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Xie Z, Wu Z, Sun W, Chen H, Zhang W, Li Y, Niu Q, Li H, Guo H, Ma R, He J. Association between depression and multimorbidity in Chinese middle-aged and older adults: a prospective cohort study. J Affect Disord 2025; 385:119445. [PMID: 40389174 DOI: 10.1016/j.jad.2025.119445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 04/16/2025] [Accepted: 05/16/2025] [Indexed: 05/21/2025]
Abstract
BACKGROUND The association between depression and multimorbidity and different multimorbidity patterns in Chinese middle-aged and older people remains unclear. METHODS This prospective cohort study used the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS), which included 7185 middle-aged and older adults aged 45 years and older as the study sample. Study analyses were conducted using the adjusted Cox proportional hazard model, restricted cubic spline (RCS), latent class analysis (LCA), subgroup analysis, and mediation analysis. RESULTS Patients with depression at baseline exhibited a 47.5 % elevated risk of developing multimorbidity in comparison to the general population (HR:1.475, 95 % CI: (1.372, 1.585)). For each one-unit increase in the depression score, the risk of developing multimorbidity increases by 3.8 % (HR:1.038, 95 % CI: (1.032, 1.044)). There was an overall non-linear trend in the RCS curves (P < 0.001, P for nonlinear <0.001). Meanwhile, we found a significantly reduced risk of complex disease patterns (OR: 2.744, 95%CI: (1.990, 3.783)) and respiratory disease patterns (OR: 2.296, 95%CI: (1.508, 3.495)) in depressed participants compared to healthy participants. The mediation rate of activities of daily living (ADL) between depression and multimorbidity was 8.838 %. CONCLUSION Chinese middle-aged and older adults with depression were more prone to multimorbidity than healthy person, and more likely to suffer from the respiratory disease pattern and the complex disease pattern. We should adopt diversified prevention and treatment measures tailored to different patterns of multimorbidity and varying degrees of chronic diseases, including weight management, physical exercise, and attention to functional health.
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Affiliation(s)
- Zhanpeng Xie
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China
| | - Zhen Wu
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China
| | - Wen Sun
- Third Affiliated Hospital, School of Medicine, Shihezi University Shihezi People's Hospital, China
| | - Haina Chen
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China
| | - Wei Zhang
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China
| | - Yu Li
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Department of Preventive Medicine, Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China.
| | - Qiang Niu
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Department of Preventive Medicine, Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China.
| | - Haiyan Li
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Department of Preventive Medicine, Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China.
| | - Heng Guo
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Department of Preventive Medicine, Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China.
| | - Rulin Ma
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Department of Preventive Medicine, Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China.
| | - Jia He
- Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Department of Preventive Medicine, Medical School of Shihezi University, Shihezi 832003, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases(First Affiliated Hospital of Shihezi University), China.
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Mulla RT, Hirdes JP, McAiney C, Heckman G. Factors Associated with Mood Transitions among Older Canadian Long-Term Care Residents: A Multistate Transition Model. J Am Med Dir Assoc 2025; 26:105612. [PMID: 40318696 DOI: 10.1016/j.jamda.2025.105612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 03/20/2025] [Accepted: 03/20/2025] [Indexed: 05/07/2025]
Abstract
OBJECTIVES This study examines the complex transitions between the different mood states and absorbing states out of long-term care settings, as well as the factors affecting those transitions. DESIGN A retrospective longitudinal analysis of older residents in Canadian long-term care homes in 3 provinces. SETTING AND PARTICIPANTS Residents residing in long-term care homes in 3 Canadian provinces (Alberta, British Columbia, and Ontario) over a 10-year period from January 2010 to February 2020, with an age of at least 65. METHODS We used a 1-step Markov multistate transition model to examine transitions in mood over time as well as the factors affecting those transitions using the standardized interRAI MDS 2.0 comprehensive health assessment. The MDS 2.0 assessments are completed by trained assessors within 2 weeks of the resident's admission. RESULTS Our results showed that 46% of residents initially present with no mood disturbance on admission and 31% with mild mood disturbance on admission and 23% with moderate/severe mood disturbance on admission. Factors associated with worsening of mood include aggressive behavior; health instability; impaired cognition; major comorbidities; pain or poor sleep; conflict with family, friends, or other residents; and anxiety. Of the facility-level attributes, Alberta was associated with worsening of mood. CONCLUSIONS AND IMPLICATIONS Our study identified key factors influencing mood transitions, highlighting pain and aggressive behavior as significant contributors to worsening mood, both of which are modifiable through targeted interventions. The findings suggest substantial opportunities for mood improvement in long-term care settings.
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Affiliation(s)
- Reem T Mulla
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
| | - John P Hirdes
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - George Heckman
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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Zerbini G, Strömel-Scheder C, Karmann A, Lang P, Kunz M, Lautenbacher S. The association between chronic pain and deficits in attention: Is it mediated by disturbed sleep? Br J Pain 2025:20494637251342005. [PMID: 40365575 PMCID: PMC12066467 DOI: 10.1177/20494637251342005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 03/01/2025] [Accepted: 04/05/2025] [Indexed: 05/15/2025] Open
Abstract
Objective Persons with chronic pain suffer from additional symptoms and deficits that are directly or indirectly related to their condition. Attentional deficits are a common problem in these individuals. The same is true for sleep disturbances. It is well-known that night sleep affects attention the next day. Therefore, sleep disturbances might be responsible for the association between chronic pain and deficits in attention. Methods We studied the gaze behaviour (absolute and relative fixation times, i.e., attentional biases) in patients with chronic musculoskeletal pain (N = 20) and pain-free individuals (N = 28). For that purpose, we used an eye-tracker to monitor gaze behaviour during the presentation of affective stimuli, that is, pictures of faces displaying joy, anger, pain, and neutral expressions. In addition, we assessed subjective/wellbeing parameters, as well as objective sleep parameters with a portable polysomnography (PSG) device during two nights at home, with the aim of testing the mediating role of sleep for the relationship between chronic pain and alterations of attention. Results Patients with chronic pain exhibited overall shorter fixation times (on average ∼160 ms shorter fixation times). With respect to the attentional biases, all participants looked longer at the affective faces compared to the neutral ones, independent of group or type of affective stimulus. Several subjective sleep/wellbeing parameters, together with two PSG parameters (sleep efficiency and duration of awakenings), were significantly worse in patients with chronic pain. Despite this, only subjective sleep quality and sleep efficiency mediated the association of chronic pain and attentional processes. Conclusions Our findings confirm previous studies showing attentional deficits and sleep disturbances in patients with chronic pain. However, our results only partially support the hypothesis that the relationship between chronic pain and altered attentional processes is due to disturbed sleep. Other mechanisms might be involved, highlighting the need for further studies.
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Affiliation(s)
- Giulia Zerbini
- Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | | | - Anna Karmann
- Physiological Psychology, University of Bamberg, Bamberg, Germany
| | - Philip Lang
- Clinic for Anesthesiology, Surgical Intensive Care Medicine and Pain Therapy, Bamberg Hospital, Bamberg, Germany
| | - Miriam Kunz
- Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Stefan Lautenbacher
- Physiological Psychology, University of Bamberg, Bamberg, Germany
- Bamberg Living Lab Dementia (BamLiD), University of Bamberg, Bamberg, Germany
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Corbel C, Le Cerf F, Breaud J, Corveleyn X. Effects of virtual reality on pain and anxiety in older adults: A scoping review. Geriatr Nurs 2025; 63:619-629. [PMID: 40349625 DOI: 10.1016/j.gerinurse.2025.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 03/31/2025] [Accepted: 04/28/2025] [Indexed: 05/14/2025]
Abstract
BACKGROUND Interventions using Virtual Reality (VR) improve physical and mental health in different populations. Despite the prevalence of anxiety and pain and their impact on the quality of life of older adults, only a few studies have examined the effects of VR-delivered interventions on these conditions. OBJECTIVE This paper reports findings on the feasibility and efficacy of interventions delivered through VR to reduce pain and/or anxiety among older patients. METHOD A systematic literature search was conducted focused on 8 databases, using the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines. RESULTS Seventeen studies met the inclusion criteria. VR intervention appears to be a suitable and effective method for reducing anxiety in older adults. Results regarding pain are promising, although some studies report non-significant effects. CONCLUSIONS Despite methodological limitations, the studies revealed the acceptability and feasibility of VR interventions for reducing pain and anxiety. The development of personalized VR interventions, considering factors like familiarity and comfort, holds promise for further investigation.
