW, Jahn R, Wancata J. Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models. PLoS One 2018; 13:e0197908. [PMID: 29799866 PMCID: PMC5969764 DOI: 10.1371/journal.pone.0197908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/10/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one. Methods The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional model reflecting the subscale structure suggested by [1], and a four-dimensional model with the background variables gender and age were applied. Results While the one-dimensional model showed relatively good fit, the four-dimensional model fitted much better. EAP reliability indices were generally satisfying and the latent correlations varied between 0.31 and 0.88. In the analysis involving background variables, we found a limited effect of the participants’ gender. DIF effects were found unveiling some peculiarities. The two-items subscale Interpersonal Difficulties showed severe weaknesses and the Positive Affect subscale with the reversed item wordings also showed unexpected results. Conclusions While a one-dimensional over-all score might still contain helpful information, the differentiation according to the latent dimension is strongly preferable. Altogether, the CES-D can be recommended as a screening instrument, however, some modifications seem indicated.
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Affiliation(s)
| | - Rebecca Jahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Johannes Wancata
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Edmonds EC, Martin AS, Palmer BW, Eyler LT, Rana BK, Jeste DV. Positive mental health in schizophrenia and healthy comparison groups: relationships with overall health and biomarkers. Aging Ment Health 2018; 22:354-362. [PMID: 27834490 DOI: 10.1080/13607863.2016.1251572] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Positive psychological factors (PPFs) have been reported to have a significant impact on health in the general population. However, little is known about the relationship of these factors with mental and physical health in schizophrenia. METHOD One hundred and thirty-five outpatients with schizophrenia and 127 healthy comparison subjects (HCs), aged 26-65 years, were evaluated with scales of resilience, optimism, happiness, and perceived stress. Measures of mental and physical health were also obtained. Regression analyses examined associations of a PPF composite with health variables. RESULTS Relative to the HCs, the schizophrenia group had lower levels of PPFs. However, there was considerable heterogeneity, with over one-third of schizophrenia participants having values within the 'normative' range. The PPF composite was positively related to mental and physical health variables and with biomarkers of inflammation and insulin resistance. The relationship between PPFs and mental health was particularly strong for individuals with schizophrenia. CONCLUSION A sizable minority of adults with chronic schizophrenia have levels of resilience, optimism, happiness, and perceived stress similar to HCs. Psychosocial interventions to enhance PPFs should be tested in patients with serious mental illnesses, with the goal of improving their mental health (beyond controlling symptoms of psychosis) and their physical health.
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Affiliation(s)
- Emily C Edmonds
- a Department of Psychiatry , University of California San Diego , La Jolla , CA , USA
| | - Averria Sirkin Martin
- a Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.,b Sam and Rose Stein Institute for Research on Aging, University of California San Diego , La Jolla , CA , USA
| | - Barton W Palmer
- a Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.,b Sam and Rose Stein Institute for Research on Aging, University of California San Diego , La Jolla , CA , USA.,c VA San Diego Healthcare System , San Diego , CA , USA
| | - Lisa T Eyler
- a Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.,b Sam and Rose Stein Institute for Research on Aging, University of California San Diego , La Jolla , CA , USA
| | - Brinda K Rana
- a Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.,b Sam and Rose Stein Institute for Research on Aging, University of California San Diego , La Jolla , CA , USA
| | - Dilip V Jeste
- a Department of Psychiatry , University of California San Diego , La Jolla , CA , USA.,b Sam and Rose Stein Institute for Research on Aging, University of California San Diego , La Jolla , CA , USA.,d Department of Neurosciences , University of California San Diego , La Jolla , CA , USA
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Briggs R, Kennelly SP, Kenny RA. Does baseline depression increase the risk of unexplained and accidental falls in a cohort of community-dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA). Int J Geriatr Psychiatry 2018; 33:e205-e211. [PMID: 28766755 DOI: 10.1002/gps.4770] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/21/2017] [Accepted: 07/04/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression independently increases the risk of falls in older people, but the mechanism for this relationship, as well as the specific falls type involved, remains unclear. Accidental falls (AFs) are due to slips or trips, while the cause of unexplained falls (UFs) is not immediately apparent and can include unrecognised syncope. METHOD This longitudinal study examines the relationship between baseline depression and subsequent falls, both accidental and unexplained, at 2-year follow-up in a cohort of community dwelling adults aged ≥50 years. Baseline depression was defined as a score ≥16 on The Centre for Epidemiological Studies Depression Scale. At follow-up, participants were assessed regarding falls since last interview. RESULTS One-third (228/647) of the depressed group had fallen at follow-up, compared with 22% (1388/6243) of the nondepressed group (P < .001). Multiple logistic regression models demonstrated that depression was associated with an odds ratio of 1.58 (1.31-1.89) P < .001; 1.24 (1.00-1.52), P = .046; and 1.89 (1.45-2.46), P < .001 for total falls, AFs and UFs, respectively, after controlling for relevant covariates. Participants with depression who fell were more likely to have prior falls, functional impairment and slower gait when compared with depressed participants who did not fall. DISCUSSION The risk of falls associated with depression in older adults is more marked for UFs, with the association for AFs approaching borderline significance only. This finding is important because UFs require focused clinical assessment with attention to potential causes such as cardiac arrhythmia or orthostatic hypotension.
