Nicotine Dependence in Patients with Major Depressive Disorder and Psychotic Disorders and Its Relationship with Quality of Life

The aim of the current study was to examine the associations between nicotine dependence and quality of life (QOL) among individuals diagnosed with major depressive disorder (MDD) or psychotic disorders. Methods: A total of 378 participants diagnosed with either MDD or psychotic disorders were recruited. The Fagerstorm Test for Nicotine Dependence was used to measure the level of nicotine dependence. The SF-12 health survey questionnaire was used to measure the QOL. Results: The prevalence of nicotine dependence was 23.3% in this sample population. For those diagnosed with MDD, moderate level of nicotine dependence was negatively associated with Vitality and Mental Component Score. For those diagnosed with a psychotic disorder high nicotine dependence was negatively associated with Role Emotional, Mental Health and Mental Component Score. Discussion: Compared to the general population, the prevalence of smoking in this psychiatric population was 2.4 times higher, while that of nicotine dependence was seven times higher. Individuals with psychotic disorder generally reported better QOL as compared to individuals with MDD. QOL differed across diagnostic groups with regards to socio-demographics, such as age, ethnicity, marital status, education, employment status and monthly income. Among individuals with MDD and psychotic disorders, different levels of nicotine dependence resulted in different levels of association with QOL. More research is needed to better understand the differences in QOL among the varying levels of nicotine dependence.

Change in psoriatic arthritis outcome measures impacts SF-36 physical and mental component score differently: an observational cohort study

OBJECTIVES The objective was to investigate interplay between change (Δ) in health-related quality of life (HRQoL) quantified by physical component score (PCS) and mental component score (MCS) retrieved from short-form health survey (SF-36), change in disease activity (ΔDAS28CRP) and manifestations of Psoriatic Arthritis (PsA). METHODS PsA patients initiating new medical therapy were enrolled. Independent disease measures evaluating disease activity, enthesitis, psoriasis, pain and fatigue were collected at treatment initiation and after 4 months. Interplay between independent disease measures and dependent outcome measures; ΔPCS and ΔMCS was described with univariate regression analyses. Multivariate regression analyses were applied to assess impact of independent variables e.g. individual disease outcome measures versus ΔDAS28CRP on ΔPCS and ΔMCS. RESULTS 108 PsA patients were included. In the univariate regression analyses, improvement in fatigue, pain, and disability were associated with improvement in ΔPCS (β; -2.08, -0.18, -13.00, respectively, all; p < 0.001) and ΔMCS (β; -1.59, -0.12, -6.07, respectively, and p < 0.001, p < 0.001, p = 0.003, respectively). When PROs were included in the final multivariate models, improvements in ΔPCS and ΔMCS were associated with improvements in pain, fatigue and disability (p < 0.001). Improvement in enthesitis positively impacted ΔPCS (β -0.31, p < 0.001). No association was found between change in skin psoriasis, ΔPCS and ΔMCS (β 0.15, p = 0.056 and β 0.05, p = 0.561, respectively). CONCLUSION In this PsA patient cohort, diminishing pain, disability and fatigue improved PCS and MCS significantly. Changes in enthesitis and psoriasis, did not grossly impact HRQoL compared to DAS28CRP. Individual PsA manifestations influence HRQoL differently which is clinically important when targeting treatment.

Exercise Training for Pulmonary Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Pulmonary hypertension (PH) is a chronic disease with a notable health burden; regular exercise may improve specific health outcome measures. Objective: The objective of this meta-analysis was to estimate the effectiveness of exercise training for PH patients. Data sources: PubMed, CINAHL, SportDiscuss and Google Scholar databases and reference lists of included studies were searched. Study selection: The selection criteria were randomized controlled trials (RCTs) employing an exercise training intervention. Data were extracted from the entered studies for analysis. The primary outcomes were peak oxygen uptake (VO2peak), anaerobic threshold (AT), 6-minute walk distance (6-MWD), and quality of life (QoL) measures (physical component score and mental component score). The analysis included 9 articles with a total of 302 participants: intervention (n = 154), and control (n = 148). Results: In the pooled analysis, improvements were seen in: VO2peak, mean difference (MD) 2.79 ml/kg/min (95% CI 2.00 to 3.59, p < 0.00001); AT, MD 107.83 ml/min (95% CI 39.64 to 176.00, p = 0.002); and 6-MWD, MD 46.67 meters (95% CI 32.39 to 60.96, p < 0.00001). Differences were found in the SF-36 physical component score MD 3.57 (95% CI 2.04 to 5.10, p < 0.00001) and the SF-36 mental component score MD 3.92 (95% CI 1.92 to 5.91, p = 0.001). Conclusion: This meta-analysis demonstrates exercise training has a beneficial effect on fitness, walking performance, and self-reported QoL in PH patients.