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Affiliation(s)
- Camille Corbel
- Université Côte d'Azur, LAPCOS, Nice, France; Université Côte d'Azur, CoBTeK lab, Nice, France; MSHS Sud-Est, Maison des Sciences de l'Homme et de la Société Sud-Est, Nice France.
| | | | - Jean Breaud
- Université Côte d'Azur, CoBTeK lab, Nice, France; Department of Pediatric Surgery and Urology, Lenval Hospital, Nice, France
| | - Xavier Corveleyn
- Université Côte d'Azur, LAPCOS, Nice, France; MSHS Sud-Est, Maison des Sciences de l'Homme et de la Société Sud-Est, Nice France
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Eum MJ, Si E. Association Between Depression and the Short Sleep Duration on Weekdays and Weekends in South Korean Adults: A Cross-Sectional Study Using the 2016 and 2018 Korea National Health and Nutrition Examination Survey. Healthcare (Basel) 2025; 13:1043. [PMID: 40361821 PMCID: PMC12071711 DOI: 10.3390/healthcare13091043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 04/17/2025] [Accepted: 04/29/2025] [Indexed: 05/15/2025] Open
Abstract
OBJECTIVE This study aimed to examine the association between sleep duration on weekdays and weekends and depression among Korean adults. DESIGN Cross-sectional study. SETTING South Korea, utilizing data from 2016 and 2018 Korea National Health and Nutrition Examination Survey (KNHANES). PARTICIPANTS A total of 7669 South Korean adults aged 19-64 years. MEASURES Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Sleep duration was classified separately for weekdays and weekends and categorized into three groups: <7, 7-9, and ≥9 h. Multiple logistic regression analysis was performed, adjusting for socioeconomic, lifestyle, and health-related variables. RESULTS Among the participants, 3.6% were identified as having depression. On weekdays, 40.5% of respondents reported an average sleep duration of less than 7 h per day, whereas only 20.3% did so on weekends. Compared to those who averaged 7 to less than 9 h of sleep per day, individuals with short sleep duration (<7 h) on weekdays had significantly higher odds of depression (OR: 1.65; 95% CI: 1.16-2.35), as did those with short sleep on weekends (OR: 1.62; 95% CI: 1.10-2.38). Notably, participants who consistently averaged less than 7 h of sleep per day across both weekdays and weekends demonstrated the highest odds of depression (OR: 1.76; 95% CI: 1.13-2.75). CONCLUSIONS Short sleep duration on both weekdays and weekends was found to be associated with depression. These findings suggest that sleep duration should be considered an important factor in the prevention of depression.
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Affiliation(s)
| | - Euna Si
- Department of Nursing, Gangdong University, Eumseong-gun 27710, Chungcheongbuk-do, Republic of Korea;
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Ren Y, Huang P, Jin X. Dexmedetomidine for chronic pain patients with anxiety and depression: a propensity score matching cohort study. BMC Anesthesiol 2025; 25:222. [PMID: 40301770 PMCID: PMC12039180 DOI: 10.1186/s12871-025-03087-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Accepted: 04/18/2025] [Indexed: 05/01/2025] Open
Abstract
BACKGROUND Chronic pain patients often experience moderate to severe anxiety and depressive symptoms. Growing evidence supporting dexmedetomidine as a potential treatment for mental health conditions, research on its application in chronic pain patients with comorbid anxiety and depression remains limited. METHODS Patients who received intravenous infusions of dexmedetomidine during their interventional pain management procedures from January to July 2024 were compared to those who underwent similar procedures without dexmedetomidine infusion during the same period, utilizing propensity score matching. RESULTS A total of 290 patients were included in the analysis from January to July 2024. Propensity score matching resulted in 92 matched pairs for further analysis. At the one-month follow-up, the perioperative application of dexmedetomidine was associated with a greater improvement in anxiety and depression disorders, as measured by the Generalized Anxiety Disorder 7-item scale, showing a reduction of -4.43 points (95% CI, -4.98 to -3.88) compared to -2.42 points (95% CI, -2.97 to -1.87) for the local analgesia group and the Patient Health Questionnaire-9 scores indicated a reduction of -6.19 points (95% CI, -6.84 to -5.55) for the dexmedetomidine group versus -3.92 points (95% CI, -4.56 to -3.28) for the local analgesia group. The use of dexmedetomidine was also associated with a greater improvement of pain(-3.32 points vsurs -2.62 points). CONCLUSIONS Intraoperative dexmedetomidine significantly improves anxiety and depression in patients with chronic pain. Therefore, dexmedetomidine may serve as a promising adjunctive treatment for chronic pain patients, particularly those with comorbid anxiety and depression. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Yiting Ren
- Department of Anesthesiology and Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China
| | - Peng Huang
- Department of Anesthesiology and Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China
| | - Xiaohong Jin
- Department of Anesthesiology and Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China.
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Ek S, Ding M, Hedström M, Fors S, Modig K. The impact of hip fracture on resilience in health-related quality of life: a cohort study. Eur Geriatr Med 2025:10.1007/s41999-025-01213-z. [PMID: 40299269 DOI: 10.1007/s41999-025-01213-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 04/09/2025] [Indexed: 04/30/2025]
Abstract
PURPOSE Hip fractures significantly impact health-related quality of life (HRQoL) in older adults. This study aimed to investigate and quantify changes in different domains of HRQoL following a hip fracture and to identify factors associated with maintaining HRQoL (resilience). METHODS The study included a cohort of 2,529 individuals aged 65 + who experienced their first hip fracture between 2016 and 2020. HRQoL was assessed using the EQ5D-5L tool both prior to and 4 months after the fracture. Resilience was defined as maintaining or improving pre-fracture EQ5D levels at follow-up. Associations between sociodemographic characteristics, acute conditions, medical factors, and resilience in specific EQ5D domains-Mobility, Usual Activities, Self-Care, Pain/Discomfort, and Anxiety/Depression-were analyzed using regression models. RESULTS Sixty-nine percent were women and the mean age was 82.6 years. A decline was observed across all EQ5D domains and in the global EQ5D index following a hip fracture. The proportion of patients exhibiting resilience varied by domain, ranging from 36 to 77%, with Mobility being the most adversely affected and Anxiety/Depression the least affected. Factors associated with resilience differed by domain. Mobility, Usual Activities, and Self-Care followed a similar pattern, while Pain/Discomfort and Anxiety/Depression showed distinct patterns. Notably, the absence of fall-risk-increasing medications was the only factor consistently associated with resilience across all domains. CONCLUSIONS While hip fractures generally lead to declines in HRQoL, a significant proportion of patients demonstrate resilience within 4 months post-fracture. Patterns of resilience vary across EQ5D domains, with physical functions being most impacted and mental health the least.
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Affiliation(s)
- Stina Ek
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, S-17165, Stockholm, Sweden.
| | - Mozhu Ding
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, S-17165, Stockholm, Sweden
| | - Margareta Hedström
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Trauma and Reparative Medicine Theme (TRM), Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Public Health Science, Stockholm University, Stockholm, Sweden
| | - Karin Modig
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, S-17165, Stockholm, Sweden
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Khan MG, Hussain SHA, Alkhayl FFA, Ahsan M, Ridha-Salman H. Cannabinoids in neuropathic pain treatment: pharmacological insights and clinical outcomes from recent trials. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025:10.1007/s00210-025-04134-7. [PMID: 40261351 DOI: 10.1007/s00210-025-04134-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Accepted: 04/01/2025] [Indexed: 04/24/2025]
Abstract
Neuropathic pain, a complex and often devastating condition, poses significant challenges for its effective management. Despite promising research on various cannabis formulations and delivery methods for neuropathic pain, significant gaps remain in our knowledge. While inhaled cannabis shows analgesic effects and alternative delivery methods may improve bioavailability, oral formulations have yielded mixed results, often limited by small sample sizes and placebo effects. Therefore, further research is essential to optimize cannabis formulations, identify responder profiles to tailor treatments effectively, and, most critically, confirm the long-term safety and efficacy of cannabis-based therapies in managing NP. This review article aims to provide a comprehensive analysis of the therapeutic potential of cannabis-based medicines, with a particular focus on cannabinoids. This review, though not systematic, examines 11 clinical studies, specifically Randomised Clinical Trials) published from 2014 to 2024, highlighting the efficacy of numerous cannabis formulations, in alleviating neuropathic pain. Key findings show that cannabinoids can reduce pain perception, improve patient quality of life, and mitigate other symptoms associated with neuropathic pain. The synergistic effects of tetrahydrocannabinol and cannabidiol are discussed, emphasizing their ability to enhance analgesic effects, while potentially reducing the psychoactive side effects of tetrahydrocannabinol. This review emphasizes the importance of the personalized approach to improve therapeutic outcomes. Limitations of the existing research focusing on cannabis for neuropathic pain are limited by heterogeneity, lack of standardization, small sample sizes, and reliance on subjective outcomes, impacting the reliability and generalizability of findings. However, this exhaustive review aims to inform clinicians and researchers about the evolving role of cannabis in contemporary pain management strategies, illustrating the diverse pharmacological profiles of cannabinoids and their potential as adjunct therapies for neuropathic pain management.
