Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors

Objective Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity-a risk factor for suicidal ideation per se-could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation.Methods In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected.Results 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation.Discussion The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation

Tired of pain or so tired it hurts? Mechanisms and factors influencing the temporal relationship between insomnia and pain in adolescents

Onset of both chronic pain and insomnia is high during adolescence, a phenomenon believed to be caused by a range of biological, psychological and social factors that are unique or particularly salient during adolescence. Negative mood has been established as a salient mechanism explaining the sleep-pain relationship, but an elaborate understanding of if and how mood mediate the relationship in adolescents is lacking. The current thesis aimed to fill this gap in the literature through three empirical studies that each focused on distinct aspects of the sleep-pain relationship in adolescents. All three studies were based on a prospective dataset, consisting of 2766 adolescents followed across 5 consecutivey early measurement waves. Study I focused on how insomnia and pain longitudinally co-develop during adolescence, finding that they follow each other to a high degree among all adolescents. A late sleep phase and cognitive-emotional presleep arousal predicted steeper rate of change in insomnia and pain. Study II found a bidirectional relationship between insomnia and pain, with the effect of insomnia on pain being significantly stronger than vice versa. Depressed and anxious mood mediated the effect of insomnia on pain, but not vice versa. Study III assessed if the effect of insomnia on pain was mediated by rumination and depressed mood, and if the effect differed between girls and boys. The effect of insomnia on pain was considerably stronger in adolescent girls, compared to boys, and rumination only mediated the effect in girls, while primarily depressed mood mediated the effect in boys. Taken together, these findings have both conceptual and applied implications: the findings add to – and deepen – the understanding of how the relationship between insomnia and pain functions in adolescents. The mechanisms that were identified as mediators, as well as insomnia itself, are also highly modifiable through psychological interventions. Therefore, the findings may inform treatment strategies for adolescents with comorbid insomnia and chronic pain, as well as preventive programs for adolescents at risk for developing insomnia and/or pain

Tired of pain or so tired it hurts? Mechanisms and factors influencing the temporal relationship between insomnia and pain in adolescents

Onset of both chronic pain and insomnia is high during adolescence, a phenomenon believed to be caused by a range of biological, psychological and social factors that are unique or particularly salient during adolescence. Negative mood has been established as a salient mechanism explaining the sleep-pain relationship, but an elaborate understanding of if and how mood mediate the relationship in adolescents is lacking. The current thesis aimed to fill this gap in the literature through three empirical studies that each focused on distinct aspects of the sleep-pain relationship in adolescents. All three studies were based on a prospective dataset, consisting of 2766 adolescents followed across 5 consecutivey early measurement waves. Study I focused on how insomnia and pain longitudinally co-develop during adolescence, finding that they follow each other to a high degree among all adolescents. A late sleep phase and cognitive-emotional presleep arousal predicted steeper rate of change in insomnia and pain. Study II found a bidirectional relationship between insomnia and pain, with the effect of insomnia on pain being significantly stronger than vice versa. Depressed and anxious mood mediated the effect of insomnia on pain, but not vice versa. Study III assessed if the effect of insomnia on pain was mediated by rumination and depressed mood, and if the effect differed between girls and boys. The effect of insomnia on pain was considerably stronger in adolescent girls, compared to boys, and rumination only mediated the effect in girls, while primarily depressed mood mediated the effect in boys. Taken together, these findings have both conceptual and applied implications: the findings add to – and deepen – the understanding of how the relationship between insomnia and pain functions in adolescents. The mechanisms that were identified as mediators, as well as insomnia itself, are also highly modifiable through psychological interventions. Therefore, the findings may inform treatment strategies for adolescents with comorbid insomnia and chronic pain, as well as preventive programs for adolescents at risk for developing insomnia and/or pain

Do both the research community and the general public share an interest in the sleep–pain relationship, and do they influence each other?

Introduction: Chronic pain and sleep disturbance bidirectionally influence each other in a negative spiral. Although this academic knowledge is known by researchers, it is imperative to bridge it over to the general public because of its applied implications. However, it is unclear how academia and the general public reciprocally shape each other in terms of knowledge of the sleep–pain relationship. The purpose of this study was (1) to assess the longitudinal trajectories of research on the sleep–pain relationship and the general public’s interest in this topic and (2) to examine whether the academic interest leads to the general public’s interest, or vice versa. Methods: We used a Big Data approach to gather data from scientific databases and a public search engine. We then transformed these data into time trends, representing the quantity of published research on, and the general public’s interest in, the sleep–pain relationship. The time trends were visually presented and analyzed via dynamic structural equation modeling. Results: The frequency of both published articles and searches soared after 2004. Published research leads to an increased interest in the sleep–pain relationship among the general public but does not predict more published articles. Furthermore, the general public’s interest reinforces itself over time but does not predict published research. Conclusion: These results are encouraging because it is essential for research on the sleep–pain relationship to reach a broader audience, beyond the walls of academia. However, to prevent a potential alienation between academic and practical knowledge, we encourage openness among researchers to being inspired by the general public’s knowledge of the sleep–pain relationshi

Protective health behaviors and fear of social isolation during the COVID-19 pandemic : a public opinion perspective

