scholarly journals AB0821 PSYCHOMETRIC PROFILE OF PATIENTS WITH CHRONIC INFLAMMATORY ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1434.2-1435
Author(s):  
G. L. Fonti ◽  
M. S. Chimenti ◽  
P. Conigliaro ◽  
P. Triggianese ◽  
E. Bianciardi ◽  
...  

Background:Psoriatic Arthritis (PsA) is a chronic inflammatory disease characterized by a condition of inflammation of joint and periarticular tissues with progressive destruction of bone and cartilage tissues and consequent disability. Numerous studies suggest that the systemic inflammation that characterizes this disease is the basis of the onset of numerous comorbidities, including anxiety and depression.Objectives:This prospective study aims to examine the psychometric profile of patients with chronic inflammatory arthritis to investigate possible correlations with psychiatric comorbidities and disease status.Methods:from October 2018 to March 2019, consecutive out-patients with PsA (according to CASPAR criteria) referred to the Rheumatology Unit of the University of Rome Tor Vergata, were evaluated by a dedicated psychiatrist for attachment style (Relationship Questionnaire - RQ), alexithymia (Toronto Alexithymia Scale - TAS20), perceived stress (Perceived Stress Scale - PSS) and depressive symptoms (Beck Depression Inventory - BDI). These indices were then correlated with clinimetric indices, indices of inflammation and therapy taken by the patient. Statistical analysis was performed using Fisher’s exact test and Pearson’s correlation coefficient.Results:33 patients affected by PsA and 40 healthy individuals as control group were enrolled. The RQ test showed that in patients an insecure “avoidant” attachment style prevails (51.5%) compared to the control group (10%) (p<0.0008)[Figure 1]. This result correlates with the presence of alexithymia and with the duration of illness, showing that patients with an “insecure” profile at the RQ test are those who have higher scores on the TAS-20 scale (p=0.035) and a longer duration of illness (p<0.0001). Regarding the perception of stress, at the PSS test women have mean values (18.12±7.31) statistically superior to the values of the male population (11.69±7.79)(p=0.0015). PSS values of the overall study population were directly proportional to RQ values (p<0.0068) and TAS-20 values (p<0.0001). The correlation between PSS and TAS-20 was further confirmed in the analysis of the individual subgroups “patients” (p<0.0001) and control group (p<0.0001)[Figure 2]. No correlation was shown with phlogosis and clinimetric indices.Conclusion:This study suggests how PsA patients are a more vulnerable subtype of patient from the psychological point of view, with an avoidant attachment style, characterized by the difficulty to express emotions and to rely on others in times of need. These characteristics can influence the adherence to pharmacological therapies and the doctor-patient relationship. This profile is manifested more frequently in female patients, with long duration of illness, high perception of stress. The state of disease activity does not influence these elements, suggesting that the insecure attachment style is not related to the single inflammatory flare, but is the result of years of illness and long-standing disease. Our results support the relevance of early diagnosis in PsA.Disclosure of Interests:None declared

Author(s):  
Alfonso Troisi ◽  
Roberta Croce Nanni ◽  
Alessandro Giunta ◽  
Valeria Manfreda ◽  
Ester Del Duca ◽  
...  

AbstractThe aim of this study was to estimate the contribution of adult attachment style and alexithymia to cutaneous body image in patients with psoriasis while controlling for the confounding effects of disease severity and depressive symptoms. Participants were 107 consecutive patients (60% women) with a diagnosis of plaque-type psoriasis. Cutaneous body dissatisfaction was measured with the Cutaneous Body Image Scale (CBIS) and disease severity with the Psoriasis Area and Severity Index (PASI). Depressive symptoms, attachment style and alexithymia were assessed with the Beck Depression Inventory (BDI), the Attachment Style Questionnaire (ASQ) and the Toronto Alexithymia Scale (TAS-20), respectively. Hierarchical regression analysis showed that, independently from the severity of skin disease and depressive symptoms, patients with an insecure-avoidant attachment style and higher levels of alexithymia reported greater cutaneous body dissatisfaction. Because of the cross-sectional design, the causal relationship between avoidant attachment, alexithymia and cutaneous body image cannot be determined. There was no control group. Clinical assessment of patients with psoriasis should include attachment style and alexithymia among the psychological variables related to cutaneous body dissatisfaction.


2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Valentina Meuti ◽  
Franca Aceti ◽  
Nicoletta Giacchetti ◽  
Giuseppe Mattia Carluccio ◽  
Michela Zaccagni ◽  
...  

