Does personality affect health-related quality of life? A systematic review

Influence of Owner Personality and Other Owner-, Cat- and Treatment-Related Factors on the Perception of Quality of Life in Cats With Hyperthyroidism

BACKGROUND

Assessment of quality-of-life (QoL) is becoming increasingly important in veterinary medicine. In human medicine, it is known that the assessor's personality might affect QoL.

OBJECTIVE

To evaluate the impact of owner personality and other owner, cat, and treatment-related factors on the health-related QoL (HRQoL) of hyperthyroid cats.

ANIMALS

Five hundred hyperthyroid cats.

METHODS

A prospective, cross-sectional, questionnaire-based study, conducted between April 2023 and February 2024. Owners completed the HyperthyroidismQoL-cat and the Big Five Inventory-2 to assess the cat's HRQoL and owner's five personality domains, respectively. Additional information about owner-, cat-, and treatment-related factors was collected. Univariable and multivariable linear regression modeling was used to assess associations between owner personality, other factors, and the cat's HRQoL. Significance was p < 0.05.

RESULTS

In multivariable analysis, radioiodine treatment (RAIT; p = 0.001) and having a comorbidity (p ≤ 0.001) resulted in better HRQoL, whereas negative owner emotionality (p ≤ 0.001), having children ≤ 18 years of age (p = 0.04), treatment using a low iodine diet (LID; p = 0.023), no treatment (p = 0.03) and being hyperthyroid (p ≤ 0.001), hypothyroid (p = 0.004) or unknown thyroid status (p = 0.001) resulted in worse HRQoL.

CONCLUSION AND CLINICAL IMPORTANCE

When interpreting HRQoL data, the potential impact of the personality domain negative emotionality (tendency to experience anxiety, fear, negative emotions) should be considered. Based on HRQoL, RAIT is the treatment of choice, whereas LID or no treatment are the least favored options. These findings should be considered when counseling owners about their cats' hyperthyroidism and its management.

The longitudinal association of optimism with quality of life after percutaneous coronary intervention for coronary heart disease; The THORESCI study

BACKGROUND

Positive psychological factors such as optimism are predictive of favorable clinical outcomes in patients with cardiac disease. Evidence suggests that trait optimism can vary over time, especially after a coronary event. We therefore examined whether the level and change in optimism across the one-year time period after percutaneous coronary intervention (PCI) were associated with changes in quality of life (QoL) over time. The analyses were adjusted for negative psychological functioning and health behavior adherence as potential explanatory factors.

METHODS

Patients who underwent PCI (n = 1759, 21 % female, mean age = 64 ± 10 years) filled out a psychological survey including positive (optimism; LOT-R) and negative psychological factors (depression (PHQ9) and anxiety (GAD7)), QoL (WHOQOL-BREF), and health behavior adherence (MOS-GAS) at inclusion and one year later (n = 1474). Data were analyzed using hierarchical linear mixed modeling with time-varying predictors and covariates.

RESULTS

Optimism levels increased from baseline (MeanBL = 7.6 (SD = 2.1) to 1-year follow-up in 43 % of the patients, whereas optimism decreased in 36 %; rintraclass = 0.53). Optimism was associated with a higher level of overall QoL (B = 1.96, se = 0.09, p < .001) and more positive 1-year change in QoL (B = 0.55, se = 0.09, p < .001), adjusting for demographic and clinical covariates, with similar findings for all subdomains. Adding depression and anxiety (both significant negatively correlated with of QoL) explained part of the associations of optimism with physical, psychological and environmental QoL, but not with social QoL. Health behavior adherence was significantly correlated with most QoL components, but adherence did not affect the association between optimism and QoL.

CONCLUSION

These data indicate marked individual differences in the magnitude of changes in optimism following PCI. Both higher levels and increases in optimism were associated with higher and improving QoL. Depression and anxiety, but not health behavior adherence, explained part of this relationship. Optimism might be an important psychological factor to address in cardiac rehabilitation.

Exploring the Impact of Personality Trait Clusters on the Quality of Life of Breast Cancer Survivors: An 18-Month Prospective Follow-Up Study

OBJECTIVE

To investigate the impact of personality trait clusters on the quality of life (QoL) of breast cancer survivors (BCS) during the first 18 months following diagnosis.

METHODS

A cohort of 476 newly diagnosed breast cancer patients was recruited between January 2017 and August 2018 from a single academic hospital in Seoul, Korea. Five-factor models of personality traits were assessed at baseline. QoL evaluations were performed prior to surgery and up to 18 months post-surgery. K-means clustering analysis was employed to construct personality clusters. Long-term QoL trajectories in BCS were compared between clusters, adjusting for individual resilience. Furthermore, a polygenic risk score (PRS) for neuroticism was calculated, exploring its relationships with neuroticism and personality trait clusters identified in this study.

RESULTS

Cluster analysis suggested that a two-cluster model was more appropriate than a three-cluster model. The two clusters were characterized by (1) low neuroticism and high scores in the other four traits, and (2) high neuroticism and low scores in the other four traits. Patients in cluster 2 exhibited significantly lower baseline QoL scores compared to those in other clusters, from baseline through 18 months post-surgery. The PRS for neuroticism showed a significant association with neuroticism scores (p = 0.032) after adjusting for age and depression scores. No significant differences in PRS were observed between the clusters. Additionally, the PRS for neuroticism was not significantly associated with QoL.

CONCLUSION

Our findings underscore the influence of individual personality traits on long-term QoL in BCS. These results suggest the potential for targeted interventions to enhance long-term QoL based on personalized personality profiles.

Three-year patient-reported outcomes of the BOOG 2013-08 RCT evaluating omission of sentinel lymph node biopsy in early-stage breast cancer patients treated with breast conserving surgery: Impact of personality traits on health-related quality of life

BACKGROUND

The non-inferiority randomized controlled trial BOOG 2013-08 investigates the oncological safety and impact on health-related quality of life (HRQoL) of sentinel lymph node biopsy (SNLB) omission in cT1-2 N0 breast cancer. The primary aim of the present study was to compare patient-reported arm function and HRQoL up to 3 years after study inclusion in cT1-2 N0 patients with breast cancer undergoing breast-conserving surgery (BCS) with or without SLNB. The secondary aim was to explore the association between personality traits 'trait anxiety' and 'neuroticism', and perceived arm function and HRQoL.

METHODS

A total of 1733 women with unilateral cT1-2 N0 invasive breast cancer treated with BCS with or without SLNB were included. The primary outcomes of arm function (assessed using the Lymphoedema Functioning, Disability, and Health Questionnaire) and HRQoL (assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR-23 questionnaires) were analysed.

RESULTS

Analyses included 821 patients (383 with SLNB and 438 without SLNB). Those in the SLNB group experienced a slight, temporary decline in arm function (P < 0.025) and reported more HRQoL arm and breast symptoms (P < 0.049). High trait anxiety or neuroticism was associated with significant poorer arm function and lower HRQoL.

CONCLUSION

SLNB slightly reduced arm function, temporarily affecting HRQoL arm and breast symptoms. Neuroticism significantly negatively impacted arm function and HRQoL. Measuring and stratifying for personality traits is crucial for interpreting patient-reported outcomes and to identify patients needing additional support after surgery.

REGISTRATION NUMBER

NCT02271828 (http://www.clinicaltrials.gov).

The relationship between personality traits and health-related quality of life after mild-to-moderate traumatic brain injury

BACKGROUND

Traumatic brain injury (TBI) causes major societal burden and may negatively influence an individual's health-related quality of life (HRQoL). Personality factors have been linked to persistent post-concussion symptoms (PPCS), and PPCS have been found to affect HRQoL. However, there is a knowledge gap concerning the association between personality traits and HRQoL after mild-to-moderate TBI. Thus, this study aims to investigate the association between personality traits and HRQoL in patients with mild-to-moderate TBI at 15 months post-injury, while controlling for socio-demographic characteristics, injury-related factors and symptom burden.

METHODS

Data from 86 participants with mild- to-moderate TBI from a previous randomised controlled trial were analysed. Sociodemographic, injury-related and psychological factors were recorded 2-3 months post-injury. Personality traits were measured at 15 months post-injury with The NEO Five-factor Inventory-3. The Quality of Life after Brain Injury- Overall Scale (QOLIBRI-OS) and the EuroQol-visual analogue scale (EQ-VAS) were used to measure HRQoL at 15 months post-injury. Two separate multiple linear regression models were performed for the outcome variables; QOLIBRI-OS (model 1) and EQ-VAS (model 2).

RESULTS

The factors associated with lower HRQoL were more severe PPCS, higher levels of the personality traits neuroticism and conscientiousness (model 1), female sex and being single/living alone (model 2). Higher levels of the personality trait extraversion were associated with higher HRQoL in both models.

CONCLUSION

The results highlight how non-injury factors may be associated with recovery and HRQoL after TBI. Considering personality factors may be helpful when identifying individual risk and protective factors for outcomes after mild-to-moderate TBI.

