Coexisting medical comorbidity and depression: Multiplicative effects on health outcomes in older adults

2014 ◽  
Vol 26 (7) ◽  
pp. 1221-1229 ◽  
Author(s):  
Cyrus SH Ho ◽  
Liang Feng ◽  
Johnson Fam ◽  
Rathi Mahendran ◽  
Ee Heok Kua ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Short Form ◽  
Medical Comorbidity ◽  
Cross Sectional ◽  
Increased Risk ◽  
Multiplicative Effects ◽  
Longitudinal Relationships

ABSTRACTBackground:Depression in the elderly is often associated with coexisting medical illnesses. We investigated the individual and combined impacts of depression and medical illnesses on disability and quality of life among community-living older persons.Methods:Cross-sectional and longitudinal analyses of data from 1,844 participants aged 55 and above of the Singapore Longitudinal Aging Study (SLAS-1). Baseline depressive symptoms (Geriatric Depressive Scale, GDS≥5) and chronic medical comorbidity (≥2) from self-reports were related to baseline and 2-year follow up instrumental and basic activities of daily living (IADL-BADL), and quality of life (Medical Outcomes Study 12-item Short Form (SF-12) physical component summary (PCS) and mental component summary (MCS) scores.Results:The prevalence of depressive symptoms was 11.4%. In main effect analyses of cross-sectional and longitudinal relationships, depression and medical comorbidity were individually associated with higher risk of IADL-BADL disability and lower PCS and MCS scores of quality of life, and only medical comorbidity was associated with increased risk of hospitalization. Significant interactive effects of depression and medical comorbidity were observed in longitudinal relationships with IADL-BADL disability (p = 0.03), PCS (p < 0.01), and MCS (p < 0.01) scores at follow up. The associations of medical comorbidity with increased odds of IADL-BADL disability and decreased SF-12 PCS and MCS scores were at least threefolds stronger among depressed than nondepressed individuals.Conclusion:Medical comorbidities and depression exert additive and multiplicative effects on functional disability and quality of life. The adverse impact and potential treatment benefits of coexisting mental and physical conditions should be seriously considered in clinical practice.

Quality of Life and its Determinants in Patients With Treated Acromegaly: A Cross-Sectional Nationwide Study in China

2020 ◽  
Vol 106 (1) ◽  
pp. 211-225
Author(s):  
Xiaopeng Guo ◽  
Kailu Wang ◽  
Siyue Yu ◽  
Lu Gao ◽  
Zihao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Short Form ◽  
Somatostatin Analogs ◽  
Chinese Patients ◽  
Treatment Modalities ◽  
Biochemical Control ◽  
Cross Sectional

Abstract Context Quality of life (QoL) continues to be impaired in acromegaly after treatment. Objective We conducted the first nationwide survey assessing QoL status among Chinese patients with treated acromegaly and explored correlations with clinical parameters, treatment modalities, and outcomes. Design Cross-sectional study. Setting Survey via Chinese Association of Patients with Acromegaly (CAPA) online platform. Patients Treated patients from CAPA. Main Outcome Measures QoL was assessed using acromegaly QoL questionnaire (AcroQoL), 5-level EuroQoL five-dimensional questionnaire (EQ-5D-5L), and 12-item short-form health survey questionnaire (SF-12). Results Complete, valid questionnaires from 327 patients (mean age: 39.2 years, 61.5% females) at a mean of 10 years after treatment were included. Biochemical control was satisfied in 52.9% of these patients. The controlled patients had significantly better QoL than the uncontrolled patients in all AcroQoL dimensions, most SF-12 dimensions, and pain/discomfort and anxiety/depression dimensions of the EQ-5D-5L. Patients with either controlled or uncontrolled acromegaly had significantly worse QoL than the age- and sex-adjusted population reference in most SF-12 dimensions except for physical functioning. More acromegaly-associated symptoms and comorbidities at follow-up were independent risk factors for decreased QoL across all questionnaires. Medical treatment, especially with somatostatin analogs (SSAs), and radiotherapy were predictors of worse QoL. Female patients had lower scores of physical-related QoL than male patients. Conclusions Our study suggests that biochemical control improved but did not normalize QoL in acromegaly. Numbers of symptoms and comorbidities at follow-up, sex, radiotherapy, and medical treatment with SSAs were factors determining QoL of patients with treated acromegaly.

scholarly journals Impact of anxiety-depressive symptoms on outpatients’ quality of life: Preliminary results from an Italian observational study

