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Unal-Ulutatar C, Ozsoy-Unubol T. The relationship of centralized pain in fibromyalgia syndrome with sleep, fatigue and quality of life. Mod Rheumatol 2023; 33:224-228. [PMID: 35107136 DOI: 10.1093/mr/roac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/06/2021] [Accepted: 12/23/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The aim of this study was to examine the central role of pain in patients' lives by evaluating the relationship between the centralization of pain and clinical and functional parameters. METHODS Adult patients aged 18-70 diagnosed with FM were included in the study. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess the severity of FM, and the Centrality of Pain Scale (COPS) was used to assess pain centralization. The European Quality of Life Scale 5 Dimension (EQ-5D) assessed quality of life, the Jenkins Sleep Scale (JSS-TR) sleep, and the Beck Depression Inventory (BDI) depression.Spearman correlation coefficient (rho) was used to examine the relationship between COPS scores and other parameters, and p < .05 was considered significant. RESULTS One hundred and sixty-five FM patients (143 female) were included in the study. The mean age of the patients was 43.7 ± 10.1 years, and the mean disease duration was 4.8 ± 7.8 years. Centrality of pain was found to be related to FIQ (rho = 0.59, p = .0005), EQ-5D (rho = -0.53, p = .0005), JSS-TR (rho = 0.43, p = .0005), and BDI (rho = 0.41, p = .0005). CONCLUSION Centralization of pain in FM was more common in patients with high disease severity, poor quality of life, and sleep and depression problems.
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Affiliation(s)
- Cagri Unal-Ulutatar
- Physiotherapy and Rehabilitation Department, Istanbul Rumeli University, Istanbul, Turkey
| | - Tugba Ozsoy-Unubol
- Istanbul Sultan II. Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Factors Influencing Quality of Life Among Older Persons Living With Osteoarthritis Using 3 Different Definitions. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grekhov RA, Suleimanova GP, Trofimenko AS, Shilova LN. Psychosomatic Features, Compliance and Complementary Therapies in Rheumatoid Arthritis. Curr Rheumatol Rev 2021; 16:215-223. [PMID: 31830886 DOI: 10.2174/1573397115666191212114758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 11/22/2022]
Abstract
This review highlights the issue of psychosomatic conditions in rheumatoid arthritis, paying special attention to new researches and trends in this field. Emerging concepts in all the major parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain on the emotional state to disease influence over quality of life, socio-psychological, and interpersonal relationships. Chronic pain is closely related to emotional responses and coping ability, with a pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading to further decrease in quality of life, low compliance, and high suicide risk. Influence of psychosomatic conditions on the overall treatment effect is usually underestimated by rheumatologists and general practitioners. Psychosomatic considerations are of great importance for up-to-date management of rheumatoid arthritis, as they strongly influence the quality of life, compliance, and thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping with pain through the regulation of emotion and psychotherapeutic intervention, which not only helps patients in coping with the disease, but also aimed at improving the overall adaptation of the patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy. Current data about the efficacy of the additional correcting therapies for patients with rheumatoid arthritis, both emerging and common ones, are discussed in the review.
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Affiliation(s)
- Rostislav A Grekhov
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Galina P Suleimanova
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Andrei S Trofimenko
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
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Kwan A, Bingham K, Touma Z. Measures of Anxiety in Rheumatic Diseases. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:630-644. [PMID: 33091269 DOI: 10.1002/acr.24351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Andrew Kwan
- University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Bingham
- University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Zahi Touma
- University Health Network, Toronto, Ontario, Canada
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Sönmez AÖ, Sönmez HE, Çakan M, Yavuz M, Keskindemirci G, Aktay Ayaz N. The evaluation of anxiety, depression and quality of life scores of children and adolescents with familial Mediterranean fever. Rheumatol Int 2020; 40:757-763. [DOI: 10.1007/s00296-020-04519-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
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Paz C, Aguilera M, Salla M, Compañ V, Medina JC, Bados A, García-Grau E, Castel A, Cañete Crespillo J, Montesano A, Medeiros-Ferreira L, Feixas G. Personal Construct Therapy vs Cognitive Behavioral Therapy in the Treatment of Depression in Women with Fibromyalgia: Study Protocol for a Multicenter Randomized Controlled Trial. Neuropsychiatr Dis Treat 2020; 16:301-311. [PMID: 32021219 PMCID: PMC6987966 DOI: 10.2147/ndt.s235161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Fibromyalgia (FM) is a debilitating syndrome, more prevalent in women, which is aggravated by the presence of depressive symptoms. In the last decade, cognitive behavioral therapy (CBT) has demonstrated to reduce such depressive symptoms and pain in these patients, but there are still a considerable number of them who do not respond to interventions. The complexity of the disorder requires the consideration of the unique psychological characteristics of each patient to attain good outcomes. One approach that could accomplish this goal might be personal construct therapy (PCT), an idiographic approach that considers identity features and interpersonal meanings as their main target of intervention. Then, the aim of the study is to test the efficacy of PCT as compared to a well-established treatment in the reduction of depressive symptoms in women with fibromyalgia. METHODS AND ANALYSIS This is a multicenter randomized controlled trial. In each condition participants will attend up to eighteen 1-hr weekly therapy sessions and up to three 1-hr booster sessions during the following 3-5 months after the end of treatment. The depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) will be the primary outcome measure and it will be assessed at baseline, at the end of therapy, and at 6-month follow-up. Other secondary measures will be applied following the same schedule. Participants will be 18- to 70-years-old women with a diagnosis of FM, presenting depressive symptoms evinced by scores above seven in depression items of the HADS-D. Intention-to-treat and complete case analyses will be performed for the main statistical tests. Linear mixed models will be used to analyze and to compare the treatment effects of both conditions. TRIAL REGISTRATION ClinicalTrials.gov: NCT02711020.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Mari Aguilera
- Department of Cognition, Development and Educational Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Marta Salla
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Victoria Compañ
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Joan C Medina
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Arturo Bados
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Eugeni García-Grau
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Castel
- Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | | | - Adrián Montesano
- Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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Machin AR, Babatunde O, Haththotuwa R, Scott I, Blagojevic-Bucknall M, Corp N, Chew-Graham CA, Hider SL. The association between anxiety and disease activity and quality of life in rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol 2020; 39:1471-1482. [PMID: 31897960 DOI: 10.1007/s10067-019-04900-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/02/2019] [Accepted: 12/15/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In people with rheumatoid arthritis (RA), mental health problems are common, but often not recognized or treated, contributing to increased morbidity and mortality. Most studies examining the impact of mental health problems in RA have focused on depression. We aimed to determine the association between anxiety, and disease activity and quality of life (QoL) in people with RA. METHODS A systematic review and meta-analysis were performed. A protocol was registered with PROSPERO (CRD2-17062580). Databases (Web of Science, PsycINFO, CINAHL, Embase, Medline) were searched for studies examining the association between anxiety and disease activity and QoL, in adults with RA, from inception to February 2019. Primary outcome measures were DAS28 and SF-36. Eligibility screening and data extraction were completed by two reviewers. Disagreements were resolved by discussion or a third reviewer. Quality assessment was carried out using the Newcastle-Ottawa Scale. RESULTS From 7712 unique citations, 60 articles were assessed for eligibility. The final review included 20 studies involving 7452 people with RA (14 cross-sectional, 6 cohort). Eleven examined disease activity, 6 reported QoL outcome measures and 3 included both. Anxiety was associated with increased disease activity and worse QoL. Meta-analysis showed anxiety to be correlated with increased DAS28 scores (r = 0.23, CI 0.14, 0.31) and reduced physical (r = - 0.39, CI - 0.57, - 0.20) and mental QoL (- 0.50, CI - 0.57, - 0.43). CONCLUSIONS Anxiety in people with RA is associated with increased disease activity and worse QoL. Improved recognition and management of comorbid anxiety may help to improve outcomes for people with RA.Key Points• This is the first systematic review and meta-analysis to examine the relationship between anxiety and disease activity and QoL in people with RA.• Anxiety was associated with higher disease activity both cross-sectionally and at up to 12-month follow-up.• Anxiety may have a more significant impact on disease activity in early RA, highlighting the importance of early recognition and management of comorbid anxiety.• People with anxiety had poorer self-reported physical and mental QoL, although there was some heterogeneity in study findings, particularly for physical QoL (I2 = 78.5%).
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Affiliation(s)
- Annabelle R Machin
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.
| | - Opeyemi Babatunde
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Randula Haththotuwa
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Ian Scott
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Staffordshire, UK
| | - Milica Blagojevic-Bucknall
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Nadia Corp
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Carolyn A Chew-Graham
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.,West Midlands CLAHRC, West Midlands, UK.,Midlands Partnership Foundation Trust, Staffordshire, UK
| | - Samantha L Hider
- Primary Care Centre Versus Arthritis, School for Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Staffordshire, UK.,Midlands Partnership Foundation Trust, Staffordshire, UK
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Sahin HG, Kunduracilar Z, Sonmezer E, Ayas S. Effects of two different aquatic exercise trainings on cardiopulmonary endurance and emotional status in patients with knee osteoarthritis. J Back Musculoskelet Rehabil 2019; 32:539-548. [PMID: 30584113 DOI: 10.3233/bmr-171116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Aquatic exercises are often recommended for people with osteoarthritis (OA), however, there is a lack of evidence about the effects of these exercises. OBJECTIVES The purpose of this study was to investigate the effects of two different aquatic exercise trainings on cardiopulmonary endurance and emotional status in patients with knee osteoarthritis. METHODS Eighty-nine patients who had been diagnosed with knee osteoarthritis were divided into three groups as two different aquatic exercise training groups (only lower extremity training vs. lower extremity + upper extremity and trunk exercises) or the control group. All groups have received the conventional therapy which consisted of hotpack, ultrasound, transcutaneous electrical nerve stimulation (TENS), and home exercises. Six-minute walk test (6MWT) and the Hospital Anxiety and Depression Scale (HAD) were used for assessing cardiopulmonary endurance and emotional status, respectively. RESULTS Following the treatment, all groups improved in terms of systolic blood pressure, walking distance and total HAD scores. Group 1 showed additional improvements in diastolic blood pressure, heart rate and perceived exertion, while Group 2 showed additional improvements only in perceived exertion. Greater changes before and after the treatment in diastolic blood pressure at rest and following 6MWT, perceived exertion following 6MWT, walking distance, HAD depression scores and HAD anxiety scores were observed in Group 1. CONCLUSIONS Exercise therapy consisting of only lower extremity exercises in water might be more effective in improving exercise capacity and depression levels in comparison to upper extremity and trunk added exercises or conventional physical therapy.
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Affiliation(s)
| | - Zuhal Kunduracilar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bulent Ecevit University, Zonguldak, Turkey
| | - Emel Sonmezer
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Baskent University, Ankara, Turkey
| | - Sehri Ayas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
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Intriago M, Maldonado G, Cardenas J, Rios C. Quality of life in Ecuadorian patients with established rheumatoid arthritis. Open Access Rheumatol 2019; 11:199-205. [PMID: 31565005 PMCID: PMC6732902 DOI: 10.2147/oarrr.s216975] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/16/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate quality of life in patients with established rheumatoid arthritis (RA) and identify the factors that negatively affect it. Methods This was a cross-sectional study with patients with established RA from a rheumatology center in Ecuador. The RA Quality of Life (RAQoL) questionnaire was used to assess QoL and the Health Assessment Questionnaire — disability index (HAQ-DI) questionnaire for functional capacity. In addition, demographics, clinical characteristics, and markers of disease activity were included. Data were analyzed using SPSS 22. Results Of 186 patients, 89.8% were women, with a mean age of 51 years, 86.6% had symmetrical polyarticular involvement, 40.3% erosions, 46.8% morning stiffness, 46.8% xerophthalmia, and 39.2% fatigue. Depression was the most frequent comorbidity — 42.5%. The mean HAQ-DI score was 0.8, and 26.9% had functional disability. The mean RAQoL score was 7.2. Xerophthalmia, xerostomia, fatigue, morning stiffness, and depression were related to higher scores in the RAQoL (p<0.05). The mean RAQoL was higher in patients with more disease activity and comorbidities (p<0.05). Likewise, patients with functional disability had a mean RAQoL score of 15.6 versus 4.1 in patients without disability (p<0.05). There were positive correlations between RAQoL and ESR, CRP, painful-joint count, swollen-joint count, VAS of pain, and physician assessment (p<0.05). Conclusion QoL is severely affected in patients with RA. Depression, fatigue, morning stiffness, pain, high disease activity, and disability have a negative effect on QoL in RA. Likewise, patients with more comorbidities and extraarticular manifestations show worse QoL.
