scholarly journals The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma

2021 ◽  
Vol 2 ◽  
Author(s):  
Rebecca F. McLoughlin ◽  
Vanessa M. McDonald

Asthma is a complex and heterogenous disease characterized by variability in disease expression and severity. Multiple extrapulmonary comorbidities and treatable traits are common in people with asthma, and there is an increasing appreciation of how these may complicate asthma management. This review will discuss the prevalence and impact of extrapulmonary comorbidities/risk factors or “traits,” which have been found to co-exist in asthma (obesity, symptoms of depression and/or anxiety and physical inactivity), the impact these traits have on future outcomes (including exacerbation risk and quality of life) and asthma management, and how we should target treatment in asthma when these extrapulmonary traits are present.

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041947
Author(s):  
Pamela G Mckay ◽  
Helen Walker ◽  
Colin R Martin ◽  
Mick Fleming

ObjectiveTo explore the relationship between symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM). The hypothesis predicated that there would be no significant differences between the group’s symptom experience.DesignA quasiexperimental design. Structural equation modelling (SEM) and invariance testing.ParticipantsMales (M) and females (F) >16 with a confirmed diagnosis of CFS/ME or FM by a general practitioner or specialist. CFS/ME (n=101, F: n=86, M: n=15, mean (M) age M=45.5 years). FM (n=107, F: n=95, M: n=12, M=47.2 years).Outcome measuresDiagnostic criteria: the American Centers for Disease Control and Prevention (CDC) for CFS/ME and the American College of Rheumatology (ACR) criteria for FM. Additional symptom questionnaires measuring: pain, sleep quality, fatigue, quality of life, anxiety and depression, locus of control and self-esteem.ResultsInvariance was confirmed with the exception of the American CDC Symptom Inventory, Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression Scale (p<0.05) based on five questions. Consequently, it was erroneous to conclude differences. Therefore, the Syndrome Model was created. SEM could not have tested the ACR previously, as it comprised a single data point. Thus, it was combined with these three questionnaires, increasing the data points, to create this new measurable model. Results confirmed no significant differences between groups (p=0.07 (p<0.05)).ConclusionParticipants responded in a similar manner to the questionnaire, confirming the same symptom experience. It is important to consider this in context with differing criteria and management guidelines, as this may influence diagnosis and the trajectory of patient’s management. With the biomedical cause currently unclear, it is the symptom experience and the impact on quality of life that is important. These findings are meaningful for patients, clinicians and policy development and support the requirement for future research.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Raquel Bravo-Escobar ◽  
Alicia González-Represas ◽  
Adela María Gómez-González ◽  
Ángela Heredia-Torres

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.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Mol ◽  
J Wessel ◽  
H A Verhoeve ◽  
J Maas ◽  
J P D Bruin ◽  
...  

Abstract Study question Is health-related quality of life (HRQoL) in women with unexplained subfertility and a poor prognosis influenced by expectant management or intrauterine insemination with ovarian stimulation? Summary answer HRQoL did not differ, except for the relational domain which was lower after expectant management. Anxiety and depression disorders occurred frequently in both groups. What is known already In couples with unexplained subfertility and a poor prognosis, IUI with ovarian stimulation (IUI-OS) is a first line treatment. Not much is known about quality of live or depression and anxiety in these couples. The Fertility Quality of Life (FertiQoL) is reliable for assessment within relational and social domains, the Hospital Anxiety and Depression Scale (HADS) is a reliable tool to detect anxiety and depression disorders. Study design, size, duration We performed a multicentre RCT in couples with unexplained subfertility with a poor prognosis of conceiving naturally within one year. Women were allocated 1:1 to six months expectant management or to six months IUI-OS. HRQoL was assessed with standard self-administered psychometric measures with established reliability and validity: FertiQol and HADS. We intended to include 1091 couples but after almost 4 years, the study had to stop due to slow inclusion and therefore lack of funding. Participants/materials, setting, methods Between June 2017 and September 2020, we recruited 178 women of wich 92 were assigned expectant management and 86 IUI-OS. All women who participated and could read Dutch were eligible for the HRQoL measurements because HRQoL questionnaires in foreign languages were not yet available online. Women completed the questionnaires before randomisation, 3 and 6 months after randomisation. We used mixed model analyses to assess differences between treatment groups and the effect of time. Main results and the role of chance One hundred sixty-two women could read Dutch and were invited (162/178 (91%)). Analyzable data of the FertiQol questionnaire were available for 80% (130/162). Compared to women allocated to IUI-OS, women allocated to expectant management had a lower FertiQol score in the relational domain (mean difference –4.3 (95% CI –7.3 to –1.3) but not in the social domain (mean diff van –0.8 (95% CI –4.5 to 2.9). Data of the HADS questionnaire were available of 156 women (96% (156/162)). Both groups had comparable scores in the Anxiety (mean difference –0.20; 95% CI 0.63; –0.99 to 0.6) and Depressions score (mean difference 0.002; 95% CI –0.67 to 0.67) at all three moments. At baseline, the incidence of an anxiety disorder (definition score 8 or higher) was 19% (30/156) and increased to 30% and 29% at 3 months and 6 months respectively. The incidence of a depression disorder (definition score 8 or higher) was 5% (7/156) and increased to 16% and 18% at 3 months and 6 months respectively. The incidences of anxiety or depression disorders did not differ significantly between expectant management and IUI. Limitations, reasons for caution Our randomized controlled trial did not reach the planned sample size. The results are only applicable to women with unexplained subfertility and a poor prognosis and not to all women with unexplained subfertility. Wider implications of the findings: Although often assumed, IUI-OS does not improve HRQoL compared to expectant management in all domains. IUI might prevent loss of quality of the relationship, but the impact seems small. Future studies should look into the high incidence of anxiety and depression disorders in these women and how to support them. Trial registration number Trial register NL5455 (NTR5599)


