scholarly journals Revisiting the tryptophan-serotonin deficiency and the inflammatory hypotheses of major depression in a biopsychosocial approach

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3968 ◽  
Author(s):  
Andreas Baranyi ◽  
Omid Amouzadeh-Ghadikolai ◽  
Dirk von Lewinski ◽  
Robert J. Breitenecker ◽  
Hans-Bernd Rothenhäusler ◽  
...  
Keyword(s):  
Social Support ◽  
Life Satisfaction ◽  
Major Depression ◽  
Healthy Controls ◽  
Sf 36 ◽  
Study Results ◽  
Related Quality ◽  
Health Related ◽  
Serotonin Deficiency ◽  
Depressive Patients

Background The aim of this cross-sectional study was to identify important biopsychosocial correlates of major depression. Biological mechanisms, including the inflammatory and the tryptophan-serotonin deficiency hypotheses of major depression, were investigated alongside health-related quality of life, life satisfaction, and social support. Methods The concentrations of plasma tryptophan, plasma kynurenine, plasma kynurenic acid, serum quinolinic acid, and the tryptophan breakdown to kynurenine were determined alongside health-related quality of life (Medical Outcome Study Form, SF-36), life satisfaction (Life Satisfaction Questionnaire, FLZ), and social support (Social Support Survey, SSS) in 71 depressive patients at the time of their in-patient admittance and 48 healthy controls. Results Corresponding with the inflammatory hypothesis of major depression, our study results suggest a tryptophan breakdown to kynurenine in patients with major depression, and depressive patients had a lower concentration of neuroprotective kynurenic acid in comparison to the healthy controls (Mann–Whitney-U: 1315.0; p = 0.046). Contradicting the inflammatory theory, the concentrations of kynurenine (t: −0.945; df = 116; p = 0.347) and quinolinic acid (Mann-Whitney-U: 1376.5; p = 0.076) in depressive patients were not significantly different between depressed and healthy controls. Our findings tend to support the tryptophan-serotonin deficiency hypothesis of major depression, as the deficiency of the serotonin precursor tryptophan in depressive patients (t: −3.931; df = 116; p < 0.001) suggests dysfunction of serotonin neurotransmission. A two-step hierarchical linear regression model showed that low tryptophan concentrations, low social support (SSS), occupational requirements (FLZ), personality traits (FLZ), impaired physical role (SF-36), and impaired vitality (SF-36) predict higher Beck Depression Inventory (BDI-II) scores. Discussion Our study results argue for the validity of a biopsychosocial model of major depression with multiple pathophysiological mechanisms involved.

scholarly journals Psychosocial Resources for Hedonic Balance, Life Satisfaction and Happiness in the Elderly: A Path Analysis

2020 ◽  
Vol 17 (16) ◽  
pp. 5684
Author(s):  
Raquel Lara ◽  
Mᵃ Luisa Vázquez ◽  
Adelaida Ogallar ◽  
Débora Godoy-Izquierdo
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Older Adults ◽  
Life Satisfaction ◽  
Self Efficacy ◽  
Psychosocial Resources ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

We explored possible paths from physical and mental health-related quality of life, self-efficacy, optimism, and social support to happiness in older adults, considering hedonic balance and life satisfaction as mediators. A total of 154 Spanish male and female (50%) older adults (65–96 years old, M = 77.44, SD = 8.03; 64% noninstitutionalized elderly) voluntarily participated in this correlational, cross-sectional study. The participants completed self-reports on their perceived health status, self-efficacy, social support, optimism, and global subjective well-being (SWB) as well as its dimensions. Path analysis was used to examine direct and indirect relationships. The final model had an excellent fit with the data (χ2(10) = 11.837, p = 0.296, χ2/df = 1.184; SRMR = 0.050, CFI = 0.994, RMSEA = 0.035), revealing the unique causal effects of all the included predictors on happiness. With the exception of self-efficacy, the psychosocial resources predicted older adults’ current happiness, and this relationship was fully mediated by hedonic balance and life satisfaction, which were found to be putative intermediary factors for SWB. Self-efficacy in turn predicted the remaining psychosocial resources. Our findings extend the existing evidence on the influences of health-related quality of life, self-efficacy, optimism, and social support on SWB. Furthermore, they support the proposal of hedonic balance and life satisfaction as dimensions of SWB, thus supporting the tripartite hierarchical model of happiness. These results may inform future interventions seeking to improve happiness in late adulthood.