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Affiliation(s)
- Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.,Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St. James Hospital, Dublin 8, Ireland.,Centre for Ageing, Neuroscience and the Humanities, Tallaght Hospital, Dublin 24, Ireland
| | - Sean P Kennelly
- Centre for Ageing, Neuroscience and the Humanities, Tallaght Hospital, Dublin 24, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.,Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St. James Hospital, Dublin 8, Ireland
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Qiu P, Caine ED, Hou F, Cerulli C, Wittink MN. Depression as seen through the eyes of rural Chinese women: Implications for help-seeking and the future of mental health care in China. J Affect Disord 2018; 227:38-47. [PMID: 29053974 PMCID: PMC5805647 DOI: 10.1016/j.jad.2017.10.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND As part of a larger epidemiological study of depression among rural Chinese women, we sought to understand their explanatory models of depression. We explored how participants describe depression, to what cause they attribute depression, and what sources of treatment they would recommend. METHODS Participants first were assessed with the Center for Epidemiological-Depression scale (CES-D), with a cut-point of 16 or greater indicative of depression. The Short Explanatory Model Interview (SEMI), a semi-structured questionnaire, was our primary tool for exploring participants' explanatory models relating to a vignette describing a rural Chinese woman with depression. RESULTS Among the 416 women who consented and completed the SEMI, 277(66.6%) reported that the woman in the vignette had something wrong with her health. Among these, only 8(2.9%) women provided a specific psychiatric name for the condition, while 150(54.2%) provided non-specific psychiatric disease names or affective symptoms, and 78(28.2%)of the sample provided physical disease names. Participants attributed causes largely to internal factors (41.5%) or external factors (36.8%). In terms of help-seeking, 101(36.4%) said the woman in the vignette should see a doctor, 70(25.3%) indicated that she should solve the problem herself, and 42(15.2%) recommended seeking support from family members and friends. We did not find any differences in recognition, causal attribution, and help-seeking suggestions between women with a CES-D ≥ 16 and those with CES-D < 16. LIMITATIONS The use of a vignette to prompt discussion was not the same as talking about real-life personal situations. CONCLUSION Our results point to potential challenges and opportunities that lay ahead as China develops mental health services in its vast rural areas among women who may be at risk for developing depression. We found that our participants often attributed their symptoms to internal or external social causes, and preferred not speaking with family members and friends. Our findings suggest that rural Chinese women may be reticent to recognize or describe categorical concepts such as "depression" as a health problem, and they invite further consideration about how best to develop new health services in China's rural regions.
