Resilience and health-related quality of life in patients with pulmonary diseases receiving ambulatory oxygen therapy

Background: Pulmonary diseases affect health-related quality of life (HRQoL), but there are few data on patients' adaptation to a serious illness. This study assessed resilience and its associations with HRQoL, life satisfaction, anxiety and depression in patients with pulmonary diseases receiving ambulatory oxygen therapy. Methods: In this prospective cohort study, we enrolled 42 patients with pulmonary diseases receiving ambulatory oxygen therapy. The patients completed the following questionnaires at baseline and after one and three months; the Resilience Scale-25, the Life Satisfaction Scale-4, the 15D instrument of HRQoL, the Hospital Anxiety and Depression Scale (HADS) and the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). To compare HRQoL, we recruited age- and gender-matched controls from the general population (n = 3574). The primary outcome was the proportion of patients with low resilience. Results: Half (42-48%) of the patients had low resilience, which was correlated with low HRQoL, low levels of life satisfaction and higher levels of anxiety and depression. Patients had very low HRQoL compared to controls. Dissatisfaction with life increased during the 3-months follow-up, but only a few patients had anxiety or depression. Patient satisfaction with assistive technology was high; the median QUEST 2.0 score (scale 1-5) was 4.00 at baseline, 3.92 at one month and 3.88 at three months. Conclusions: Resilience was low in half of the patients with pulmonary diseases receiving ambulatory oxygen therapy. Higher resilience was positively correlated with HRQoL and life satisfaction and negatively correlated with anxiety and depression.Peer reviewe

Association between alexithymia and substance use : A systematic review and meta-analysis

Alexithymia has been associated with substance use, but the magnitude of the association has not been evaluated and sub-group differences, if any, are unknown. The aim of this meta-analysis is to systematically review the association between alexithymia and substance use (alcohol or illicit drugs). We identified studies through a systematic review of PubMed and Web of Science and obtained a total of 52 publications using the Toronto Alexithymia Scale-20 scale. Random effects meta-analysis was used to evaluate the overall and sub-group associations. Of the studies, 50 were cross-sectional and two longitudinal. Alexithymia was associated with any substance use (Cohen's d = 0.62, 95% confidence interval [CI] 0.49-0.76), with little difference between estimates for use of alcohol or illicit drugs. A stronger association was observed for the alexithymia dimension "Difficulty in Identifying Feelings" (d = 0.64, 95% CI = 0.47-0.81) and "Difficulty in Describing Feelings" (d = 0.44, 95% CI = 0.32-0.55) than for "Externally Oriented Thinking" (d = 0.19, 95% CI = 0.09-0.28). The association was stronger in studies with clinical patient populations (d = 0.83, 95% CI = 0.62-1.05) than in those investigating general or student populations, and in studies with a majority of male rather than female participants. These findings suggest a strong overall association between alexithymia and substance use and a very strong association among clinical patient populations. The association may be stronger with the emotion-related dimensions than with the cognition-related dimension of alexithymia. As nearly all the studies were cross-sectional, more longitudinal studies are needed.Peer reviewe

Psykiatriseen erikoissairaanhoitoon lähetettyjen potilaiden koettuun työkykyyn liittyvät tekijät

Tässä artikkelissa selvitetään psykiatrisen erikoissairaanhoidon avohoidon potilaiden koettuun työkykyyn liittyviä tekijöitä heidän ensimmäisellä hoitokäynnillään. Tutkimuksen poikkileikkausaineiston muodostavat 295 iältään 20–65-vuotiasta Kuopion psykiatrian keskuksen potilasta. Koetulla työkyvyllä tutkimuksessa tarkoitetaan potilaan itsearvioimaa kokemusta työkyvystään kolmiportaisella asteikolla 1) Täysin työkykyinen, 2) Alentunut työkyky, 3) Työkyvytön. Tutkimusajankohdan masennusoireiden vakavuus ja toimintakyvyn taso olivat selkeässä yhteydessä alentuneeksi koettuun työkykyyn ja työkyvyttömyyteen. Korkeampi ikä ja useamman kuin kahden mielenterveyden häiriön sairastaminen edeltäneen vuoden aikana olivat koetun työkyvyttömyyden ennustetekijöitä. Toistuva masennus lähetediagnoosina oli yhteydessä alentuneeksi koettuun työkykyyn. Toistuvan masennuksen työkykyä alentava vaikutus ja psyykkisen sairastamisen kasautumisen yhteys työkyvyttömyyteen korostavat ennaltaehkäisevän työn ja kuntoutuksen merkittävyyttä. Abstract This article examines factors related to subjective work ability among psychiatric outpatients in their first appointment to psychiatric special health care. Quantitative cross-sectional sample consists of 295 patients of Kuopio Psychiatric Centre, aged 20–65 years. Subjective work ability was defined using tripartite assessment of work ability ranging from 1) Full work ability, 2) Lowered work ability, 3) Inability to work. Depressive symptoms and level of functioning at the time of research were strongly related to lowered subjective work ability and subjective inability to work. Age and history of two or more previous mental illnesses were significant predictive factors to subjective inability to work. Recurrent depression as diagnose was associated with lowered work ability. Effects of recurrent depression and psychiatric comorbidity on subjective work ability emphasise the importance of preventative interventions and rehabilitation