Fatigue Is the Major Aspect Compromising Health-Related Quality of Life of Chronic Myeloid Leukemia Patients Receiving Long-Term Imatinib Therapy

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4234-4234
Author(s):  
Fabio Efficace ◽  
Michele Baccarani ◽  
Massimo Breccia ◽  
Francesco Cottone ◽  
Gianantonio Rosti ◽  
...  
Keyword(s):  
Social Support ◽  
Myeloid Leukemia ◽  
Imatinib Therapy ◽  
Health Related Quality ◽  
Factors Associated ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Abstract Abstract 4234 Background: Whilst recent data indicates that survival of chronic myeloid leukemia (CML) patients, who are in complete cytogenetic response (CCyR) with Imatinib therapy, is not statistically significantly different from that of the general population, health-related quality of life (HRQOL) differences do exist. However, to date no study has investigated the predictive factors of long-term HRQOL outcomes of CML patients treated with TKIs. Aim: The main objective of this study was to investigate potential key factors associated with long-term HRQOL outcomes of CML patients in CCyR treated with first line Imatinib therapy. A secondary objective was to investigate the relationships between fatigue and other treatment related symptoms and describe how fatigue relates to socio-demographic and clinical data. Patients and Methods: Analysis was performed on 422 CML patients recruited in an observational multicenter study. Median time in treatment with Imatinib was five years (range: 3 to 9.3 years). HRQOL was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). This questionnaire consists of 36 items covering eight generic HRQOL domains: physical functioning (PF), role limitations due to physical health (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social functioning (SF), role limitations due to emotional problems (RE), and mental health (MH). Predictor variables investigated included, fatigue and social support, measured with two psychometrically robust questionnaires, that is the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and the multidimensional scale of perceived social support (MSPSS) scale. Other CML treatment related symptoms were measures with an ad hoc CML symptom checklist. Key socio-demographic and clinical data including, age, gender, education, Sokal risk, response to therapy and duration of treatment, were also considered. Univariate and multivariate regression analyses were used to identify a set of independent predictors for each SF-36 scale, via a stepwise selection procedure. Results: In the multivariate analysis the following factors independently predicted a better PF: younger age (P<0.001), being male (P<0.001), higher education (P=0.002), and less fatigue(P<0.001). Together, this set of variables explained 56% of the variance in the PF scale. Fatigue was the only variable showing an independent and consistent association across all HRQOL domains measured by the SF-36. Role physical (RP) and role emotional (RE) scales (SF-36) were found to be the two mostly compromised aspects by fatigue severity. As fatigue was found to be the main predictor variable, for descriptive purposes in figure 1 we report mean scores of the SF-36 scales by levels of fatigue. Mean score differences, between patients reporting low versus high fatigue levels, were respectively 70 and 63 points for the RP and RE scales. Higher perceived social support independently predicted better social functioning (P<.001) and mental health (P<.001). Hb levels, measured at the most recent follow-up visit (mean time 2.9 weeks), showed a weak correlation (r=.187) with fatigue. Higher levels of fatigue were more common in those patients who already had comorbidity at diagnosis and in female patients. Patients who reported higher levels of fatigue also reported a higher severity of other CML symptoms. Conclusion: To our knowledge, this was the first investigation to date of factors associated with long-term HRQOL in CML patients being treated with an oral anticancer-targeted therapy. Our findings suggest that although responding to Imatinib therapy, long-term patient's HRQOL is greatly affected by fatigue levels. Also, our results suggest that symptom management is crucial to the possible improvement of HRQOL outcomes. Legend: Low, Low-Medium, Medium-High and High correspond respectively to the 4th (75th to 100th percentile), 3rd, 2nd and 1st (0th to 25th percentile) quartile of FACIT-Fatigue scale. On this scale, the higher the score the lower is the level of fatigue. Disclosures: Efficace: Bristol Myers Squibb: Consultancy; Novartis: Research Funding. Baccarani:Novartis : Consultancy, Honoraria; Bristol Myers Squibb: Consultancy, Honoraria; Pfizer and Ariad: Honoraria. Breccia:Bristol Myers Squibb: Consultancy; Novartis: Consultancy. Rosti:Novartis: Consultancy, Honoraria, Research Funding; Bristol Myers Squibb: Consultancy, Honoraria. Alimena:Novartis: Honoraria; Bristol Myers Squibb: Honoraria. Turri:Novartis: Consultancy, Novartis Other; Bristol Myers Squibb: Bristol Myers Squibb, Bristol Myers Squibb Other, Consultancy.