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Affiliation(s)
- Mohammad Gayoor Khan
- Department of Pharmacology, Daksh Institute of Pharmaceutical Science, Chhatarpur Madhya Pradesh, General Secretary Society of Clinical Research and Medical Professionals, Hyderabad, 500059, India
| | - Sajid Hussain Altaf Hussain
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, 11952, Majmaah, Saudi Arabia.
| | - Faris F Aba Alkhayl
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Marya Ahsan
- Department of Pharmacology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Hayder Ridha-Salman
- College of Pharmacy, Department of Pharmacology, Al-Mustaqbal University, 51001, Babylon, Iraq
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Chen G, Luo M, Chen W, Zhang Y, Gu Z, Xu M, Zhang Y, Bian J. The primary somatosensory sensory cortex-basolateral amygdala pathway contributes to comorbid depression in spared nerve injury-induced neuropathic pain. Sci Rep 2025; 15:13678. [PMID: 40258918 PMCID: PMC12012082 DOI: 10.1038/s41598-025-97164-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Accepted: 04/02/2025] [Indexed: 04/23/2025] Open
Abstract
Comorbid depression in chronic pain is a prevalent health problem, yet the underlying neural mechanisms remain largely unexplored. This study identified a dedicated neural circuit connecting the hind limb region of the primary somatosensory cortex (S1HL) to the basolateral amygdala (BLA) that mediated neuropathic pain-induced depression. We demonstrated that depressive-like behaviors in the chronic phase of a mouse neuropathic pain model were associated with heightened activity in the S1HL and BLA. Using viral tracing and RNAscope in situ hybridization, we characterized the circuit architecture of S1HL glutamatergic projections to BLA cholecystokinin (CCK) neurons (S1HLGlu → BLACCK). In vivo fiber photometry calcium imaging revealed that both the S1HL BLA-projecting afferents and the BLA S1HL-innervating neurons exhibited hyperactivity in neuropathic pain-induced depressive states. Chemogenetic inhibition of the S1HL → BLA circuit could block neuropathic pain-induced depressive-like behaviors. In addition, specific knockdown of CCK expression in BLA S1HL-innervating neurons alleviated these depressive-like behaviors. Our findings demonstrated that the cortical-amygdala circuit S1HLGlu → BLACCK drove the transition from chronic pain to depression, thus suggesting a potential neural circuit basis for treating chronic pain-related depressive disorders.
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Affiliation(s)
- Guo Chen
- Department of Orthopaedic, Chengdu First People's Hospital, Chengdu, 610000, China
| | - Min Luo
- The Third Affiliated Hospital of Zunyi Medical University, The First People's Hospital of Zunyi, Zunyi, 563000, Guizhou, China
| | - Wentao Chen
- Department of Orthopaedic, Chengdu First People's Hospital, Chengdu, 610000, China
| | - Yu Zhang
- Department of Orthopaedic, Chengdu First People's Hospital, Chengdu, 610000, China
| | - Zuchao Gu
- Department of Orthopaedic, Chengdu First People's Hospital, Chengdu, 610000, China
| | - Miaomiao Xu
- Department of Orthopaedic, Chengdu First People's Hospital, Chengdu, 610000, China
| | - Ying Zhang
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Southwest Medical University, Luzhou, 646000, Sichuan, China.
- Central Nervous System Drug Key Laboratory of Sichuan Province, Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Jiang Bian
- Department of Anesthesiology, Panzhihua Central Hospital, Panzhihua, 637000, Sichuan, China.
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Zhao H, Guan D, Ma Z, Yang M, Dong N, Guo J. Artificially Sweetened Food Mediates the Perception of Chronic Pain in Individuals With Neuroticism Traits: A Mendelian Randomization Study. Brain Behav 2025; 15:e70476. [PMID: 40205859 PMCID: PMC11982623 DOI: 10.1002/brb3.70476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 03/18/2025] [Accepted: 03/20/2025] [Indexed: 04/11/2025] Open
Abstract
BACKGROUND Previous studies have shown that neuroticism and artificially sweetened food all play essential roles in chronic pain to varying degrees. However, it is unclear precisely the causal relationship between neuroticism traits and chronic pain and whether an unhealthy sweetened food is a mediator in this process. METHODS This study employed rigorous research methods to ensure the validity of the findings. We utilized Mendelian randomization (MR) to examine the causal relationships between neuroticism traits, artificially sweetened food, and chronic pain. The data encompass four neuroticism traits (neuroticism, experiencing mood swings, depressed affect, and worry), consumption levels of nine artificially sweetened foods, and seven types of chronic pain. The primary statistical method employed was inverse variance weighting (IVW). Eventually, we explored whether artificially sweetened food serves as a mediator in the relationship between neuroticism traits and chronic pain. RESULTS We found that genetic predisposition to higher neuroticism traits and the consumption of artificial sweeteners is associated with an increased risk of chronic pain across multiple sites. Reverse MR analysis also confirms that chronic pain at multiple sites similarly increases the risk of neuroticism traits. Two-step MR suggests the mediating effects of five artificial sweeteners on sciatica: low back pain, thoracic pain, low back pain, joint pain, and muscular pain. These findings could inform interventions and treatments for chronic pain. CONCLUSION Neuroticism traits and chronic pain have causal relationships, with artificially sweetened food mediating the pathway from neuroticism traits to chronic pain.
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Affiliation(s)
- Huanghong Zhao
- Henan Provincial Hospital of Traditional Chinese MedicineZhengzhouChina
| | - Dongsheng Guan
- Henan Provincial Hospital of Traditional Chinese MedicineZhengzhouChina
| | - Zhen Ma
- Henan Provincial Hospital of Traditional Chinese MedicineZhengzhouChina
| | - Minghui Yang
- Henan Provincial Hospital of Traditional Chinese MedicineZhengzhouChina
| | - Ning Dong
- Henan Provincial Hospital of Traditional Chinese MedicineZhengzhouChina
| | - Jian Guo
- Henan Provincial Hospital of Traditional Chinese MedicineZhengzhouChina
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11
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Kekkonen E, Hall A, Antikainen R, Havulinna S, Kivipelto M, Kulmala J, Laatikainen T, Paajanen TI, Sindi S, Soininen H, Strandberg T, Tuomilehto J, Ngandu T, Solomon A. Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial. BMC Geriatr 2025; 25:211. [PMID: 40158087 PMCID: PMC11954347 DOI: 10.1186/s12877-025-05830-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 02/26/2025] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Physical activity (PA) and exercise interventions offer health benefits can reduce dementia risk. However, there might be barriers to engage in PA, such as sleep problems, depressive symptoms and pain, which are common complaints with older adults. We investigated sleep duration, sleep quality, depressive symptoms, and pain at baseline as potential determinants of: (i) adherence to the exercise intervention component of a 2-year multidomain lifestyle intervention; (ii) intervention's effect on PA after 2 years; and (iii) overall PA after 2 years (exploratory analyses). METHODS The FINGER trial included 1259 individuals at risk for dementia, aged 60-77 years who were randomized (1:1) to a multidomain lifestyle intervention (exercise, diet, cognitive training, vascular risk factor management) or a control (regular health advice) group. Logistic regression analyses were used with exercise adherence (adherent: ≥66% participation) or self-reported PA (active: ≥2 times/week) as outcomes, adjusted for relevant baseline characteristics. Data on PA at baseline and at 2-years were available for 1100 participants. RESULTS Adherence to the exercise intervention was less likely with sleep duration < 6 h or ≥ 9 h per night compared with 7-8 h. OR (95% CI) were 0.46 (0.21-0.99) and 0.38 (0.20-0.74), respectively. The intervention group was more likely to be physically active than the control group at two years (OR 1.87, 95% CI 1.36-2.55). This intervention benefit did not significantly vary by baseline sleep duration, depressive symptoms, or pain (p > 0.3 for all interactions). Regardless of randomization group, those sleeping < 6 h were less likely to be physically active at two years, compared with participants sleeping 7-8 h (OR 0.36, 95% CI 0.18-0.72). Depressive symptoms or pain were not related to PA at two years. CONCLUSIONS Older adults with sleep problems, depressive symptoms, or pain may benefit from lifestyle interventions. However, both short and long sleep duration can pose barriers to engaging in exercise intervention and should be carefully considered when designing strategies to promote PA among older populations at risk for dementia. TRIAL REGISTRATION The FINGER trial was registered at ClinicalTrials.gov with identifier NCT01041989 on 04/01/2010.
