Risk-Targeted Behavioral Activation for the Management of Work-Disability Associated with Co-Morbid Pain and Depression: A Feasibility Study

Purpose The purpose of the present study was to conduct a preliminary evaluation the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with co-morbid pain and depression. Methods The design of the study was a single arm non-randomized trial. The sample consisted of 66 work-disabled individuals with co-morbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk-factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were ‘very’ or ‘completely’ satisfied with their involvement in the treatment program. Significant reductions in pain (d = .71), depression (d = .86), catastrophic thinking (d = 1.1) and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with co-morbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with co-morbid pain and depression.

NOM-035-STPS-2018

Looking at the structure of NOM-035-STPS-2018, there is an assumption that there are areas of opportunity to improve the implementation of the standard. Thus, the purpose of this research is to identify through a review whether there are areas of opportunity that can improve the implementation of NOM-035. For the review, articles addressing the psychosocial risk factors evaluation were selected and analyzed. Four topics of discussion were identified: impact of psychosocial risk factors, policy and regulations, management systems, and evaluation of psychosocial risk factors. Subsequently, a synthesis was made, and it was found that there are three areas of opportunity to improve NOM-035-STPS-2018: it does not have a risk management system, its instruments do not present evidence of statistical validity, and the instruments do not take into account indicators of consequence.

Self-perceived and reported mental health in older adults

Several studies assess mental health in older adults, but relatively few do so from a multi-informant perspective. In this work, discrepancies in self-perception and third-person perception of the mental health of older adults were analyzed in two age groups and differentiated by sex and place of residence. Relationships between different scales that measure psychopathology and psychosocial competencies were also analyzed. A sample of 288 older people aged between 60-95 years old (154 women, 53.47%) belonging to 12 municipalities in the Region of Murcia was employed, and the Older Adult Self-Report (OASR) questionnaire was used to measure the psychopathology of older people and the Older Adult Behavior Checklist (OABCL) instrument to find out the family's perception of these problems. Outcomes show different perceptions of mental health among older people and their families, which worsen with increasing age, psychosocial risk status and female gender. This reflects the need to develop specific treatment protocols for each gender and psychosocial risk situation, in order to address the differential mental health needs in older people. Son numerosos los trabajos que evalúan la salud mental de las personas mayores, pero relativamente escasos los que lo hacen desde una perspectiva multi-informante. En este trabajo se analizaron las discrepancias en la autopercepción y la percepción que tienen otros de la salud mental de las personas mayores, en dos franjas de edad, diferenciando por sexos, lugar de residencia y se analizaron las relaciones entre diferentes escalas que miden psicopatología y competencias psicosociales. Se empleó una muestra de 288 personas mayores entre 60-95 años (154 mujeres, 53.47%) pertenecientes a 12 municipios de la Región de Murcia, y se empleó el cuestionario OlderAdultSelf-Report (OASR) para medir la psicopatología de las personas mayores y el instrumentoOlderAdultBehaviorChecklist (OABCL) para conocer la percepción de la familia de estos problemas. Los resultados reflejan que existen diferentes percepciones de la salud mental entre personas mayores y sus familiares, que empeoran al aumentar la edad, la situación de riesgo psicosocial y el género femenino. Esto refleja la necesidad de desarrollar protocolos de tratamiento específicos para cada género y situación de riesgo psicosocial, con el fin de atender las necesidades diferenciales de salud mental de las personas mayores.

POST-TRAUMATIC STRESS DISORDER IN COVID-19 PCR POSITIVE PATIENTS; ITS FREQUENCY AND PSYCHOSOCIAL RISK FACTORS HAVE BEEN OBSERVED IN ENT AND NEUROLOGY OUTPATIENT’S CLINICS

Objective: To find out the occurrence and psychosocial risk factors of post-traumatic stress disorder in COVID-19 polymerase chain reaction (PCR) positive patients presented to ENT and neurology clinics of a tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: Creek General Hospital, Karachi, Pakistan, from Sep to Dec 2020. Methodology: Total 60 patients with positive COVID-19 PCR test were included. After taking written and informed consent, they were evaluated using a semi-structured questionnaire. Questionnaire comprises of four main parts; first part includes demographic data, second part includes information about the course of COVID-19 in patient and other members of family, third part comprised of reasons of anxiety during COVID-19 and fourth part consist of Impact of Event Scale-revised (IES-R). Data was entered and analyzed through SPSS-23. Results: Out of total 60 patients, 36 (60%) had post COVID stress disorder. Females were affected more than the males (63% vs. 57%), above 50 years of age were affected more than below 50 years of age (81% vs 52%), singles were affected more than married (72% vs 38%) and lower socio-economic status were affected more than higher (65% vs 50%). Conclusion: PTSD was observed as long-term psychiatric problem leading to significant morbidity and mortality in patients with COVID-19 infection.