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Affiliation(s)
- Maria Intriago
- Rheumatology Department, Universidad Espiritu Santo, Guayaquil, Ecuador
| | | | - Jenny Cardenas
- Rheumatology Department, Universidad Espiritu Santo, Guayaquil, Ecuador
| | - Carlos Rios
- Rheumatology Department, Universidad Espiritu Santo, Guayaquil, Ecuador
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Sempere-Rubio N, Aguilar-Rodríguez M, Inglés M, Izquierdo-Alventosa R, Serra-Añó P. Physical Condition Factors that Predict a Better Quality of Life in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173173. [PMID: 31480366 PMCID: PMC6747062 DOI: 10.3390/ijerph16173173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022]
Abstract
What physical qualities can predict the quality of life (QoL) in women with fibromyalgia (FM)? QoL is a very complex outcome affected by multiple comorbidities in people with fibromyalgia. This study aims to determine which physical qualities can predict the quality of life in women with FM. Also, a comparison between the physical qualities of women with FM and healthy counterparts was conducted. In total, 223 women participated in this cross-sectional study, 123 with FM, with ages ranging between 45 and 70 years. The study was conducted at several fibromyalgia associations and specialized medical units. QoL was measured as the main outcome. In addition, functional capacity, muscular strength, maintenance of thoracic posture, postural control, flexibility, pain threshold, and anxiety were measured. Prediction of the QoL was conducted with multiple linear regression analysis and comparison between groups, using the Mann–Whitney U test. There were significant differences between groups in all the variables measured (p < 0.01). The multiple linear regression model showed that factors influencing QoL in women with FM for all the variables measured were functional capacity, handgrip strength and bicep strength, maintenance of thoracic posture, pain threshold, and anxiety (R2 = 0.53, p < 0.05). To conclude, women with FM show a significantly lower QoL than their healthy counterparts, and the factors that predict their perceived QoL are functional capacity, muscular strength, postural maintenance, pain threshold, and anxiety.
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Affiliation(s)
- Núria Sempere-Rubio
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain
| | - Marta Aguilar-Rodríguez
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES-ISCIII), Fundación Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), València 46010, Spain
| | - Ruth Izquierdo-Alventosa
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain
| | - Pilar Serra-Añó
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain.
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Marchi L, Marzetti F, Orrù G, Lemmetti S, Miccoli M, Ciacchini R, Hitchcott PK, Bazzicchi L, Gemignani A, Conversano C. Alexithymia and Psychological Distress in Patients With Fibromyalgia and Rheumatic Disease. Front Psychol 2019; 10:1735. [PMID: 31417462 PMCID: PMC6685004 DOI: 10.3389/fpsyg.2019.01735] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/12/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a chronic rheumatologic disease characterized by widespread musculoskeletal pain and other psychopathological symptoms which have a negative impact on patients' quality of life. FMS is frequently associated with alexithymia, a multidimensional construct characterized by difficulty in identifying feelings (DIF) and verbally communicating them difficulty describing feelings (DDF) and an externally oriented cognitive thinking style (EOT). The aim of the present study was to investigate the relationship between alexithymia, anxious and depressive symptoms and pain perception, in patients with FMS and other rheumatic diseases (RD). METHODS The sample consisted of 127 participants (M = 25, F = 102; mean age: 51.97; SD: 11.14), of which 48 with FMS, 41 with RD and 38 healthy control group (HC). All groups underwent to a test battery investigating anxiety and depressive symptoms (HADS), pain (VAS; QUID-S/-A) and alexithymia (TAS-20). RESULTS A high prevalence of alexithymia (TAS ≥ 61) was found in FMS (47.9%) and RD (41.5%) patients, compared to the HC group (2.6%). FMS patients showed significant higher scores than HC on DIF, DDF, EOT, anxiety and depression. The clinical sample, FMS and RD groups combined (n = 89), alexithymic patients (AL, n = 40) exhibited higher scores in pain and psychological distress compared to non-alexithymic patients (N-AL, n = 34). Regression analysis found no relationship between alexithymia and pain in AL, meanwhile pain intensity was predicted by anxiety in N-AL. CONCLUSION While increasing clinical symptoms (pain intensity and experience, alexithymia, anxiety, and depression) in patients with fibromyalgia or rheumatic diseases, correlations were found on the one side, between alexithymia and psychological distress, on the other side, between pain experience and intensity. Meanwhile, when symptoms of psychological distress and alexithymia were subthreshold, correlations with pain experience and intensity became stronger.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Aree-Ue S, Kongsombun U, Roopsawang I, Youngcharoen P. Path model of factors influencing health-related quality of life among older people with knee osteoarthritis. Nurs Health Sci 2019; 21:345-351. [PMID: 30810266 DOI: 10.1111/nhs.12602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Abstract
Chronic illness has a significant effect on quality of life, and a critical measure of health outcomes. Correlations between pain, depressive symptoms, fatigue, and physical function and their direct and indirect effects on quality of life were determined among 200 Thai older population with knee osteoarthritis using the Numeric Rating Scale, the Multidimensional Assessment of Fatigue, and the Thai Geriatric Depression Scale-15. Physical function was investigated by using the Timed Up and Go test. Path analysis revealed significant negative direct paths from pain, depressive symptoms, fatigue, and Timed Up and Go test results to quality of life. Pain, fatigue, and the Timed Up and Go test results had indirect effects on quality of life, while depressive symptoms had no indirect effect on quality of life. Increases in pain, depressive symptoms, fatigue, and Timed Up and Go test results were associated with reductions in quality of life. An understanding of the complex relationship among these variables is beneficial for designing an appropriate intervention for improving quality of life among older people with knee osteoarthritis.