Background. This study aims to verify if the presence and severity of perinatal depression are related to any particular pattern of attachment.Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, who were administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS) and the Experience in Close Relationship (ECR). A clinical group of subjects with perinatal depression (PND, 89 subjects) was selected and compared with a control group (C), regarding psychopathological variables and attachment patterns.Results. The ECR showed a prevalence of “Fearful-Avoidant” attachment style in PND group (29.2% versus 1.1%,p<0.001); additionally, the EPDS average score increases with the increasing of ECR dimensions (Avoidance and Anxiety).Conclusion. The severity of depression increases proportionally to attachment disorganization; therefore, we consider attachment as both an important risk factor as well as a focus for early psychotherapeutic intervention.


2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Hartini Tiono

Ulcerative colitis is a chronic inflammatory disease mainly affects sigmoid colon and rectum. The inflammation process will activate NF-κB and leads to proinflamatory cytokine release such as Interleukin-6 (IL-6). Fig leaves contain a high level of flavonoid which can prevent NF-κB activation, and further inhibits IL-6 secretion. This research aims to see the preventive effect of methanolic extract of fig leaves towards colon histopathological feature and IL-6 serum level on ulcerative colitis induced mice. Balb/C male mice were randomly assigned into 5 groups (n=5). The treatment groups were dextran suphate sodium (DSS) control group (group I), methanolic extract of Fig leaves dose 28 mg/ day control group (group II), and methanolic extract of Fig leaves dose 7 mg/ day (group III), 14 mg/ day (group IV), and 28 mg/ day (group V) for 14 days, which at the 8th till 14th day were given DSS to induce colitis. The results showed that both of colon mucosal damage and IL-6 serum level of group I were significantly different from other groups (p=0,029). In  conclusion, the methanolic extract of Fig leaves can improve colon mucous damage and decrease IL-6 serum level on ulcerative colitis-induced mice. Keywords: ulcerative colitis, fig leaves, colon mucousal damage, interleukin-6


Author(s):  
Mohamad Reza Nikouei Moghaddam ◽  
Monireh Movahedi ◽  
Maryam Bananej ◽  
Soheil Najafi ◽  
Nahid Beladi Moghadam ◽  
...  

Background: Multiple sclerosis is an autoimmune chronic inflammatory disease of the central nervous system that can lead to some serious disabilities. Despite using various immunomodulatory and anti-inflammatory drugs that have therapeutic effects, they cannot reduce its progression completely, and have some unwanted side effects too. The immunomodulatory and anti-inflammatory effects of the β-D-Mannuronic acid [M2000] have been proven in several surveys, and the present research was designed to determine its toxicity and therapeutic effects in MS patients. Methods: This study was performed on 15 MS patients who took 25 mg/kg/day the oral form of the β-D-Mannuronic acid for six months, and 15 healthy people as a control group. Serum levels of Urea, Creatinine, GGT, Vitamin D3, Uric acid, and Anti-Phospholipids were compared to evaluate the therapeutic and possible toxic effects of this drug after this period. Results: Non- toxic effects through the study of Urea, Creatinine, GGT, and non-significant changes in Uric acid and AntiPhospholipids levels, besides a significant rise in Vitamin, D3 levels in the M2000 treated cases were found. Conclusions: Our results suggested that β-D-Mannuronic acid is a safe drug and has no toxicity when administered orally and also has some therapeutic effects in MS patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Shaygan ◽  
Zahra Yazdani ◽  
Adib Valibeygi