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Affiliation(s)
- Eija Kekkonen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio, FI-70211, Finland.
| | - Anette Hall
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio, FI-70211, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland
| | - Satu Havulinna
- Department Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jenni Kulmala
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University, Tampere, Finland
| | - Tiina Laatikainen
- Department Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Teemu I Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio, FI-70211, Finland
| | - Timo Strandberg
- Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland
- Department of Medicine, Geriatric Clinic, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio, FI-70211, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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12
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Presciutti AM, Ehmann M, Levey N, Brewer J, Rush CL, Greenberg J, McDermott K, Ritchie CS, Vranceanu AM. Underserved older adults' treatment preferences for a mind-body activity program for chronic pain delivered via shared medical visits in a community clinic. PSYCHOL HEALTH MED 2025:1-17. [PMID: 40098344 DOI: 10.1080/13548506.2025.2478517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 03/05/2025] [Indexed: 03/19/2025]
Abstract
Older adults with chronic pain from underserved communities need evidence-based pain management programs. To meet this need, we interviewed patients and staff from an underserved community clinic to identify their treatment preferences and barriers and facilitators to participating in a mind-body activity program. We conducted nine qualitative interviews (two staff; seven patients) and six focus groups (three staff groups; three patient groups), transcribed them verbatim and then used inductive-deductive thematic analysis guided by two pre-specified superordinate domains: (1) treatment preferences and (2) barriers and facilitators to participation. Participants recommended flexible, group participation options (in person, remote) with a credible leader and with multi-cultural considerations. They generally reacted positively to the proposed content. Barriers included logistical barriers (e.g. transportation, finances), weather, and skepticism about novel treatments; facilitators centered on expanding access and increasing sense of community. Our findings highlight important considerations to facilitate the uptake of mind-body activity programs for underserved older adults with chronic pain.
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Affiliation(s)
- Alexander M Presciutti
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Madison Ehmann
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, USA
| | - Nadine Levey
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
| | - Julie Brewer
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
| | - Christina L Rush
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Katherine McDermott
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Christine S Ritchie
- Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, USA
- Department of Medicine, Harvard Medical School, Boston, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
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13
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Zhao WJ, Feng HJ, Wang S, Liu CH, Lv PY, Zhu H, Zhang PX, Hu XY, Li JN, Dong YL. Involvement of a central amygdaloid nucleus-lateral habenular nucleus pathway in the processing of formalin-induced pain. Neuroscience 2025; 569:103-113. [PMID: 39884420 DOI: 10.1016/j.neuroscience.2025.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 01/17/2025] [Accepted: 01/27/2025] [Indexed: 02/01/2025]
Abstract
The central amygdaloid nucleus (CeA) and the lateral habenular nucleus (LHb) are essential nuclei playing modulatory roles in encoding noxious stimuli. Their interaction has recently been demonstrated in chronic pain-induced depression. However, little is known about the CeA-LHb pathway in a formalin-induced pain model. In the present study, we aimed to clarify whether the CeA-LHb pathway modulates the formalin-induced pain model using a neuroanatomical tracing method combined with a designer receptor exclusively activated by a designer drugs strategy (DREADD). The results revealed that the CeA predominantly sends projections to vesicular glutamate transporter-2 (VGluT2)-expressing neurons of the LHb, and inhibition of LHb function exhibits an analgesic effect in the formalin-induced pain model. Furthermore, activating the CeA-LHb pathway significantly attenuates pain sensation only in phase 2 of formalin-induced pain in mice. The present results indicate the participation of the LHb in inflammatory pain sensation and reveal a CeA-LHbVGluT2 pathway that displays analgesic effects in a formalin pain model.
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Affiliation(s)
- Wen-Jun Zhao
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; Institute of Orthopedics, Xijing Hospital, the Fourth Military Medical University, Xi'an, China; Innovation Researh Institute, Xijing Hopsital, The Fourth Military Medical University, Xi'an 710032, China
| | - Hui-Jie Feng
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; Department of Anatomy, Medical College, Yan'an University, Yan'an, Shaanxi 716000, China
| | - Shan Wang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China
| | - Chu-Han Liu
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China
| | - Pei-Yuan Lv
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; The Fourth Cadets Brigade of Basic Medical University, The Fourth Military Medical University, Xi'an 710032, China
| | - Hui Zhu
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; Innovation Researh Institute, Xijing Hopsital, The Fourth Military Medical University, Xi'an 710032, China; Institute of Medical Research, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Peng-Xin Zhang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; The Fourth Cadets Brigade of Basic Medical University, The Fourth Military Medical University, Xi'an 710032, China
| | - Xue-Yu Hu
- Institute of Orthopedics, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Jia-Ni Li
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; Beijing Institute of Medical Sciences, Beijing 100080, China.
| | - Yu-Lin Dong
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an 710032, China; Innovation Researh Institute, Xijing Hopsital, The Fourth Military Medical University, Xi'an 710032, China.
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Pellegrini MJ, Meziat-Filho N, Fernandez J, Costa N. 'Despite the Pain, I Keep Moving Forward': A Qualitative Study on Brazilian Older Adults' Experiences With Chronic Low Back Pain. Musculoskeletal Care 2025; 23:e70050. [PMID: 39853682 DOI: 10.1002/msc.70050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Revised: 12/23/2024] [Accepted: 01/02/2025] [Indexed: 01/26/2025]
Abstract
OBJECTIVE The burden of chronic low back pain (CLBP) is increasing rapidly along with the global population ageing. Such an increase will occur more rapidly in low- and middle-income countries (LMICs). Yet, few studies have explored the experiences of older adults with CLBP, and these are primarily conducted in high-income countries. To address this concern, we explored the experiences of older Brazilian adults with CLBP. METHODS We used a descriptive qualitative study and gathered data through interviews and drawings from participants representing their experiences. Data were analysed using reflexive thematic analysis principles. RESULTS We interviewed 22 participants and identified the following themes: (1) Low back pain: an intense sensory and emotional experience; (2) causes of pain: wear and tear due to ageing, physical overload and emotional overload; (3) seeking treatment and not improving; (4) health professionals with a biomedical and pessimistic view; (5) the impact of pain on life: functional limitations and social repercussions; and (6) dealing with pain through movement, resilience and passive strategies. CONCLUSIONS Participants described CLBP as a sensory and emotional experience that impacts various aspects of their lives. Wear and tear due to ageing, physical and emotional overload were highlighted as causes of pain, and health professionals as a source of pessimism. Despite this, many participants discussed coping through movement, resilience, and passive strategies. Health professionals should address the emotional aspects associated with CLBP, explore its impact on their patients' lives and provide information that aligns with current evidence, promoting reassurance and a multidimensional understanding of CLBP.
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Affiliation(s)
- Marina Jacobucci Pellegrini
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Ney Meziat-Filho
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Jessica Fernandez
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Nathalia Costa
- The University of Queensland's Clinical Trial Capability (ULTRA) Team, Centre for Clinical Research, The University of Queensland, Brisbane, Australia
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15
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Kakazu VA, Pinto RZ, Dokkedal-Silva V, Fernandes GL, Araujo CGA, Pires GN, Dias TA, Tufik S, Andersen ML, Morelhão PK. Are Sleep Quality, Daytime Sleepiness, and Depression Associated with Knee Pain? A Cross-Sectional Study in Older Adults. Sleep Sci 2025; 18:e91-e96. [PMID: 40292211 PMCID: PMC12020562 DOI: 10.1055/s-0044-1787528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/15/2024] [Indexed: 04/30/2025] Open
Abstract
Introduction Osteoarthritis (OA) is common among older adults, and studies have suggested that it is commonly associated with sleep problems and depression. However, the results are inconsistent concerning overall sleep quality, daytime sleepiness, and depression in studies that consider OA knee pain specifically. Objectives To examine the relationship between sleep quality, daytime sleepiness and depression, and OA knee pain in older adults. Methods This was a cross-sectional study. Adults aged 60 and above with OA knee pain according to the National Institute for Health and Care Excellence (NICE) guidelines, and who had preserved cognitive function were recruited. Sleep quality, daytime sleepiness, and depression symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Center for Epidemiologic Studies Depression Scale (CESD), respectively. The generalized linear model (GzLM) approach was used in the statistical analysis. A logistic regression model was performed to evaluate whether ESS, PSQI, and CESD symptoms were associated with knee pain. Results The sample comprised 451 older adults. Sleep quality (OR = 1.22, 95% confidence interval [CI]: 1.07 to 1.40) and depressive symptoms (OR = 1.09, 95%CI: 1.01 to 1.17) were associated with knee pain, but there was no association with excessive daytime sleepiness (OR= 1.09, 95%CI: 0.90 to 1.20). Conclusions Sleep quality and depression symptoms are associated with knee pain.