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Affiliation(s)
- Suparb Aree-Ue
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Usa Kongsombun
- Department of Nursing, Sirindhorn Hospital, Bangkok, Thailand
| | - Inthira Roopsawang
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Phichpraorn Youngcharoen
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Yurdakul FG, Garip Çimen Y, Kılıçarslan A, Çalışkan Uçkun A, Bodur H. Depression in Rheumatoid Arthritis: Association with Quality of Life, Function and Disease Activity. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.461385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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14
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Ferreira MDC, Oliveira JCP, Zidan FF, Franciozi CEDS, Luzo MVM, Abdalla RJ. Artroplastia total de joelho e quadril: a preocupante realidade assistencial do Sistema Único de Saúde brasileiro. Rev Bras Ortop 2018. [DOI: 10.1016/j.rbo.2016.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ferreira MDC, Oliveira JCP, Zidan FF, Franciozi CEDS, Luzo MVM, Abdalla RJ. Total knee and hip arthroplasty: the reality of assistance in Brazilian public health care. Rev Bras Ortop 2018; 53:432-440. [PMID: 30027075 PMCID: PMC6052187 DOI: 10.1016/j.rboe.2018.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/10/2016] [Indexed: 11/19/2022] Open
Abstract
Objective To analyze the number of hospital permits for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in Brazil between 2008 and 2015, and correlate them with regional, national, and international demographic and epidemiological aspects. Methods Data on demographics, economic level, and TKA and THA were obtained from the website of the Ministry of Health/DATASUS, Brazilian Institute of Geography and Statistics, and the National Health Agency to assess the assistance provided by the Public Health Care System in arthroplasties for elderly Brazilian population without private health care. Results The South and Southeast had the best care, with 8.07 and 6.07 TKAs/100,000 inhabitants, one TKA per 1811 and 2624 seniors, 17.3 and 10.99 THAs/100,000 inhabitants, and one THA per 923 and 1427 seniors, respectively. The worst rates were found in the North and Northeast, with 0.88 and 0.98 TKAs/100,000, one TKA per 6930 and 10,411 seniors, 0.96 and 3.25 THAs/100,000, and one THA per 6849 and 2634 seniors, respectively. The national average was 4.00 TKAs/100,000, one TKA per 3249 seniors, 8.01 THAs/100,000, and one THA per 1586 seniors. The international average was 142.8 TKAs/100,000 and 191.8 THAs/100,000. Conclusion The results expressed unsatisfactory results for TKA and THA in Brazil, with greater relevance in the North and Northeast.
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Kukshina AA, Vereschagina DA, Kotel'nikova AV, Zaitsev VP. [The specific features of the psycho-emotional status and the application of psychotherapy for the rehabilitative treatment of the patients presenting with rheumatoid arthritis]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2017; 94:54-61. [PMID: 28884740 DOI: 10.17116/kurort201794354-61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The relevance of the problem of rheumatoid arthritis arises from the influence of such factors as its prevalence rate, unpredictability, tendency towards the transition to the chronic form, severe pain syndrome, high levels of disability, and long-term loss of working ability, as well as the accompanying psycho-emotional disorders. The present reviews article was designed to analyze the premorbid personality characteristics, the specifics features of mental health, and the response to the disease in the patients presenting with rheumatoid arthritis. Special emphasis is placed on the discusses of the relationship between the intensity of the pain syndrome and psycho-emotional disorders. The factors responsible for the development of the depressive states associated with rheumatoid arthritis are distinguished; they are shown to be related to both pathogenesis and the clinical symptoms of the underlying pathology as well as the general course of the disease and the specific features of the patients' psychological condition. The most extensively applied psychodiagnostics techniques are described, and the commonest psychotherapeutic approaches to the combined therapy and rehabilitation of the patients presenting with rheumatoid arthritis are overviewed.
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Affiliation(s)
- A A Kukshina
- Moscow Scientific and Practical Centre for Medical Rehabilitation, Restorative and Sports Medicine, Zemlyanoy val, 53, Moscow, Russia, 107120
| | - D A Vereschagina
- Moscow Scientific and Practical Centre for Medical Rehabilitation, Restorative and Sports Medicine, Zemlyanoy val, 53, Moscow, Russia, 107120
| | - A V Kotel'nikova
- Moscow Scientific and Practical Centre for Medical Rehabilitation, Restorative and Sports Medicine, Zemlyanoy val, 53, Moscow, Russia, 107120
| | - V P Zaitsev
- Moscow Scientific and Practical Centre for Medical Rehabilitation, Restorative and Sports Medicine, Zemlyanoy val, 53, Moscow, Russia, 107120
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Zhang X, Chen F, Chen L, Li B, Xu S, Cui D, Yu L, Liu M, Shi X, Li Q, Li Y. Symptoms and signs of temporomandibular disorders in patients with knee osteoarthritis. Int Dent J 2017; 67:78-84. [DOI: 10.1111/idj.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sambamoorthi U, Shah D, Zhao X. Healthcare burden of depression in adults with arthritis. Expert Rev Pharmacoecon Outcomes Res 2017; 17:53-65. [PMID: 28092207 PMCID: PMC5512931 DOI: 10.1080/14737167.2017.1281744] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/10/2017] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Arthritis and depression are two of the top disabling conditions. When arthritis and depression exist in the same individual, they can interact with each other negatively and pose a significant healthcare burden on the patients, their families, payers, healthcare systems, and society as a whole. Areas covered: The primary objective of this review is to summarize, identify knowledge gaps and discuss the challenges in estimating the healthcare burden of depression among individuals with arthritis. Electronic literature searches were performed on PubMed, Embase, EBSCOhost, Scopus, the Cochrane Library, and Google Scholar to identify relevant studies. Expert Commentary: Our review revealed that the prevalence of depression varied depending on the definition of depression, type of arthritis, tools and threshold points used to identify depression, and the country of residence. Depression exacerbated arthritis-related complications as well as pain and was associated with poor health-related quality of life, disability, mortality, and high financial burden. There were significant knowledge gaps in estimates of incident depression rates, depression attributable disability, and healthcare utilization, direct and indirect healthcare costs among individuals with arthritis.
