scholarly journals Trajectories of functioning in bipolar disorders: A longitudinal study in the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort

2020 ◽  
Vol 54 (10) ◽  
pp. 985-996
Author(s):  
Ophelia Godin ◽  
Marion Leboyer ◽  
Yassin Mazroui ◽  
Bruno Aouizerate ◽  
Jean-Michel Azorin ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Childhood Maltreatment ◽  
Sleep Disturbances ◽  
Latent Class ◽  
Area Under The Curve ◽  
Bipolar Disorders ◽  
Global Functioning ◽  
Logistic Regression Models ◽  
Patients At Risk ◽  
Stable Trajectory

Objective: We aimed at identifying distinct trajectories of functioning and at describing their respective clinical characteristics in a cohort of individuals with bipolar disorders. Methods: We included a sample of 2351 individuals with bipolar disorders who have been followed-up to 3 years as part as the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort. Global functioning was measured using the Functioning Assessment Short Test. We used latent class mixed models to identify distinct longitudinal trajectories of functioning over 3 years. Multivariable logistic regression models were used to identify the baseline factors that were associated with the membership to each trajectory of functioning. Results: Three distinct trajectories of functioning were identified: (1) a majority of individuals (72%) had a stable trajectory of mild functional impairment, (2) 20% of individuals had a stable trajectory of severe functional impairment and (3) 8% of individuals had a trajectory of moderate functional impairment that improved over time. The membership to a trajectory of stable severe versus stable mild functional impairment was associated with unemployment, a higher number of previous hospitalizations, childhood maltreatment, a higher level of residual depressive symptoms, higher sleep disturbances, a higher body mass index and a higher number of psychotropic medications being prescribed at baseline. The model that included these seven factors led to an area under the curve of 0.85. Conclusion: This study enabled to stratify individuals with bipolar disorders according to three distinct trajectories of functioning. The results regarding the potential determinants of the trajectory of severe functional impairment needs to be replicated in independent samples. Nevertheless, these potential determinants may represent possible therapeutic targets to improve the prognosis of those patients at risk of persistent poor functioning.

Examination of the Screener and Opioid Assessment for Patients with Pain-Short Form (SOAPP-SF) in an oncology palliative medicine clinic.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 196-196
Author(s):  
Rebecca Greiner ◽  
Danielle Boselli ◽  
Mariam Salib ◽  
Jai Narendra Patel
Keyword(s):  
At Risk ◽  
Short Form ◽  
Smoking Habit ◽  
Area Under The Curve ◽  
Symptom Assessment ◽  
Assessment System ◽  
Cutoff Score ◽  
Opioid Misuse ◽  
Logistic Regression Models ◽  
Patients At Risk

196 Background: The National Comprehensive Cancer Network states opioids can be used to treat cancer pain and prescribers should identify patients at risk for opioid misuse; research in this area is limited. In the non-cancer population, SOAPP-SF is a validated tool to predict aberrant drug behavior; a score of ≥ 4 (out of 20) is considered high risk. We performed a retrospective observational study to determine the utility of the SOAPP in identifying opioid misuse in the oncology population as measured by a non-compliant toxicology screen. Methods: Consecutive consults seen during a 6-month period completed the 5-question SOAPP-SF and Edmonton Symptom Assessment System (ESAS) form. Toxicology screens assessed non-compliance (i.e., absence of prescribed medications and/or presence of non-prescribed or illegal substances). Logistic regression models estimated the associations of composite and individual SOAPP-SF scores and ESAS symptom scores with non-compliant screens. Threshold analysis were conducted to identify an optimal SOAPP-SF cutoff. Results: Of 192 consults, 64 patients providing SOAPP-SF score and toxicology screen were evaluable. Mean age was 59 ± 9.8 years: 56% were female, 34% and 62% were African American and Caucasian respectively. Median SOAPP-SF score was 2 (range: [0, 12]). Non-compliant screens were observed in 31% of patients. The area under the curve (AUC) was 0.65. The validated SOAPP-SF cutoff score of ≥ 4 was associated with a sensitivity and specificity of 0.43 and 0.79, respectively (p = 0.082). Sensitivity (0.76) and specificity (0.72) were maximized at a cutoff score of ≥ 3 (p < 0.001). When evaluated individually, the SOAPP-SF question about smoking habit was associated with a non-compliant screen (p = 0.020). Increased ESAS pain scores were associated with SOAPP-SF score ≥ 3 (p = 0.013). Conclusions: SOAPP-SF can identify oncology patients at risk for opioid misuse. Preliminary analyses suggest a more appropriate threshold of identification is a score of ≥ 3 not ≥ 4. Future work will increase numbers of evaluable patients and examine other factors associated with opioid misuse.