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Affiliation(s)
- Viviane Akemi Kakazu
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rafael Z Pinto
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vinicius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Guilherme Luiz Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Tayná A Dias
- Departamento de Fisioterapia, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Presidente Prudente, SP, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Priscila K Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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16
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Granata N, Vercesi M, Bonfanti A, Mencacci C, Coco I, Mangrella M, Piazza R, Cerveri G. Choline Alphoscerate: A Therapeutic Option for the Management of Subthreshold Depression in the Older Population. Geriatrics (Basel) 2025; 10:32. [PMID: 40126282 PMCID: PMC11932255 DOI: 10.3390/geriatrics10020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 01/21/2025] [Accepted: 02/10/2025] [Indexed: 03/25/2025] Open
Abstract
Background and Objectives: Subthreshold depression (StD) presents with depressive symptoms similar to major depressive disorder (MDD) but of lower intensity. Despite its milder form, StD is significantly prevalent in the older population, affecting up to 12.9%. StD is associated with adverse outcomes, such as an increased risk of MDD and mild cognitive impairment (MCI). Treating StD in older adults is challenging due to the limited efficacy and side effects of traditional antidepressants. As a result, clinicians often adopt a "watchful waiting" strategy, which increases the risk of StD progressing into MDD or MCI. Choline alphoscerate (α-GPC), a cholinergic drug, is indicated in the treatment of pseudodepression in the elderly, a condition that corresponds to the actual definition of StD. This review highlights the role of α-GPC in the treatment of StD in older subjects. Methods: A comprehensive review of preclinical and clinical studies was conducted, focusing on the efficacy of α-GPC in improving cognitive and behavioral functions in mental conditions and in modulating neurotransmitter systems involved in depression, such as dopamine and serotonin. Results: Evidence points to the therapeutic benefits of using α-GPC in StD as it acts on cholinergic dysfunction and cognitive impairment. Additionally, it may improve mood regulation and motivation, key factors in StD and in depressive disorders. These findings suggest that α-GPC may reduce the risk of progression from StD to MDD or MCI. Conclusions: α-GPC represents an effective and safe therapeutic option for the treatment of StD in the older population, improving clinical outcomes and enhancing the quality of life in this high-risk group.
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Affiliation(s)
- Nicolò Granata
- Dipartimento di Salute Mentale e Dipendenze, ASST Lodi, 26900 Lodi, Italy; (N.G.); (M.V.); (G.C.)
| | - Marco Vercesi
- Dipartimento di Salute Mentale e Dipendenze, ASST Lodi, 26900 Lodi, Italy; (N.G.); (M.V.); (G.C.)
| | - Annamaria Bonfanti
- Dipartimento di Salute Mentale e Dipendenze, ASST Lodi, 26900 Lodi, Italy; (N.G.); (M.V.); (G.C.)
| | - Claudio Mencacci
- Dipartimento di Scienze Mentali e Neuroscienze, ASST Fatebenefratelli, 20157 Milano, Italy;
| | - Ilaria Coco
- Medical Affairs Department, Italfarmaco S.p.a., 20092 Milan, Italy; (I.C.); (M.M.); (R.P.)
| | - Mario Mangrella
- Medical Affairs Department, Italfarmaco S.p.a., 20092 Milan, Italy; (I.C.); (M.M.); (R.P.)
| | - Roberto Piazza
- Medical Affairs Department, Italfarmaco S.p.a., 20092 Milan, Italy; (I.C.); (M.M.); (R.P.)
| | - Giancarlo Cerveri
- Dipartimento di Salute Mentale e Dipendenze, ASST Lodi, 26900 Lodi, Italy; (N.G.); (M.V.); (G.C.)
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Hong S, Lu B, Wang S, Jiang Y. Comparison of logistic regression and machine learning methods for predicting depression risks among disabled elderly individuals: results from the China Health and Retirement Longitudinal Study. BMC Psychiatry 2025; 25:128. [PMID: 39953491 PMCID: PMC11829540 DOI: 10.1186/s12888-025-06577-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/05/2025] [Indexed: 02/17/2025] Open
Abstract
BACKGROUND Given the accelerated aging population in China, the number of disabled elderly individuals is increasing, and depression is a common mental disorder among older adults. This study aims to establish an effective model for predicting depression risks among disabled elderly individuals. METHODS The data for this study was obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS). In this study, disability was defined as a functional impairment in at least one activity of daily living (ADL) or instrumental activity of daily living (IADL). Depressive symptoms were assessed by using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D10). We employed SPSS 27.0 to select independent risk factor variables associated with depression among disabled elderly individuals. Subsequently, a predictive model for depression in this population was constructed using R 4.3.0. The model's discrimination, calibration, and clinical net benefits were assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curves. RESULTS In this study, 3,107 elderly individuals aged 60 years and older with disabilities were included. Poor self-rated health, pain, absence of caregivers, cognitive impairment, and shorter sleep duration were identified as independent risk factors for depression in disabled elderly individuals. The XGBoost model demonstrated superior performance in the training set, while the logistic regression model outperformed it in the validation set, with AUCs of 0.76 and 0.73, respectively. The calibration curve and Brier score (Brier: 0.20) indicated a good model fit. Moreover, decision curve analysis confirmed the clinical utility of the model. CONCLUSIONS The predictive model exhibits outstanding predictive efficacy, greatly assisting healthcare professionals and family members in evaluating depression risks among disabled elderly individuals. Consequently, it enables the early identification of elderly individuals at high risk for depression.
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Affiliation(s)
- Shanshan Hong
- Center of Health Administration and Development Studies, Hubei University of Medicine, NO. 30 Ren Min South Road, Maojian District, Shiyan, Hubei, 442000, China
| | - Bingqian Lu
- Center of Health Administration and Development Studies, Hubei University of Medicine, NO. 30 Ren Min South Road, Maojian District, Shiyan, Hubei, 442000, China
| | - Shaobing Wang
- Center of Health Administration and Development Studies, Hubei University of Medicine, NO. 30 Ren Min South Road, Maojian District, Shiyan, Hubei, 442000, China.
| | - Yan Jiang
- Center of Health Administration and Development Studies, Hubei University of Medicine, NO. 30 Ren Min South Road, Maojian District, Shiyan, Hubei, 442000, China.
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Chen Y, Bajpai AK, Li N, Xiang J, Wang A, Gu Q, Ruan J, Zhang R, Chen G, Lu L. Discovery of Novel Pain Regulators Through Integration of Cross-Species High-Throughput Data. CNS Neurosci Ther 2025; 31:e70255. [PMID: 39924344 PMCID: PMC11807727 DOI: 10.1111/cns.70255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 01/15/2025] [Accepted: 01/22/2025] [Indexed: 02/11/2025] Open
Abstract
AIMS Chronic pain is an impeding condition that affects day-to-day life and poses a substantial economic burden, surpassing many other health conditions. This study employs a cross-species integrated approach to uncover novel pain mediators/regulators. METHODS We used weighted gene coexpression network analysis to identify pain-enriched gene module. Functional analysis and protein-protein interaction (PPI) network analysis of the module genes were conducted. RNA sequencing compared pain model and control mice. PheWAS was performed to link genes to pain-related GWAS traits. Finally, candidates were prioritized based on node degree, differential expression, GWAS associations, and phenotype correlations. RESULTS A gene module significantly over-enriched with the pain reference set was identified (referred to as "pain module"). Analysis revealed 141 pain module genes interacting with 46 pain reference genes in the PPI network, which included 88 differentially expressed genes. PheWAS analysis linked 53 of these genes to pain-related GWAS traits. Expression correlation analysis identified Vdac1, Add2, Syt2, and Syt4 as significantly correlated with pain phenotypes across eight brain regions. NCAM1, VAMP2, SYT2, ADD2, and KCND3 were identified as top pain response/regulator genes. CONCLUSION The identified genes and molecular mechanisms may enhance understanding of pain pathways and contribute to better drug target identification.
