Poor quality of life and sleep in patients with adrenal insufficiency—another cause of increased mortality?

Abstract Background Patients with adrenal insufficiency (AI) are treated with glucocorticoid replacement therapy (GRT). Although current glucocorticoid regimens aim to mimic the physiological circadian rhythm of cortisol secretion, temporary phases of hypo- and hypercortisolism are common undesired effects which lead to a variety of consequences like increased cardiovascular risk and premature mortality. Additionally, poor quality of life (QoL) and impaired sleep have been reported. However, little is known about these topics regarding the effects of daily dosage, duration of therapy, and patients with different forms of AI (primary, PAI, and secondary, SAI). Methods In this study, 40 adults with AI substituted with hydrocortisone (HC) and 20 matched healthy controls completed questionnaires evaluating depressive symptoms, subjective health status, quality of sleep and daytime sleepiness. Furthermore, demographic data, dosage of HC, duration of therapy and co-medication were evaluated. Patients were compared in different groups. Results Patients assessed general health significantly worse than controls; likewise, daytime sleepiness was reported significantly more often. Depressive symptoms differed significantly in the two groups but did not reach clinically relevant scores. There was no difference between patients with PAI and SAI. High dosage of hydrocortisone had negative impact on mental health but not on sleep quality or daytime sleepiness. Conclusions The present data highlight that poor QoL and impaired sleep are still severe and underrated issues in current GRT and might be additional factors for premature mortality in patients with AI. Some AI patients reach normal or near-normal self-assessed QoL and sleep, even despite unphysiological replacement.

Download Full-text

Influence of Sleep Disturbances on Quality of Life of Iranian Menopausal Women

Psychiatry Journal ◽

10.1155/2013/907068 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Zohreh Yazdi ◽

Khosro Sadeghniiat-Haghighi ◽

Amir Ziaee ◽

Khadijeh Elmizadeh ◽

Masomeh Ziaeeha

Keyword(s):

Quality Of Life ◽

Daytime Sleepiness ◽

Sleep Disturbances ◽

Negative Impact ◽

Berlin Questionnaire ◽

Life Questionnaire ◽

Cross Sectional ◽

Obstructive Sleep ◽

Menopausal Women

Background. Subjective sleep disturbances increase during menopause. Some problems commonly encountered during menopause, such as hot flushes and sweating at night, can cause women to have difficulty in sleeping. These complaints can influence quality of life of menopausal women.Methods. This cross-sectional study was performed on menopausal women attending health centers in Qazvin for periodic assessments. We measured excessive daytime sleepiness by Epworth sleepiness scale (ESS), obstructive sleep apnea (OSA) by the Berlin questionnaire, and insomnia by the insomnia severity index (ISI). We evaluate quality of life by the Menopause specific quality of life questionnaire (MENQOL).Results. A total of 380 menopausal women entered the study. Mean age of participated women was 57.6 ± 6.02. Mean duration of menopause was 6.3 ± 4.6. The frequency of severe and moderate insomnia was 8.4% (32) and 11.8% (45). Severe daytime sleepiness (ESS ≥ 10) was present in 27.9% (80) of the participants. Multivariate analytic results show that insomnia and daytime sleepiness have independent negative impact on each domain and total score of MENQOL questionnaire.Conclusion. According to our findings, EDS and insomnia are frequent in menopausal women. Both EDS and insomnia have significant quality of life impairment.

Download Full-text

Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

International Psychogeriatrics ◽

10.1017/s1041610220000782 ◽

2020 ◽

Vol 32 (7) ◽

pp. 849-861

Author(s):

Darina V. Petrovsky ◽

Karen B. Hirschman ◽

Miranda Varrasse McPhillips ◽

Justine S. Sefcik ◽

Alexandra L. Hanlon ◽

...