Early maladaptive schemas in chronically depressed patients : A preliminary investigation

Background Schema therapy has been proposed as a potentially effective treatment for chronic depression. However, little is known about early maladaptive schemas (EMSs), a key concept in schema therapy, in relation to chronic depression or chronic depression with comorbid personality pathology. The aim of the present study was to compare EMSs between currently chronically depressed patients with comorbid cluster C personality disorder (CDCPD), currently chronically depressed patients (CD), and patients remitted from chronic depression (CDR). Methods Based on data from a naturalistic follow-up study on psychiatric outpatients with major depressive disorder, three groups were formed according to Diagnostic and Statistical Manual of Mental Disorders-IV: CDCPD (n = 15), CD (n = 23), and CDR (n = 13). Groups were compared in terms of background information and measurements for depression (Beck Depression Inventory) and EMSs (Young Schema Questionnaire). Results Patients with CDCPD and CD did not differ in terms of background variables or the severity of depressive symptoms, but patients with CDCPD were more maladaptive with respect to the majority of EMSs. Patients with CDR were less depressed than CDCPD or CD patients, but did not differ in terms of EMSs compared with CD patients. Conclusions Comorbid cluster C personality disorder appears to be associated with more severe EMS endorsement in chronically depressed patients. Remitted patients show similar cognitive vulnerability factors in terms of EMSs compared to those currently chronically depressed. The findings suggest that EMSs may contribute to vulnerability to chronic depression. Focusing on EMSs may be beneficial in the treatment of chronic depression.Peer reviewe

Huumeita suonensisäisesti käyttävien terveysneuvontapisteen asiakkaiden muutosvalmius ja siihen vaikuttavat tekijät

Tutkimuksessa tarkastellaan suonensisäisesti huumeita käyttävien muutosvalmiutta ja siihen liittyviä tekijöitä. Muutosvalmiudella tarkoitetaan itse ilmaistua halua ja valmiutta muuttaa huumeidenkäyttöä, toimia muutokseen eteen ja ottaa vastaan ammattiapua. Aineisto (N=99) on kerätty Kuopiossa sijaitsevassa huumeita suonensisäisesti käyttäville tarkoitetussa Terveysneuvontapiste Portissa. Muutosvalmiutta arvioitiin tätä tutkimusten varten laaditulla mittarilla, joka perustuu muutosmotivaatiota mittaavan DUDIT-E-mittarin muutosvalmiuden itsearviointiosioon. Tutkimuksessa tarkastellaan myös vastaajien elämäntyytyväisyyttä, jota arvioitiin tutkimusta varten muodostetulla elämäntyytyväisyyden summamuuttujalla. Tutkimuksessa verrattiin matalan ja korkean muutosvalmiuden ryhmiä. Tutkimukseen osallistuneiden terveysneuvontapiste Portin asiakkaiden muutosvalmius on korkealla tasolla ja suurin osa vastaajista toivoi huumeiden käyttöönsä muutosta. Muutosvalmiutta ennustivat huumeiden käytön koettu haitallisuus, myönteinen suhtautuminen ammattiapuun sekä työssä käyminen, työkokeilu tai opiskelu. Uskonnollisten yhteisöjen toimintaan osallistuminen oli myös yhteydessä korkeampaan muutosvalmiuteen. Jos potilaan muutosvalmius ja muutosta edistävät tekijät ja niiden merkitys pystyttäisiin tunnistamaan paremmin, Portin tavoin toimivat matalan kynnyksen pisteet voisivat kohdentaa tarkemmin yksilöityä neuvontaa ja ohjausta huumeita suonensisäisesti käyttäville henkilöille