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Affiliation(s)
- Usha Sambamoorthi
- a Department of Pharmaceutical Systems and Policy , School of Pharmacy, West Virginia University , Morgantown , WV , USA
| | - Drishti Shah
- a Department of Pharmaceutical Systems and Policy , School of Pharmacy, West Virginia University , Morgantown , WV , USA
| | - Xiaohui Zhao
- a Department of Pharmaceutical Systems and Policy , School of Pharmacy, West Virginia University , Morgantown , WV , USA
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Soósová MS, Macejová Ž, Zamboriová M, Dimunová L. Anxiety and depression in Slovak patients with rheumatoid arthritis. J Ment Health 2016; 26:21-27. [PMID: 27809630 DOI: 10.1080/09638237.2016.1244719] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is significantly associated with psychiatric morbidity. Mental health conditions are often unrecognized and untreated in primary care. AIMS To assess prevalence of anxiety and depression and their impact on arthritis pain and functional disability in Slovak patients with rheumatoid arthritis. METHODS Anxiety was assessed by the Beck Anxiety Inventory (BAI), depression by the Zung self-rating depression scale (SDS), pain by the visual analog scale (VAS) and functional disability by the health assessment questionnaire - disability index (HAQ-DI) in 142 patients with rheumatoid arthritis. Spearman's rho was calculated to assess relations between variables. Stepwise linear regression analysis was used to assess impact of anxiety and depression on arthritis pain and functional disability. RESULTS High prevalence of anxiety and depression was observed in arthritis patients. Anxiety and depression were significant predictors of arthritis pain and functional disability. Sex, education, marital status, disease duration and comorbidity had no impact on arthritis pain and functional disability. CONCLUSION These findings support the notions that psychological negative affect can influence subjective perception of arthritis pain and disability. The regular screening of anxiety and depression and the psychological approaches can be useful for managing arthritis patients.
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Affiliation(s)
| | - Želmíra Macejová
- b 1st Department of Internal Medicine, Faculty of Medicine , Pavol Jozef Šafárik University in Košice , Košice , Slovakia
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Woollard JD, Bost JE, Piva SR, Kelley Fitzgerald G, Rodosky MW, Irrgang JJ. The ability of preoperative factors to predict patient-reported disability following surgery for rotator cuff pathology. Disabil Rehabil 2016; 39:2087-2096. [PMID: 27548366 DOI: 10.1080/09638288.2016.1219396] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Minimal research has examined the prognostic ability of shoulder examination data or psychosocial factors in predicting patient-reported disability following surgery for rotator cuff pathology. The purpose of this study was to examine these factors for prognostic value in order to help clinicians and patients understand preoperative factors that impact disability following surgery. METHODS Sixty-two patients scheduled for subacromial decompression with or without supraspinatus repair were recruited. Six-month follow-up data were available for 46 patients. Patient characteristics, history of the condition, shoulder impairments, psychosocial factors, and patient-reported disability questionnaires were collected preoperatively. Six months following surgery, the Western Ontario Rotator Cuff Index (WORC) and global rating of change dichotomized subjects into responders versus nonresponders. Logistic regression quantified prognostic ability and created the most parsimonious model to predict outcome. RESULTS Being on modified job duty (OR = .17, 95%CI: 0.03-0.94), and having a worker's compensation claim (OR = 0.08, 95%CI: 0.01-0.74) decreased probability of a positive outcome, while surgery on the dominant shoulder (OR = 11.96, 95%CI: 2.91-49.18) increased probability. From the examination, only impaired internal rotation strength was a significant univariate predictor. The Fear-avoidance Beliefs Questionnaire (FABQ) score (OR = 0.95, 95%CI: 0.91-0.98) and the FABQ_work subscale (OR = 0.92, 95%CI: 0.87-0.97) were univariate predictors. In the final model, surgery on the dominant shoulder (OR = 8.9, 95%CI 1.75-45.7) and FABQ_work subscale score ≤25 (OR = 15.3, 95%CI 2.3-101.9) remained significant. DISCUSSION Surgery on the dominant arm resulted in greater improvement in patient-reported disability, thereby increasing the odds of a successful surgery. The predictive ability of the FABQ_work subscale highlights the potential impact of psychosocial factors on patient-reported disability. Implications for Rehabilitation Impairment-based shoulder measurements were not strong predictors of patient-reported outcome. Having high fear-avoidance behavior scores on the FABQ, especially the work subscale, resulted in a much lower chance of responding well to rotator cuff surgery as measured by self-reported disability. Having surgery on the dominant shoulder, as compared to the nondominant side, resulted in larger improvements in disability levels.
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Affiliation(s)
- Jason D Woollard
- a Department of Physical Therapy , Chatham University , Pittsburgh , PA , USA
| | - James E Bost
- b Center for Outcomes and Quality Measurement , Children's Healthcare of Atlanta , GA , USA
| | - Sara R Piva
- c Department of Physical Therapy , University of Pittsburgh , Pittsburgh , PA , USA
| | - G Kelley Fitzgerald
- c Department of Physical Therapy , University of Pittsburgh , Pittsburgh , PA , USA
| | - Mark W Rodosky
- d Department of Orthopedic Surgery , University of Pittsburgh , Pittsburgh , PA , USA
| | - James J Irrgang
- c Department of Physical Therapy , University of Pittsburgh , Pittsburgh , PA , USA
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Yıldırıım MA, Uçar D, Öneş K. Comparison of therapeutic duration of therapeutic ultrasound in patients with knee osteoarthritis. J Phys Ther Sci 2015; 27:3667-70. [PMID: 26834328 PMCID: PMC4713767 DOI: 10.1589/jpts.27.3667] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/02/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of study was to compare different durations of
ultrasound in patients with knee osteoarthritis. [Subjects and Methods] One hundred
patients diagnosed with bilateral knee osteoarthritis (OA) were enrolled in this study.