When coronavirus disease (COVID-19) news along with protective health recommendations first came to people’s life, such ambiguous information became a public opinion. Performing protective behaviors can be regarded as an approval of the majority opinion as people have to alter their established health positions and practices. So far, the association between public opinion and protective health behaviors is unclear especially in the pandemic context. This study utilized a survey data collected between 1 and 10 April 2020 in Germany (n = 101), Austria (n = 261), Switzerland (n = 26), and China (n = 267). We compared the protective health behaviors between the Chinese and European participants, as well as examined the associations between the protective health behaviors, peer influence, and fear of social isolation. Protective health behaviors were found similar between Chinese and European participants, although being independent from peer influence and fear of social isolation were related to protective health behaviors in the Chinese sample. Our cross-national findings are consistent with previous studies, suggesting that both official and unofficial health communication show stronger influences in Asian populations. Findings from this study provide advice for public communication strategies to promote protective health behaviors during pandemics

Safety of and response to electroconvulsive therapy during pregnancy: Results from population‐based nationwide registries

Introduction: Psychiatric disorders are common during pregnancy, affectingup to 16% of pregnant women. Severe depression and anxiety have significantnegative effects on the health of both the mother and the developing fetus.Electroconvulsive therapy (ECT) is considered a treatment option for pregnantwomen with severe psychiatric disorders when other treatments have beenineffective or pose risks to the fetus. Knowledge of the safety and efficacy ofECT during pregnancy, however, remains limited. Methods: Data were obtained from nationwide registries of pregnant womenin Sweden who received ECT for a severe psychiatric disorder from January2008 to December 2021. ECT-related outcomes in pregnant women were com-pared by propensity score matching with a group of non-pregnant women whoalso received ECT. Pregnancy-related outcomes were compared with two addi-tional control groups: one consisting of the same group of women who did notreceive ECT during another pregnancy and the other composed of pregnantwomen admitted to inpatient psychiatric care but who did not receive ECT,matched based on propensity score. Results: Ninety-five pregnant women received ECT during the study period,accounting for 97 pregnancies. The response rate to ECT in pregnant women(n=54) was similar to the matched control group of non-pregnant women(74% vs. 65%; OR 1.61; 95% CI 0.79–3.27). Rates of adverse events related toECT were similar to those in the control group. There were no pre-term birthsor severe adverse outcomes related to the pregnancy, that were close in time toECT. Therefore, no adverse outcomes related to pregnancy and childbirthcould be directly attributed to ECT. The likelihood of premature birth and a5-min Apgar score <7 in the newborn were both significantly higher in theECT group, compared with the matched non-ECT group (OR 2.33, 95% CI1.15–4.73,p=0.008, and OR 3.68, 95% CI 1.58–8.55,p< 0.001, respectively).By contrast, no significant differences were observed when women in the pregnant ECT group were compared with the same group lacking ECT duringanother pregnancy. Conclusions: ECT was associated with a positive treatment response in preg-nant women with severe psychiatric disorders. The response rate to ECT wassimilar in pregnant and non-pregnant women. Nevertheless, the risks of pre-mature birth and of a slightly poorer condition in newborns were higher inwomen who did than did not receive ECT, emphasizing the need for increasedattention to severe psychiatric disorders during pregnancy

Posttraumatic Stress among women with HIV in Zambia

Objective: To examine whether HIV-positive women in Lusaka District, Zambia, displays a higher degree of PTSD-symptoms than a HIV-negative control group. Method: The study targeted 50 HIV-positive women from four ART-clinics and 42 HIV-negative women from corresponding VCT-units. All sites were located in Lusaka District, Zambia. The HIV-positive women were compared with the control group in regard for PTSD, PTSD-symptoms, dissociative symptoms and history of traumatic experiences. The instruments used were PCL-C, DES-T and LYLES-A. Prior to the main study, the validity of the instruments were assessed with a pilot-sample. Results: Three participants in the HIV-positive group fulfilled the criteria for clinical PTSD (10.7 %), as compared to none in the control group. The HIV-positive group also displayed a significantly higher degree of PTSD-symptoms and previous traumatic experiences, with strong effect sizes, but not for dissociative symptoms. The significant difference in PTSD-symptoms remained while trauma-history was controlled for. Conclusions: The results of this study clearly indicates that women with HIV are vulnerable to PTSD and that contracting HIV in itself can constitute a psychological trauma in itself. Since PTSD among persons with HIV has been associated with transmission risk behaviours, reduced treatment adherence and a faster disease progression, these findings are important to consider in actions against HIV and AIDS. Funding Agency:Office of Global AIDS/US Department of State</p

Longitudinal, bidirectional relationships of insomnia symptoms and musculoskeletal pain across adolescence

Previous studies have established a bidirectional relationship between sleep and pain, and mood has been proposed as a mediator of this relationship. There are only a limited number of longitudinal studies examining the mediational role of mood, and the directionality of effects between sleep, pain and mood is uncertain. Also, and despite the high prevalence of pain and sleep problems during adolescence, these relationships have rarely been examined in a longitudinal sample of adolescents. Here, longitudinal survey data with five yearly measurements was used to examine the bidirectional relationship between insomnia symptoms and pain across adolescence (Mbaseline age = 13.65 years, Nbaseline = 2766). We also explored if depressed mood, positive affect and anxious mood function as mediators in both directions of the sleep-pain relationship. Utilizing latent variables for insomnia, pain and mood at multiple time-points, the data was analyzed with cross-lagged panel models for longitudinal data with structural equation modeling. Current results confirmed a bidirectional relationship between insomnia symptoms and pain, where the effect of insomnia symptoms on pain was stronger than vice versa. Depressed mood and anxious mood mediated the effect of insomnia symptoms on pain, but not the reverse effect of pain on insomnia symptoms. Positive affect did not serve as a mediator in either direction. These findings add novel insights into the temporal directionality of sleep, pain and mood during adolescence, suggesting a temporal path from sleep to pain, via mood, rather than a reciprocal relationship between the constructs.Funding agency:Regional Ethics Board of Uppsala 2013/384 </p