New horizons in personality disorders-from neglect to necessity in geriatric care

Personality disorders, characterised by enduring and maladaptive patterns of behaviour, cognition and emotional regulation, affect 1 in 10 older adults. Personality disorders are frequently encountered in geriatric care considering their association with multimorbidity and increased health care utilisation. Patients with personality disorders often receive inadequate somatic health care due to (i) difficulties in expressing their actual symptoms and needs, (ii) challenging interactions with professionals, and (iii) non-compliance with medical treatment and lifestyle advice. Acknowledging personality disorders in geriatric care may improve treatment outcomes of somatic diseases. Since empirical evidence on personality diagnosis and treatment in older adults is scarce, we summarise future endeavours. First, the development of age-inclusive diagnostic tools should be prioritised to ensure comparability across age groups and facilitate longitudinal research over the lifespan. Second, evidence-based treatment approaches should be tailored to older people. Insight-oriented psychotherapies remain effective in later life considering sufficient level of introspection. Supportive and mediative therapies may better suit those with significant cognitive or physical impairments. Geriatric care models should be ideal for managing the complex needs of these patients when a consistent approach can be assured within the geriatric team as well as within the network considering the high level of interdisciplinary exchange needed. Third, considering the dynamic nature of personality disorders older adults should not be excluded from studies using novel technologies for real-time monitoring and personalised care. By addressing these gaps, the field can improve somatic treatment outcomes and uphold the dignity and well-being of older adults with personality disorders.

Improving our understanding of the longitudinal relationship between health-related quality of life and multimorbidity: The role of personality traits

It is well known that multimorbidity negatively impacts health-related quality of life (HRQoL). However, how psychosocial factors moderate this relationship remains unclear. The present study investigated the moderating effects of personality traits on the relationship between multimorbidity and HRQoL. Data were extracted from three waves (i.e., Waves 13, 17, and 21) of the Household, Income, and Labor Dynamics in Australia (HILDA) survey and a representative cohort of the adult (20+ years) population was followed. The outcomes were three dimensions of SF-36: mental health, physical functioning, and general health. The predictor was the degree of multimorbidity, which was measured by counting the number of self-reported health conditions. The moderator was personality traits measured by the Five-Factor Model (extraversion, emotional stability, agreeableness, openness to experience, and conscientiousness). Mixed-effects models were used to explore the relationship between multimorbidity and HRQoL. Overall, the study cohort comprised 13,285 adults in 2013 who were followed up to 2021, for a total of N = 32,950 observations. There were slightly more (53.9%) females, and the mean (SD) age was 50.3 (16.8) years. Personality traits significantly moderated the relationship between multimorbidity and HRQoL. For instance, extraversion and emotional stability significantly moderated the relationship between multimorbidity and mental health. The moderation effect sizes were larger than established minimal clinically important difference (MCID) thresholds. For example, the impact of 3 health conditions on mental health was moderated from 66 (extraversion score of 4) to 77 (extraversion score of 7), a difference of almost twice the MCID threshold of 6 established for mental health. The results showed that personality traits moderated the relationship between multimorbidity and HRQoL to the extent of potentially influencing clinical decisions. Understanding the influences of personality traits on HRQoL in the context of varying degrees of multimorbidity could enhance interventions for improving quality of life.

Personality traits and quality of life: a cross-sectional study in a middle-aged Iranian general population

INTRODUCTION

Despite considerable research on the association between Personality Traits (PT) and Quality of Life (QoL) in patients and older adults, this association remains poorly understood among the middle-aged general population.This investigation examines how each PT is associated with total QoL and its dimensions.

METHODS

The present investigation utilized data collected from a cross-sectional survey involving 786 families in Isfahan (644 female/wife respondents), Iran. QoL and PT were assessed using the validated WHOQOL-BREF and NEO-FFI questionnaires. Other data including demographic and socioeconomic status (SES) were also collected. Statistical analyses included bivariate correlation and simple and multiple linear and logistic regressions.

RESULTS

Mean value of Psychological health [Mean difference = -4.34, P = 0.003], Physical health [mean difference = -3.93, P = 0.004], and total score of QoL [mean difference = -3.21, P = 0.049] were all significantly lower in women than men. Higher SES score was consistently associated with greater QoL scores (r > 0, P < 0.05). The physical domain and total QoL scores have been negatively correlated with the spouse's age (r < 0, P < 0.05). In crude and adjusted models, higher Neuroticism scores were inversly associated with higher scores of all QoL domains and total QoL (OR < 1, P < 0.05, for all models) while others personality traits except Openness showed a direct association (OR > 1, P < 0.05). Linear regression analysis also confirmed that higher Neuroticism scores were linked to poorer QoL scores (Betacoefficient < 0, P < 0.05), while all other traits, except Openness, showed a positive association (Betacoefficient > 0, P < 0.05).

CONCLUSION

This study provides robust evidence about the significant association of PT with QoL outcomes in middle aged people. This significant association highlights the importance of considering these traits in clinical applications, as tailored interventions based on personality profiles can effectively enhance the well-being of middle-aged individuals.

Psychological, behavioural and relevant factors affecting wound healing, and the buffering role of interventions

Wound healing is a complex process accompanying numerous health conditions, and millions of people across the world experience deleterious impacts caused by wounds. There are many non-biological factors that can directly or indirectly affect the health outcomes of patients with wounds. The purpose of this review was to investigate the effects of psychological, behavioural and other relevant factors on wound healing. In addition, as the possible associations among these factors have, in the authors' view, not been addressed appropriately, we also aimed to examine if there were specific relationships among these factors and between these factors and health outcomes. Finally, we reviewed the role of various interventions in buffering negative impacts during health procedures.

Health-Related Quality of Life and the Role of the Big Five Personality Traits in Postlingually Deaf Cochlear Implant Users

PURPOSE

This study aimed to investigate the relationships between generic health-related quality of life (HRQoL), the Big Five personality traits, speech understanding, and sociodemographic factors in a group of postlingually deaf cochlear implant (CI) users.

METHOD

The study group included 81 participants who met the inclusion criteria: profound sensorineural hearing loss, 18 years of age or more, and using at least one CI implanted after 18 years of age. Some 18% were bilateral CI users. The mean age of the participants was 60 ± 11 years. They completed the Assessment of Quality of Life (AQoL-8D) and the Short Form IPIP-BFM-20 (shortened version of the 50-item Big Five Markers Questionnaire from the International Personality Item Pool). The response rate was 57%.

RESULTS

The HRQoL was lower in the study group than in the general population. Moreover, all Big Five personality characteristics were significantly lower than the Polish norm. The personality traits of intellect/imagination, emotional stability, and extraversion contributed to higher overall HRQoL scores, particularly for most psychosocial AQoL-8D dimensions. Higher agreeableness predicted higher HRQoL in the Independent Living, Pain, Coping, and Relations dimensions, whereas higher extraversion predicted higher physical HRQoL in the Senses dimension. Better speech understanding in quiet and noisy environments correlated with better physical HRQoL. Additionally, male gender and higher education were linked to higher global HRQoL. Conversely, being female was associated with lower global psychosocial and physical HRQoL, particularly in Pain. Higher education also contributed to improved physical HRQoL.

CONCLUSIONS

In general, CI users have lower physical and psychosocial HRQoL as well as in measures that depend on personality traits. In terms of physical HRQoL, speech understanding plays an important role. It might prove useful if CI candidates and users were given a Big Five personality evaluation and an HRQoL assessment based on which they might be offered counseling or psychological intervention.

How strongly are trait positive and negative affectivity associated with anxiety symptoms? A multilevel meta-analysis of cross-sectional studies in anxiety disorders

There are well-established theoretical and empirical foundations for a negative association between trait positive affectivity and anxiety symptoms in anxiety disorders and a positive association between trait negative affectivity and anxiety symptoms, respectively. However, no previous meta-analysis systematically estimated to what extent trait positive and negative affectivity are associated with anxiety symptoms in anxiety disorders. The aim of this study was to conduct a systematic review and meta-analysis to obtain an evidence-based estimate of the associations between trait positive and negative affectivity with anxiety symptoms in anxiety disorders. We performed a systematic search including studies reporting estimates of the associations between trait positive and negative affectivity measures and anxiety measures in clinical populations that suffer from at least one anxiety disorder. We identified 13 and 14 eligible studies, documenting 19 and 21 mainly unpublished effect sizes from 1489 individuals that suffer from an anxiety disorder. We estimated an overall correlational effect size (r) using multilevel meta-analytic models accounting for within- and between-study variance components. The results of the omnibus models showed a small to moderate negative association between positive affectivity and anxiety symptoms (r = -0.19, 95 % CI [-0.30, -0.09]) and a strong positive association between negative affectivity and anxiety symptoms respectively (r = 0.53, 95 % CI [0.44, 0.61]). These associations are different from each other (r = .35, p < .001). The results are consistent with theoretical claims that anxiety disorders are highly associated with negative affectivity but to a lesser extent with positive affectivity. More research and systematic documentation are necessary to determine moderators of these overall associations.