2017 ◽  
Vol 41 (S1) ◽  
pp. S319-S319
Author(s):  
S. Tassi ◽  
G. Rioli ◽  
G. Mattei ◽  
S. Ferrari ◽  
G.M. Galeazzi
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Short Form ◽  
Small Sample Size ◽  
Depression Scale ◽  
Small Sample ◽  
Anxiety Symptoms ◽  
Literature Study ◽  
Cross Sectional

IntroductionSeveral studies have shown an association between the Short-Form 36 (SF36) scores and anxiety-depressive symptoms, suggesting that depression in particular could reduce Quality of Life (QoL) to the same, and even greater, extent than chronic non-communicable diseases, such as diabetes and hypertension.AimsTo explore the relationship among QoL and anxiety, depressive and anxiety-depressive symptoms in an outpatient sample.MethodsCross-sectional study. Inclusion criteria: outpatients aged ≥40 years, without history for cancer, attending colonoscopy after positive faecal occult blood test. Collected data: blood pressure, blood glucose, lipid profile. Psychometric test: Hospital Anxiety and Depression Scale (HADS). QoL was assessed with SF36. Statistics performed with STATA13.Results54 patients enrolled (27 females). Sixteen patients (30.2%) were positive for anxiety symptoms, ten (18.9%) for depressive symptoms and five (9.4%) for anxiety-depressive symptoms. The perceived QoL was precarious in twelve subjects (22.2%): eight (15.9%) had low score (≤ 42) at “Mental Component Summary” (MCS) subscale, three (5.7%) at the “Mental Health” item and one patient (1.9%) at the “Vitality” one. At the multiple regression analysis, depressive (OR = 28.63; P = 0.01) and anxiety-depressive symptoms (OR = 11.16; P = 0.02) were associated with MCS.ConclusionsThe association emerging from the present study between depressive/anxiety symptoms and the MCS component of SF36 is consistent with available literature. Study design and small sample size do not allow to generalize results, that need further studies to be confirmed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Frailty, depression, and quality of life: a study with elderly caregivers

2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Letícia Alves de Melo ◽  
Isabela Thaís Machado de Jesus ◽  
Fabiana de Souza Orlandi ◽  
Grace Angélica de Oliveira Gomes ◽  
Marisa Silvana Zazzetta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Short Form ◽  
Statistical Significance ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Elderly Caregivers

ABSTRACT Objective: to analyze the relationship between frailty, depressive symptoms, and quality of life of elderly caregivers of other elderly living in high social vulnerability. Methods: a descriptive, correlational and cross-sectional study conducted with 40 elderly caregivers. A questionnaire to characterize elderly caregivers, the Fried frailty phenotype, the Geriatric Depression Scale (to screen depressive symptoms) and the Short-Form 6 Dimension (to assess quality of life) were used. For data analysis, Student’s t-test, ANOVA, Pearson’s χ2 and Fisher’s exact test were used. Results: most were pre-frail (52.5%) and had no evidence of depressive symptoms (57.5%). They presented, on average, a score of 0.76 (±0.1) in relation to quality of life. Statistical significance was observed between the average scores of quality of life with depressive symptoms (p=0.012) and frailty level (p=0.004). Conclusion: frail elderly caregivers with depressive symptoms had a worse perception of quality of life.

scholarly journals Association of exercise participation levels with cardiometabolic health and quality of life in individuals with hepatitis C

2021 ◽  
Vol 8 (1) ◽  
pp. e000591
Author(s):  
Kate Hallsworth ◽  
Shion Gosrani ◽  
Sarah Hogg ◽  
Preya Patel ◽  
Aaron Wetten ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hepatitis C ◽  
Short Form ◽  
Cardiometabolic Health ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Exercise Interventions ◽  
Exercise Participation ◽  
Increased Risk

ObjectiveHepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD) and reduced health-related quality of life (HRQoL). Although physical activity (PA)/exercise has been shown to reduce CVD risk and improve HRQoL in patients with liver disease, there is limited data in HCV. We aimed to explore the association between PA/exercise levels, CVD risk and HRQoL in patients with HCV and assess individuals’ attitudes to PA/exercise.DesignCross-sectional observational study recruiting consecutive patients with HCV from viral hepatitis clinics. Data were collected on CVD risk factors, anthropometry, HRQoL and the Exercise Benefits and Barriers Scale (EBBS).Results86 patients were recruited (71% men, 94% white, age 52±13 years); 49% of the cohort self-reported to be currently active. Although HRQoL was reduced across the cohort, patients that were regularly ‘active’ reported significantly higher HRQoL scores across Short-Form 36v2 domains compared with their inactive counterparts (p<0.05). Metabolic and cardiovascular characteristics were no different between groups stratified by PA/exercise status (p>0.05). EBBS scores were similar in the ‘active’ versus ‘inactive’ groups, however, patients categorised as ‘active’ scored significantly higher on the psychological outlook and social interaction subscales (p<0.05) than those that were ‘inactive’. There were significant associations between EBBS scores and HRQoL (p<0.05).ConclusionsPA/exercise is associated with increased HRQoL in patients with HCV irrespective of clinical parameters. Addressing specific motivators/barriers to exercise for patients will be key to designing effective PA/exercise interventions in this patient population to ensure maximum uptake and adherence.