Patients were divided into two groups. The first group (G1) received 4 minutes of
ultrasound. The second group (G2) received the exact same treatment, but the duration of
ultrasound was longer at 8 minutes. Patients in both groups underwent a total of 10
ultrasound over 2 weeks. Following treatment, all patients provided self-evaluations of
pain via the Visual Analog Scale (VAS), overall physical function with WOMAC, disability
via the Lequesne index (Leq), and depressive symptoms with the Beck Depression Index
(BDI). [Results] There were no significant differences in VAS, WOMAC Leq, and BDI values
between groups 1 and 2. After treatment, VAS, WOMAC, Leq, and BDI values improved for both
treatment groups. However, following treatment, G2 had significantly greater values for
WOMAC functional and total scores than G1. No statistically significant differences were
observed for VAS scores while inactive, WOMAC pain and stiffness scores, and BDI values
after treatment between both groups. VAS pain scores while active and Leq index values
were significantly lower in G1 than G2. [Conclusion] Patients in both groups demonstrated
improved functionality, pain and psychological status following a consistent, 2-week
regimen of 4-minute or 8-minute treatments with ultrasound. Yet, patients that experienced
longer treatment durations of 8 minutes demonstrated better outcomes in pain and the
ability to carry out activities of daily living.
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Affiliation(s)
| | - Demet Uçar
- Istanbul Medeniyet University Göztepe Education and Research Hospital, Turkey
| | - Kadriye Öneş
- Istanbul Physical Therapy Rehabilitation, Education and Research Hospital, Turkey
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Oh J, Yi M. Structural Equation Modeling on Quality of Life in Older Adults with Osteoarthritis. J Korean Acad Nurs 2014; 44:75-85. [DOI: 10.4040/jkan.2014.44.1.75] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jihyun Oh
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
| | - Myungsun Yi
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
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Zhao Y, Sun P, Bernauer M. Comparing common reasons for inpatient and outpatient visits between commercially-insured duloxetine or pregabalin initiators with fibromyalgia. J Pain Res 2012; 5:443-51. [PMID: 23152695 PMCID: PMC3496526 DOI: 10.2147/jpr.s35649] [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: 11/23/2022] Open
Abstract
Background The purpose of this study was to examine the main reasons for inpatient or outpatient visits after initiating duloxetine or pregabalin. Methods Commercially insured patients with fibromyalgia and aged 18–64 years who initiated duloxetine or pregabalin in 2006 with 12-month continuous enrollment before and after initiation were identified. Duloxetine and pregabalin cohorts with similar demographics, pre-index clinical and economic characteristics, and pre-index treatment patterns were constructed via propensity scoring stratification. Reasons for inpatient admissions, physician office visits, outpatient hospital visits, emergency room visits, and primary or specialty care visits over the 12 months post-index period were examined and compared. Logistic regression was used to assess the contribution of duloxetine versus pregabalin initiation to the most common reasons for visits, controlling for cross-cohort differences. Results Per the study design, the duloxetine (n = 3711) and pregabalin (n = 4111) cohorts had similar demographics (mean age 51 years, 83% female) and health care costs over the 12-month pre-index period. Total health care costs during the 12-month post-index period were significantly lower for duloxetine patients than for pregabalin patients ($19,378 versus $27,045, P < 0.05). Eight of the 10 most common reasons for inpatient admissions and outpatient hospital (physician office, emergency room, primary or specialty care) visits were the same for both groups. Controlling for cross-cohort differences, duloxetine patients were less likely to be hospitalized due to an intervertebral disc disorder or major depressive disorder, to have a physician office visit due to nonspecific backache/other back/neck pain (NB/OB/NP) disorder, or to go to specialty care due to a soft tissue, NB/OP/NP, or intervertebral disc disorder. However, duloxetine patients were more likely to have a primary care visit due to a soft tissue disorder, essential hypertension, or other general symptoms. Conclusion Among similar commercially insured patients with fibromyalgia who initiated duloxetine or pregabalin, duloxetine patients had significantly lower health care costs over the 12-month post-index period. The leading reasons for inpatient or outpatient visits were also somewhat different.
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Affiliation(s)
- Yang Zhao
- Eli Lilly and Company, Indianapolis, IN, USA
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Harris ML, Loxton D, Sibbritt DW, Byles JE. The relative importance of psychosocial factors in arthritis: findings from 10,509 Australian women. J Psychosom Res 2012; 73:251-6. [PMID: 22980528 DOI: 10.1016/j.jpsychores.2012.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 06/19/2012] [Accepted: 06/19/2012] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the relative importance of psychosocial factors in arthritis diagnosis in an ageing cohort of Australian women. METHODS This study focused on 10,509 women from the 1946-1951 cohort who responded to questions on arthritis in the fifth mailed population-based survey of the Australian Longitudinal Study on Women's Health conducted in 2007. RESULTS Arthritis was characterised by widespread psychosocial concerns, particularly relating to chronic stress and poor mental health. Univariate analyses revealed that in comparison to women without stress, women with moderate/high stress levels had a 2.5-fold increase in reporting arthritis. Experiencing ongoing negative interpersonal life events concerning illness of a family member/close friend and relationship difficulties was also associated with a 1.4-fold increase in the reporting of arthritis. Likewise, significantly reduced levels of optimism and perceived social support were noted (all associations p<.001). Psychiatric diagnosis was also associated with a two-fold increase in having arthritis (p<.001). Following adjustment for behavioural, demographic and health-related characteristics, anxiety was the only psychosocial factor associated with arthritis (OR=1.4, 95% CI=1.2, 1.7; p<.001). CONCLUSION This study examined, epidemiologically, the relative importance of psychosocial factors in arthritis in an ageing cohort of Australian women. The findings from this population-based study indicate that women with arthritis are more likely to report a range of psychosocial-related problems, particularly with regard to chronic stress perception and anxiety. Longitudinal analyses are required to examine the processes by which stress and psychosocial factors may contribute to arthritis risk and poor adaptation in terms of health-related quality of life.