Keyword(s):

Quality Of Life ◽

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Daytime Sleepiness ◽

Daily Living ◽

Services And Supports ◽

Over Time

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

Download Full-text

The Prevalence of Insomnia Symptoms and Its Association With Quality of Life Among Clinically Stable Older Patients With Psychiatric Disorders in China During the COVID-19 Outbreak

10.21203/rs.3.rs-95735/v1 ◽

2020 ◽

Author(s):

Xiuying Xu ◽

Wen Li ◽

Siyun Zou ◽

Yulong Li ◽

Huan Wang ◽

...

Keyword(s):

Quality Of Life ◽

Logistic Regression ◽

Regression Analysis ◽

Depressive Symptoms ◽

Older Patients ◽

Negative Impact ◽

Psychiatric Patients ◽

Analysis Of Covariance ◽

Insomnia Symptoms

Abstract Aims: The negative impact of the COVID-19 outbreak on sleep quality of clinically stable psychiatric patients is unknown. This study examined the prevalence of insomnia symptoms and its association with quality of life (QOL) in clinically stable older psychiatric patients during the COVID-19 outbreak. Methods: This multicenter, cross-sectional study involved older patients attending maintenance-treatment at the outpatient departments of four major psychiatric hospitals in China. Patients’ basic socio-demographic and clinical characteristics were collected. Insomnia symptoms, depressive symptoms, and QOL were assessed with the Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), and two items of the World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. Binary logistic regression analysis was conducted to examine the independent associations of socio-demographic and clinical variables with insomnia symptoms, while the association between insomnia symptoms and QOL was examined with analysis of covariance.Results: A total of 941 patients were recruited. The prevalence of insomnia symptoms was 57.1% (95% CI: 53.9-60.2%). Analysis of covariance revealed that QOL was significantly lower in patients with insomnia symptoms compared to those without them (P<0.01). Multivariate logistic regression analysis showed that insomnia symptoms were positively and independently associated with more severe depressive symptoms (P<0.01, OR=1.31, 95%CI: 1.26-1.37). Compared to patients with major depressive disorder, those with other psychiatric diagnoses had significantly higher prevalence of insomnia symptoms (P=0.03, OR=1.47, 95%CI: 1.02-2.12).Conclusions: Insomnia symptoms were common among clinically stable older psychiatric patients during the COVID-19 outbreak. Considering their negative impact on QOL, regular assessment and treatment of insomnia symptoms need to be addressed in this population.

Download Full-text

Anxiety: a hidden element in dementia

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.110.008458 ◽

2012 ◽

Vol 18 (2) ◽

pp. 119-128 ◽

Cited By ~ 9

Author(s):

Vellingiri Raja Badrakalimuthu ◽

Andrew F. Tarbuck

Keyword(s):

Quality Of Life ◽

Cognitive Impairment ◽

Anxiety Disorders ◽

Old Age ◽

Negative Impact ◽

Poor Quality ◽

Therapeutic Options ◽

Prevalence Rates ◽

People With Dementia

SummaryAnxiety has reported prevalence rates between 38 and 72% among people with dementia. It has a negative impact on cognitive impairment and is associated with agitation and poor quality of life. The presence of excessive anxiety can be difficult to establish in people with dementia, especially when expressive or receptive speech is impaired. Unfortunately, there is a lack of research on the treatment of anxiety in dementia, and also on the wider issue of the management of anxiety disorders in old age. We explore the prevalence, presentation and diagnosis of anxiety in dementia and discuss the therapeutic options available.

Download Full-text

Depressive symptoms and perception of quality of life in Parkinson's disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000200006 ◽

2009 ◽

Vol 67 (2a) ◽

pp. 203-208 ◽

Cited By ~ 24

Author(s):