Fatigue and Quality of Life After Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Hereditary Breast-Ovarian Cancer

2009 ◽  
Vol 19 (6) ◽  
pp. 1029-1036 ◽  
Author(s):  
Trond M. Michelsen ◽  
Anne Dørum ◽  
Claes G. Tropé ◽  
Sophie D. Fosså ◽  
Alv A. Dahl
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Cross Sectional ◽  
Hereditary Breast Ovarian Cancer ◽  
Increased Risk ◽  
General Population Norm ◽  
Clinically Significant ◽  
Risk Reducing

Background:Risk-reducing salpingo-oophorectomy (RRSO) is the safest intervention for prevention of ovarian cancer in women at increased risk for hereditary breast-ovarian cancer. Little is known about other effects of RRSO. The objective of this study was to investigate quality of life (QoL) and fatigue in a sample of women who had RRSO for increased cancer risk and to compare the findings with those of age-matched controls from the general population (NORM).Materials and Methods:In a cross-sectional follow-up mailed questionnaire design, 301 (67%) of 450 invited Norwegian women with RRSO attended. The questionnaire contained measures of QoL, fatigue, anxiety/depression, and body image, and questions about demography, lifestyle, and morbidity. The findings were compared with those of the NORM.Results:For RRSO women, mean age at survey was 53.7 years (SD, 9.2), mean age at RRSO was 48.4 years (SD 8.4), and median follow-up time was 5.0 years (range, 1-15 years). No clinically significant differences were observed between RRSO and NORM for any of the QoL or fatigue dimensions. In subgroup analyses of the RRSO group, no clinically significant differences in QoL and fatigue were observed between those who had surgery before or after age 50 years, or between BRCA1/2 carriers and women with unknown mutation statuses. Women who had cancer (32%), however, showed clinically significant lower levels of QoL and more fatigue than women without cancer.Conclusions:Women who had RRSO showed similar levels of QoL and fatigue as NORM. Women who had cancer before RRSO had lower levels of QoL and more fatigue.

scholarly journals Quality of Life in Transitioned Trans Persons: A Retrospective Cross-Sectional Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Lena Jellestad ◽  
Tiziana Jäggi ◽  
Salvatore Corbisiero ◽  
Dirk J. Schaefer ◽  
Josef Jenewein ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Short Form ◽  
Depression Scale ◽  
Transition Process ◽  
Epidemiologic Studies ◽  
Mental Wellbeing ◽  
Cross Sectional ◽  
Trans People

Background. Medical gender-affirming interventions (GAI) are important in the transition process of many trans persons. The aim of this study was to examine the associations between GAI and quality of life (QoL) of transitioned trans individuals. Methods. 143 trans persons were recruited from a multicenter outpatient Swiss population as well as a web-based survey. The QoL was assessed using the Short Form (36) Health Survey questionnaire (SF-36). Depressive symptoms were examined using the Short Form of the Center for Epidemiologic Studies-Depression Scale (ADS-K). Multiple interferential analyses and a regression analysis were performed. Results. Both transfeminine and transmasculine individuals reported a lower QoL compared to the general population. Within the trans group, nonbinary individuals showed the lowest QoL scores and significantly more depressive symptoms. A detailed analysis identified sociodemographic and transition-specific influencing factors. Conclusions. Medical GAI are associated with better mental wellbeing but even after successful medical transition, trans people remain a population at risk for low QoL and mental health, and the nonbinary group shows the greatest vulnerability.

scholarly journals Impact of clinical, sociodemographic and quality of life factors on dialysis patient survival: a nine-year follow-up cohort study

2020 ◽  
Vol 36 (12) ◽  
Author(s):  
Daniela Cristina Sampaio de Brito ◽  
Elaine Leandro Machado ◽  
Ilka Afonso Reis ◽  
Mariangela Leal Cherchiglia
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Physical Functioning ◽  
Short Form ◽  
Factors Associated ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Sf 36