P0824QUALITY OF LIFE (QOL) DURING THE COURSE OF CKD: A LONGITUDINAL STUDY

Background and Aims Measuring QoL in CKD patients is fundamental to estimate the human cost of chronic diseases and to assess the effect of treatments. Non-medical factors play an important role in CKD progression and QoL. However, there is very limited information on the evolution of QoL over time in CKD patients and it remains unclear whether traditional and CKD specific risk factors are implicated QoL in CKD patients over CKD progression. Method We studied a cohort of 582 stage 2-5 CKD patients (age: 61±12 years; M: 60%, diabetics: 33%) and measured QoL by the short form of the Rand corporation questionnaire (SF36), an instrument which measures eight domains of QoL (physical functioning, role physical health, energy fatigue, pain, role emotional problem, emotional well-being, social function, and general health] and two summary scores, (the physical component score and the mental component score) which are calculated by a well validated algorithm (Taft C et al, 2001, Quality of life research). In all patients the SF36 was administered at enrolment and after one (489 patients), two (n=434) and three (n=287) years. The evolution of SF36 dimensions over-time and the predictors of SF36 changes were analyzed by the Linear Mixed Model (LMM). Results At baseline the median value of the Physical Component Score (PCS) was 43.7 (Interquartile range: 34.0-50.3) and the Mental Component Score (MCS) was 46.3 (37-52.9) and on average did not change over the 3 years follow up [median PCS at the 3rd year: . 46.3 (35.7-52.0), median MCS at the 3rd year 43 (33.6-50.6)]. On average the GFR at baseline was 36±13 ml/min/1.73 m2 and declined to 34±17 ml/min/1.73m2 at the 3rd year. On detailed longitudinal analysis by the LMM the PCS associated with the evolution of the GFR over time (beta=0.10; 95% CI from 0.06 to 0.13; P&lt;0.001). Adjustment for time (0,1,2,3 years), age and gender did not materially modify such an association (beta=0.09; 95%CI from 0.06 to 0.13, p&lt;0.001) while further adjustment for traditional (Systolic BP, diabetes, smoking, cholesterol), BMI, CV comorbidities and CKD specific (hemoglobin, albumin, calcium, phosphate) risk factors attenuated but did not cancel out the PCS-GFR link (beta=0.05, 95%CI 0.006 to 0.093, P=0.03). This finding suggests that the PCS-GFR link is either largely confounded or mediated by these risk factors but that the same risk factors do not explain in full the same link . The MCS – GFR association was weaker (beta=0.05, 95%CI from 0.008 to 0.09; P=0.02) than the PCS-GFR relationship, became non significant after simple adjustment for time, age and gender (beta=0.04 ; 95%CI -0.003 to 0.08; P=0.07) and was nullified after full adjustment (beta=-0.01; 95%CI -0.07 to 0.04; P=0.59) for the same risk factors. Conclusion The PCS and the MCS remain stable over the course of CKD but appear associated with the evolution of the GFR over time. Traditional and CKD specific risk factors substantially confound and/ or mediate these associations.

