Depression

Author(s):  
Ndapewa Nehale Shifiona ◽  
Daniel Opotamutale Ashipala

This chapter provides a broad overview of depression in adults. Depression is one of the leading causes of disability globally. It is a syndrome with central features of low mood, lack of enjoyment, reduced energy, negative thinking, poor sleep and appetite, lack of concentration, and suicidal ideation. It affects everyone. The purpose of this chapter is to outline the link between various contributory factors and depression among the adult population. Optimal management processes, including self-care, reduce the risk of relapse and improve the quality of life.

Author(s):  
Pernilla Lagergren ◽  
Asif Johar ◽  
Helen Rosenlund ◽  
Lars Arnberg ◽  
Lena Haglund ◽  
...  

Abstract Purpose Esophagectomy for cancer is an extensive procedure often followed by severe complications. This study investigated whether patients with severe symptoms of reflux are more likely to have sleep disturbances and reduced health-related quality of life (HRQL) after esophagectomy. Methods This Swedish nationwide prospective cohort study encompassed all patients who had undergone esophagectomy for cancer between 2013 and 2018. One year after surgery, the patients responded to three questionnaires on reflux (EORTC QLQOG25), sleep disturbances (KSQ), and HRQL (EORTC QLQ-C30). Multivariable logistic regression provided odds ratios (OR) with 95% confidence intervals (CI) for sleep disturbance/reduced HRQL between patients with and without reflux, adjusted for potential confounders. Results Among 241 esophagectomy patients, 66 (27%) reported severe reflux. Patients with reflux had an increased risk of sleep disturbances (OR 2.3, 95% CI: 1.3–4.3) compared to patients without reflux. More specifically, these patients were more likely to suffer from poor sleep quality (OR 4.9, 95% CI: 1.9–12.4). Patients with reflux and sleep disturbances reported reductions in global quality of life, role function, emotional function, social function, and more symptoms in all scales, except for dyspnea. Conclusions This study suggests that patients with severe symptoms of reflux after esophagectomy have an increased risk of sleep disturbances and poor sleep quality, which in turn are associated with reduced HRQL. Implications for Cancer Survivors Alleviating reflux after oesophageal cancer surgery is important, since this common symptom might reduce HRQL and well-being.


Obesity ◽  
2017 ◽  
Vol 25 (9) ◽  
pp. 1540-1548
Author(s):  
Sandra A. Tsai ◽  
Lan Xiao ◽  
Nan Lv ◽  
Ying Liu ◽  
Jun Ma

2020 ◽  
Vol 10 (9) ◽  
pp. 3282
Author(s):  
Angela Shin-Yu Lien ◽  
Yi-Der Jiang ◽  
Jia-Ling Tsai ◽  
Jawl-Shan Hwang ◽  
Wei-Chao Lin

Fatigue and poor sleep quality are the most common clinical complaints of people with diabetes mellitus (DM). These complaints are early signs of DM and are closely related to diabetic control and the presence of complications, which lead to a decline in the quality of life. Therefore, an accurate measurement of the relationship between fatigue, sleep status, and the complication of DM nephropathy could lead to a specific definition of fatigue and an appropriate medical treatment. This study recruited 307 people with Type 2 diabetes from two medical centers in Northern Taiwan through a questionnaire survey and a retrospective investigation of medical records. In an attempt to identify the related factors and accurately predict diabetic nephropathy, we applied hybrid research methods, integrated biostatistics, and feature selection methods in data mining and machine learning to compare and verify the results. Consequently, the results demonstrated that patients with diabetic nephropathy have a higher fatigue level and Charlson comorbidity index (CCI) score than without neuropathy, the presence of neuropathy leads to poor sleep quality, lower quality of life, and poor metabolism. Furthermore, by considering feature selection in selecting representative features or variables, we achieved consistence results with a support vector machine (SVM) classifier and merely ten representative factors and a prediction accuracy as high as 74% in predicting the presence of diabetic nephropathy.


2005 ◽  
Vol 19 (1) ◽  
pp. 15-35 ◽  
Author(s):  
David Armstrong ◽  
John K Marshall ◽  
Naoki Chiba ◽  
Robert Enns ◽  
Carlo A Fallone ◽  
...  