Abstract Background There is evidence suggesting that quarantine might have undesirable psychological impacts on the patients. Therefore, it is important to seek for ways to increase the resilience and alleviate the psychological pressure of the patients who are quarantined due to infection with COVID-19. The present study was conducted to assess an online multimedia psychoeducational intervention regarding the feasibility, adherence, patient satisfaction and effectiveness on resilience and perceived stress of patients hospitalized with confirmed COVID-19. Method This was a pilot cluster randomized parallel-controlled trial with hospital wards as the units of randomization. Participants in this fully online trial were 50 consecutive patients who were hospitalized in 2 hospitals in Shiraz, after being diagnosed with COVID-19. Before the beginning of the intervention, four inpatient wards inside two of the hospitals were randomly assigned to either intervention or control conditions. All eligible participants in the wards allocated to the intervention condition received online multimedia psychoeducational interventions during the 2 weeks, whilst the patients in the wards allocated to the control condition were offered the opportunity to receive telephone-based psychological counseling if needed. Psychoeducational interventions mainly included cognitive–behavioural techniques, stress management techniques, mindfulness-based stress reduction and positive psychotherapy. The patients were assessed regarding resilience and perceived stress at baseline and after two weeks. Results Of 27 patients starting multimedia psychoeducational interventions, 26 (96.29%) completed post-assessments. A high level of adherence (80.76%) and satisfaction (Mean = 29.42; SD = 4.18) with the online multimedia psychoeducational interventions was found. Compared with the control group, the patients who used online multimedia psychoeducational interventions reported greater resilience (Meanintervention = 81.74; Meancontrol = 72.86; adjusted t (46) = 2.10; p = 0.04; CI: 0.39 to 17.38; dppc2 = 0.83) and fewer perceived stress (Meanintervention = 22.15; Meancontrol = 29.45; adjusted t (46) = 2.66; p = 0.01; CI: − 12.81 to − 1.78; dppc2 = − 0.77) after 2 weeks. Discussion The findings of the present study provided a successful first attempt at implementing feasible online multimedia psychoeducational interventions to promote resilience and mitigate stress among the patients who were hospitalized due to infection with COVID-19. The present results could help mental health professionals to determine which psychological techniques should be emphasized to promote patients’ resilience in the context of COVID-19 disease. Trial registration Iranian Registry of Clinical Trials, IRCT20201001048893N1. Retrospectively registered, 29 Jan 2021.


Author(s):  
Marco Di Carlo ◽  
Gianluca Smerilli ◽  
Fausto Salaffi

Abstract Purpose of the review Pain in chronic inflammatory joint diseases is a common symptom reported by patients. Pain becomes of absolute clinical relevance especially when it becomes chronic, i.e., when it persists beyond normal healing times. As an operational definition, pain is defined chronic when it lasts for more than 3 months. This article aims to provide a review of the main mechanisms underlying pain in patients with chronic inflammatory joint diseases, discussing in particular their overlap. Recent findings While it may be intuitive how synovial inflammation or enthesitis are responsible for nociceptive pain, in clinical practice, it is common to find patients who continue to complain of symptoms despite optimal control of inflammation. In this kind of patients at the genesis of pain, there may be neuropathic or nociplastic mechanisms. Summary In the context of chronic inflammatory joint diseases, multiple mechanisms generally coexist behind chronic pain. It is the rheumatologist’s task to identify the mechanisms of pain that go beyond the nociceptive mechanisms, to adopt appropriate therapeutic strategies, including avoiding overtreatment of patients with immunosuppressive drugs. In this sense, future research will have to be oriented to search for biomarkers of non-inflammatory pain in patients with chronic inflammatory joint diseases.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Lilla Nóra Kovács ◽  
Dániel Baksa ◽  
Dóra Dobos ◽  
Nóra Eszlári ◽  
Kinga Gecse ◽  
...  

Abstract Background The main goal of this research was to explore whether migraineurs had a higher level of perceived stress than healthy controls during the times of the coronavirus and related restrictive measures, and to examine the relationship between different subtypes of rumination and perceived stress in these groups. We measured two facets of depressive rumination, brooding and reflection, along with rumination about the current COVID-19 situation to see whether these different subtypes of rumination explained perceived stress among migraineurs and healthy controls. Methods Healthy adults (n = 64) and migraine patients (n = 73) filled out self-report questionnaires online. A multiple linear regression model was used to test whether depressive rumination (i.e. brooding and reflection) and COVID-related rumination explained perceived stress among adults with and without migraine during the times of COVID-19, after controlling for gender, age, migraine/control group status and migraine disability. Results Although we did not find any difference in the level of perceived stress among migraineurs and the control group, perceived stress was more strongly associated with brooding as well as COVID-related rumination among migraineurs than healthy controls. COVID-related rumination and brooding (but not reflection) explained the level of perceived stress after controlling for gender, age, migraine/control group status and migraine disability. Conclusions The similar degree of perceived stress among migraineurs and the control group may imply that there is great variation in the personal experience of people regarding the pandemic, that may be determined by numerous other factors. Our results demonstrate that ruminating about the pandemic and related difficulties, as well as brooding (but not reflection) appear to be associated with higher level of perceived stress during the times of the coronavirus. This association was slightly stronger among migraineurs, hinting at the increased vulnerability of this patient group in stressful situations like the COVID-19 pandemic. Our results also suggest that ruminating about the pandemic and its consequences is weakly associated with trait-level depressive rumination, thus may be more contingent on specific factors.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Susan Bridgewater ◽  
Joe Lomax ◽  
Bryan Abbott ◽  
Jo Adams ◽  
Alice Berry ◽  
...  