Hypothyroidism and Type D Personality: Results From E-MPATHY, a Cross-sectional International Online Patient Survey

CONTEXT

Between 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving biochemical euthyroidism. The underlying causes are unclear. Type D personality (a vulnerability factor for general psychological distress) is associated with poor health status and symptom burden but has not been studied in people with hypothyroidism.

OBJECTIVE

To investigate type D personality in hypothyroidism and explore associations with other characteristics and patient-reported outcomes.

DESIGN

Multinational, cross-sectional survey.

SETTING

Online.

PARTICIPANTS

Individuals with self-reported, treated hypothyroidism.

INTERVENTION

Questionnaire.

MAIN OUTCOME MEASURES

Type D personality and associations with baseline characteristics, control of the symptoms of hypothyroidism by medication, satisfaction with care and treatment of hypothyroidism, impact of hypothyroidism on everyday living.

RESULTS

A total of 3915 responses were received, 3523 of which were valid. The prevalence of type D personality was 54.2%. Statistically significant associations were found between type D personality and several respondent characteristics (age, marital status, ethnicity, household income, comorbidities, type of treatment for hypothyroidism, most recent TSH level), anxiety, depression, somatization, poor control of the symptoms of hypothyroidism by medication, dissatisfaction with care and treatment of hypothyroidism, and a negative impact of hypothyroidism on everyday living).

DISCUSSION

Our study found a high prevalence of type D personality among people with hypothyroidism who responded to the survey. Type D personality may be an important determinant of dissatisfaction with treatment and care among people with hypothyroidism. Our findings require independent confirmation. Close collaboration between the disciplines of thyroidology and psychology is likely to be key in progressing our understanding in this area.

Actor-Partner Effects of Personality Traits and Psychological Flexibility on Psychological Distress Among Couples Coping with Cancer

In this study, we applied the actor-partner interdependence model (APIM) to explore the associations between personality traits (Big Five) and psychological flexibility, on the one hand, and depression and anxiety, on the other hand, among patients with cancer and their spouses. Method: Forty-six patient-spouse dyads (N = 92) completed the anxiety and depression scales from the Patient-Reported Outcomes Measurement Information System (PROMIS), the ten-item personality inventory (TIPI), and the psychological flexibility scale (AAQ-2). Multilevel APIM models, adjusted for multiple testing, showed that neuroticism and psychological flexibility had actor effects on patients' depression and anxiety. Furthermore, neuroticism had actor effects on spouses' depression and anxiety, and agreeableness had actor effects on spouses' anxiety. In addition, patients' psychological flexibility and neuroticism had partner effects on spouses' depression. Conclusion: Being psychologically flexible but emotionally stable is important for one's own and one's partner's psychological outcomes in the context of dyadic coping with cancer. Implications include informing couples' therapists in the context of psycho-oncology on the importance of considering personality traits and improving psychological flexibility.

Health-related quality of life in adults with metabolic syndrome: a multi-level analysis of family and individual level variation

PURPOSE

The current study aimed to investigate the associations between metabolic syndrome (MetS) with health-related quality of life (HRQoL) using multilevel analysis among the Iranian adult population.

METHODS

This cross-sectional study was conducted in the framework of the Tehran Lipid and Glucose Study (TLGS). Participants were 6113 participants (3318 women and 2795 men) aged≥20 years of the TLGS seventh phase who had completed data on HRQoL and MetS. HRQoL was assessed using the short-form 12-item health survey V.2 and MetS defined based on the guidelines outlined in the Joint Interim Statement. The two-level model was fitted to assess the association between MetS and HRQoL.

RESULTS

The prevalence of MetS and its components was higher in men, and regardless of metabolic status, men exhibited higher HRQoL values. The deleterious impact of MetS on HRQoL was more pronounced in women, while the detrimental effects of MetS on men's HRQoL were confined to specific subscales. These results were obtained through multilevel analysis, considering both familial and individual variation levels. Moreover, our investigation highlighted the positive influence of leisure-time physical activity on both the physical and mental component summaries (PCS and MCS, respectively), regardless of gender. Education had a greater positive impact on PCS in both sexes. Additionally, a history of cardiovascular diseases was associated with a decline in mental and physical HRQoL, while age was linked to a decline in PCS and MCS, and smoking was associated with a decline in MCS.

CONCLUSION

This study revealed the significant influence of gender, as well as the unique characteristics and circumstances of individuals, on the relationship between MetS and HRQoL in a general population with low/middle income.

Personality Feedback With Tailored Self-Care Recommendations Improves Self-Efficacy for Cancer Management: A Randomized Controlled Trial

OBJECTIVE

To test whether a personality feedback intervention improves three domains of cancer self-management: self-awareness, self-efficacy, and positive affect.

METHODS

From 11/2020-02/2021, 372 adults diagnosed with cancer participated in a randomized controlled trial (RCT) of an intervention that entailed reading a brief personality-related excerpt during an online survey. Eligibility included self-reported age ≥ 18 years, current or past cancer diagnosis, and ability to read English. The survey included a baseline assessment with a personality questionnaire, then randomized participants to one of two groups. The intervention group (n = 184) received a personality feedback report with tailored self-care tips, whereas the control group (n = 188) received a generic reading on personality theory. At the end of the survey, participants completed outcome measures of self-awareness (primary), self-efficacy for illness management, and positive affect. General linear models tested between-group differences in changes from baseline to post-test on each outcome.

RESULTS

There was no intervention effect on self-awareness (primary outcome) or positive affect. However, compared to controls, intervention participants experienced a greater increase in self-efficacy for illness management (d = 0.33, p = 0.002), including in 2 of 3 constituent domains: self-efficacy for managing symptoms (d = 0.36, p < 0.001) and self-efficacy for managing treatments/medication (d = 0.22, p = 0.035).

CONCLUSION

Despite the primary outcome's null results, this was the first RCT of a personality feedback intervention to show improvements in self-efficacy for managing chronic illness. Given the important role of self-efficacy in self-management, the intervention has implications for other cancer outcomes. Follow-up studies on longer-term outcomes such as health behaviors and quality of life should be explored.

TRIAL REGISTRATION

NCT04625439.

How Spiteful Are We? Validation of the Spitefulness Scale in Spaniards

Spitefulness has been defined as the willingness to cause some kind of harm to other people, even if this action does not bring any benefit and causes harm to herself. Given its relationship with a multitude of antisocial behaviors, interest in studying this trait has been growing and it was in 2014 when the first scale to measure it was validated: the Spitefulness Scale. This study aimed to examine the psychometric properties of its Spanish version. In a sample of 758 participants (M = 31.44; SD = 12.91; 72.80% female), the Spitefulness Scale, the Short Dark Triad, the Assessment of Sadistic Personality, the HEXACO-60, and the Global Assessment of Internet Trolling were administered. Results showed the unidimensionality of the scale, adequate reliability indices, and construct validity, evidenced by positive relationships with the Dark Tetrad traits and trolling behavior. Additionally, the analysis revealed significant gender differences, with males scoring higher on spitefulness. This Spanish validation allows us to establish a solid basis for cross-cultural comparisons. Understanding this trait, considered like the Dark Tetrad traits an antagonistic personality trait, has important implications for understanding the interpersonal and social dynamics. Given that spitefulness is closely related to aggressive behaviors, it is essential to study it to understand the underlying mechanisms of aggression and hostility in social interactions.

Health-related quality of life in psychiatric outpatients: a cross-sectional study of associations with symptoms, diagnoses, and employment status

BACKGROUND

This cross-sectional study aimed to explore health-related quality of life (HRQoL) in a large heterogeneous patient sample seeking outpatient treatment at a specialist mental health clinic.

METHOD

A sample of 1947 patients with common mental disorders, including depressive-, anxiety-, personality-, hyperkinetic- and trauma-related disorders, completed the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) to assess HRQoL. We investigated clinical and sociodemographic factors associated with the EQ-5D index and the EQ Visual Analogue Scale (VAS) using regression analyses.

RESULTS

The sample reported lower HRQoL compared with the general population and primary mental health care patients. Sick leave, disability pension, work assessment allowance, and more symptoms of anxiety and depression were associated with lower EQ-5D index and EQ VAS scores. Furthermore, being male, use of pain medication and having disorders related to trauma were associated with reduced EQ-5D index scores, while hyperkinetic disorders were associated with higher EQ-5D index scores.

CONCLUSION

HRQoL of psychiatric outpatients is clearly impaired. This study indicated a significant association between employment status, symptom severity, and HRQoL in treatment-seeking outpatients. The findings highlight the importance of assessing HRQoL as part of routine clinical assessment.

The relationship between self-efficacy, health literacy, and quality of life in patients with chronic diseases: a cross-sectional study in China

Background

Self-efficacy and health literacy are closely related to the quality of life in patients with chronic diseases; however, it remains unclear whether their combined effects on the quality of life (QoL) in these patients operate through mediation, interaction, or a combination of both.