scholarly journals POS1439 A MULTI-PREDICTOR MODEL TO PREDICT RISK OF SCLERODERMA RENAL CRISIS IN SYSTEMIC SCLEROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1004.1-1004
Author(s):  
D. Xu ◽  
R. Mu
Keyword(s):  
Systemic Sclerosis ◽  
Prediction Model ◽  
Renal Involvement ◽  
Area Under The Curve ◽  
Individual Risk ◽  
Multivariable Logistic Regression Analysis ◽  
Scleroderma Renal Crisis ◽  
Lasso Regression ◽  
Patients At Risk ◽  
Renal Crisis

Background:Scleroderma renal crisis (SRC) is a life-threatening syndrome. The early identification of patients at risk is essential for timely treatment to improve the outcome[1].Objectives:We aimed to provide a personalized tool to predict risk of SRC in systemic sclerosis (SSc).Methods:We tried to set up a SRC prediction model based on the PKUPH-SSc cohort of 302 SSc patients. The least absolute shrinkage and selection operator (Lasso) regression was used to optimize disease features. Multivariable logistic regression analysis was applied to build a SRC prediction model incorporating the features of SSc selected in the Lasso regression. Then, a multi-predictor nomogram combining clinical characteristics was constructed and evaluated by discrimination and calibration.Results:A multi-predictor nomogram for evaluating the risk of SRC was successfully developed. In the nomogram, four easily available predictors were contained including disease duration <2 years, cardiac involvement, anemia and corticosteroid >15mg/d exposure. The nomogram displayed good discrimination with an area under the curve (AUC) of 0.843 (95% CI: 0.797-0.882) and good calibration.Conclusion:The multi-predictor nomogram for SRC could be reliably and conveniently used to predict the individual risk of SRC in SSc patients, and be a step towards more personalized medicine.References:[1]Woodworth TG, Suliman YA, Li W, Furst DE, Clements P (2016) Scleroderma renal crisis and renal involvement in systemic sclerosis. Nat Rev Nephrol 12 (11):678-91.Disclosure of Interests:None declared

scholarly journals Predicting drowning from sea and weather forecasts: development and validation of a model on surf beaches of southwestern France

2021 ◽  
pp. injuryprev-2020-044092
Author(s):  
Éric Tellier ◽  
Bruno Simonnet ◽  
Cédric Gil-Jardiné ◽  
Marion Lerouge-Bailhache ◽  
Bruno Castelle ◽  
...  
Keyword(s):  
Regression Models ◽  
Area Under The Curve ◽  
Temperature Wave ◽  
Medical Emergency ◽  
Emergency Center ◽  
Logistic Regression Models ◽  
Weather Forecasts ◽  
Step Model ◽  
Daily Risk ◽  
Development And Validation

ObjectiveTo predict the coast-wide risk of drowning along the surf beaches of Gironde, southwestern France.MethodsData on rescues and drownings were collected from the Medical Emergency Center of Gironde (SAMU 33). Seasonality, holidays, weekends, weather and metocean conditions were considered potentially predictive. Logistic regression models were fitted with data from 2011 to 2013 and used to predict 2015–2017 events employing weather and ocean forecasts.ResultsAir temperature, wave parameters, seasonality and holidays were associated with drownings. Prospective validation was performed on 617 days, covering 232 events (rescues and drownings) reported on 104 different days. The area under the curve (AUC) of the daily risk prediction model (combined with 3-day forecasts) was 0.82 (95% CI 0.79 to 0.86). The AUC of the 3-hour step model was 0.85 (95% CI 0.81 to 0.88).ConclusionsDrowning events along the Gironde surf coast can be anticipated up to 3 days in advance. Preventative messages and rescue preparations could be increased as the forecast risk increased, especially during the off-peak season, when the number of available rescuers is low.

scholarly journals POS0998 SPONDYLOARTHRITIS AND SLEEP DISORDERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Functional Impairment ◽  
Sleep Disturbances ◽  
Negative Impact ◽  
University Hospital ◽  
Quality Of Sleep ◽  
The Mean ◽  
Sleep Deficit ◽  
Impaired Sleep ◽  
The Impact

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.