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Affiliation(s)
- Ying Chen
- Department of Histology and Embryology, Medical CollegeNantong UniversityNantongJiangsuChina
| | - Akhilesh K. Bajpai
- Department of Genetics, Genomics and InformaticsUniversity of Tennessee Health Science CenterMemphisTennesseeUSA
| | - Nan Li
- Department of Histology and Embryology, Medical CollegeNantong UniversityNantongJiangsuChina
| | - Jiahui Xiang
- Medical CollegeNantong UniversityNantongJiangsuChina
| | - Angelina Wang
- Department of Genetics, Genomics and InformaticsUniversity of Tennessee Health Science CenterMemphisTennesseeUSA
| | - Qingqing Gu
- Department of Genetics, Genomics and InformaticsUniversity of Tennessee Health Science CenterMemphisTennesseeUSA
- Department of CardiologyAffiliated Hospital of Nantong UniversityJiangsuChina
| | - Junpu Ruan
- Medical CollegeNantong UniversityNantongJiangsuChina
| | - Ran Zhang
- Medical CollegeNantong UniversityNantongJiangsuChina
| | - Gang Chen
- Department of Histology and Embryology, Medical CollegeNantong UniversityNantongJiangsuChina
- Department of AnesthesiologyAffiliated Hospital of Nantong UniversityJiangsu ProvinceChina
| | - Lu Lu
- Department of Genetics, Genomics and InformaticsUniversity of Tennessee Health Science CenterMemphisTennesseeUSA
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Sohn JE, Ha SY, Sung YH. Characteristics according to pain intensity and duration in patients with nonspecific neck pain. J Exerc Rehabil 2025; 21:38-44. [PMID: 40083828 PMCID: PMC11898883 DOI: 10.12965/jer.2448616.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 11/27/2024] [Accepted: 12/03/2024] [Indexed: 03/16/2025] Open
Abstract
Nonspecific neck pain occurs without a clear cause and has a variety of causes. We investigated the characteristics and subjective feelings according to the intensity and duration of pain in patients with nonspecific neck pain. A survey was conducted on 43 patients complaining of neck pain according to pain duration and pain intensity. As a result, there was a significant difference between pain intensity and sleep (P<0.05). There was a significant difference between pain duration and sleep, pain duration and emotion (P<0.05). In addition, common feelings such as stiff, heavy, tight, and throbbing were observed according to pain intensity and duration. Therefore, consideration of sleep and emotion is necessary when composing an intervention to improve pain in patients with nonspecific neck pain.
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Affiliation(s)
- Ju-Eun Sohn
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon,
Korea
| | - Sun-Young Ha
- Health and Wellness Research Institute, Kyungnam University, Changwon,
Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon,
Korea
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20
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Uskur T, Kurt BF. Polypharmacy and Drug-Drug Interactions in Elderly Patients With Gastrointestinal Bleeding: A Single-Center Retrospective Study. Cureus 2025; 17:e77866. [PMID: 39991352 PMCID: PMC11847164 DOI: 10.7759/cureus.77866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2025] [Indexed: 02/25/2025] Open
Abstract
INTRODUCTION Gastrointestinal (GI) bleeding is a significant clinical presentation in elderly patients, where comorbidities, polypharmacy, and drug-drug interactions markedly increase the risk of bleeding. The aim of this study was to evaluate the types of medications prescribed during the six months prior to the patients' admission and the potential risks associated with drug interactions in patients aged 65 and older diagnosed with GI bleeding. METHODS This retrospective study included 49 patients aged 65 and older who were admitted to the emergency department of Kırklareli Training and Research Hospital with a diagnosis of GI bleeding between January 1 and December 31, 2022. Patient demographics, type of GI bleeding (upper or lower), duration of hospital stay, clinical outcomes, and medications prescribed during the six months prior to hospitalization were recorded. Statistical analyses were performed using GraphPad Prism 8.0. Continuous variables were reported as mean±standard deviation and categorical variables were analyzed using Fisher's exact test and Chi-square test, with a significance level of p<0.05. RESULTS The study included 49 patients, comprising 25 (51.02%) males and 24 (49.98%) females, with a mean age of 78.4±7.6 years. Female patients had a significantly higher mean age than males (p=0.045). Upper GI bleeding (81.6%) was more prevalent than lower GI bleeding (18.4%), with no statistically significant gender difference (p=0.7252). The mortality rate was 10.2%, with all deceased patients being female and diagnosed with upper GI bleeding (p=0.0226). A total of 110 medications were prescribed during the six months prior to hospitalization. Drug interactions were identified in 28 patients, with 67.9% classified as moderate and 28.6% as major. NSAIDs, anticoagulants, and antidepressants were the most frequently involved drug groups, significantly heightening the risk of GI bleeding. CONCLUSION Polypharmacy and drug-drug interactions are critical factors that contribute to the increased risk of GI bleeding in elderly patients. Comprehensive evaluation of medication regimens and strategies to mitigate polypharmacy are essential for improving patient safety and outcomes in this population.
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Affiliation(s)
- Tugce Uskur
- Medical Pharmacology, Kırklareli University Faculty of Medicine, Kırklareli, TUR
| | - Bedriye Feyza Kurt
- Emergency Medicine, Kırklareli Training and Research Hospital, Kırklareli, TUR
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21
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Pérez-Solá V, Montes JM, Trillo-Calvo E, Gasull V, García-Campayo J, Olivares-Diez JM, Berrocoso E, Mico JA, Agüera-Ortiz L. Consensus on the detection and management of patients with depression and pain as an associated somatic symptom. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2025; 18:21-27. [PMID: 37952640 DOI: 10.1016/j.sjpmh.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/13/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Globally, depression is the most common psychiatric disorder and is frequently associated with somatic symptom disorders, including pain as a physical symptom. There is a current need to improve the detection and management of the individuals in which depression and pain coexist. Hence, the aim of this document is to provide recommendations in the diagnosis and management of patients with major depressive disorder (MDD) who have pain as a physical symptom (PPS), in order to reduce the variability of clinical practice. MATERIAL AND METHODS The methodology used is based on the internationally recognized RAND/UCLA consensus method. The scientific committee, consisted of a group of eight multidisciplinary experts, defined 12 clinically relevant questions. After the systematic review of the literature, the scientific committee assessed the evidence and developed recommendations. The panel group with 15 participants validated these recommendations using a single Delphi round. To conclude, there was a final consensus meeting held to redefine with minor modifications the final recommendations. RESULTS The scientific committee developed a total of 19 recommendations on the diagnosis and detection, impact of PPS in MDD, treatment of MDD with associated PPS, use of healthcare resources, additional recommendations, and care coordination of these patients. Globally, a substantial level of agreement (≥80%) was reached on all items during the Delphi round. All the 19 achieved consensus, seven of them (37%) were agreed with unanimity during the Delphi round. The recommendations with higher consensus were in relation to diagnosis, impact of PPS in MDD, treatment and use of healthcare resources. CONCLUSIONS Currently, the evidence base for patients with MDD and PPS is still being developed and this consensus statement aims to bridge that gap by providing practical recommendations.
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Affiliation(s)
- Víctor Pérez-Solá
- Director of Healthcare and Medical Area, Hospital del Mar, Barcelona, Spain; Biomedical Research Network in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Director of the Institute of Mental Health, Hospital del Mar, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain.