2020 ◽  
Vol 2 (3) ◽  
pp. 14
Author(s):  
Fatima I. AlNashri ◽  
Hayfa H. Almutary ◽  
Elham A. Al Nagshabandi

Context: Chronic kidney disease (CKD) is a life-threatening problem of global concern. Living with CKD is associated with many psychological problems, including depression and anxiety, which can directly or indirectly affect the quality of life. Only one review in the existing literature has assessed these associations among CKD patients using different dialysis modalities. However, the experience of these symptoms could be higher among patients on hemodialysis therapy. In this purview, there is a need to narrow the previous work to be more focused on hemodialysis patients. Aim: This scoping review aims to determine the gaps in the knowledge about the impact of anxiety and depression concerning QOL among people undergoing hemodialysis. Methods: The studies selected were those examined the relationships between depression or/and anxiety with quality of life in adult patients on hemodialysis. The CINAHL, MEDLINE, and Pub Med databases were searched for literature published between January 2012 and December 2019. The quality of the included studies was also apprised. Eleven studies met the inclusion criteria. Results: Six studies examined the impact of depression and anxiety on the quality of life. Five studies identified from the review have examined the relationships between depression and quality of life. It was established that the prevalence of anxiety and depression was high among hemodialysis patients, and the same was associated with low quality of life. Conclusion: The literature review highlights the negative associations between anxiety, depression, and quality of life among hemodialysis patients. It is, therefore, essential to screen hemodialysis patients frequently for anxiety and depression using a short-form questionnaire. This screening would allow for providing early interventions, and the potential deterioration of quality of life could be prevented. Further longitudinal studies are needed to assess these relationships. Additionally, further research is needed to determine effective interventional programs to improve the overall quality of life.


Cephalalgia ◽  
2007 ◽  
Vol 27 (8) ◽  
pp. 920-928 ◽  
Author(s):  
JC Garcia-Monco ◽  
N Foncea ◽  
A Bilbao ◽  
I Ruiz de Velasco ◽  
M Gomez-Beldarrain

Preventive therapy is aimed at reducing migraine frequency, but should also improve the much deteriorated quality of life of the migraneur. We aimed to evaluate the impact of preventive therapy with two widely employed drugs (topiramate and nadolol) on the quality of life of migraine patients. A population of consecutive migraineurs aged ≥16 years, with frequent migraines, was selected prospectively for evaluation at baseline and after 16 weeks of therapy with nadolol or topiramate (40 mg and 100 mg daily, respectively) by generic and specific quality of life questionnaires (SF-36 and MSQOL) and by an anxiety and depression scale (HADS). Preventive therapy resulted in a statistically significant improvement in physical domains of the SF-36, whereas mental domains remained almost unchanged. Despite this improvement, all domains remained below the population norms. The HADS revealed a moderate depressive state at baseline that did not change with therapy. The MSQOL global score also revealed statistically significant improvement. Both drugs were similarly effective, although topiramate was superior on the role physical domain compared with nadolol. Preventive therapy with nadolol and topiramate significantly improves the quality of life of migraineurs, although additional efforts are needed to place them in a nearer-to-normal situation compared with the general population.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6039-6039
Author(s):  
Fulvia Pedani ◽  
Mario Airoldi ◽  
Massimiliano Garzaro ◽  
Riccardo Torta ◽  
Luca Raimondo ◽  
...  