scholarly journals Health-Related Quality of Life in Older Coastal Residents After Multiple Disasters

2016 ◽  
Vol 11 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Katie E. Cherry ◽  
Laura Sampson ◽  
Sandro Galea ◽  
Loren D. Marks ◽  
Kayla H. Baudoin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Older Adults ◽  
Social Engagement ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Coastal Residents

AbstractObjectiveExposure to multiple disasters, both natural and technological, is associated with extreme stress and long-term consequences for older adults that are not well understood. In this article, we address age differences in health-related quality of life in older disaster survivors exposed to the 2005 Hurricanes Katrina and Rita and the 2010 BP Deepwater Horizon oil spill and the role played by social engagement in influencing these differences.MethodsParticipants were noncoastal residents, current coastal residents, and current coastal fishers who were economically affected by the BP oil spill. Social engagement was estimated on the basis of disruptions in charitable work and social support after the 2005 hurricanes relative to a typical year before the storms. Criterion measures were participants’ responses to the SF-36 Health Survey which includes composite indexes of physical (PCS) and mental (MCS) health.ResultsThe results of logistic regressions indicated that age was inversely associated with SF-36 PCS scores. A reduction in perceived social support after Hurricane Katrina was also inversely associated with SF-36 MCS scores.ConclusionsThese results illuminate risk factors that impact well-being among older adults after multiple disasters. Implications of these data for psychological adjustment after multiple disasters are considered. (Disaster Med Public Health Preparedness. 2017;11:90–96)

scholarly journals Analysis of the Situation of Unmet Health Care Need Among Extremely Rare Disease of Gaucher

2020 ◽  
Author(s):  
Xinye Qi ◽  
Jiao Xu ◽  
Linghan Shan ◽  
Ye Li ◽  
Yu Cui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Health Care ◽  
Health Service ◽  
Health Service Utilization ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Abstract BackgroundThe diagnosis and health care of patients with rare diseases present a tremendous challenge worldwide. This study estimated the health service utilization, cost of illness, and patients with Gaucher disease (GD)’s/caregivers’ health-related quality of life in China.MethodAn online retrospective survey of patients with GD and their caregivers was conducted during May-June 2018. Socio-demographic, health service utilization, disease-related expenses, social support, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the Short Form Health Survey (SF-36) were investigated. Using self-reported information, we estimated the annual cost of illness, including direct medical, direct non-medical, and indirect medical costs. ResultsForty patients and their 49 caregivers were surveyed. The patients’ onset age of GD was 9.3±10.9; their disease course was 3.5±3.1 years. 21 (42.9%) patients had ≥2 caregivers, but 35 (71.4%) caregivers reported have no experience as a caregiver. 79.6% caregivers have stopped working, and 87.8% changed weekly working schedule. Before final diagnosis, patients visited 3.9±3.1 (max=20) hospitals and took 1.2±1.7 (max=6.6) years for confirmed diagnosis. On average, 5.0±9.6 misdiagnoses occurred, and the per-patient diagnoses cost was USD ($) 7,576. After GD confirmation, 8 (16.3%) patients received no treatment, 40 (81.6%) received pharmacotherapy, 10 (20.4%) received surgery, 38 (77.6%) received outpatient service (8.8±9.1 times/annually), and 37 (77.5%) received inpatient service (4.0±3.5 times/annually). Annual per-patient cost was USD ($) 49,925 (95% confidence interval: 29,178, 70,672). Average direct medical cost was $41,816, including pharmaceutical ($29,908), inpatient ($7,451), and outpatient ($1,838). Productivity loss per-caregiver was $1,980, and their Zarit Burden Inventory score was moderate-severe (48.6±19.6). Both patients/caregivers reported lower social support (32.4±7.4, 34.9±7.6), two times higher PSQI (7.9±2.9, 8.7±3.6), and half lower SF-36 (41.3±18.6, 46.5±19.3) than those reported for healthy Chinese individuals.ConclusionThis study finds out that fill the unmet need for extremely rare diseases is very challenging. The high misdiagnosis rate, together with delayed diagnosis, substantial costs, and deteriorated health-related quality of life of GD patients as well as their heavy care burden, calls for extreme attention from policymakers in China. Further efforts of government and society are urgently demanded, including pharmaceutical reimbursement, screening newborns, developing precise diagnostic tools, and training doctors.