Purine metabolism is dysregulated in patients with major depressive disorder

Peer reviewe

Biological and other health related correlates of long-term life dissatisfaction burden

Background Mental health is interconnected with somatic health and can manifest itself in biological processes. Life dissatisfaction is an indicator of subjective well-being, but information on its biological correlates is scarce. The aim of this study was to investigate the biological correlates along with other health-related factors of long-term life dissatisfaction in a population-based sample. Methods As part of the Kuopio Depression Study, health questionnaires were sent to a randomly selected population-based sample in 1998, 1999, and 2001. In 2005, among a clinically studied sub-sample (n = 305), the 7-year long-term life dissatisfaction burden was assessed by summing life satisfaction scores from previous health questionnaires. Several sociodemographic, health, health behavior, and biological factors were investigated in respect to their associations to categorized (low and high) and continuous (linear regression) life satisfaction burden score (higher values indicating dissatisfaction). Results In the final linear regression model long-term life dissatisfaction burden was significantly associated with poor social support (B = 0.138; p < 0.001), marital status (i.e. living alone) (B = 0.049; p = 0.019), current smoking (B = 0.087; p < 0.001), poor sleep (B = 0.052; p = 0.001), use of statins (B = −0.052; p = 0.002) and lower serum adiponectin level (B = −0.001; p = 0.039) whereas association of metabolic syndrome was marginally nonsignificant (B = 0.029; p = 0.055). Conclusion Long-term life dissatisfaction is associated with adverse health, health behavioral, and social factors, as well as with a decreased anti-inflammatory buffer capacity, all indicating close relationships between subjective well-being and somatic morbidity.BioMed Central open acces

Increased Serum PAI-1 Levels in Subjects with Metabolic Syndrome and Long-Term Adverse Mental Symptoms: A Population-Based Study

Depression is an independent risk factor for cardiovascular diseases and is associated with metabolic syndrome (MetS). Levels of plasminogen activator inhibitor-1 (PAI-1), an inhibitor of tissue-type and urokinase-type plasminogen activators, are associated with MetS. To clarify the role of PAI-1 in subjects with long-term adverse mental symptomatology (LMS; including depression) and MetS, we measured circulating PAI-1 levels in controls (n = 111), in subjects with MetS and free of mental symptoms (n = 42), and in subjects with both MetS and long-term mental symptoms (n = 70). PAI-1 increased linearly across the three groups in men. In logistic regression analysis, men with PAI-1 levels above the median had a 3.4-fold increased likelihood of suffering from the comorbidity of long-term adverse mental symptoms and MetS, while no such associations were detected in women. In conclusion, our results suggest that in men high PAI-1 levels are independently associated with long-term mental symptomatology

Global arginine bioavailability ratio is decreased in patients with major depressive disorder

Background: Major depressive disorder (MDD) is characterized by increased oxidative and nitrosative stress. We compared nitric oxide metabolism, i.e., the global arginine bioavailability ratio (GABR) and related serum amino acids, between MDD patients and non-depressed controls, and between remitted and non-remitted MDD patients. Methods: Ninety-nine MDD patients and 253 non-depressed controls, aged 20-71 years, provided background data via questionnaires. Fasting serum samples were analyzed using ultra-performance liquid chromatography coupled to mass spectrometry to determine the serum levels of ornithine, arginine, citrulline, and symmetric and asymmetric dimethylarginine. GABR was calculated as arginine divided by the sum of ornithine plus citrulline. We compared the above measures between: 1) MDD patients and controls, 2) remitted (n= 33) and non-remitted (n = 45) MDD patients, and 3) baseline and follow-up within the remitted and non-remitted groups. Results: Lower arginine levels (OR 0.98, 95% CI 0.97-0.99) and lower GABR (OR 0.13, 95% CI 0.03-0.50) were associated with the MDD vs. the non-depressed group after adjustments for potential confounders. The remitted group showed a decrease in GABR, arginine, and symmetric dimethylarginine, and an increase in ornithine after the follow-up compared with within-group baseline values. The non-remitted group displayed an increase in arginine and ornithine levels and a decrease in GABR. No significant differences were recorded between the remitted and non-remitted groups. Limitations: The MDD group was not medication-free. Conclusions: Arginine bioavailability may be decreased in MDD. This could impair the production of nitric oxide, and thus add to oxidative stress in the central nervous system.Peer reviewe