Maltreatment Type Classifications and Transitions During Childhood for a California Birth Cohort

2021 ◽  
pp. 107755952110067
Author(s):  
John Prindle ◽  
Regan Foust ◽  
Emily Putnam-Hornstein
Keyword(s):  
Childhood Maltreatment ◽  
Child Protection ◽  
Latent Class ◽  
Child Protective Services ◽  
Latent Transition Analysis ◽  
Protective Services ◽  
Transition Analysis ◽  
Children In Foster Care ◽  
Protection Systems ◽  
Maltreatment Type

Childhood maltreatment involves dynamics between the type of maltreatment experienced and the context of maltreatment. Reports of alleged maltreatment to child protective services may overlap and shift over time, complicating understanding of their independent and interacting nature, including how child protection systems respond. Latent class analysis (LCA) and latent transition analysis (LTA) were used to construct data-based models of longitudinal dynamics of alleged maltreatment throughout childhood. We sought to identify patterns leading to system decisions to substantiate allegations of maltreatment and place children in foster care. Using linked birth and child protection records, we defined a cohort of children born in California in 1999, 29.4% of whom had at least one referral for alleged maltreatment before their 18th birthday. Maltreatment and perpetrator indicators were coded, and LCA identified five alleged maltreatment classes and one class of children without referrals. LTA determined consistency of classifications and estimated transitions between classes over age periods. Children with multitype maltreatment patterns or experiences of neglect were most likely to experience future maltreatment allegations. Estimated probabilities of placement indicated children with Multitype Maltreatment allegations were more likely to experience substantiated maltreatment allegations and out-of-home placements. Findings identify a repeatable method for better understanding complex systems.

Network of co-expressed circadian genes, childhood maltreatment and sleep quality in bipolar disorders

2021 ◽  
pp. 1-8
Author(s):  
D. Grillault Laroche ◽  
E. Curis ◽  
F. Bellivier ◽  
C. Nepost ◽  
G. Gross ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Childhood Maltreatment ◽  
Bipolar Disorders ◽  
Circadian Genes

Couple Religiosity and Well-Being Among Older Adults in the United States

2021 ◽  
pp. 089826432110421
Author(s):  
Laura Upenieks ◽  
Jeremy E. Uecker ◽  
Markus H. Schafer
Keyword(s):  
Social Life ◽  
Latent Class ◽  
Well Being ◽  
The United States ◽  
Older Couples ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Individual Trait ◽  
The Us ◽  
Married Men

Objectives: This article evaluates whether couples’ religious similarity is consequential for the health of older married men and women. Alternatively, we examine whether women’s religiosity alone is health-protective to their husbands . Methods: Using dyadic data from the US National Social Life, Health, and Aging Project, a representative sample of 913 individuals ages 62–91 plus their marital partners, we perform latent-class analysis to separate older couples into classes based on religious characteristics. Ordered logistic regression models are then used to assess whether different combinations of religious (dis)similarity are associated with married men and women’s well-being. Results: We find that older women in highly religious, homogamous marriages report better mental and physical health relative to women in heterogamous and secular (non-religious) marriages. No significant associations were observed for men. Discussion: Our results emphasize that religiosity is not only an individual trait—dis/similarities within a couple have important implications for older women’s well-being.

scholarly journals Predicting Onset of Dementia Using Clinical Notes and Machine Learning: Case-Control Study (Preprint)

2020 ◽  
Author(s):  
Christopher A Hane ◽  
Vijay S Nori ◽  
William H Crown ◽  
Darshak M Sanghavi ◽  
Paul Bleicher
Keyword(s):  
Machine Learning ◽  
Language Processing ◽  
Disease Onset ◽  
Area Under The Curve ◽  
Learning Models ◽  
Term Care ◽  
Clinical Notes ◽  
Patients At Risk ◽  
Hospital Systems ◽  
Machine Learning Models

BACKGROUND Clinical trials need efficient tools to assist in recruiting patients at risk of Alzheimer disease and related dementias (ADRD). Early detection can also assist patients with financial planning for long-term care. Clinical notes are an important, underutilized source of information in machine learning models because of the cost of collection and complexity of analysis. OBJECTIVE This study aimed to investigate the use of deidentified clinical notes from multiple hospital systems collected over 10 years to augment retrospective machine learning models of the risk of developing ADRD. METHODS We used 2 years of data to predict the future outcome of ADRD onset. Clinical notes are provided in a deidentified format with specific terms and sentiments. Terms in clinical notes are embedded into a 100-dimensional vector space to identify clusters of related terms and abbreviations that differ across hospital systems and individual clinicians. RESULTS When using clinical notes, the area under the curve (AUC) improved from 0.85 to 0.94, and positive predictive value (PPV) increased from 45.07% (25,245/56,018) to 68.32% (14,153/20,717) in the model at disease onset. Models with clinical notes improved in both AUC and PPV in years 3-6 when notes’ volume was largest; results are mixed in years 7 and 8 with the smallest cohorts. CONCLUSIONS Although clinical notes helped in the short term, the presence of ADRD symptomatic terms years earlier than onset adds evidence to other studies that clinicians undercode diagnoses of ADRD. De-identified clinical notes increase the accuracy of risk models. Clinical notes collected across multiple hospital systems via natural language processing can be merged using postprocessing techniques to aid model accuracy.