Methods

The research occurred in China between July 10 and September 15, 2021. A multi-stage random sampling technique was utilized to gather information on self-efficacy, health literacy, and QoL among individuals with chronic diseases. Linear regression models investigated the relationships between these patients' self-efficacy, health literacy, and QoL. Additionally, the four-way decomposition method was used to decompose the overall effects of self-efficacy and health literacy on the QoL in patients with chronic diseases.

Results

Significant correlations were found between self-efficacy, health literacy, and QoL among individuals with chronic diseases (all p < 0.05). In the four-way decomposition results, the results of the European Quality of Life Five Dimension Five Level (EQ-5D-5L) displayed the interaction effects mediated by self-efficacy, and the reference interaction effects were not significant, with small effect sizes observed. The influence of health literacy levels on the QoL in these patients was primarily attributed to the controlled direct effect (CDE), accounting for approximately 86.12% [excess relative risk = 0.00415; 95% CI: 0.00326, 0.00504; p < 0.0001]. The proportion solely attributable to the pure indirect effect (PIE) of self-efficacy was 14.5% [excess relative risk = 0.0007; 95% CI: 0.00031, 0.00109; p < 0.0001]. In the EQ visual analog scale (EQ-VAS) results, the proportion of the controlled direct effect was 84.9% [excess relative risk = 0.62443; 95% CI: 0.52269, 0.72618; p < 0.0001], while the proportion solely attributable to the pure indirect effect of mediation was 14.8% [excess relative risk = 0.10876; 95% CI: 0.06409, 0.15344; p < 0.0001].

Conclusion

Self-efficacy and health literacy primarily influence QoL in patients with chronic diseases through controlled and pure indirect effects. Enhancing patients' health literacy and self-efficacy can contribute to improving their QoL.

Personality and Health-Related Quality of Life of Older Chinese Adults: Cross-Sectional Study and Moderated Mediation Model Analysis

Background

Personality has an impact on the health-related quality of life (HRQoL) of older adults. However, the relationship and mechanisms of the 2 variables are controversial, and few studies have been conducted on older adults.

Objective

The aim of this study was to explore the relationship between personality and HRQoL and the mediating and moderating roles of sleep quality and place of residence in this relationship.

Methods

A total of 4123 adults 60 years and older were from the Psychology and Behavior Investigation of Chinese Residents survey. Participants were asked to complete the Big Five Inventory, the Brief version of the Pittsburgh Sleep Quality Index, and EQ-5D-5L. A backpropagation neural network was used to explore the order of factors contributing to HRQoL. Path analysis was performed to evaluate the mediation hypothesis.

Results

As of August 31, 2022, we enrolled 4123 older adults 60 years and older. Neuroticism and extraversion were strong influencing factors of HRQoL (normalized importance >50%). The results of the mediation analysis suggested that neuroticism and extraversion may enhance and diminish, respectively, HRQoL (index: β=-.262, P<.001; visual analog scale: β=-.193, P<.001) by increasing and decreasing brief version of the Pittsburgh Sleep Quality Index scores (neuroticism: β=.17, P<.001; extraversion: β=-.069, P<.001). The multigroup analysis suggested a significant moderating effect of the place of residence (EQ-5D-5L index: P<.001; EQ-5D-5L visual analog scale: P<.001). No significant direct effect was observed between extraversion and EQ-5D-5L index in urban older residents (β=.037, P=.73).

Conclusions

This study sheds light on the potential mechanisms of personality and HRQoL among older Chinese adults and can help health care providers and relevant departments take reasonable measures to promote healthy aging.

Personality Traits and eHealth Study Enrollment Among Racial and Sexual Minoritized Men Living with HIV

Inequities in eHealth research enrollment persist among Black and Latinx sexual minoritized men (SMM) partly due to socio-ecological barriers. Less is known about how personality traits are associated with their study enrollment. We examined the role of personality traits among 1,285 U.S. Black and Latinx SMM living with HIV recruited from sexual networking websites/apps for an eHealth intervention. Lower neuroticism and higher openness were associated with greater odds of study enrollment among Latinx SMM. Given these exploratory findings, future research should examine this phenomenon, along with well-established socio-ecological factors such as medical mistrust to better understand eHealth study enrollment gaps among Black and Latinx SMM.

Personality and quality-of-life improvement after apomorphine infusion in Parkinson's disease

People with Parkinson's disease with motor fluctuations can be treated by continuous subcutaneous apomorphine infusion (CSAI) to reduce their symptoms. Nonetheless, factors are lacking to predict patients' quality-of-life amelioration after CSAI. This pilot study aimed to evaluate associations between personality dimensions and quality-of-life improvement after 6 months of CSAI. Thirty-nine people with Parkinson's disease awaiting CSAI were included. Linear regression models between 'Temperament and Character Inventory' personality dimensions at baseline and percentage of change in Parkinson's Disease Questionnaire-39 scores after 6 months of CSAI were realized (n = 35). The Temperament and Character Inventory was also compared between patients awaiting CSAI and patients awaiting deep brain stimulation of the sub-thalamic nucleus (n = 39 from the PREDI-STIM study). Higher reward dependence scores were associated with a better quality-of-life outcome after 6 months of CSAI, while self-directedness scores were associated with a better quality of life before CSAI (as opposed to harm avoidance, reward dependence and self-transcendence scores associated with a worse quality of life). Moreover, people with Parkinson's disease awaiting deep brain stimulation of the sub-thalamic nucleus had similar Temperament and Character Inventory dimensions compared to patients awaiting CSAI. People with Parkinson's disease with higher reward dependence scores at baseline had the best quality-of-life improvement after 6 months of CSAI. This finding could be used to better prepare and accompany people with Parkinson's disease during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.

Factors Influencing Social Isolation among Cancer Patients: A Systematic Review

(1) Background: Social isolation, which has numerous adverse effects on health status, is prevalent among cancer patients. This review proposes to identify the influencing factors of social isolation among cancer patients. (2) Methods: Articles published in English or Chinese from six electronic databases before December 2023 were identified via a systematic search. A manual search was also performed. (3) Results: Twenty-eight studies were identified in this systematic review. The factors associated with social isolation can be summarized into the following categories: demographic characteristics, having cancer, health status, coping, social support and social interaction. Despite the heterogeneity, 20 factors were significantly associated with social isolation, including age, gender, comorbidity burden, education level, residence, medical insurance, occupation status, personality, race, smoking status, having children, not living alone, household income level, marital status, the role of primary caregiver, physical health status, mental health status, social health status, coping styles, and the level of social support and social interaction. (4) Conclusions: The systematic review showed that cancer patients' social isolation was influenced by their demographic characteristics, cancer-related factors, physical condition, psychological status, social health status, coping styles, and level of social support and social interaction. In addition, future group intervention could be considered to improve social isolation.

Reciprocal association between pain and quality of life after newly acquired spinal cord injury

PURPOSE

Pain is highly prevalent in spinal cord injury (SCI) and a key determinant of quality of life (QoL). This is the first study to examine reciprocal associations between pain and QoL in patients undergoing their first inpatient rehabilitation after SCI.

METHODS

Longitudinal data, with three measurement time points (1 month and 3 months after SCI onset, and at discharge from inpatient rehabilitation) from the Inception Cohort of the Swiss Spinal Cord Injury Cohort Study. Participants were 381 individuals aged ≥ 16 years with a newly diagnosed traumatic or non-traumatic SCI. 75.1% were male and the average age was 53.2 years. Random intercept cross-lagged panel models were conducted to examine the reciprocal association between pain intensity and QoL, as measured with the International SCI QoL Basic Data Set three individual items (satisfaction with life, physical health, and psychological health) and total score (mean of the three individual items).

RESULTS

Both item and total QoL scores increased over time. 1 month: 5.3 (SD = 2.7), 3 months: 5.9 (SD = 2.3), discharge: 6.6 (SD = 2.0). Participants reported relatively low levels of pain intensity that remained stable over the course of inpatient rehabilitation. 1 month: 2.7 (SD = 2.3), 3 months: 2.6 (SD = 2.4), discharge: 2.7 (SD = 2.5). There were no significant cross-lagged associations between QoL and pain intensity across time.

CONCLUSION

Results indicate that pain intensity does not predict changes in QoL during first rehabilitation, and vice versa. Associations between pain intensity and QoL reported by previous studies may be attributable to individual characteristics and timely events that simultaneously influence pain and QoL.

Influence of depressive disorders, stress, and personality traits on quality of life after cochlear implantation

PURPOSE

This study aimed to determine whether preoperative depressiveness, stress, and personality influence quality of life (QOL) after cochlear implant (CI) surgery.

METHODS

In this prospective study, 79 patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Disease-specific QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and general QOL with the WHOQOL-BREF. Depressiveness and stress were assessed with the Patient Health Questionnaire (PHQ-D). The Charlson Comorbidity Index (CCI) was used to classify comorbidities. The Big Five Personality Test (B5T) was used to assess the basic personality dimensions. Speech comprehension was evaluated in quiet with the Freiburg monosyllable test and in noise with the Oldenburg sentence test.