scholarly journals P230 Health-related quality of life in adolescents and young adults (AYA) with inflammatory bowel disease and its correlations with demographic, clinical, laboratory and therapeutic evaluations

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S257-S258
Author(s):  
J Oba ◽  
M Deboni ◽  
R Toma ◽  
C Sobrado ◽  
M Azevedo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Young Adults ◽  
Healthy Controls ◽  
Health Related Quality ◽  
Overlap Syndromes ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Abstract Background IBD, including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic recurrent inflammatory diseases of the gastrointestinal tract, most often diagnosed in adolescence and young adulthood. Extra-intestinal manifestation (EIM) may be present initially in up 50% or before IBD is diagnosed. IBD and its complications are associated with morbidity and has considerable impact upon patients’ health-related quality of life (HRQoL). HRQoL is an essential complement to the examination of clinical symptoms and functional limitations and has emerged as an important outcome measure to evaluate an individual’s adaptation to a chronic medical condition like IBD. It is known the neurocognitive maturation that support integration of executive and emotion systems are not fully mature until 25 years, making this period a time of socio-emotional vulnerability and adjustment. So, our objective was to evaluate the HRQoL in adolescents and young adults (AYA) patients with IBD and compare with a peer’s health control and investigate the variables which can be attributed to HRQoL in these patients. Methods 59 AYA IBD patients (13–25 years) and 60 AYA healthy controls (13–25 years) completed the Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Short Form Health Survey (SF-36) questionnaires and pain visual scale, according to age. After we compared HRQoL between Crohn’s disease (CD) vs. UC (ulcerative colitis) in AYA population. The demographic data, extra-intestinal manifestation, overlap syndromes, disease active status, treatment and outcomes were also evaluated. Results PedsQL4.0 domain ‘school/ work’ and SF-36 domain ‘general health perception’ was reduced in IBD AYA patients compared with healthy controls (p &lt; 0.05). However, no difference in all domains and pain scale was observed between CD and UC AYA patients. Disease activity, as well as extra-intestinal manifestations, overlap syndromes, treatments and outcomes, did not influence the HRQoL of the AYA patients. Autoimmune sclerosing cholangitis and the use of prednisone were significantly higher among UC patients, whereas previous gut surgery was higher between CD patients. However, these disease factors did not significantly influence the HRQoL between CD vs. UC. Conclusion HRQoL was significantly lower among IBD AYA patients when compared with healthy controls. Disease factors did not influence HRQoL between CD and UC AYA patients. These results highlight areas to focus clinical attention for assessment and future interventions among AYA with IBD.

scholarly journals MOVE UP STUDY RESULTS: WEIGHT LOSS POSITIVELY AFFECTS HEALTH-RELATED QUALITY OF LIFE BUT NOT DEPRESSIVE SYMPTOMS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S896-S896
Author(s):  
Elizabeth M Venditti ◽  
Robert M Boudreau ◽  
Anne B Newman ◽  
Michelle E Danielson ◽  
Lori A Kieffer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Depressive Symptoms ◽  
Physical Component Score ◽  
Health Related Quality ◽  
Sf 36 ◽  
Study Results ◽  
Related Quality ◽  
Health Related

Abstract Obesity is prevalent among older adults as are increases in depressive symptoms and declines in health-related quality of life (HRQOL). Healthy weight loss and mitigating mild depressive symptoms (MDS) and HRQOL could have critical public health significance. The Mobility and Vitality Lifestyle Program (MOVE UP) led by Community Health Workers delivered 32 healthy aging/weight management group sessions over 13 months. Data from 240 participants were evaluated to assess program impact on CES-D (20-item) depressive symptom and SF-36 HRQOL scores. Participants were 88% female, 28% black/other race, 42% ≥ college-educated. Mean (SD) age was 67.6 (4.1) and BMI was 34.7 (4.7). At baseline, average CES-D score was 7.9 (7.2) and 27.9 % (N = 67) had MDS, scoring 17.1 (6.2). Results show significant mean (SD) weight change of -12.7 (13.3) lb from baseline (p&lt;0.0001). Overall, CES-D mean (SD) score change was -0.4 (6.7) (p=0.33); participants with MDS had an average CES-D decrease of -4.4 (7.8) points (p&lt;0.0001). Further, HRQOL improved significantly in all realms, particularly the physical component score (p&lt;0.0001). SF-36 (SD) total score improved +1.1 (7.6), mental + 2.1 (11.7), and physical + 5.0 (16.7). Regression analyses (age/sex adjusted) demonstrate that for each 5 lb of weight loss there was an average (SEM) 3.35 (1.49) point increase in SF-36 total score (p=0.03). The mitigation of depressive symptoms in the MDS subgroup was not significantly associated with weight loss but may reflect other positive effects of the intervention experience. Conversely, positive HRQOL changes appear to be driven strongly by weight loss.