BACKGROUND: Gastroesophageal reflux disease (GERD) is the most prevalent acid-related disorder in Canada and is associated with significant impairment of health-related quality of life. Since the last Canadian Consensus Conference in 1996, GERD management has evolved substantially.OBJECTIVE: To develop up-to-date evidence-based recommendations relevant to the needs of Canadian health care providers for the management of the esophageal manifestations of GERD.CONSENSUS PROCESS: A multidisciplinary group of 23 voting participants developed recommendation statements using a Delphi approach; after presentation of relevant data at the meeting, the quality of the evidence, strength of recommendation and level of consensus were graded by participants according to accepted principles.OUTCOMES: GERD applies to individuals who reflux gastric contents into the esophagus causing symptoms sufficient to reduce quality of life, injury or both; endoscopy-negative reflux disease applies to individuals who have GERD and a normal endoscopy. Uninvestigated heartburn-dominant dyspepsia -- characterised by heartburn or acid regurgitation - includes erosive esophagitis or endoscopy-negative reflux disease, and may be treated empirically as GERD without further investigation provided there are no alarm features. Lifestyle modifications are ineffective for frequent or severe GERD symptoms; over-the-counter antacids or histamine H2-receptor antagonists are effective for some patients with mild or infrequent GERD symptoms. Proton pump inhibitors are more effective for healing and symptom relief than histamine H2-receptor antagonists; their efficacy is proportional to their ability to reduce intragastric acidity. Response to initial therapy - a once-daily proton pump inhibitor unless symptoms are mild and infrequent (fewer than three times per week) - should be assessed at four to eight weeks. Maintenance medical therapy should be at the lowest dose and frequency necessary to maintain symptom relief; antireflux surgery is an alternative for a small proportion of selected patients. Routine testing for Helicobacter pylori infection is unnecessary before starting GERD therapy. GERD is associated with Barrett's epithelium and esophageal adenocarcinoma but the risk of malignancy is very low. Endoscopic screening for Barrett's epithelium may be considered in adults with GERD symptoms for more than 10 years; Barrett's epithelium and low-grade dysplasia generally warrant surveillance; endoscopic or surgical management should be considered for confirmed high-grade dysplasia or malignancy.CONCLUSION: Prospective studies are needed to investigate clinically relevant risk factors for the development of GERD and its complications; GERD progression, on and off therapy; optimal management strategies for typical GERD symptoms in primary care patients; and optimal management strategies for atypical GERD symptoms, Barrett's epithelium and esophageal adenocarcinoma.


2021 ◽  
Vol 105 (1) ◽  
pp. 78-81
Author(s):  
N. Zhachko ◽  
◽  
T. Nespriad’ko-Monborgne ◽  
I. Skrypnyk ◽  
M. Zhachko ◽  
...  

Summary: The search for and development of methods for determining the quality of life is an urgent problem of foreign and domestic medicine, and the state of dental health plays a very important role. An important role in human communication plays the maxillofacial area. Therefore, the most important areas and defects associated with the communication process – defects in the frontal area, smile, change of pronunciation, spitting during the conversation – all these signs accompany a number of anomalous processes. Objective: to assess the impact of dental status on the quality of life of the adult population in the presence of the disease periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities. Materials and methods. To study this goal, a survey of 283 patients who applied was conducte with complaints of aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity. Results. A complete analysis of factors that significantly affected the quality of life of patients with a number of diseases was obtained oral cavity. Conclusions. Deficiencies related to oral health reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But for the best results positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment. Key words: quality of life, dental health correction.


2021 ◽  
Vol 11 (1) ◽  
pp. 69-77
Author(s):  
THAÍS CAMPELO BEDÊ VALE ◽  
LÍVIA RODRIGUES DE ARAÚJO ◽  
VITÓRIA NUNES MEDEIROS ◽  
JOSÉ HÍCARO HELLANO GONÇALVES LIMA PAIVA ◽  
TATIANA PASCHOALETTE RODRIGUES BACHUR ◽  
...  