RESULTS

After CI surgery, the total NCIQ score improved significantly (Δ 17.1 ± 14.7, p < 0.001). General QOL (WHOQOL-BREF, Δ 0.4 ± 9.9, p = 0.357), stress (Δ 0.25 ± 3.21, p = 0.486), and depressiveness (Δ 0.52 ± 3.21, p = 0.121) were unaffected by CI surgery. Patients without elevated depressiveness (p < 0.01) or stress (p < 0.001) had significantly better total NCIQ scores. The results of the multiple regression analyses show that, after adjusting for the CCI, personality, age, and mental health stress (ß = - 0.495, p < 0.001) was significantly associated with postoperative NCIQ outcome scores. Depressiveness and neuroticism had the strongest influence on the generic QOL (ß = - 0.286 and ß = - 0.277, p < 0.05).

CONCLUSION

Stress symptoms and personality traits are significant predictive factors for disease-specific QOL, as well as hearing status. This should be considered in the preoperative consultation and in optimizing the rehabilitation process.

The mediating effect of eHealth literacy on the relationship between health personality and quality of life in community-dwelling older adults

AIMS

To explore the relationship between health personality and quality of life among community-dwelling older adults and to examine the mediating effect of eHealth literacy on this relationship.

METHODS

A total of 413 community-dwelling older adults from central China were recruited from September 2022 to January 2023. A cross-sectional investigation was conducted using the Chinese versions of the Health Personality Assessment (HPA), eHealth Literacy Scale (eHEALS), and 12-item Short Form Health Survey (SF-12). Correlations between the three variables were examined by Pearson analysis, and mediation analysis was conducted to explore the direct, indirect, and total effects of the health personality on quality of life vis-à-vis eHealth literacy.

RESULTS

Health personality factors (including health neuroticism, health openness, and health conscientiousness), eHealth literacy, and quality of life are significantly correlated (P<0.05); eHealth literacy can play a significant mediating role in the relationship between health neuroticism (β= -0.256, 95 %CI: [-0.405, -0.119]), health openness (β = 0.488, 95 % CI: [0.343,0.652]), health conscientiousness (β= 0.489, 95 % CI: [0.354, 0.634]) and quality of life.

CONCLUSION

This study revealed that the effect of health personality factors (including health neuroticism, health openness, and health conscientiousness) on quality of life in older adults was mediated through eHealth literacy.

IMPACT

Individual personality is essential to understanding eHealth literacy and quality of life among community-dwelling older adults. It may be helpful to identify the health personality traits of older adults first, then implement targeted interventions accordingly to enhance eHealth literacy and ultimately improve quality of life.

Ablation techniques or active surveillance compared to surgical resection in patients with low-risk papillary thyroid cancer: a systematic review and meta-analysis

BACKGROUND

The global prevalence of thyroid cancer is on the rise. About one-third of newly diagnosed thyroid cancer cases comprise low-risk papillary thyroid cancer (1.5 cm or more minor). While surgical removal remains the prevailing approach for managing low-risk papillary thyroid cancer (LPTC) in patients, other options such as active surveillance (AS), radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) are also being considered as viable alternatives. This study evaluated and compared surgical thyroid resection (TSR) versus non-surgical (NS) methods for treating patients with LPTC.

METHODS

The study encompassed an analysis of comparisons between surgical thyroid resection (TSR) and alternative approaches, including active surveillance (AS), radiofrequency ablation (RFA), microwave ablation (MWA), or laser ablation (LA). The focus was on patients with biopsy-confirmed low-risk papillary thyroid cancer (LPTC) of less than 1.5 cm without preoperative indications of local or distant metastasis. The primary outcomes assessed were recurrence rates, disease-specific mortality, and quality of life (QoL). Data were collected from prominent databases, including Cochrane Database, Embase, MEDLINE, and Scopus, from inception to June 3rd, 2020. The CLARITY tool was utilized to evaluate bias risk. The analysis involved odds ratios (OR) with 95% confidence intervals (CI) for dichotomous outcomes, as well as mean differences (MD) and standardized mean differences (SMD) for continuous outcomes. The study is registered on PROSPERO under the identifier CRD42021235657.

RESULTS

The study incorporated 13 retrospective cohort studies involving 4034 patients. Surgical thyroid resection (TSR), active surveillance (AS), and minimally invasive techniques like radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) were performed in varying proportions of cases. The analysis indicated that specific disease mortality rates were comparable among AS, MWA, and TSR groups. The risk of recurrence, evaluated over different follow-up periods, showed no significant differences when comparing AS, RFA, MWA, or LA against TSR. Patients undergoing AS demonstrated better physical health-related quality of life (QoL) than those undergoing TSR. However, no substantial differences were observed in the overall mental health domain of QoL when comparing AS or RFA with TSR. The risk of bias was moderate in nine studies and high in four.

CONCLUSION

Low-quality evidence indicates comparable recurrence and disease-specific mortality risks among patients with LPTC who underwent ablation techniques or active surveillance (AS) compared to surgery. Nevertheless, individuals who opted for AS exhibited enhanced physical quality of life (QoL). Subsequent investigations are warranted to validate these findings.

Aesthetic sensitivity: relationship with openness to experience and agreeableness, health-related quality of life and adaptive coping strategies in people with high sensory processing sensitivity

Aesthetic sensitivity in people with high sensory processing sensitivity (SPS) reflects the positive perception of life, especially aspects related to the arts and nature. This study is focused on the analysis of the effect of aesthetic sensitivity in relation to indicators of health-related quality of life (general health, mental health and emotional role), the personality traits openness to experience and agreeableness, and coping strategies in people with SPS. The adult participants (N = 10,520, mean age = 33.61) completed the Spanish versions of the High Sensitivity Person Scale (HSPS-S), Short Form Health Survey (SF-36), NEO Five Factor Inventory (NEO-FFI) and Coping Strategies Inventory (CSI). It was observed that people with high aesthetic sensitivity presented greater openness and agreeableness, tended to use adaptive coping strategies and showed a slightly poorer functioning in different areas of daily living. Moreover, health-related quality of life, mental health and adaptive coping strategies occupied central positions in the correlations between variables, with a positive impact between mental health and adaptive coping strategies with openness and agreeableness. Lastly, the level of aesthetic sensitivity did not play a moderator role, and it exerted no differential influence on its relationship with the analysed variables. Now, it has been found that people with high levels of aesthetic sensitivity cope more adequately, which would cushion the effect that high SPS can have on mental health, specifically on anxious and depressive symptoms. It is concluded that these findings are relevant and useful for future propositions of prevention and clinical intervention, as well as for counselling in the psychoeducational, labour and family scopes, amongst others.

Time perspective profile and self-reported health on the EQ-5D

OBJECTIVES

Time perspective (TP) is a psychological construct that is associated with several health-related behaviours, including healthy eating, smoking and adherence to medications. In this study, we aimed to examine the associations of TP profile with self-reported health on the EQ-5D-5L and to detect which domains display response heterogeneity (cut-point shift) for TP.

METHODS

We conducted a secondary analysis of EQ-5D-5L data from a representative general population sample in Hungary (n = 996). The 17-item Zimbardo Time Perspective Inventory was used to measure individuals' TP on five subscales: past-negative, past-positive, present-fatalist, present-hedonist and future. The associations between TP subscales and EQ-5D-5L domain scores, EQ VAS and EQ-5D-5L index values were analysed by using partial proportional odds models and multivariate linear regressions.

RESULTS

Respondents that scored higher on the past-negative and present-fatalist and lower on the present-hedonist and future subscales were more likely to report more health problems in at least one EQ-5D-5L domain (p < 0.05). Adjusting for socio-economic and health status, three EQ-5D-5L domains exhibited significant associations with various TP subscales (usual activities: present-fatalist and future, pain/discomfort: past-negative and future, anxiety/depression: past-negative, present-fatalist, present-hedonist and future). The anxiety/depression domain showed evidence of cut-point shift.

CONCLUSIONS

This study identified response heterogeneity stemming from psychological characteristics in self-reported health on the EQ-5D-5L. TP seems to play a double role in self-reported health, firstly as affecting underlying health and secondly as a factor influencing one's response behavior. These findings increase our understanding of the non-health-related factors that affect self-reported health on standardized health status measures.

The influence of personality on patient-reported outcomes in women undergoing implant-based breast reconstruction

BACKGROUND

Despite the lack of hard evidence for causality, some women attribute their systemic complaints to their silicone breast implants. Personality and psychological distress are associated with the development of medically unexplained symptoms. It could be hypothesized that these psychological factors are related to the development of breast implant illness (BII). In a previous study, we found a relationship between personality traits and BII-related complaints in patients with cosmetic breast implants. This association may also exist in patients with implant-based breast reconstruction.

OBJECTIVES

This cross-sectional study evaluated the association between personality, self-reported health complaints, and health- and breast-related quality of life (QoL) in women with implant-based breast reconstruction.

METHODS

Women who underwent breast reconstruction between January 2015 and December 2018 in either the Maastricht University Medical Center or Zuyderland Medical Center were invited to participate in this study. Participants were asked to complete a physical complaint score form and the BREAST-Q, SF-36, and EPQ-RSS questionnaires through an online survey. The association between outcomes was analyzed with multivariate linear regression.