Compromised Health-Related Quality of Life in Patients With Low-Grade Glioma

2011 ◽  
Vol 29 (33) ◽  
pp. 4430-4435 ◽  
Author(s):  
Neil K. Aaronson ◽  
Martin J.B. Taphoorn ◽  
Jan J. Heimans ◽  
Tjeerd J. Postma ◽  
Chad M. Gundy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Healthy Controls ◽  
Health Related Quality ◽  
Neurocognitive Deficits ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Purpose To investigate the generic and condition-specific health-related quality of life (HRQL) of patients with low-grade glioma (LGG). Patients and Methods A total of 195 patients with LGG, which was diagnosed, on average, 5.6 years before the study, were compared with 100 patients with hematologic (non-Hodgkin's) lymphoma and chronic lymphatic leukemia cancer (NHL/CLL) and 205 general population controls who were comparable with patients with LGG at the group level for age, sex, and education (healthy controls). Generic HRQL was assessed with the Short Form-36 (SF-36) Health Survey, and condition-specific HRQL was assessed with the Medical Outcomes Study cognitive function questionnaire and the European Organisation for Research and Treatment of Cancer brain cancer module. Objective neurocognitive functioning was assessed with a standardized battery of neuropsychological tests. Results No statistically significant differences were observed between patients with LGG and patients with NHL/CLL in SF-36 scores. Patients with LGG scored significantly lower than healthy controls on six of eight scales and on the mental health component score of the SF-36. Approximately one quarter of patients with LGG reported serious neurocognitive symptoms. Female sex, epilepsy burden, and number of objectively assessed neurocognitive deficits were associated significantly with both generic and condition-specific HRQL. Clinical variables, including the time since diagnosis, tumor lateralization, extent of surgery, and radiotherapy, did not show a consistent relationship with HRQL. Conclusion Patients with LGG experienced significant problems across a broad range of HRQL domains, many of which were not condition-specific. However, the neurocognitive deficits and epilepsy that were relatively prevalent among patients with LGG were associated with negative HRQL outcomes and, thus, contributed additionally to the vulnerability of this population of patients with cancer.

scholarly journals 372Social Isolation, Social Support and Loneliness as independent interconnected concepts

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rosanne Freak-Poli ◽  
Joanne Ryan ◽  
Thach Tran ◽  
Alice Owen ◽  
Joanna McHugh Power ◽  
...  
Keyword(s):  
Social Support ◽  
Social Isolation ◽  
Community Dwelling ◽  
P Value ◽  
Strongly Correlated ◽  
Social Constructs ◽  
Sf 36 ◽  
High Social Support ◽  
Related Quality ◽  
Health Related

Abstract Background Social isolation, lack of social support and loneliness have historically been assessed as overlapping or even interchangeable terms. We aimed to assess whether these three social constructs are independently associated with health-related quality of life (HRQoL). Methods This analysis included 10,517 women aged 70-75 years from the Australian Longitudinal Study on Women's Health (ALSWH). Social isolation (Duke Social Support Index: DSSI), social support (DSSI), and loneliness (one-item) were investigated for their association with HRQoL (physical [PCS] and mental [MCS] component scores of the SF-36® questionnaire). Multivariable analyses adjusted for age, demographics, socio-economic position and medical conditions. Results Social isolation, social support and loneliness were not strongly correlated with one another. However, all were independently associated with HRQoL (PCS: isolation -0.97, low support -2.24, loneliness -2.70; MCS: isolation -1.96, low support -4.78, loneliness -10.31; p-value&lt;0.001 for each). Compared to those with low social isolation, high social support and lack of loneliness, women highly isolated, with low social support and lonely reported the lowest HRQoL (MCS: -18 to -17; PCS: -8 to -6). Other combinations of isolation, support and loneliness varied in their associations with HRQoL. Conclusions Social isolation, social support and loneliness are distinct, yet interconnected concepts that may coexist and are each adversely associated with HRQoL. Key messages Ageing populations present the challenge of supporting older people to maintain a longer, healthy, meaningful and community-dwelling lives. Social isolation, low social support and loneliness have adverse associations with HRQoL.

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