scholarly journals The multifaceted impact of anxiety and depression on patients with rheumatoid arthritis

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Steve Peterson ◽  
James Piercy ◽  
Stuart Blackburn ◽  
Emma Sullivan ◽  
Chetan S. Karyekar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Anxiety And Depression ◽  
Relative Risk Ratio ◽  
Depression Symptoms ◽  
Patient Anxiety ◽  
Patient Reported ◽  
The Usa ◽  
The Impact

Abstract Background The prevalence of mood disturbances such as anxiety and depression is greater in rheumatoid arthritis (RA) patients than in the general population. Given this association, the primary aim of this study was to assess the incremental impact of anxiety or depression on patients with RA from the United States of America (USA) and Europe, independent of the impact of the underlying RA disease. Methods Rheumatologists (n = 408) from the USA and 5 European countries completed patient record forms for a predetermined number of RA patients who consulted consecutively during the study period; these patients completed patient-reported questionnaires. Descriptive statistics and multivariate regression were used to investigate the relationship between anxiety and depression with treatment and economic outcomes in RA patients. Results Of 1015 physician and patient pairs who completed all relevant questionnaire sections, 390 (38.4%) patients self-reported anxiety or depression, while 180 (17.7%) patients were reported to have anxiety or depression by their physicians. Controlling for age, gender, body mass index and clinical factors (flaring and severity), multiple regression analyses suggested that patients with anxiety or depression more often experienced treatment dissatisfaction (odds ratio [OR] 2.28; P < .001), had greater impairment in work (coefficient [β] = 11.82; P = .001) and usual activity (β = 14.73; P < .001), greater disability (β = .35; P < .001), and more often reported unemployment (OR 1.74; P = .001). Multinomial logistic regression revealed discordance between physician and patient satisfaction with treatment. For patients reporting anxiety or depression, physicians were more often satisfied with achievement of current disease control than patients (relative risk ratio 2.19; P = .002). Conclusion Concomitant anxiety or depression was associated with a significant incremental impact on the health-related quality of life and economic aspects of life of patients with RA. In light of observed differences between physician recognition of patient anxiety and/or depression versus patient reporting of anxiety and/or depression symptoms, further research is warranted to develop optimal screening and management of depression and anxiety in patients with RA.

scholarly journals Prospective evaluation of the impact of stress, anxiety, and depression on household income among young women with early breast cancer from the Young and Strong trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Erin E. Cook ◽  
Shoshana M. Rosenberg ◽  
Kathryn J. Ruddy ◽  
William T. Barry ◽  
Mary Greaney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Household Income ◽  
The United States ◽  
Anxiety And Depression ◽  
Link Type ◽  
Patient Reported ◽  
Household Incomes ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Background Young women with breast cancer tend to report lower quality of life and higher levels of stress than older women with breast cancer, and this may have implications for other psychosocial factors including finances. We sought to determine if stress, anxiety, and depression at diagnosis were associated with changes in household income over 12-months in young women with breast cancer in the United States. Methods This study was a prospective, longitudinal cohort study comprised of women enrolled in the Young and Strong trial. Of the 467 women aged 18–45 newly diagnosed with early-stage breast cancer enrolled in the Young and Strong trial from 2012 to 2013, 356 (76%) answered income questions. Change in household income from baseline to 12 months was assessed and women were categorized as having lost, gained, maintained the same household income <$100,000, or maintained household income ≥$100,000. Patient-reported stress, anxiety, and depression were assessed close to diagnosis at trial enrollment. Adjusted multinomial logistic regression models were used to compare women who lost, gained, or maintained household income ≥$100,000 to women who maintained the same household income <$100,000. Results Although most women maintained household income ≥$100,000 (37.1%) or the same household income <$100,000 (32.3%), 15.4% lost household income and 15.2% gained household income. Stress, anxiety, and depression were not associated with gaining or losing household income compared to women maintaining household incomes <$100,000. Women with household incomes <$50,000 had a higher risk of losing household income compared to women with household incomes ≥$50,000. Women who maintained household incomes ≥$100,000 were less likely to report financial or insurance problems. Among women who lost household income, 56% reported financial problems and 20% reported insurance problems at 12 months. Conclusions Baseline stress, anxiety, and depression were not associated with household income changes for young women with breast cancer. However, lower baseline household income was associated with losing household income. Some young survivors encounter financial and insurance problems in the first year after diagnosis, and further support for these women should be considered. Trial registration Clinicaltrials.gov, NCT01647607; date registered: July 23, 2012.