PENGARUH FAKTOR YANG BERHUBUNGAN DENGAN USIA TERHADAP KUALITAS HIDUP PASIEN EPILEPSI

Pendahuluan: Epilepsi merupakan penyakit neurologis yang mempengaruhi kualitas hidup penderitanya. Hanya ada sedikit penelitian tentang kualitas hidup pasien epilepsi di Indonesia. Tujuan: Melihat hubungan antara usia, usia saat onset pertama muncul, dan durasi epilepsi terhadap kualitas hidup pasien epilepsi. Metode: Penelitian cross-sectional ini dilakukan di Departemen Neurologi, Rumah Sakit Bethesda, Yogyakarta, Indonesia pada November 2017 sampai Februari 2018. Pasien epilepsi yang berusia ≥ 18 tahun diikutkan dalam penelitian ini. Kualitas hidup diukur menggunakan instrument Short form 8 (SF-8). Hasil: Terkumpul 27 pasien yang memenuhi kriteria inklusi. Pasien dengan usia ≥ 60 tahun secara signifikan mengalami penurunan kualitas hidup dalam beberapa aspek, yaitu: physical functioning (42.44±8.243), general health (40.04±7.641), role emotional (39.60±7.638), mental health (43.50±10.347), dan mental component score (42.04±10.282). Pasien dengan usia saat onset pertama muncul ≥ 55 tahun secara signifikan memiliki role emotional (40.54±7.245) dan mental component score (42.98±10.155) yang lebih rendah. Durasi epilepsi tidak memiliki hubungan yang signifikan terhadap kualitas hidup pasien epilepsi. Kesimpulan: Penelitian ini menunjukkan bahwa usia dan usia saat onset epilepsi pertama muncul berhubungan dengan kualitas hidup pasien epilepsi. Kata kunci: Epilepsi, faktor risiko yang berhubungan dengan usia, kualitas hidup, SF-8.

Quality of Life among Patients with Coronary Heart Disease Admitted in a Selected Tertiary Level Hospital

Introduction: Coronary heart disease and cerebrovascular disease are the two main contributors of global morbidly and mortality. Coronary Heart Disease deaths in Bangladesh reached 1,63,769 or 17.11% of total deaths and reaches 25th in world. Importantly quality of life among them can modify the coronary heart disease. The opportunity for improved quality of life should be a factor in the health care provider's decision to recommend the treatment procedure. Objective: To ascertain the physical and mental health component of Quality of Life with sociodemographic characteristics and health-related morbidity status among admitted coronary heart disease patients. Materials and Methods: This cross-sectional study was conducted from January 2013 to December 2013 among coronary heart disease patients admitted in Cardiology department of Combined Military Hospital, Dhaka. The data were collected purposively by using Medical Outcomes short form SF-36 invented by RAND corporation, UK for measuring health-related quality of life among Bangladeshi patients where data were expressed as a score on a 0-100 scale. Data analysis was done by using software SPSS version 19. Results: A total of 105 cases were selected purposively amongst which majority were in the age group of 50-60 years with mean age of 55.27 years. Among the respondents 97.1% were males and 98.1% were Muslims. Majority (41%) of them were retired personnel. The mean monthly income was Tk. 16,393.56. Regarding education level 73% of the study population were SSC pass and below. Among the study group, 27(25.7%) patient had undergone coronary artery bypass graft operation. The study group possessed a total quality of life obtaining 63.4% score in their interviews as per SF-36. Among the whole study group, mental components score (63.61%) was found slightly higher than physical components score (63.2%). CABG operated patients mental component score (69.43%) was found relatively higher than Non CABG patients mental component score (60.01%). Patients having better monthly income as well as better educational level possess better mental component and total quality of life than others. Conclusion: It is of paramount importance to maintain the quality of life among coronary heart disease patients. Mental assurance and surgical intervention can improve quality of life among coronary heart disease patients. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 90-94

A PROSPECTIVE STUDY ON QUALITY OF LIFE IN PATIENTS WITH ARTHRITIS

<p>ABSTRACT<br />Objective: Patient counseling can scientifically improve the physical and mental symptoms of certain diseases that could be a relief to the patient.<br />Non-pharmacological approaches could be an alternative to the drug therapy. Health issues affecting the quality of life (QoL) are to be studied to<br />understand the patient’s physical, mental, emotional, and social functioning.<br />Methods: The present study involves prospective analysis of QoL in men and women with arthritis. The methodology involves the collection and<br />documentation of general information of the patient including personal history, family background, clinical findings, investigations, and medical illness<br />associated with arthritis. Further, the QoL is documented using a specific questionnaire designed to assess the impact of arthritis and their complications.<br />Results: It can be seen that there is no significant changes in the physical and mental component score (MCS) in between the type of arthritis, but<br />there is an extremely significant (p&lt;0.05) values were obtained when compared between pre- and post-counseling phases of physical and MCS.<br />Conclusion: Patients counseling plays a major role in the management of signs and symptoms among patients with arthritis. The non-pharmacological<br />method is also be used for the management of arthritis.<br />Keywords: Quality of life, Arthritis, Patient counseling, Questionnaire, Physical component score, Mental component score.</p>