Depression is a common mental condition worldwide and a major cause of debility, with the potential to impair the quality of life of affected people. Medical students are more likely to develop psychiatric disorders, with depression, anxiety, and burnout being the most common ones. The aim of this study was to investigate the prevalence of depressive symptoms in medical students and their association with burnout and aspects of life. This is an analytical cross-sectional study. Data collection was performed using four validated scales and a questionnaire in 511 medical students from the first to the fourth year from different universities. Depression was present in 49% of the students. A correlation was found between depression and female gender. Regarding the students' daily sleep time, 54.5% of the students slept only 3 to 6 hours per night. The use of psychoactive substances was reported by 29.9%. Regarding the emotional support offered by universities, about 92.8% of students with depressive symptoms reported not receiving adequate emotional support. As for quality of life, all domains were impaired among students with depression. According to the two-dimensional criterion, 37% of the students have burnout, with correlation between the presence of the syndrome and depressive symptoms. In addition, burnout proved to be an independent risk factor for suicidal ideation and self-mutilation. New methods that can help detect and address factors that trigger stress and depressive symptoms in medical students are needed to reduce the incidence of depression.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Svetlana Solgaard Nielsen ◽  
Søren T. Skou ◽  
Anette Enemark Larsen ◽  
Jens Søndergaard ◽  
Jeanette Reffstrup Christensen

Abstract Objectives We investigated the associations between health-related quality of life (HRQoL) and health, pain and lifestyle factors, as well as motivation for lifestyle changes, in adults living with chronic pain referred to a Danish pain centre. Methods A total of 144 outpatients completed a questionnaire on HRQoL (EQ-5D-5L), health, pain, lifestyle factors (Body Mass Index [BMI], physical activity, smoking, alcohol, physical fitness, eating, sleep and stress) and motivation for lifestyle changes. We used multiple linear regression analyses to assess associations between HRQoL and the independent variables. Results The participants (age mean 50 years, 81% females) had ≥2 body pain sites (93%), BMI≥25 (64%), sedentary lifestyle (43%) and multiple (n≥2) elevated metabolic risk factors (58%). Most considered lifestyle important for HRQoL (72%) and expressed moderate to very high motivation for changing lifestyle (92%). Poorer HRQoL in the study population was significantly associated with higher pain intensity in the most painful body site (β=−0.316, p=0.001) and very poor sleep quality (β=−0.410, p=0.024). Serious-to-extreme problems in usual activities were associated with significantly poorer health (β=−0.328, p=0.030). Conclusions Adults living with chronic pain participating in this survey had significantly lower self-evaluated HRQoL than the general population. Lower HRQoL was significantly associated with greater pain intensity and poor sleep quality. Serious-to-extreme problems in usual activities, such as work, study, housework, family and leisure, were associated with poorer self-evaluated health. We observed high frequencies of overweight, obesity, sedentary lifestyle, pain in multiple body sites and multiple lifestyle-related risk factors in the study population. Most participants felt motivated for changing lifestyle. Further interventions addressing pain alleviation, sleep quality, prevention of problems in usual activities and promotion of healthy lifestyle, e.g. physical activity and healthy eating, are needed to estimate the effect of a lifestyle-oriented approach on health and quality of life in people living with chronic pain. The results of this study will inform the research project reg. SJ-703, the Danish the Research Ethics Committee for Region Zealand, Denmark.


Author(s):  
Rebecca Burke ◽  
Sriram Yennurajalingam

Sleep disturbance is a persistent source of suffering in palliative care patients. Symptoms such as difficulty falling asleep, staying asleep, early awakening, or nonrestorative sleep are all indicative of sleep disorders. Poor sleep can have consequential effects on perception of pain, fatigue, mood, and quality of life. It is not only a prevalent symptom in the primary care population but also may in fact affect more than 60% of the palliative care population. In addition to the complexities of treatment, insomnia often serves as a red herring to alarm physicians of underlying conditions. Therefore, it is essential that palliative care physicians maintain a high index of suspicion for such confounding conditions as restless leg syndrome, sleep apnea, and delirium. This chapter highlights the intricacies of sleep disturbance and focuses on the most common patient presentations.


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