scholarly journals Changes in the illness perceptions of patients with rheumatoid arthritis over the first year of methotrexate therapy

Rheumatology ◽  
2020 ◽  
Author(s):  
James M Gwinnutt ◽  
Sam Norton ◽  
Kimme L Hyrich ◽  
Mark Lunt ◽  
Anne Barton ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Latent Class ◽  
Illness Perceptions ◽  
Group Membership ◽  
Multinomial Logistic Regression ◽  
Illness Perception ◽  
Relative Risk Ratio ◽  
First Year ◽  
Patient Reported

Abstract Objectives To describe the illness perceptions of patients with RA over the first year of MTX treatment, and the association between illness perceptions and outcomes. Methods Data came from the Rheumatoid Arthritis Medication Study (RAMS), a UK multicentre cohort study of RA patients starting MTX for the first time. Patients were assessed at baseline, and at 6 and 12 months. Patients completed the Brief Illness Perception Questionnaire (B-IPQ) at each assessment, as well as other patient-reported outcomes (PROs). The inflammation score (2-component DAS28) was calculated. Subgroups of patients with similar trajectories across the eight (B-IPQ) items were identified using a latent class growth model. Predictors of group membership were identified using multinomial logistic regression. Associations between subgroups and PROs over follow-up were assessed using linear mixed models. Results Three subgroups were identified in the analysis population (N = 1087): Positive illness perceptions (N = 322), Negative illness perceptions (N = 534) and Improvers (N = 231) who switched from negative to positive illness perceptions over follow-up. Baseline disability was associated with group membership [Positive vs Negative: relative risk ratio (RRR) 0.37, 95% CI: 0.25, 0.54; Improvers vs Negative: RRR 0.60, 95% CI: 0.43, 0.83], as were other PROs (pain, fatigue, anxiety, depression). The Negative group had worse disability, pain and fatigue over follow-up compared with the other groups, controlling for inflammation. Conclusion Negative illness perceptions are associated with poor PROs over time. The Improvers subgroup illustrated that illness perceptions can change in RA. Illness perceptions represent a potential therapeutic target that should be assessed using randomized trials.

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043863
Author(s):  
Jingyuan Wang ◽  
Ke Tang ◽  
Kai Feng ◽  
Xin Lin ◽  
Weifeng Lv ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Relative Humidity ◽  
Human Mobility ◽  
The United States ◽  
Reproductive Number ◽  
Cross Sectional ◽  
The Usa ◽  
Higher Temperature ◽  
Potential Impact ◽  
The Impact

ObjectivesWe aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.DesignA retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.SettingWe use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.ParticipantsA total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.Primary outcome measuresRegression analysis of the impact of temperature and relative humidity on the effective reproductive number (R value).ResultsStatistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (R value) in both China and the USA.ConclusionsHigher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in the R value of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in the R value by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.

scholarly journals Prevalence of anxiety and depression symptoms in pregnant women with type 2 diabetes and the impact on glycaemic control

2020 ◽  
Author(s):  
Björg Ásbjörnsdóttir ◽  
Marianne Vestgaard ◽  
Nicoline C. Do ◽  
Lene Ringholm ◽  
Lise L.T. Andersen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Pregnant Women ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
The Impact

scholarly journals POS1455-HPR RELATIONSHIP BETWEEN PSYCHOLOGICAL FACTORS AND MEASURES OF RHEUMATOID ARTHRITIS ACTIVITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1011.2-1011
Author(s):  
Y. Olyunin ◽  
V. Rybakova ◽  
E. Likhacheva ◽  
E. Nasonov
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Psychological Factors ◽  
Global Assessment ◽  
Activity Level ◽  
Anxiety And Depression ◽  
Tender Joint Count ◽  
Sf 36 ◽  
Patient Reported