| | - José M Montes
- Biomedical Research Network in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain; University of Alcalá, Alcala de Henares, Spain
| | - Eva Trillo-Calvo
- Primary Care, Institute for Health Research (IIS Aragón). Centro de Salud Campo de Belchite, Zaragoza, Spain
| | | | - Javier García-Campayo
- Professor of Psychiatry, University of Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain; Research Network on Chronicity, Primary Care and Prevention, and Health Promotion, Spain
| | - Jose Manuel Olivares-Diez
- Director of the Area of Neuroscience, Health Research Institute Galicia Sur (IISGS, CIBERSAM), Spain; Psychiatry Service of the Health Area of Vigo, Spain
| | - Esther Berrocoso
- Biomedical Research Network in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology & Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, Cádiz, Spain
| | - Juan Antonio Mico
- Biomedical Research Network in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology & Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, Cádiz, Spain
| | - Luis Agüera-Ortiz
- Biomedical Research Network in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Institute for Health Research (imas12), University Hospital October 12, Madrid, Spain
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Bae J, Lim YH, Hong SJ, Jeong JH, Choi HR, Park SK, Kim JE, Kim JH. Perceptions of treatment, accompanying symptoms, and other problems in patients with chronic pain: a multicenter cross-sectional study in Korea. Korean J Pain 2025; 38:69-78. [PMID: 39743319 PMCID: PMC11695254 DOI: 10.3344/kjp.24314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 11/28/2024] [Accepted: 12/02/2024] [Indexed: 01/04/2025] Open
Abstract
Background Chronic pain significantly affects daily activities, mental health, and the interpersonal relationships of patients. Consequently, physicians use various treatments to manage pain. This study investigated the perceptions of treatment, accompanying symptoms, and other problems in patients with chronic pain. Methods The authors enrolled patients with chronic pain from 19 university hospitals in South Korea. Data was collected on age, gender, diagnosis, disease duration, severity of pain, perception of pain treatment, and accompanying symptoms or problems using an anonymous survey comprising 19 questions. Results In total, 833 patients with chronic pain completed the survey, and 257 (31.0%) and 537 (64.5%) patients expressed concerns about the potential adverse effects of medication and opioid addiction, respectively. Personality changes such as irritability or anger were the most frequent accompanying symptoms in 507 (63.8%) patients, followed by depression and sleep disturbance in 462 (58.1%) and 450 (54.5%) patients, respectively. Depression (P = 0.001) and anxiety (P = 0.029) were more common among women, whereas divorce (P = 0.016), family conflict (P < 0.001), unemployment (P < 0.001), suicide attempts (P < 0.001), and restrictions on economic activity (P < 0.001) were more common among men. The frequency of accompanying symptoms, except for suicidal ideation, was higher in the younger patients aged ≤ 40 years than in the older patients aged > 40 years. Conclusions Many patients with chronic pain had concerns about adverse effects or medication tolerance and experienced anxiety, depression, or sleep disturbances. The prevalence of accompanying problems varies according to age and gender.
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Affiliation(s)
- Jieun Bae
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Yun Hee Lim
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Sung Jun Hong
- Department of Anesthesiology and Pain Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jae Hun Jeong
- Department of Anesthesiology and Pain Medicine, Jeong-clinic, Seoul, Korea
| | - Hey Ran Choi
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Sun Kyung Park
- Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jung Eun Kim
- Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jae Hun Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
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Shi JW, Kang W, Wang XH, Zheng JL, Xu W. Construction and validation of a risk prediction model for depressive symptoms in a middle-aged and elderly arthritis population. World J Orthop 2024; 15:1164-1174. [DOI: 10.5312/wjo.v15.i12.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/20/2024] [Accepted: 11/14/2024] [Indexed: 12/17/2024] Open
Abstract
BACKGROUND Arthritis is a prevalent and debilitating condition that affects a significant proportion of middle-aged and older adults worldwide. Characterized by chronic pain, inflammation, and joint dysfunction, arthritis can severely impact physical function, quality of life, and mental health. The overall burden of arthritis is further compounded in this population due to its frequent association with depression. As the global population both the prevalence and severity of arthritis are anticipated to increase.
AIM To investigate depressive symptoms in the middle-aged and elderly arthritic population in China, a risk prediction model was constructed, and its effectiveness was validated.
METHODS Using the China Health and Retirement Longitudinal Study 2018 data on middle-aged and elderly arthritic individuals, the population was randomly divided into a training set (n = 4349) and a validation set (n = 1862) at a 7:3 ratio. Based on 10-fold cross-validation, least absolute shrinkage and selection regression was used to screen the model for the best predictor variables. Logistic regression was used to construct the nomogram model. Subject receiver operating characteristic and calibration curves were used to determine model differentiation and accuracy. Decision curve analysis was used to assess the net clinical benefit.
RESULTS The prevalence of depressive symptoms in the middle-aged and elderly arthritis population in China was 47.1%, multifactorial logistic regression analyses revealed that gender, age, number of chronic diseases, number of pain sites, nighttime sleep time, education, audiological status, health status, and place of residence were all predictors of depressive symptoms. The area under the curve values for the training and validation sets were 0.740 (95% confidence interval: 0.726-0.755) and 0.731 (95% confidence interval: 0.709-0.754), respectively, indicating good model differentiation. The calibration curves demonstrated good prediction accuracy, and the decision curve analysis curves demonstrated good clinical utility.
CONCLUSION The risk prediction model developed in this study has strong predictive performance and is useful for screening and assessing depression symptoms in middle-aged and elderly arthritis patients.
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Affiliation(s)
- Jun-Wei Shi
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu Province, China
| | - Wei Kang
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu Province, China
| | - Xin-Hao Wang
- Department of Rheumatology and Immunology, Minda Hospital of Hubei Minzu University, Enshi 445000, Hubei Province, China
| | - Jin-Long Zheng
- Department of Nursing, Xiangyang Centre Hospital, Xiangyang 441100, Hubei Province, China
| | - Wei Xu
- Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
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24
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Guo L, He Z. Case report: Depression in an older patient with dysgeusia as the initial symptom. Front Psychiatry 2024; 15:1478359. [PMID: 39720431 PMCID: PMC11666477 DOI: 10.3389/fpsyt.2024.1478359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 11/15/2024] [Indexed: 12/26/2024] Open
Abstract
Introduction Depression is the most common mental illness among older adults, with substantial and persistent mood depression as the main clinical feature, which is unfavorable for improvement. The clinical manifestations can range from melancholy to grief or even numbness. Approximately one-third of older adult patients exhibit physical discomfort as the first symptom; dysgeusia as the first symptom, is very rare in clinical practice. Dysgeusia is a clinical symptom with no specific objective indicator; thus, the likelihood of misdiagnosis and missed diagnosis is high. Case presentation In this study, a 60-year-old female housewife with elementary school as her highest level of education, presented to the outpatient department with dysgeusia, poor sleep, and poor mood persisting for >1 year, which aggravated 2 weeks before hospital visit. Psychiatric examination showed clear consciousness; the patient was cleanly and timely dressed and demonstrated self-care but had a worrisome expression. Using the diagnostic criteria of the International Classification of Diseases (10th edition), a diagnosis of a major depressive episode with psychotic symptoms was made. Following pharmacological and psychological treatment, the patient's condition improved. The patient was compliant to treatment (10 mg/day of escitalopram), had a stable mood, good sleep, and no dysgeusia at >2 years of follow-up as an outpatient. She was able to do housework and take care of her children normally and did not complain about any other issues. Conclusion Physical discomfort is a very common complaint in older patients with depression. If persistent physical symptoms do not improve after repeated medical treatment, timely assessment of the patient's mental state or psychiatric referral should be considered to diagnose geriatric depression. Timely pharmacological and psychological therapy are the preferred treatment for older adults.
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Affiliation(s)
- Longrun Guo
- Department of Rehabilitation Medicine, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi, China
| | - Zhufa He
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi, China
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Muhammad T, Pai M, Ali W. The Association Between Pain and Physical Frailty Among Older Adults in India: Depression and Insomnia as Mediators. Exp Aging Res 2024:1-19. [PMID: 39644185 DOI: 10.1080/0361073x.2024.2429314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 11/11/2024] [Indexed: 12/09/2024]
Abstract
OBJECTIVES To investigate the association between body pain and physical frailty among older adults in India and to examine whether this association is mediated by symptoms of depression and insomnia. METHODS Data were obtained from the Longitudinal Aging Study in India, comprising 31,464 adults aged 60 and older. Physical frailty was assessed using a modified version of the frailty phenotype developed by Fried and colleagues. Multivariable logistic regression was used to analyze associations, and the Karlson-Holm-Breen method was employed to evaluate mediation effects. RESULTS The prevalence of frailty was 30.65%, with women showing a higher prevalence than men (33.16% vs. 27.85%). Older adults experiencing body pain had increased odds of frailty (adjusted odds ratio [aOR]: 1.17, 95% CI: 1.06-1.35). Depression (aOR: 1.70, 95% CI: 1.44-2.01) and insomnia symptoms (aOR: 1.58, 95% CI: 1.38-1.81) were independently associated with higher odds of frailty. Mediation analysis showed that depression mediated 8.4% of the association between pain and frailty in men and 6.11% in women. Insomnia symptoms mediated 11.47% of the association in men and 14.54% in women. CONCLUSION Body pain was significantly associated with a higher likelihood of frailty among older adults in India. Symptoms of depression and insomnia partially mediated this association, with a stronger mediating effect observed for insomnia in women. Inclusive health care strategies addressing pain, depression, and insomnia could help mitigate the risk of frailty in this population.