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Affiliation(s)
- Melissa L Harris
- Priority Research Centre for Gender, Health and Ageing, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
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Batmaz İ, Sarıyıldız MA, Dilek B, Bez Y, Karakoç M, Çevik R. Sleep quality and associated factors in ankylosing spondylitis: relationship with disease parameters, psychological status and quality of life. Rheumatol Int 2012; 33:1039-45. [PMID: 22940709 DOI: 10.1007/s00296-012-2513-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 08/23/2012] [Indexed: 12/18/2022]
Abstract
The aim of this study is to investigate sleep quality in patients with ankylosing spondylitis (AS) and to evaluate the relationship of the disease parameters with sleep disturbance. Eighty AS patients (60 males and 20 females) fulfilling the modified New York criteria, and 52 age- and gender-matched controls (33 males and 19 females) were enrolled in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured by visual analogue scale. The disease activity and functional status were assessed by the Bath AS disease Activity Index and the Bath AS Functional Index. The Bath AS Metrology Index was used to evaluate mobility restrictions, and the Bath AS Radiology Index was employed to evaluate the radiological damage. The psychological status and quality of life were assessed with the hospital anxiety-depression scale and AS quality of life scale. The patients with AS had significantly more unfavourable scores in the subjective sleep quality, habitual sleep efficiency domains (p < 0.001) and the total PSQI score (p < 0.05). Poor sleep quality (total PSQI score) was positively correlated with increased pain, poor quality of life, higher depressed mood, higher disease activity and mobility restrictions. Pain was also an independent contributor to poorer sleep quality (p = 0.002). The sleep quality is disturbed in patients with AS. The lower quality of sleep is greatly associated with the pain, disease activity, depression, quality of life and increased limitation of mobility.
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Affiliation(s)
- İbrahim Batmaz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University School of Medicine, Diyarbakır, Turkey.
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Santos EBD, Quintans Junior LJ, Fraga BP, Macieira JC, Bonjardim LR. Avaliação dos sintomas de ansiedade e depressão em fibromiálgicos. Rev Esc Enferm USP 2012; 46:590-6. [DOI: 10.1590/s0080-62342012000300009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 09/29/2011] [Indexed: 11/22/2022] Open
Abstract
Este estudo teve como objetivo identificar a frequência de sintomas ansiosos e depressivos verificando a associação entre a ansiedade-traço, sintomas atuais de depressão e ansiedade nos fibromiálgicos. Foram entrevistados 60 sujeitos com diagnóstico de fibromialgia no Ambulatório de Reumatologia da Universidade Federal de Sergipe, entre agosto de 2007 a março de 2008, sendo aplicados dois questionários: Escala Hospitalar de Ansiedade e Depressão (EHAD) e o Inventário de Ansiedade Traço-Estado (IDATE-T). A frequência de sintomas depressivos e ansiosos foi, respectivamente, de 50% e 86% para os fibromiálgicos e a média do escore do traço ansioso foi de 59,38. Detectou-se associação entre a ansiedade-traço e estado. A ansiedade e a depressão foram sintomas frequentes nos pacientes com fibromialgia. Entretanto, a ansiedade revelou-se um sintoma secundário mais frequente que a depressão, apresentando-se uma forma mais grave, sendo uma comorbidade que deve ser melhor valorizada e estudada.
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Falsarella GR, Coimbra IB, Neri AL, Barcelos CC, Costallat LTL, Carvalho OMF, Coimbra AMV. Impact of rheumatic diseases and chronic joint symptoms on quality of life in the elderly. Arch Gerontol Geriatr 2012; 54:e77-82. [DOI: 10.1016/j.archger.2011.06.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 06/26/2011] [Accepted: 06/27/2011] [Indexed: 10/17/2022]
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Ulus Y, Tander B, Akyol Y, Durmus D, Buyukakıncak O, Gul U, Canturk F, Bilgici A, Kuru O. Therapeutic ultrasound versus sham ultrasound for the management of patients with knee osteoarthritis: a randomized double-blind controlled clinical study. Int J Rheum Dis 2012; 15:197-206. [PMID: 22462424 DOI: 10.1111/j.1756-185x.2012.01709.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIM The aim of this trial was to evaluate the short-term effectiveness of ultrasound (US) therapy on pain, physical function, ambulation activity, disability and psychological status in patients with knee OA. METHODS Forty-two inpatients with bilateral knee OA were randomized by an independent researcher not involved in the data assessment, to receive either therapeutic continuous US (group 1) or sham US (group 2). A 1-MHz US head was used, set to an intensity of 1 W/cm(2) for 10 min. All patients received 20 min of hot packs, 10 min of interferential current, and 15 min of quadriceps isometric exercise of both knees. Patients in each group received treatments five times weekly for 3 weeks. Patients were evaluated at baseline and at the end of the treatment sessions. Outcome measures included visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 50-m walking speed, Lequesne index, Hospital Anxiety and Depression Scale (HADS). RESULTS The patients with knee OA had significant improvements in pain, stiffness, functional activity, walking time, disability, depression and anxiety scores with therapeutic US and sham US (P < 0.05). The improvement in pain VAS scores, WOMAC scores, Lequesne index and HADS scores were not significantly different in patients treated with US and sham US (P > 0.05). No side-effects were reported during or after the US treatment periods. CONCLUSION US therapy is safe but use of US in addition to conventional physical therapy programs seems to have no further significant effect in people with knee OA.