RESULTS

A total of 118 women completed the questionnaires. Social desirability and extroversion were predominant personality traits. Neuroticism levels were comparable with normative data. Neuroticism correlated significantly with health status and breast-related QoL. Health-related QoL had the strongest correlation with neuroticism (β = -2.93, β = -3.41, p < 0.001).

CONCLUSION

This study suggests that personality, and neuroticism in particular, may contribute to the development of medically unexplained complaints in women with implant-based reconstruction. The influence of personality on BII needs to be further investigated in large prospective studies.

Pain-related and psychological factors mediate the effect of personality on health-related quality of life. A study in breast cancer survivors with persistent pain

Introduction

Personality characteristics affect the long-term well-being and health-related quality of life (HrQoL) of breast cancer (BC) survivors. Persistent pain significantly affects psychosocial well-being and HrQoL in this patient group. We studied the effects of temperament and character via pain-related and psychological factors on dimensions of HrQoL in BC survivors.

Methods

We studied 273 patients who had been treated for BC and who reported persistent pain at any site of the body in Brief Pain Inventory. The patients were recruited from a longitudinal cohort of patients 4-9 years after surgery for BC. Short-Form-36 inventory was used to assess physical and mental dimensions of HrQoL and Temperament and Character Inventory to assess dimensions of temperament and character. We used parallel mediation modeling for studying effects of temperament and character on physical and mental HrQoL.

Results

A significant total effect was found for harm avoidance (HA) temperament (β_total = -0.665, p < 0.001) and character dimensions self-directedness (SD) (β_total = 0.609, p = 0.001) and cooperativeness (CO) (β_total = 0.584, p = 0.028) on physical and mental HrQoL. Additionally, different combinations of pain-related and psychological variables fully mediated the indirect effects of HA, SD, and CO on physical and mental HrQoL.

Discussion

HA temperament is a potential emotional vulnerability factor for psychological burden and impaired HrQoL in BC survivors. Character dimensions SD and CO may protect from the negative effect of mood on HrQoL. The results provide new insights about the risk-and target-factors for clinical interventions and effective pain management to improve psychosocial well-being and HrQoL in BC survivors.

How personality influences health outcomes and quality of life in adult patients with cystic fibrosis

BACKGROUND

The present study evaluates personality traits in adult patients with cystic fibrosis (CF) and correlates these results with health-related quality of life (HRQoL) and other clinical parameters indicative of disease severity.

METHODS

Seventy adults completed the Cystic Fibrosis Questionnaire-Revised (CFQ-R 14+), a CF-specific measure of HRQoL, and a self-administered questionnaire about personality traits and disorders. Mean subscale scores and the prevalence of extreme personality traits on the `Persönlichkeits-Stil- und Störungs-Inventar (PSSI)´ were compared to the norming sample. Moreover, a cluster analysis was conducted to identify personality styles among people with cystic fibrosis (pwCF). The relationship between mean PSSI subscale scores and personality clusters with HRQoL and clinical outcomes, e.g., percent predicted forced expiratory volume in one second (ppFEV1), and body mass index (BMI), was studied by regression analysis considering important confounders.

RESULTS

On several of the subscales of the personality questionnaire, people with cystic fibrosis (pwCF) showed either significantly higher or lower scores than the norm sample. In further analyses, two personality clusters could be identified. PwCF from the cluster with predominantly low scores on the subscales 'negativistic', 'schizoid', 'borderline', 'depressed', and 'paranoid' showed better HRQoL than pwCF from the other cluster with mainly high normal or elevated scores. The studied health outcomes proved to be independent of the respective personality clusters.

CONCLUSIONS

In pwCF, HRQoL is mainly determined by psychological factors, including personality. Since more recent personality theories assume that personality is modifiable, our findings imply that patients with accentuated personality traits may benefit from psychosocial support.

Effects of oleic acid and/or exercise on diet-induced thermogenesis and obesity in rats: involvement of beige adipocyte differentiation and macrophage M1 inhibition

Background and purpose

Obesity is a public health problem and the existence of beige adipocytes has got interested as a potential therapeutic involvement for obesity and obesity-associated diseases. Adipose tissue M1 macrophage inhibition, also, has a vital role in obesity via down-regulating adipose tissue inflammation and the use of natural compounds such as oleic acid with exercise has been proposed. The present study aimed to evaluate the possible effects of oleic acid and exercise on diet-induced thermogenesis and obesity in rats.

Experimental approach

Wister albino rats were categorized into six groups. Group I: normal control, group II: oleic acid group (9.8 mg/kg; orally), group III: high-fat diet (HFD), group IV: HFD plus oleic acid, group V: HFD plus exercise training, group VI: HFD plus exercise training and oleic acid.

Findings/Results

Oleic acid administration and/or exercise significantly decreased body weight, TG, and cholesterol, as well as elevated HDL levels. Furthermore, oleic acid administration and/or exercise reduced serum MDA, TNF-α, and IL-6 levels, elevated the levels of GSH and irisin, increased the expression of UCP1, CD137, and CD206, and reduced CD11c expression.

Conclusion and implications

Oleic acid supplementation and/or exercise could be used as therapeutic agents for treating obesity via its antioxidant and anti-inflammatory activities, stimulation of beige adipocyte differentiation, and macrophage M1 inhibition.

Grit is associated with psychological health among older sexual minority men

Objectives: Studies have shown that grit-defined as perseverance and passion for achieving one's long-term goals-is associated with improved health outcomes, including lower levels of psychological distress. However, the psychometric properties of the original Grit Scale (Grit-O Scale) has not been validated among sexual minority men (SMM). The present study aimed to validate the Grit-O Scale among a sample of older SMM and assess the relationships between the Grit-O Scale factors and symptoms of psychological distress.Method: We used data from a single visit of participants in the Multicenter AIDS Cohort Study (MACS) Healthy Aging longitudinal study. The sample included 981 older SMM (mean age = 61, SD = 8.5) with and without HIV. We conducted confirmatory factor analysis (CFA) to identify the two factors of the Grit-O Scale: consistency of interest and perseverance of effort. We also conducted a latent profile analysis (LPA) to identify distinct profiles of psychological distress from self-reported scales of depression, anxiety, and perceived stress.Results:The Grit-O Scale showed acceptable reliability estimates for the items with Cronbach's alpha reliability coefficients ranging from 0.77 to 0.82. The CFA identified the two factors of the Grit-O Scale with acceptable model fit (root mean square error of approximation = 0.058 [95% CI = 0.050, 0.067], comparative fit index = 0.95, Tucker-Lewis Index = 0.93, standardized root mean square residual = 0.07). The LPA yielded three mutually exclusive profiles of psychological distress (profile 1: low stress, anxiety, and depression; profile 2: high stress and depression and low anxiety; and profile 3: high stress, anxiety, and depression). In adjusted multinominal logistic regression analysis, we found that both higher levels of consistency of interest and perseverance of effort factors of the Grit-O Scale were significantly associated with decreased odds of being in profiles 2 and 3 compared with being in profile 1.Conclusion: Our findings support the use of the Grit-O Scale among older SMM. Grit factors could explain variability in the negative psychological symptoms among older SMM and warrant further investigation.Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2032594.

Social hobbies can increase self-esteem and quality of life in female breast cancer patients with type A personality trait: KRATOS study

Self-esteem is a way of coping with stress for cancer patients and this improves their quality of life. It was aimed to determine the relationship between type A personality traits and self-esteem and quality of life in women with breast cancer and to determine the effective factors. 154 women with breast cancer and 78 healthy women were included. Bortner's Rating scale, Rosenberg's Self-Esteem scale, and EORTC QOL-C30 scale were used. The relationship between the presence of hobbies, self-esteem, quality of life, and personality type was examined. Mann-Whitney U, Kruskal-Wallis, Fisher's Exact, and Spearman Rank correlation tests were performed. Independent factors affecting personality type, self-esteem, and quality of life were determined by multivariate logistic (binary) regression analysis. The p < 0.05 value was significant in the SPSS v19 program. There was no age difference between the patients (54 ± 11 years) and the control group (42 ± 8 years) (p = 0.108). The rate of type A personality was 69% in patients and 58% in controls (p = 0.093). Similarly, the rate of high self-esteem was 93% in patients and 96% in controls (p = 0.098). Besides personality type and self-esteem, there was no relationship between personality type and quality of life in cancer patients (p = 0.960 and p = 0.946, respectively). A relationship was established between self-esteem and quality of life (p = 0.018) in patients. In patients with type A personality, hobbies providing socially active communication were common (p = 0.039), and had more than two hobbies (p = 0.015). Type A personality trait was independently effective on self-esteem (p = 0.046). Hobby orientation and the number of hobbies had independent effects on self-esteem (p = 0.032, p = 0.041), quality of life (respectively, p = 0.004, p = 0.007), and personality type (respectively, p = 0.014, p = 0.027). Hobbies that provide active social communication may have important effects on changes in personality traits, self-esteem, and quality of life in patients with breast cancer.