Paula Scalzo ◽

Arthur Kummer ◽

Francisco Cardoso ◽

Antonio Lucio Teixeira

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Depressive Symptoms ◽

Well Being ◽

Poor Quality ◽

Life Questionnaire ◽

Perception Of Quality ◽

The Relationship

BACKGROUND: Depression has been proposed as a major contributor to poor quality of life (QoL) in Parkinson's disease (PD). OBJECTIVE: To evaluate the relationship between depressive symptoms and QoL in subjects with PD. METHOD: Beck Depression Inventary (BDI) was used to evaluate depressive symptoms and Parkinson's Disease Quality of Life Questionnaire (PDQ-39) to assess the perception of the QoL. RESULTS: Thirty seven patients (19 male/ 18 female) with a typical onset PD and mean disease duration of 7.7 years were studied. Higher scores on BDI correlated with poorer perception of the QoL. This association occurred at the expense of the following PDQ39 domains: mobility, activities of daily living, social support, cognition and emotional well-being dimensions. PD severity also correlated with QoL. CONCLUSION: Our study corroborates the assumption that depressive symptoms contributed significantly to QoL in PD.

Download Full-text

Differential illness intrusiveness associated with sleep-promoting medications

European Psychiatry ◽

10.1016/0924-9338(96)80097-6 ◽

1995 ◽

Vol 10 (S3) ◽

pp. 153s-159s ◽

Cited By ~ 10

Author(s):

GM Devins ◽

M Flanigan ◽

JAE Fleming ◽

R Morehouse ◽

A Moscovitch ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Emotional Distress ◽

Daytime Sleepiness ◽

Psychosocial Outcomes ◽

Self Report ◽

Illness Intrusiveness ◽

Psychiatric Units ◽

Long Acting

SummaryDifferences in daytime sleepiness, lifestyle disruptions, and emotional distress were compared across nine groups taking sleep-promoting substances. Groups included individuals taking zopiclone (n = 274), amitriptyline (n = 107), lorazepam (n = 258), oxazepam (n= 141), diphenhydramine HCl (n = 99), triazolam(n = 137), long acting benzodiazepines (n = 120), temazepam (n = 176), and miscellaneous other medications (n = 286). Data were gathered by self-report, using standardized instruments in a mail-back questionnaire procedure. Respondents included the first 1,598 participants enrolled in a Canadian multicentre project, including six sites attached to academic psychiatric units. Results indicated that quality of life effects differed across groups in both daytime sleepiness and lifestyle disruptions (illness intrusiveness), but not in depressive symptoms. Daytime sleepiness was significantly higher among people taking diphenhydramine HCl as compared to temazepam, zopiclone, lorazepam, and oxazepam. Illness intrusiveness was significantly higher among patients taking amitriptyline as compared to those taking triazolam, oxazepam, long-acting benzodiazepines, and zopiclone. It may be useful to inform patients of differences in psychosocial outcomes when prescribing hypnotic medications.

Download Full-text

Neuro-Psychiatric Disorders: From Diagnosis to Care

Diseases ◽

10.3390/diseases7030048 ◽

2019 ◽

Vol 7 (3) ◽

pp. 48

Author(s):

Omar Cauli

Keyword(s):

Quality Of Life ◽

Psychiatric Disorders ◽

Premature Mortality ◽

Poor Quality

Neuro-psychiatric disorders are an important cause of poor quality of life, disability, and premature mortality [...]

Download Full-text

The influence of frailty syndrome on quality of life in elderly patients with type 2 diabetes

Quality of Life Research ◽

10.1007/s11136-021-02829-x ◽

2021 ◽

Author(s):

E. Bąk ◽

A. Młynarska ◽

C. Marcisz ◽

R. Bobiński ◽

D. Sternal ◽

...