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Affiliation(s)
- Yasemin Ulus
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Psychological Status in Moroccan Patients With Ankylosing Spondylitis and Its Relationships With Disease Parameters and Quality of Life. J Clin Rheumatol 2011; 17:424-8. [DOI: 10.1097/rhu.0b013e31823a498e] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Ho RCM, Fu EHY, Chua ANC, Cheak AAC, Mak A. Clinical and psychosocial factors associated with depression and anxiety in Singaporean patients with rheumatoid arthritis. Int J Rheum Dis 2011; 14:37-47. [PMID: 21303480 DOI: 10.1111/j.1756-185x.2010.01591.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To assess the frequency of, and factors associated with, depression and anxiety in Singaporean patients with rheumatoid arthritis (RA). METHOD One hundred RA patients were recruited in a cross-sectional study. Socio-demographics, severity of anxiety and depression, disease activity, levels of serological markers and health-related quality of life were analyzed. RESULTS Twenty-six percent presented with anxiety, 15% with depression and 11% with both. Univariate regression showed that age (P = 0.039), Disease Activity Scale (DAS-28) (P < 0.001), number of medications (P < 0.001) and rheumatoid factor (RF) (P < 0.001) were positively associated with severity of depression, while income (P = 0.001), education (P = 0.029), self-perceived social support (P = 0.007), Short form 12 (SF-12) physical health (P < 0.001) and SF-12 mental health (P < 0.001) were negatively associated with severity of depression. After adjustment for confounding factors in multivariate regression, income (β = -0.347, P = 0.018), RF (β = 0.304, P = 0.043) and SF-12 mental health (β = -0.501 P = 0.001) remained significantly associated with depression. Univariate regression showed that DAS-28 (P = 0.009), number of medications (P = 0.004) and RF (P = 0.043) were positively associated with anxiety, while income (P = 0.022), self-perceived social support (P = 0.04), SF-12 physical health (P < 0.001) and SF-12 mental health (P < 0.001) were negatively associated with anxiety. After adjustment for confounding factors, no factors remained significantly associated with anxiety. CONCLUSION Low income, high levels of RF and poor mental health were associated with depression in RA. Our findings may help to formulate depression screening strategies. Further research is required to identify the role of RF in depression.
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Affiliation(s)
- Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Godha D, Shi L, Mavronicolas H. Association between tendency towards depression and severity of rheumatoid arthritis from a national representative sample: the Medical Expenditure Panel Survey. Curr Med Res Opin 2010; 26:1685-90. [PMID: 20455827 DOI: 10.1185/03007991003795808] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The association between RA and depression has been well documented but so far there is not much research at a national level and none using a quick classification system of RA. The purpose of this study is to further determine if this association varies by differing severity in functional status of RA patients. METHODS This study involved a retrospective pooled cross-sectional analysis of the Household Component of Medical Expenditure Panel Survey (MEPS) for the years 2004-2006. Each year's medical conditions file was merged with the person-level consolidated file. A total of 289 individuals comprised the final adult sample of RA and related diseases. RA cases were classified into four classes of functional status according to the ACR classification criteria. Tendency towards depression was ascertained by Patient Health Questionnaire (PHQ-2) scores with scores greater than or equal to three classified as high tendency towards depression. Multivariate logistic regression with survey weights was done using SAS 9.1. RESULTS After controlling for other relevant factors, patients belonging to Class III RA were 5.92 times more likely and those belonging to Class II RA were 3.78 times more likely to have high tendency towards depression as compared to Class I RA patients. Older age groups (>or=68 years) and physical activity were other significant predictors but in a negative direction, whereas a co-morbidity index of two showed a significant positive association. CONCLUSION The study provides important evidence that in a nationally representative sample of US non-institutionalized civilians, there is a strong association of depression to RA and related diseases by functional severity. However, the findings should be interpreted with caution because the data does not offer any information on duration in relation to PHQ-2 scores, thus making it hard to deduce if tendency towards depression was present before the diagnosis of RA. Furthermore, disease-specific and data-specific validation of the Charlson comorbidity index has not been done which leaves the possibility of residual confounding.
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Affiliation(s)
- Deepali Godha
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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Health-related quality of life and its associations with mood condition in familial Mediterranean fever patients. Rheumatol Int 2010; 31:623-8. [DOI: 10.1007/s00296-009-1334-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 12/20/2009] [Indexed: 10/20/2022]
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Boume PA, McGrowder DA. Health status of patients with self-reported chronic diseases in Jamaica. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2009; 1:356-64. [PMID: 22666724 PMCID: PMC3364682 DOI: 10.4297/najms.2009.7356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Developing countries such as Jamaica suffer increasingly from high levels of public health problems related to chronic diseases. AIMS To examine the physical health status and use a model to determine the significant predictors of poor health status of Jamaicans who reported being diagnosed with a chronic non-communicable disease. METHODS AND MATERIALS The current study extracted a sub-sample of 714 people from a larger nationally representative cross-sectional survey of 6,783 Jamaicans. A self-administered questionnaire was used to collect the data from the sample. Statistical analysis was performed using chi-square to investigate non-metric variables, and logistic regression to determine predictors of poor health status. RESULTS Approximately one-quarter 25.3%) of the sample reported that they had poor health status. Thirty-three percent of the sample indicated unspecified chronic diseases: 7.8% arthritis, 28.9% hypertension, 17.2% diabetes mellitus and 13.3% asthma. Asthma affected 47.2% of children and 23.2% of young adults. S ignificant predictors of poor health status of Jamaicans who reported being diagnosed with chronic diseases were: age of respondents, area of residence and inability to work. CONCLUSION Majority of the respondents in the sample had good health, and adults with poor health status were more likely to report having hypertension followed by diabetes mellitus and arthritis, while asthma was the most prevalent among children. Improvement in chronic disease control and health status can be achieved with improved patient education on the importance of compliance, access to more effective medication and development of support groups among chronic disease patients.
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Affiliation(s)
- Paul A. Boume
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica, W.I
| | - Donovan A. McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica, W.I
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