[Modern ideas about the relationship between fibromyalgia and mental disorders]

Fibromyalgia (FM) is a pain syndrome with a high burden and an understudied etiology and pathogenesis. There is now considerable evidence that FM has a strong bidirectional relationship with psychiatric disorders and is associated with certain personality traits that contribute to the severity of key somatic symptoms and affect overall prognosis. In this article, the authors present data from recent epidemiological and neurobiological studies, discuss the multilevel relationship between FM and psychiatric disorders, and briefly review approaches to the treatment of co-morbid conditions.

Systemic Diseases with Oral Manifestations and Their Impact on Health-Related Quality of Life

Health-related quality of life is a multidimensional concept established to evaluate the physical, psychological, and social impacts of health conditions on individuals’ well-being. Various tools for measuring health-related quality of life can be categorized into two subsets: generic and disease–specific instruments. The oral cavity can be stricken by a broad range of local and systemic diseases and their systemic treatment modalities. The most common systemic illnesses associated with oral lesions are hematologic disorders, endocrinopathies, neurological disorders, gastrointestinal conditions, mucocutaneous and rheumatic diseases, and neoplastic processes. Their manifestations in the oral cavity are, in most cases, rather nonspecific but should not be overlooked. Oral health is one of the most important parts of overall health, thus it has been proposed that poor oral health may affect health–related quality of life. The presence of oral manifestations of systemic diseases has a negative impact on the daily functioning of patients, decreasing their overall well-being. This article will review the most common systemic diseases with oral manifestations and their impact on the health–related quality of life. Oral health researchers should put a stronger emphasis on the patient-reported quality of life as a primary outcome in future clinical trials. The significance of this area has still not been widely understood in the current dental literature even though it could help improve patients’ health-related quality of life.

Relationship between Type D personality and adverse health outcomes in people with type 2 diabetes: The parallel mediating roles of diabetes distress and social isolation

AIM

To investigate the relationship between Type D personality and adverse health outcomes [glycated haemoglobin (HbA1c) and health-related quality of life (HRQOL)] directly, and indirectly via diabetes distress and social isolation in people with type 2 diabetes.

DESIGN

A secondary analysis of 524 participant's data derived from a cross-sectional, correlational study with people with type 2 diabetes.

METHODS

Data were analysed using the PROCESS macro of SPSS.

RESULTS

Type D personality was present in 31.3% of the participants, and exerted a direct effect on HRQOL but not on HbA1c. Type D personality indirectly affected both HbA1c and HRQOL via the mediators of diabetes distress and social isolation. Nurses need to monitor people with type 2 diabetes to determine whether Type D personality is present. Those with Type D personality should be provided with interventions to reduce diabetes distress and alleviate social isolation in order to improve HbA1c and HRQOL.

Personality and health-related quality of life (HRQoL) of Hong Kong Chinese older people: resilience as a mediator and financial status as a moderator

Objectives: Personality can influence older adults' health and quality of life. However, the pathways are relatively less examined. This study aimed to understand the mediating effect of resilience in the relationship between two personality traits-neuroticism and extraversion-and Hong Kong Chinese older adults' health-related quality of life (HRQoL). Whether such effect varied across older adults in different financial conditions were also examined. Method: A purposive non-probability sample of 253 Hong Kong Chinese older adults aged 60 and above was recruited for a face-to-face questionnaire survey. Neuroticism and extraversion were measured using the subscales form the Big Five Inventory (BFI). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HRQoL was measured by the short-form 8 (SF- 8). Path analysis was conducted to examine the relationship between key variables. Multi-group path analysis was also performed to investigate whether the pathways differed by financial status. Indirect effects were computed in the path analyses to detect the mediatory role of resilience between personalities and HRQoL.Results: The findings included that after controlling for confounders, neuroticism, but not extraversion was significantly associated with HRQoL. The relationships were mediated by resilience. Moreover, the mediating role of resilience is more pronounced among the participants who live in a financially poor or fair condition, comparing to their wealthier peers.Conclusion: This study confirmed the important role of personality in shaping older adults' resilience and quality of life. Personality should be kept in mind in the identification of potential vulnerable groups for interventions, especially those in financial hardships who may face double disadvantages.

Cognition and brain health among older adults in Iceland: the AGES-Reykjavik study

The paper aimed to compare how factors previously identified as predictive factors for cognitive decline and dementia related to cognitive performance on the one hand and brain health on the other. To that aim, multiple linear regression was applied to the AGES-Reykjavik study epidemiological data. Additionally, a regression analysis was performed for change in cognition over 5 years, using the same exposure factors. The study ran from 2002 to 2011, and the sample analyzed included 1707 participants between the ages of 66 and 90. The data contains MR imaging, cognitive testing, background data, and physiological measurements. Overall, we conclude that risk factors linked to dementia relate differently to cognition and brain health. Mobility, physical strength, alcohol consumption, coronary artery disease, and hypertension were associated with cognition and brain volume. Smoking, depression, diabetes, and body fat percentage were only associated with brain volume, not cognitive performance. Modifiable factors previously linked to cognitive reserve, such as educational attainment, participation in leisure activities, multilingualism and good self-reported health, were associated with cognitive function but did not relate to brain volume. These findings show that, within the same participant pool, cognitive reserve proxy variables have a relationship with cognitive performance but have no association with relative brain volume measured simultaneously.

Association between personality factors and health-related quality of life in type 1 diabetes patients

Objective

The objective of the present study was to evaluate a possible association between personality factors (PF) and the health-related quality of life (HRQoL) of type 1 diabetes (T1D) patients. This allows for the investigation of obstacles related to treatment type and the presence of complications in HRQoL.

Materials and Methods

This cross-sectional study enrolled 78 patients aged 13-67 years from two diabetes clinics. PF was evaluated using the validated questionnaire Inventory of the Five Great Personality Factors. HRQoL was determined using the Brazilian Problem Areas in Diabetes Scale (B-PAID) questionnaire. The chi-square test, Fisher's exact test, and Welch's modified two-sample t-test were used to establish relationships.

Results

In this sample of 46 women and 32 men with T1D and mean A1C of 8%-9%, we observed great suffering in 58.97% and that HRQoL was worse in women. "Openness" was the most prevalent PF and "extroversion" the least prevalent. "Neuroticism" facilitated a tendency to tolerate suffering.

Conclusion

T1D patients' personalities influence their treatment. The PF "neuroticism" is potentially related to better HRQoL. Brazilian T1D patients indicated great suffering in their HRQoL, which may be characteristic across the country. Women experienced worse HRQoL, which is in line with world literature. However, the limited sample size in this study warrant further research to test the hypotheses.

Personality traits and income inequalities in self-rated oral and general health

The association of low income with poor health is widely recognized, but why some low-income individuals do not experience poor health remains unclear. The aim of this study was to determine whether greater positive personality trait scores modify the association between income and oral and general health-related quality of life (OHRQoL and HRQoL) among a representative sample of the South Australian population. Cross-sectional self-rated questionnaire data from a sample of 3645 adults in 2015-2016 were used for secondary analysis. In four factorial ANOVA models, the main effects, interaction, and effect modification of personality traits [measured using the Ten-Item Personality Inventory (TIPI)] on the association between income and OHRQoL [measured using the Oral Health Impact Profile (OHIP-14)] and HRQoL [measured using the European Quality of Life indicator (EQ-5D-3L)] were assessed. In the low-income group, participants with greater TIPI scale scores had lower means for the OHIP-14 and the EQ-5D-3L (better OHRQoL and HRQoL). Greater emotional stability scores modified the association between low income and HRQoL and OHRQoL. Stronger positive personality traits, such as emotional stability, appear to ameliorate the adverse effect of income inequalities in health.

Examination of Type D personality, depression and perceived social support in women With fibromyalgia

PURPOSE

This study aims to evaluate the relationship between Type D personality, depression, perceived social support, and disease activity in women with fibromyalgia (FM).

DESIGN AND METHODS

One hundred and forty women applied to the physical medicine rehabilitation outpatient clinic between October 2019 and February 2020 who also had been diagnosed with FM were recruited. Age, occupation, marital status, chronic diseases, body mass index, duration of FM, smoking and alcohol use, sleep patterns, difficulty with daily work and self-care, physical therapy, and rehabilitation status were all recorded as demographic data of subjects. All patients participating in the study were evaluated with a Type D Personality Scale, Beck Depression Inventory, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), and Multidimensional Scale of Perceived Social Support (MSPSS).

FINDINGS

It has been determined that more than half of the women diagnosed with FM had the disease for more than 2 years, the average age was 46, 70% of patients were 40 years or older, more than half were overweight or obese and 63.6% had Type D personality. Eighty-nine women diagnosed with FM had a Type D personality and a significant correlation was found between Type D personality and depression, VAS, FIQ, and the subparameters of MSPSS.