Although renal replacement therapy has contributed to the survival of chronic kidney failure (CKF) patients, mortality remains a major concern. This study aimed to identify the factors associated with mortality in a prospective cohort of CKF patients. Sociodemographic, clinical, nutritional, lifestyle and quality of life data were collected from 712 patients. The instruments used were the Short-Form Health Survey (SF-36), Global Subjective Assessment (GSA) and Charlson Comorbidity Index (CCI) questionnaires. A total of 444 patients died during the study. After five years of follow-up, factors such as not being married (hazard ratio - HR = 1.289, 95%CI: 1.001; 1.660), a low frequency of leisure activities (HR = 1.321; 95%CI: 1.010; 1.727) and not being transplanted (HR = 7.246; 95%CI: 3.359; 15.630) remained independently associated with the risk of mortality. At the end of the follow-up period, factors such as not being married (HR = 1.337, 95%CI: 1.019; 1.756), not being transplanted (HR = 7.341, 95%CI: 3.829; 14.075) and having a worse nutritional status (HR = 1.363, 95%CI: 1.002; 1.853) remained independently associated with an increased risk of mortality, whereas a high schooling level (10 to 12 years, HR = 0.578, 95%CI: 0.344; 0.972; and over 12 years, HR = 0.561, 95%CI: 0.329; 0.956) and a better SF-36 physical functioning score (HR = 0.992, 95%CI: 0.987; 0.998) were protective factors associated with survival. The survival of patients with CKF is associated with factors not restricted to the clinical spectrum. The following factors were associated with high mortality: not being married, low schooling level, a limited social routine, a longer time on dialysis, worse nutritional status, and worse physical functioning.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

scholarly journals Long-term outcome and quality of life after CNS cavernoma resection: eloquent vs. non-eloquent areas

2021 ◽  
Author(s):  
Loay Shoubash ◽  
Jörg Baldauf ◽  
Marc Matthes ◽  
Michael Kirsch ◽  
Matthias Rath ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Preoperative Evaluation ◽  
Patient Counseling ◽  
Surgical Morbidity ◽  
Term Outcome ◽  
Long Term Outcome

AbstractThe aim of this study is to analyze the long-term quality of life after surgery of cavernoma. A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12). Forty-one lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit, and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years (SD 4.6), the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. Regarding QoL assessment of 44 patients (EG n = 27, NEG n = 14) attended the last follow-up. Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles. At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. The QoL comparison between eloquent and non-eloquent cavernomas created interesting and new data after prolonged follow-up. These results add value for decision-making as well as patient counseling for future encountered cases. Preoperative evaluation of QoL is recommended for future studies to assess QoL dynamics.

scholarly journals Addressing the relationship between perceived fear of COVID-19 virus infection and emergence of burnout symptoms in a sample of Egyptian physicians during COVID-19 pandemic: a cross-sectional study

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Mohamed Abdelghani ◽  
Hayam M. El-Gohary ◽  
Eman Fouad ◽  
Mervat S. Hassan
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Virus Infection ◽  
Emotional Exhaustion ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Physicians during the COVID-19 pandemic are working under relentless stress. This study aimed to identify the impact of the perceived fears of COVID-19 virus infection on the quality of life and the emergence of burnout syndrome among physicians in Egypt during the COVID-19 outbreak. This cross-sectional study was conducted between May 10th and June 9th, 2020, and included 320 Egyptian physicians who were working during the outbreak of the COVID-19 pandemic. The participants were interviewed using the Fear of COVID-19 scale (FCV-19S), Hospital Anxiety and Depression Scale (HADS), Maslach Burnout Inventory, and World Health Organization Quality of Life Scale (WHOQOL-BREF) for assessment of the perceived fears of COVID-19 virus infection, associated anxiety and depressive symptoms, burnout symptoms, and quality of life, respectively. Results Overall, most physicians were females (63%). Ideas about death, moderate-to-severe anxiety, and depressive symptoms were reported by 11, 28, and 29% of physicians, respectively. For burnout symptoms, high emotional exhaustion, high depersonalization, and low personal accomplishment were reported by 20, 71, and 39% of physicians, respectively. The perceived fear of COVID-19 virus infection was positively correlated with anxiety, depression, and burnout emotional exhaustion, and depersonalization symptoms, and negatively correlated with personal accomplishment and all quality of life domains. Conclusions Egyptian physicians experienced higher levels of COVID-19-related fears, anxiety, and depressive and burnout symptoms. There was a robust correlation between these perceived fears, and higher burnout symptoms, and poor quality of life among physicians. Specific interventions should be tailored to minimize the physical and mental burdens on the physicians during the COVID-19 pandemic.

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