6039 Background: The treatment of oropharyngeal squamous cell carcinomas (OSCC) may heavily affect patient’s quality of life (QoL). Aim of our study was the evaluation of the impact of different treatments on physical and psychological functioning and on QoL of patients affected by stage III-IV disease. Methods: The enrolled sample was composed by 94 OSCC patients divided into 3 subgroups based on treatment modalities: surgery + adjuvant radiotherapy (S + RT: 30 patients), exclusive concomitant chemo-radiotherapy (CT + RT: 30 patients) and exclusive chemotherapy (CT) in 34 patients not suitable for surgery and/or radiotherapy. Psycho-oncological assessment included: Hospital Anxiety Depression Scale (HADS), Montgomery-Asberg Depression Scale (MADRS), Mini-Mental Adjustment to Cancer scale (MINI-MAC), EORTC QLQ C-30 questionnaire with the specific module Head and Neck 35 (H&N35). Results: The 60 patients primarily treated with S + RT or CT + RT presented superimposeable clinical and tumour characteristics while those treated with exclusive CT were affected by stage IV disease and in the 90% of cases underwent to previous treatment exclusive or combined treatment such as surgery, radiotherapy and chemotherapy. In the following table, data about physical and psychological functioning and on QoL of the 3 subgroups of patients are summarized. Conclusions: In stage III-IV OSCC treatments have a strong influence on QoL and coping styles. Patients treated with CT + RT were characterized by a lower percentage of self-reported anxiety and depression and higher EORTC Global QoL score. More than one third of patients treated with S + RT had overt symptoms of anxiety and depression. Stage IV patients treated with palliative CT had elevated level of anxiety, depression and low quality of life. Auto-evaluation is less effective in depression assessment. The role of concomitant psychological supportive care should be evaluated in these patients treated with different approaches. [Table: see text]


2021 ◽  
Author(s):  
Albin Klang ◽  
Britta Westerberg ◽  
Mats B. Humble ◽  
Susanne Bejerot

Abstract Background: Autism spectrum disorder (ASD) and schizotypal personality disorder can be difficult to distinguish. Deficits in social relationships and social interaction, present in both conditions, are known to impair quality of life. The aim of the present study was to investigate if schizotypal symptoms affect quality of life among adults diagnosed with autism spectrum disorder and to study the association between schizotypy and autistic traits among them. Methods: Participants diagnosed with autism spectrum disorder (n=110) completed questionnaires exploring schizotypy (Schizotypal Personality Questionnaire – Brief Revised (SPQ-BR)), autistic traits (The Ritvo Autism, Asperger Diagnostic Scale-Revised Screen 14 items), anxiety and depression (The Hospital Anxiety and Depression scale) and quality of life (Brunnsviken Brief Quality of Life Scale and the European quality of life index version 5D). Results: Schizotypy was found to be associated with anxiety, depressive and autistic symptoms, and poor quality of life. Although schizotypy was a predictor for impaired quality of life, this relationship was mediated by symptoms of anxiety and depression, plausibly inherent to autism. Autistic traits were positively associated with all higher order constructs of the SPQ-BR, i.e. positive and negative schizotypy, disorganization and social anxiety, as well as with poor quality of life. Conclusions: There is considerable overlap between schizotypy and autism that needs to be considered in research. Prominent schizotypal traits in people with ASD may constitute an endophenotype coinciding with a particularly poor quality of life.


2021 ◽  
pp. 345-351
Author(s):  
Iryna SHMAKOVA ◽  
Svitlana PANINA ◽  
Volodymyr MYKHAYLENKO

Introduction. Comorbidity is an independent risk factor for mortality and significantly influences the prognosis and quality of life. Purpose: to evaluate the impact of high-tone HiTOP 4 touch therapy on cognitive disorders and quality of life in the complex treatment of patients with comorbid pathology. Methods: complex treatment of 2 groups of patients with inclusion in the basic treatment regimen of high-tone therapy was carried out - a total of 80 patients (men - 34, women - 46) aged 41 to 79 years old, group I - patients with hypertension and chronic cerebral ischemia (CСI) - 38 patients and group II - patients with hypertension, CСI and concomitant diabetes mellitus (DM) type 2 - 42 patients. The average age in group I was 61.5, in group II - 65.5. Group I received lisinopril and amlodipine in one tablet, group II received metformin in addition to the above therapy. Both groups received a course of 10 sessions of high-tone therapy using the device HiTOP 4 touch (Germany) according to the general method: 2 electrodes on the feet, 2 on the forearms and one on the neck-collar area. All the patients were assessed for their cognitive condition, degree of anxiety and depression, and estimated for quality of life before and after a course of high-tone therapy. In order to do this, we used valid assessment tests, such as the Montreal Cognitive Assessment Scale (MoCA), the Hospital Anxiety and Depression Scale (HADS), and the SF-36 Quality of Life Questionnaire. Results: the course of high-tone therapy for patients with hypertension and CCI led to improved quality of life, on all indicators of the SF-36 scale, except for pain intensity, increased cognitive functions by 3.52 points on the MoCA scale, reduced anxiety by 2.06 points and depression by 1.92 points on the HADS scale. The course of high-tone therapy for patients with CCI, hypertension and type 2 DM resulted in a significant improvement of 5 out of 8 quality of life indicators on the SF-36 scale, cognitive functions by 2.27 points on the MoCA scale and reduced anxiety by 4.3 points, and depression by 0.53 points on the HADS scale. Conclusion: the inclusion of high-tone therapy in the complex treatment of patients with comorbid pathology improves cognitive functions, reduces anxiety and depression, improves quality of life. Keywords: comorbid pathology, high-tone therapy, cognitive functions, anxiety, depression, quality of life,


Author(s):  
H. Saghafi ◽  
A. Ayoub ◽  
K. Naudi ◽  
M. Venkatesh ◽  
K. Kemp

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