Abstract Background/Aims  Patients with inflammatory arthritis report that fatigue can be a challenging symptom to manage, with little support available. In response, we developed a brief one-to-one cognitive-behavioural manualised intervention, delivered by rheumatology health professionals (RHPs), to help patients manage their fatigue. Methods  We designed a single-arm feasibility study called FREE-IA (Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis). Patients were eligible if they were ≥18 years, had a clinician confirmed diagnosis of inflammatory arthritis, scored ≥6/10 on the BRAF NRS Fatigue Impact with fatigue that they considered recurrent, frequent, and/or persistent, and were not accessing support for their fatigue. Following training, RHPs delivered 2-4 one-to-one sessions to participants. The initial two core sessions were delivered face-to-face in clinic; participants then had the option of up to two further sessions, either in clinic, by telephone or online. We proposed delivering sessions 1 and 2 within two weeks of each other, and sessions 3 and 4 in the following two weeks. Baseline data were collected before the first session (T0), and outcomes at six weeks (T1) and six months (T2). The primary outcome was fatigue impact (BRAF NRS Fatigue Effect), collected by telephone. Secondary outcomes included fatigue severity, fatigue coping, multi-dimensional impact of fatigue, disease impact and disability and measures of therapeutic mechanism (self-efficacy, and perceived confidence and autonomy to manage health). These outcomes were collected by post. This study allowed us to test the feasibility and acceptability of RHP training, study design and materials, intervention delivery and outcome collection, ahead of a possible RCT to determine intervention effectiveness. Results  Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Four sessions were delivered by phone and none online. Session 2 was only delivered within the two-week time frame for 37% of participants attending both core sessions. Out of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 missing primary outcome responses and 27 missing secondary outcome responses. Results indicated improvements in all measures except disability at either T1 or T2, or both, with confidence intervals supporting an interpretation of improvement. Conclusion  We were able to design and deliver FREE-IA training to RHPs, deliver FREE-IA sessions to patients, and collect outcomes at three time points with low levels of attrition. Outcomes in all measures except disability were in a direction to suggest improvement at T1, T2, or both. Study numbers were small, there was no control group and regression to the mean was a possibility. However, outcomes were in the direction to cautiously suggest benefit, and there is evidence of promise of the intervention. A definitive RCT is the next step to test clinical and cost effectiveness of the intervention. Disclosure  S. Bridgewater: None. J. Lomax: None. B. Abbott: None. J. Adams: None. A. Berry: None. S. Creanor: None. P. Ewings: None. S. Hewlett: None. L. McCracken: None. M. Ndosi: None. J. Thorn: None. M. Urban: None. E. Dures: None.


2020 ◽  
Vol 11 (1) ◽  
pp. 10
Author(s):  
Sonia Mangialavori ◽  
Michele Giannotti ◽  
Marco Cacioppo ◽  
Federico Spelzini ◽  
Franco Baldoni

Previous studies documented gender-related differences in the expression of Perinatal Affective Disorders. However, little attention has been paid to screening the male population during the perinatal period. This study was based on three aims: (1) to investigate the mental health of expectant fathers based on their levels of depression, anxiety, addiction, anger attacks/hostility, and somatization, identifying psychological profiles; (2) to analyze the association between these profiles and the individual variable of perceived stress; (3) and to examine the association between these profiles and the couple’s variable of marital adjustment. A total of 350 Italian expectant fathers in the last trimester of pregnancy were asked to fill in questionnaires concerning perceived stress, dyadic adjustment, psychiatric symptomatology, and depression. Three different clusters were found: “psychologically healthy men” (68%) with low levels of symptoms on all the scales; “men at risk of externalized behavioral problems” (17.1%), characterized by one or more addictive or risky behaviors and moderate levels of scales scores; and “men experiencing psychological distress” (14.9%), with the highest scores on all the scales. A significant association emerged among the perceived stress, marital adjustment, and cluster membership. These results highlight the importance of screening fathers in perinatal health services, which are still predominantly mother-centered, and underscore the necessity to create tailored and personalized interventions.


Sign in / Sign up

Export Citation Format

Share Document