Background:The patient-reported outcomes are important components of quantitative methods of rheumatoid arthritis (RA) activity assessment which are used to choose the appropriate drug therapy. The value of these parameters can be significantly affected not only by the inflammatory process, but also by the psychological characteristics of the patient and, in particular, by hardiness [1].Objectives:To study the relationship between psychological factors and signs of RA activity.Methods:Patients with RA who met the EULAR/ACR 2010 criteria, and observed at the V. A. Nasonova Research Institute of Rheumatology were included. Clinical examination was performed including patient global assessment (PGA), physician global assessment (PhGA), pain measurement on a visual analog scale, tender joint count (TJC), swollen joint count (SJC). The functional status was determined by HAQ, the quality of life – by SF-36 EQ-5D, the nature of pain – by painDETECT, the presence of anxiety and depression – by HADS. Patients also completed Hardiness Survey questionnaire to assess hardiness (HDS) and 3 components of the HDS – commitment (CMT), control (CT) and challenge (CLN). Disease activity was evaluated with DAS28, CDAI, and RAPID3. All patients signed informed consent to participate in the study. Analysis of the data was performed using Spearman’s rank test, Fisher exact test, qui-square and t-tests.Results:85 patients with RA were included. There were 69 women and 16 men. Mean age was 56.7±13.1 years, disease duration – 7.6±2.7 years. 72 patients were positive for rheumatoid factor, 75 – for anti-cyclic citrullinated peptide antibody. CDAI showed high activity in 15, moderate – in 37, low – in 30, and remission in 3 patients, DAS 28 – in 10, 55, 12, and 8, and RAPID3 – in 24, 25, 15, and 21, respectively. 24 patients had subclinically or clinically expressed anxiety and 15 –subclinically or clinically expressed depression (≥8 according to HADS). In 31 patients, the painDETECT questionnaire revealed possible or probable neuropathic pain. Mean HDS was 84.8±21.7, CMT – 38.9±9.2, CT – 29.4±8.6, CLN – 17.3±7.1. These values were comparable with the corresponding population data for this age group. There was a significant inverse correlation between HDS and RA activity measures, including SJC, TJC, DAS28 (p<0.05), pain, PGA, PhGA, CDAI, RAPID3, and HAQ (p<0.01). In addition, HDS and all its components positively correlated with quality of life, assessed by SF-36 and EQ-5D (p<0.01). In patients with subclinically and clinically expressed anxiety and depression, HDS, CMT, and CT were significantly lower than in patients without anxiety and depression (p<0.01), while the values of CLN in these groups did not differ significantly.Conclusion:The results of the present study suggest that low HDS may be one of the significant factors determining RA activity level because it does not allow patients to adapt adequately to a stressful situation produced by the disease.References:[1]Maddi SR. Am Psychol. 2008 Sep;63(6):563-4.Disclosure of Interests:None declared

scholarly journals Effectiveness of e-Health cardiac rehabilitation program on quality of life associated with symptoms of anxiety and depression in moderate-risk patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Raquel Bravo-Escobar ◽  
Alicia González-Represas ◽  
Adela María Gómez-González ◽  
Ángela Heredia-Torres
Keyword(s):  
Quality Of Life ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Program ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cardiac Rehabilitation Program ◽  
Moderate Risk ◽  
Risk Patients ◽  
The Impact

AbstractExploring new models of medical care requires evaluating the impact of new care strategies not only on physiological parameters but also on the quality of life of the patient. On the other hand the presence of anxiety together with depression requires further consideration when planning appropriate management strategies. The aim of this study was to examine the effectiveness of a home-based cardiac rehabilitation program incorporating an e-Health technology on health-related quality of life associated with symptoms of anxiety and depression in moderate-risk patients. A multicenter, randomized controlled clinical trial was designed to compare a traditional hospital based cardiac rehabilitation program (n = 38, 35 male) with a mixed home surveillance program where patients exercised at home with a remote electrocardiographic monitoring device (n = 33, 31 male). The Short Form-36 (SF-36) Health Survey and the Goldberg questionnaire were used to evaluate quality of life and the presence of symptoms of anxiety and depression respectively. The results of this study show that the type of cardiac rehabilitation program did not influence the improvement in quality of life (p = 0.854), but the presence of symptoms of anxiety and depression did (p = 0.001). Although both programs achieved a decrease in anxiety and depression symptoms and improved functional capacity (p ≤ 0.001), a significant interaction effect was found between the group with or without anxiety and depression symptoms and the type of program in the bodily pain dimension (p = 0.021). Trial registration: Retrospectively registered NCT02796404 (10/06/2016) in clinialtrials.gov.