scholarly journals Assessing COVID-19-related anxiety and functional impairment amongst nurses in Malawi

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Genesis Chorwe-Sungani
Keyword(s):  
Mental Health ◽  
Functional Impairment ◽  
Area Under The Curve ◽  
Reliability And Validity ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Receiver Operating Curve ◽  
Future Research ◽  
Online Data ◽  
Cross Sectional

Background: Psychological well-being of nurses is crucial for them to effectively discharge their duties. However, coronavirus disease 2019 (COVID-19)-related anxiety can interfere with nurses’ performance and reduce their self-efficacy.Aim: The primary aim of this study was to assess COVID-19-related anxiety and functional impairment amongst nurses in Malawi. The secondary aim of the study was to determine reliability and validity of the Coronavirus Anxiety Scale.Setting: The study was conducted in Malawi.Methods: This was a cross-sectional study that collected quantitative data from 102 nurses in Malawi online. Data were analysed using descriptive statistics and receiver operating curve analysis.Results: This study found that 25.5% (26) of respondents had COVID-19-related anxiety and 48% (49) functional impairment. There were significant differences in the numbers of respondents who had functional impairment in relation to workplace (Χ2 = 8.7, p = 0.03), with many of those working in hospitals (58.6%, n = 34) having highest levels (mean = 20.6 ± 10.4). The Coronavirus Anxiety Scale proved to be an effective instrument (Sensitivity = 73.1%; Specificity = 60.5%; area under the curve = 0.73) for assessing COVID-19-related anxiety amongst nurses.Conclusion: It is necessary to screen nurses for COVID-19-related anxiety and functional impairment and provide them effective psychosocial interventions. Policymakers should place more emphasis on allocation of financial resources to mental health services and staff support programmes targeting nurses during pandemics. There is a need to conduct future research on mental health interventions that might be used to assist nurses with COVID-19-related anxiety and functional impairment.

scholarly journals The prevalence of autism spectrum traits and autism spectrum disorders in children and adolescents with obsessive compulsive disorder: a systematic review

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S56-S56
Author(s):  
Claire Tiley ◽  
Marinos Kyriakopoulos
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Obsessive Compulsive Disorder ◽  
Functional Impairment ◽  
Body Dysmorphic Disorder ◽  
Autism Spectrum ◽  
Control Group ◽  
Obsessive Compulsive ◽  
Global Functioning ◽  
Compulsive Disorder

AimsAutism Spectrum Disorder (ASD) and Obsessive Compulsive Disorder (OCD) commonly co-occur in children and adolescents (C&A); evidence suggests functional impairment is increased in those diagnosed with both disorders. The aims of this systematic review were: 1) To review studies that report on the prevalence of ASD traits and/or diagnosis in C&A with OCD. 2) To review whether the severity of OCD symptoms is related to the severity of ASD traits in C&A with OCD. 3)To review whether the severity of comorbid ASD traits or diagnosis in C&A with OCD impact on their global functioning.MethodThis systematic review was registered in PROSPERO. Prisma guidelines were followed . Electronic searches were carried out on Pubmed, EMBASE and Psychinfo with the use of selected keywords. Inclusion criteria : 1) Participants up to the age of 18 who had an ICD or DSM diagnosis of OCD. 2) Journal articles published in the English, with no date specifications. 3) Papers evaluating ASD diagnosis or traits, or where data on this could be extracted. Exclusion criteria: 1) Papers looking at OCD related disorders such as body dysmorphic disorder, compulsive skin picking, trichotillomania and hoarding disorder. 2) Samples including adults where C&A data could not be extracted. 3) Posters, abstracts and dissertations.ResultA total of 15 studies were included in the systematic review. Seven of these studies directly compared the prevalence of ASD traits (measured by questionnaires) or diagnosis in OCD to a control group or normative data, with all studies reporting a significant elevation in ASD trait scores and diagnosis in OCD. Ten of the studies reported on the correlation between ASD trait severity and OCD severity. Four studies identified a significant correlation between ASD and OCD total scores or specified subscales. In contrast, one study found significantly elevated OCD scores in an OCD only group when compared to a comorbid OCD and ASD group. Three studies reported on the correlation between ASD scores and functional impairment or compared an OCD only group to a comorbid group. All three studies demonstrated that the presence ASD or ASD traits are associated with elevated scores in global functional impairment.ConclusionIn conclusion, this review suggests that there is an increased prevalence of ASD traits and diagnosis amongst C&A with OCD. Elevated ASD traits within this population are associated with a greater impact on global functioning.

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