PRACTICAL IMPLICATIONS

The determination of a relationship between the Type D personality and depression, VAS, FIQ, and MSPSS in women with FM plays a very important role in the care of FM in terms of treatment and prognosis and it can be said that determining the personality traits of such patients may be beneficial for clinicians.

Mediating role of social capital on the association between negative life events and quality of life among adults in China: A population-based study

Objective

To evaluate whether social capital played a mediating role in the relationship between negative life events (NLE) and quality of life (QoL) among adults in China after proposed a conceptual model based on stress buffering theory.

Methods

A cross-sectional study was conducted based on baseline survey from the Chinese Multi-ethnic Cohort (CMEC) in Yunnan province. A total of 22,866 adults were recruited by multistage stratified cluster sampling. A structured questionnaire was used to collect the general demographic characteristics and the occurrence of NLE. A self-developed brief social capital scale was utilized to assess the social capital and the EQ-5D-5L scale was used to measure the QoL. The relationships among NLE, social capital and QoL were analyzed using multiple linear regression analyses. Structural equation models were used to evaluate whether social capital had a mediating effect on the relationship between NLE and QoL. The standardize coefficient (β) and it's 95% confidence intervals (CI) were calculated in this process.

Results

The mean age of participants was 52.70 years old. The mean of EQ-5D index value was 0.92 (SD = 0.12) and the mean of EQ-VAS score was 71.77 (SD = 13.80). NLE not only directly affected EQ-5D index value [β = -0.127, 95% CI (-0.144, -0.110)] but also indirectly negatively affected EQ-5D index value through social capital [β = -0.019, 95% CI (-0.023, -0.015)]. Social capital had a direct positive effect on EQ-5D index value [β = 0.114, 95% CI (0.097, 0.133)]. A similar pattern was identified for the association between NLE and EQ-VAS score. The direct effect of NLE on EQ-VAS score was negatively significant [β = -0.132, 95% CI (-0.146, -0.118)]. Moreover, the indirect effect through social capital was also negatively significant [β = -0.022, 95% CI (-0.026, -0.019)]. There was a positive direct effect of social capital on EQ-VAS score [β = 0.135, 95% CI (0.117, 0.151)].

Conclusion

Social capital played an important mediating role in the relationship between NLE and QoL, and it alleviated the negative effects of NLE on the QoL of the community residents in China. Providing reliable social capital for community residents experiencing NLE could effectively improve their quality of life.

Inter-Rater Reliability of the Structured Interview of DSM-IV Personality (SIDP-IV) in an Adolescent Outpatient Population

Personality disorders (PDs) are a class of mental disorders which are associated with subjective distress, decreased quality of life and broad functional impairment. The presence of one or several PDs may also complicate the course and treatment of symptom disorders such as anxiety and depression. Accurate and reliable means of diagnosing personality disorders are thus crucial to ensuring efficient treatment planning and resource allocation, a fact which is widely acknowledged within the adult mental health field. In adolescents, on the other hand, the consensus view has been that the rapid and discontinuous processes of normal personality development render the construct of PD in adolescents clinically unhelpful and conceptually dubious. However, recent research has established the reliability and validity of the construct, heralding an increased interest in the field, with important conceptual and clinical implications. The present article presents reliability data for the Structured Interview of DSM-IV Personality (SIDP-IV) in an adolescent outpatient population. For this study, 25 interviews conducted by experienced clinicians were blindly re-scored based on sound recordings, which allowed for the calculation of intra-class correlation metrics. The intra-class correlation coefficient for categorical diagnosis of specific personality disorders was found to be 0.876 (95% CI 0.718-0.945); Cohen's kappa for presence/absence of personality diagnosis was found to be 0.896. The present study found excellent intra-rater reliability for the sample, which suggests that the SIDP-IV is a suitable instrument for assessing personality pathology in adolescent populations.

Political Party Affinity and Fear of Conventional and Nuclear War in Germany

Aim: to clarify the association between political party affinity and fear of conventional and nuclear war in Germany. Methods: data were used from a nationally representative online survey (in terms of age bracket, sex and state; n = 3091 individuals; mid-March 2022). Multiple linear regressions were used to investigate the association between political party affinity and fear of conventional and nuclear war in Germany, adjusting for several covariates. Results: while, for example, individuals who had an affinity with the Social Democratic Party (SPD) of Germany reported the highest frequency of severe fear of a conventional war (58.0%), individuals who had an affinity with the Left Party (Die Linken, left-wing) reported a somewhat lower frequency of severe fear (48.2%) and individuals who had an affinity with the Alternative for Germany (AFD, right-wing) reported the lowest frequency (43.7%). Regressions showed that—compared to individuals who had an affinity with the SPD—individuals who had an affinity with the Free Democratic Party (FDP, liberal) and particularly individuals who had an affinity with the Alternative for Germany (AFD) reported a markedly lower fear of war (both fear of a conventional war and fear of a nuclear war). Conclusion: our study showed some interesting associations between political party affinity and fear of war in Germany. This knowledge may assist in characterising individuals at risk for higher levels of fear of war.

Mental and physical health-related quality of life in patients with recurrent patellar dislocations-a generic and disease-specific quality of life questionnaire assessment

Purpose

There is a paucity of quality of life (QoL) assessments in studies evaluating patients treated for recurrent lateral patellar dislocation (LPD). The primary aim of this study was to investigate whether mental well-being is impaired in patients with chronic (recurrent) LPD and, if so, to assess whether the mental health-related QoL dimension improves equivalently to the physical-related QoL dimension after successful surgical treatment.

Methods

Thirty-eight patients with recurrent LPD over a mean course of the disease of 4.7 ± 3.9 years (1—18 years) prior to surgery were included. Generic health-related QoL (HRQoL) (Short Form 36; SF-36) and disease-specific QoL (Banff Patella Instability Instrument 2.0; BPII 2.0) were assessed preoperatively and after a mean follow-up of 3.5 ± 0.8 years (2 – 5 years) postoperatively.

Results

Untreated LPD significantly impacted the physical dimension of patients’ generic HRQoL and their disease-specific QoL. When compared to age-equivalent normative data sets, the mental HRQoL dimension was not reduced prior to operative treatment but increased during the follow-up period. Surgical treatment normalized the physical dimension of patients’ generic HRQoL and significantly improved their disease-specific QoL. However, BPII 2.0 values remained reduced, albeit patellae were successfully stabilized.

Conclusion

The results of this study indicate that patients with recurrent LPD are generally in good mental health, although physical impairment is striking. Notwithstanding that surgery prevented further dislocations and normalized the generic HRQoL, the disease-specific QoL remained reduced as far as this can be interpreted without population-based data.

Level of evidence

Level IV; Retrospective case series.

Patient reported outcomes in oncology: changing perspectives-a systematic review

In public health context, oncology is associated with severe negative impact on patients and on their relatives’ quality of life. Over the last decades, survival has remained at 50% worldwide for some tumor locations. Patient reported outcomes (PROs) assessment and, the corresponding use in clinical practice, help establishing patient individualized profiling involving caregivers. The purpose of this systematic review was to examine critical success factors for PROs assessment in daily clinical oncology practice. Additionally, we investigated how PROs collection can change oncology perspectives for patients and caregivers. According to PRISMA guidelines, 83 studies were included in this systematic review, whether related with implementation in daily clinical practice or associated with its use in oncology. PROs assessment gathers multi-professional teams, biomedical and clinical expertise, patients, families and caregivers. Institutional involvement, first line for caregiver’s adherence, team continuous formation, encompassing training and support, design of clear workflows, continuous monitoring, and data analysis are crucial for implementation. PROs measures are decisive in oncology. Several items were improved, including caregiver–patient–physician communication, patient risk groups identification, unmet problems and needs detection, disease course and treatment tracking, prognostic markers, cost-effectiveness measurement and comfort/support provision for both patients and caregivers. Routine assessment and implementation of PROs in clinical practice are a major challenge and a paradigm transformation for future.

Role of neuroticism and perceived stress on quality of life among patients with dry eye disease

This hospital-based, cross-sectional observational study aimed to examine whether neuroticism has an impact on stress that is related to dry eye disease (DED) and quality of life (QOL). One hundred participants who had DED completed the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire, a 5-level EQ-5D (EQ-5D-5L), Neuroticism Inventory (NI), and 10-Item Perceived Stress Scale (PSS). Hierarchical linear regression was applied to determine the predictive effect of the independent variables. Participants' mean age was 50.91 ± 14.3 years, and females totalled 89.0%. Hierarchical linear regression analysis showed that DESQ-Ocular symptoms were the strongest predictor for QOL either assessed by DEQS or EQ-5D, and its effect was lessened when perceived stress and neuroticism were added to the model. The final model explained up to 30-39% variance of the QOL, compared with 13-32% by DESQ-Ocular symptoms alone. QOL of the patients with DED, is not only related to eye symptoms but perceived stress. Moreover, neuroticism was a strong predictor contributing to the QOL among patients with DED. The study showed a significant association between perceived stress, neuroticism and the QOL of patients with DED. Personality has some impact on both subjective dry eye symptoms and impact on daily life, along with the general health-related QOL.