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Depressive Symptoms ◽

Negative Impact ◽

Depression Symptoms ◽

Frailty Syndrome ◽

Polish Version ◽

The Impact

Abstract Introduction There have been no comprehensive studies that assess the impact of frailty syndrome on quality of life (QoL) of patients with diagnosed type 2 diabetes. The purpose of the study was to assess the impact of frailty syndrome on QoL and depression symptoms of patients with type 2 diabetes. Methods The study included 148 consecutive patients (aged ≥ 60y). The patients were divided into two groups according to the prevalence of the frailty syndrome: robust and frailty. For all of the patients that were included in the study, we used the Polish version of validated instruments: ADDQoL, TFI and BDI. Results In the study group, 43.2% had been diagnosed with frailty syndrome. An analysis of QoL assessment depending on the prevalence of the frailty syndrome showed that patients who were robust (without recognized frailty syndrome) assessed QoL significantly better than patients with coexisting frailty syndrome. Robust patients did not have any severe depressive symptoms, whereas in the group of patients with the frailty syndrome 43.8% of the patients had a depression. 70.2% of the patients without any depressive symptoms were robust patients, meanwhile only 14% of the patients had frailty syndrome recognized. Conclusions Frailty syndrome occurred in 43 percent of the patients with type 2 diabetes. This has a negative impact on QoL of patients. Depression is more common in patients with the frailty syndrome and diabetes.

Download Full-text

Reduced Quality of Life and Sexual Satisfaction in Isolated Hypogonadotropic Hypogonadism

Journal of Clinical Medicine ◽

10.3390/jcm10122622 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2622

Author(s):

Małgorzata Kałużna ◽

Pola Kompf ◽

Michał Rabijewski ◽

Jerzy Moczko ◽

Jarosław Kałużny ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Sexual Satisfaction ◽

Negative Impact ◽

Hormone Replacement ◽

Hypogonadotropic Hypogonadism ◽

Compliance Rate ◽

Depression Scale ◽

High Rate

(1) Background: Isolated hypogonadotropic hypogonadism (IHH) is a genetic condition characterized by impaired puberty and fertility. IHH can significantly impact patient health-related quality of life (HRQoL), sexual satisfaction (SS) and mood. (2) Methods: Participants included 132 IHH subjects (89 men and 43 women) and 132 sex- and age-matched controls. HRQoL, depressive symptoms, erectile dysfunction (ED), and SS were assessed in an online survey using the Zung Self-Rating Depression Scale (SDS), 15D instrument of HRQoL (15D), Sexual Satisfaction Questionnaire (SSQ), and 5-item International Index of Erectile Function (IIEF-5). (3) Results: QoL and SS were significantly lower in the IHH group vs. controls. There was a high rate of ED (53.2% vs. 33%, p = 0.008) and depressive symptoms (45.00 ± 17.00 vs. 32.00 ± 12.00, p < 0.001) in patients vs. controls. The age of patients at IHH diagnosis inversely correlated with their overall 15D scores. An alarming non-compliance rate was seen (51.6%). No differences were found between scores of patients receiving hormone replacement therapy (HRT) and untreated subjects in any of the scales. (4) Conclusions: The HRQoL, SS, ED, and depression levels observed in IHH patients, despite HRT, are alarming. Late IHH diagnosis may have a particularly negative impact on HRQoL. More attention should be devoted to HRT adherence and various HRQoL aspects of IHH patients.

Download Full-text

Impact on Quality of Life of Oral Diseases Related to Stress

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.2020.40293 ◽

2020 ◽

pp. 239-249

Author(s):

Diana I. Rivera-Reza DDS ◽

María C. Villanueva-Vilchis DDS, MSc, PhD ◽

Luis A. Gaitán-Cepeda DDS, MSc, PhD

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Oral Mucosa ◽

Negative Impact ◽

Health Impact ◽

Poor Quality ◽

Oral Diseases ◽

And Gender ◽

The One

It has been suggested that oral mucosa diseases related to stress have a negative impact on the quality of life. However, the information regarding which aspects are the most affected is inconclusive. The objective was to compare the quality of life associated with oral health in two groups: Cases formed by 21 patients coming from a teaching clinic, suffering oral lichen planus, recurrent aphthous stomatitis, and burning mouth syndrome; Control formed by 42 healthy subjects matched for age and gender. Oral Health Impact Profile questionnaire was applied. Statistical analysis showed that group Cases has worse quality of life (p 0.03) than the one of controls, specifically on psychological discomfort (p 0.027), physical disability (p 0.004); and handicap dimensions (p 0.002; RM 5.63 IC1.58-20.80). It was concluded that patients suffering oral mucosa disease related to stress showed poor quality of life.

Download Full-text