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Affiliation(s)
- Peiyuan Qiu
- West China School of Public Health, Scihuan University, Chengdu, China; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
| | - Eric D Caine
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of American
| | - Fengsu Hou
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of American,School of Public Health, Sun Yat-sen University, Guangzhou, China,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of American
| | - Marsha N. Wittink
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of American
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Sun H, Vamos CA, Flory SS, DeBate R, Thompson EL, Bleck J. Correlates of long-term physical activity adherence in women. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:434-442. [PMID: 30356617 PMCID: PMC6189252 DOI: 10.1016/j.jshs.2016.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/23/2015] [Accepted: 10/25/2015] [Indexed: 05/10/2023]
Abstract
BACKGROUND Little is known about the factors that may influence women's adherence to moderate-to-vigorous physical activity (MVPA) using longitudinal data. The purpose of this study was to examine the correlates of long-term physical activity (PA) participation among women. METHODS Female data from Waves I, III, and IV (n = 5381) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used for the analysis. The outcome of PA adherence was operationalized as (1) consistently physically active (at least 5 instances during the week) in both Waves III and IV (during adulthood), and (2) consistently not physically active or only physically active in either Wave III or IV. Predictor variables from Wave I (during adolescence) included race/ethnicity, PA level, self-perception of being physically fit, general health status, attempt to change weight, parents' income level, parents' education, well-being, depression, access to PA resources, days of physical education (PE), and grade level. Crude and adjusted logistic regression models were utilized to estimate the adjusted odds ratio (aOR) and 95% confidence interval (95%CI) for the outcome variable. RESULTS PA levels during adolescence significantly predicted PA adherence (aOR = 1.67, 95%CI: 1.35-2.05). Additionally, wanting to lose weight (aOR = 1.49, 95%CI: 1.20-1.85), using fitness center in the neighborhood (aOR = 1.29, 95%CI: 1.05-1.58), and having 5 days of PE a week (aOR = 1.48, 95%CI: 1.09-2.02) were significant predictors. Women who did not perceive being physically fit (aOR = 0.65, 95%CI: 0.44-0.95) and Black, non-Hispanics (aOR = 0.60, 95%CI: 0.44-0.82) were less likely to adhere to PA. CONCLUSION The findings suggested that physically active adolescents were more likely to become active adults. Future research should address interventions (e.g., PE program, community resources) that may promote lifetime PA in women, with the goal of decreasing morbidity and mortality.
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Affiliation(s)
- Haichun Sun
- Department of Teaching and Learning, College of Education, University of South Florida, Tampa, FL 33620, USA
| | - Cheryl A. Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Sara S.B. Flory
- Department of Teaching and Learning, College of Education, University of South Florida, Tampa, FL 33620, USA
| | - Rita DeBate
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Erika L. Thompson
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Jennifer Bleck
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL 33612, USA
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Morgan S, Cooper B, Paul S, Hammer MJ, Conley YP, Levine JD, Miaskowski C, Dunn LB. Association of Personality Profiles with Depressive, Anxiety, and Cancer-related Symptoms in Patients Undergoing Chemotherapy. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017; 117:130-138. [PMID: 29479128 PMCID: PMC5822738 DOI: 10.1016/j.paid.2017.05.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background This study identified latent classes of cancer patients based on Big Five personality dimensions and evaluated for differences in demographic and clinical characteristics, depression, anxiety, and cancer-related symptoms. Methods Patients (n=1248) with breast, gastrointestinal, gynecological, or lung cancer completed the Center for Epidemiological Studies-Depression scale, Spielberger State-Trait Anxiety Inventories, NEO-Five Factor Inventory (NEO-FFI), and Memorial Symptom Assessment Scale (MSAS). Latent class profile analysis of NEO-FFI scores was used to identify patient subgroups. Results Three latent classes were identified. The "Distressed" class (14.3%) scored highest on neuroticism and lowest on extraversion, agreeableness, and conscientiousness. The "Resilient" class (31.9%) scored lowest on neuroticism and highest on extraversion, agreeableness, and conscientiousness. The "Normative" class (53.8%) was intermediate on all dimensions except openness. Compared to the Resilient class, patients in the Distressed class were younger, less educated, more likely to care for another adult, had more comorbidities, and exercised less. The three classes differed by performance status, marital and employment status, and income, but not by gender, time since diagnosis, or type of prior cancer treatment. The classes differed (Distressed > Normative > Resilient) in depression, anxiety, and cancer symptoms. Conclusions Personality is associated with psychological and physical symptoms in cancer patients.
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Affiliation(s)
- Stefana Morgan
- Department of Psychiatry, University of California, San Francisco
| | - Bruce Cooper
- School of Nursing, University of California, San Francisco
| | - Steven Paul
- School of Nursing, University of California, San Francisco
| | | | | | - Jon D. Levine
- School of Dentistry, University of California, San Francisco
| | | | - Laura B. Dunn
- Department of Psychiatry and Behavioral Sciences, Stanford University
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