Psychosocial risk factors in cardiac practice

<p>Cardiovascular diseases (CVD) remain the leading cause of death in Russia. Apart from conventional modified risk factors, population health, including CVD progression and related death, is influenced by psychosocial risk factors (PS RF). In theory, the role of PS RF can be explained by the significant changes in death rates within the Russian population during social and economic alterations. However, the significance of primary CVD RF has remained unchanged since the Soviet times. Nonetheless, PS RF does not receive much attention in our country. Thus, the current review aimed to introduce specialists focusing primarily on PS RF, such as low socioeconomic status, social isolation and low levels of social support, depressive disorders and personality traits (hostility and type D personality), which are now undoubtedly closely associated with unfavourable prognosis in patients with CVD. This summary also discusses the main pathophysiological mechanisms that may facilitate the progression of CVD, which include the activation of the hypothalamic–pituitary–adrenal axis, sympathoadrenal system with increased cardiovascular reactivity, endothelial function, inflammatory markers, platelets, coagulation factors, fibrinogen and lifestyle-associated factors. Thus, PS RF have considerable practical significance, not only for individual risk estimation but also in primary and secondary interventions for the prevention of CVD.</p><p>Received 4 May 2021. Revised 6 June 2021. Accepted 11 June 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest: </strong>Authors declare no conflict of interest.</p><p><strong>Contribution of the authors: </strong>The authors contributed equally to this article.</p>

Psychosocial Risk and Health Behaviors as Predictors of Clinical Events in Patients Wait-Listed for a New Heart: Results from 7 Years of Follow-Up

We examined the long-term relationship of psychosocial risk and health behaviors on clinical events in patients awaiting heart transplantation (HTx). Psychosocial characteristics (e.g., depression), health behaviors (e.g., dietary habits, smoking), medical factors (e.g., creatinine), and demographics (e.g., age, sex) were collected at the time of listing in 318 patients (82% male, mean age = 53 years) enrolled in the Waiting for a New Heart Study. Clinical events were death/delisting due to deterioration, high-urgency status transplantation (HU-HTx), elective transplantation, and delisting due to clinical improvement. Within 7 years of follow-up, 92 patients died or were delisted due to deterioration, 121 received HU-HTx, 43 received elective transplantation, and 39 were delisted due to improvement. Adjusting for demographic and medical characteristics, the results indicated that frequent consumption of healthy foods (i.e., foods high in unsaturated fats) and being physically active increased the likelihood of delisting due improvement, while smoking and depressive symptoms were related to death/delisting due to clinical deterioration while awaiting HTx. In conclusion, psychosocial and behavioral characteristics are clearly associated with clinical outcomes in this population. Interventions that target psychosocial risk, smoking, dietary habits, and physical activity may be beneficial for patients with advanced heart failure waiting for a cardiac transplant.

Quality of life and psychosocial risk in migrant workers from the Region of Maule, Chile.

<p>Migratory figures place Chile as one of the South American countries with the most significant number of migrants. The present study evaluated the psychosocial occupational risks of migrant workers in the Maule Region and their association with health-related quality of life. Cross-sectional study with migrant workers between 18 and 60 years old, residing in the Maule Region (n = 145). The questionnaires applied were: a) SUSESO ISTA-21 Psychosocial Risk Questionnaire; b) SF-12 health and quality of life questionnaire; c) Socio-demographic questionnaire. We perform a bivariate statistical analysis with non-parametric tests of Mann Withney U, Kruskal Wallis, and Spearman correlation. The migrants with lower quality of life in terms of the physical health dimension are those who are divorced, widowed or single, who work less than 22 hours per week and arrived directly to the Maule Region from their countries of origin. The psychosocial risks related to double presence at work seem to be the dimension with the highest prevalence. Migrants who work between 33 and 43 hours per week a negative association between the number of hours worked and work rewards; lack of control, which strongly impacts job satisfaction due to insecurity; and exhaustion from overwork. Exposure to a new social and work environment could lead to different psychological responses in which anxiety, confusion, and culture shock affect the mental health of migrants. Coming into contact with a new culture is a complex process; it requires support networks, adaptation, and migration policies based on human rights.</p>