THE ACTIVITIES OF THE USA AND CHINA IN THE REGIONS OF THE WORLD, AFFECTING THE REALIZATION OF RUSSIA'S INTERESTS. Part 1: country interests and activities

2021 ◽  
Vol 1 (10) ◽  
pp. 149-166
Author(s):  
Dmitry V. Gordienko ◽  
Keyword(s):  
United States ◽  
Russian Federation ◽  
The United States ◽  
Asia Pacific ◽  
The Arctic ◽  
The World ◽  
The Usa ◽  
The Russian Federation ◽  
The Military ◽  
The Impact

The paper examines the interests of Russia, the United States and China in the regions of the world and identifies the priorities of Russia's activities in Europe, Central Asia and the Caucasus, the Asia-Pacific region, the Arctic, Africa, the Middle East and Latin America, their comparative assessment with the interests of the United States and China. An approach to assessing the impact of possible consequences of the activities of the United States and China on the realization of Russia's interests is proposed. This makes it possible to identify the priorities of the policy of the Russian Federation in various regions of the world. The results of the analysis can be used to substantiate recommendations to the military-political leadership of our country. It is concluded that the discrepancy between the interests of the United States and China is important for the implementation of the current economic and military policy of the Russian Federation.

Patient reported outcomes in patients with desmoid type fibromatosis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11574-11574
Author(s):  
VIKAS GARG ◽  
Sameer Rastogi ◽  
Adarsh Barwad ◽  
Rambha Panday ◽  
Sandeep Kumar Bhoriwal ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Symptom Burden ◽  
Benign Neoplasm ◽  
Anxiety And Depression ◽  
Appendicular Skeleton ◽  
Healthy Controls ◽  
Symptom Scale ◽  
Cross Sectional ◽  
Patient Reported ◽  
The Impact

11574 Background: Desmoid type fibromatosis (DTF) is a rare benign neoplasm with infiltrative growth and high local recurrences. Due to long disease course, unpredictable growth pattern, and low mortality, using only survival outcomes may be inappropriate. In this study we assessed the impact of DTF on health related quality of life (HRQoL). Methods: This was a cross-sectional study done in patients with DTF. The study participants were asked to fill the EORTC QLQ-C30, GAD-7 and PHQ- 9 q uestionnaires to assess HRQoL, anxiety and depression . Outcomes were also compared with healthy controls. Results: 204 subjects (102 DTF patients and 102 healthy controls) were recruited. Study parameters have been summarized in Table. Appendicular skeleton (limbs + girdle) was most commonly involved in 59 % patients and abdominal wall or mesentery was involved in 22.5 %. Patients have received median of 2 lines of therapy. 54 % patients were currently on sorafenib and 41 % were under active surveillance. Mean global health status in DTF patient 65.58 ± 22.64, was significantly lower than healthy controls. Similarly, DTF patients scored low on all functional scales except cognitive functioning. Symptom scale showed significantly higher symptom burden of fatigue, pain, insomnia and financial difficulties. Anxiety & depression was observed in 39.22 % and 50 % of DTF patients respectively. DTF patients had higher rates of mild, moderate and severe anxiety and depression compared to healthy controls. No difference was observed based on site of disease. Conclusions: DTF patients have significant symptom burden, poor functioning, and heightened anxiety and depression. Patient reported outcomes should be routinely used to assess treatment efficacy in DTF patients.[Table: see text]

An Investigation of the Impact of COVID-19 Pandemic on Energy Consumption in the United States

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Lindsey Kahn ◽  
Hamidreza Najafi
Keyword(s):  
Energy Consumption ◽  
Correlation Coefficient ◽  
Energy Use ◽  
The United States ◽  
Annual Growth Rate ◽  
Total Consumption ◽  
The Usa ◽  
End Use ◽  
The Times ◽  
The Impact

Abstract Lockdown measures and mobility restrictions to combat the spread of COVID-19 have impacted energy consumption patterns. The overall decline of energy use during lockdown restrictions can best be identified through the analysis of energy consumption by source and end-use sectors. Using monthly energy consumption data, the total 9-months use between January and September for the years 2015–2020 is calculated for each end-use sector (transportation, industrial, residential, and commercial). The cumulative consumption within these 9 months of the petroleum, natural gas, biomass, and electricity energy by the various end-use sectors are compared. The analysis shows that the transportation sector experienced the greatest decline (14.38%). To further analyze the impact of COVID-19 on each state within the USA, the consumption of electricity by each state and each end-use sector in the times before and during the pandemic is used to identify the impact of specific lockdown procedures on energy use. The distinction of state-by-state analysis in this study provides a unique metric for consumption forecasting. The average total consumption for each state was found for the years 2015–2019. The total average annual growth rate (AAGR) for 2020 was used to find a correlation coefficient between COVID-19 case and death rate, population density, and lockdown duration. A correlation coefficient was also calculated between the 2020 AAGR for all sectors and AAGR for each individual end-user. The results show that Indiana had the highest percent reduction in consumption of 10.07% while North Dakota had the highest consumption increase of 7.61%. This is likely due to the amount of industrial consumption relative to other sectors in the state.

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