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Affiliation(s)
- T Muhammad
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, Ohio, USA
| | - Waad Ali
- Department of Geography, Sultan Qaboos University, Muscat, Oman
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26
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ATLIHAN U, DURAKLI ULUKÖK M, YAVUZ O. Relationship between menstrual cycle and cognitive function in women with primary dysmenorrhea. Turk J Med Sci 2024; 55:258-264. [PMID: 40104313 PMCID: PMC11913492 DOI: 10.55730/1300-0144.5966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Revised: 02/18/2025] [Accepted: 12/05/2024] [Indexed: 03/20/2025] Open
Abstract
Background/aim To evaluate the relationship between the change in pain intensity over days of the menstrual cycle and cognitive function in females with primary dysmenorrhea. Materials and methods One hundred thirty-four females with primary dysmenorrhea who were admitted to our hospital from January 2021 to November 2023 were assessed. Of these participants, 46 individuals who subjectively stated that their cognitive function was affected, for whom neurology consultation was requested, and for whom patient data were available, were included in the study. Results A significant decrease was seen in phonemic and semantic fluency on day 3 of menstruation (p < 0.001 and p < 0.001, respectively). A significant decrease was observed in the forward and backward digit span (DGS) scores on day 3 of menstruation (p < 0.001 and p < 0.001, respectively). A significant decrease was seen in the forward and backward DGS scores on the most painful day of menstruation (p < 0.001 and p < 0.001, respectively). A significant decrease in the logical memory subtest Wechsler Memory Scale revised scores on the most painful day of menstruation (p < 0.001). Conclusion Consistent with the literature, strong evidence was found showing a negative correlation between dysmenorrhea and cognitive function. Future prospective, larger sample-size studies comparing cognitive function in females with and without dysmenorrhea at various stages of the menstrual cycle are needed.
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Affiliation(s)
- Ufuk ATLIHAN
- Department of Gynecology and Obstetrics, Private Karataş Hospital, İzmir,
Turkiye
| | | | - Onur YAVUZ
- Department of Gynecology and Obstetrics, Faculty of Medicine, Dokuz Eylul University, İzmir,
Turkiye
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Zhong T, William HM, Jin MY, Abd-Elsayed A. A Review of Remote Monitoring in Neuromodulation for Chronic Pain Management. Curr Pain Headache Rep 2024; 28:1225-1233. [PMID: 39066995 DOI: 10.1007/s11916-024-01302-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE OF REVIEW Neuromodulation techniques have emerged as promising strategies for managing chronic pain. These techniques encompass various modalities of nerve stimulation, including Spinal Cord Stimulation (SCS), Dorsal Root Ganglion Stimulation (DRG-S), and Peripheral Nerve Stimulation (PNS). Studies consistently demonstrate significant improvements in pain intensity, quality of life, and reduced opioid usage among patients treated with these modalities. However, neuromodulation presents challenges, such as the need for frequent in-person follow-up visits to ensure proper functionality of the implanted device. Our review explored factors impacting compliance in current neuromodulation users and examined how remote monitoring can mitigate some of these challenges. We also discuss outcomes of recent studies related to remote monitoring of neuromodulation. RECENT FINDINGS While remote monitoring capabilities for neuromodulation devices is an emerging development, there are promising results supporting its role in improving outcomes for chronic pain patients. Higher patient satisfaction, improved pain control, and reduced caretaker burdens have been observed with the use of remote monitoring. This review discusses the current challenges with neuromodulation therapy and highlights the role of remote monitoring. As the field continues to evolve, understanding the importance of remote monitoring for neuromodulation is crucial for optimizing pain management outcomes.
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Affiliation(s)
- Tammy Zhong
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Hannah M William
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Max Y Jin
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Giorgi V, Sarzi-Puttini P, Pellegrino G, Sirotti S, Atzeni F, Alciati A, Torta R, Varrassi G, Fornasari D, Coaccioli S, Bongiovanni SF. Pharmacological Treatment of Fibromyalgia Syndrome: A Practice-Based Review. Curr Pain Headache Rep 2024; 28:1349-1363. [PMID: 39042299 PMCID: PMC11666752 DOI: 10.1007/s11916-024-01277-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE OF REVIEW Fibromyalgia Syndrome (FMS) is a complex chronic pain condition characterized by widespread musculoskeletal pain and numerous other debilitating symptoms. The purpose of this review is to provide a comprehensive overview, based on everyday clinical practice, of the drugs presently employed in the treatment of FMS. RECENT FINDINGS The treatment of FMS is based on a multimodal approach, with pharmacologic treatment being an essential pillar. The drugs used include tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors, other antidepressants, anticonvulsants, myorelaxants, and analgesics. The effectiveness of these medications varies, and the choice of drug often depends on the specific symptoms presented by the patient. Many drugs tend to either address only some domains of the complex FMS symptomatology or have a limited effect on pain. Each treatment option comes with potential side effects and risks that necessitate careful consideration. It may be beneficial to divide patients into clinical subpopulations, such as FMS with comorbid depression, for more effective treatment. Despite the complexities and challenges, the pharmacological treatment remains a crucial part for the management of FMS. This review aims to guide clinicians in prescribing pharmacological treatment to individuals with FMS.
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Affiliation(s)
- Valeria Giorgi
- Unità di Ricerca Clinica, Gruppo Ospedaliero Moncucco, Via Soldino, 5, 6900, Lugano, CH, Switzerland.
| | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Greta Pellegrino
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Silvia Sirotti
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Villa S. Benedetto Menni, 22032, Albese con Cassano, Como, Italy
- Humanitas Clinical and Research Center, Rozzano, 20089, Milan, Italy
| | - Riccardo Torta
- Clinical Psychology, Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Diego Fornasari
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
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Paris D, Bier M, Nacher M. [A promising tool in evaluation of psychological pain?]. L'ENCEPHALE 2024; 50:686-690. [PMID: 38556395 DOI: 10.1016/j.encep.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/14/2023] [Accepted: 01/12/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Denis Paris
- Clinique Saint-Martin, 83090 Ollioules, France.
| | - Matthieu Bier
- Centre hospitalier universitaire de la Martinique, 97200 Fort-de-France, France
| | - Matthieu Nacher
- Centre d'investigation clinique Antilles-Guyane (Inserm CIC 1424), centre hospitalier de Cayenne, 97300 Cayenne, Guyane française
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Wilczyński K, Mazurski A, Kotucha K. Antidepressant Efficacy in Managing Nonspecific Chronic Lower Back Pain Among Older Adults: A Review. J Pain Palliat Care Pharmacother 2024; 38:379-393. [PMID: 39133808 DOI: 10.1080/15360288.2024.2384961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 07/02/2024] [Accepted: 07/21/2024] [Indexed: 03/15/2025]
Abstract
This review evaluates the use of antidepressants in older patients for the treatment of nonspecific chronic lower back pain (LBP), emphasizing age-related physiological changes and common degenerative conditions in this age group. We conducted a comprehensive search targeting studies on antidepressant use in older patients with LBP. Selective serotonin reuptake inhibitors, while effective for mood regulation, show limited benefits for LBP. Serotonin-norepinephrine reuptake inhibitors, particularly duloxetine, demonstrate potential in managing LBP, though further research is needed to confirm these findings. Tricyclic antidepressants have shown potential for pain relief, with limited evidence for LBP, but have a substantial side effect profile, including cardiotoxicity, weight gain, and severe anticholinergic effects. The evidence for trazodone in the treatment of LBP is limited. When prescribing new medications for older adults, it is crucial to carefully consider the patient's overall health, potential drug interactions, and sensitivity to side effects, ensuring that the benefits of treatment outweigh the risks. This review underscores the need for further research to understand the long-term effects and benefits of antidepressants in older patients with LBP, aiming to balance pain relief, mood stabilization, and minimized side effects.
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Affiliation(s)
- Krzysztof Wilczyński
- MD, PhD, Adam Mazurski, MD, and Kornela Kotucha, MD, Department of Geriatrics, School of Health Sciences, Medical University of Silesia in Katowice, Katowice, Poland
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Yi D, Yang M, Luo Q, Li H, Kong L, Cheng Q. Bidirectional relationship between pain and sleep disturbance in middle-aged and older adults: evidence from the China health and retirement longitudinal study. Front Psychiatry 2024; 15:1485822. [PMID: 39670150 PMCID: PMC11635170 DOI: 10.3389/fpsyt.2024.1485822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Accepted: 10/28/2024] [Indexed: 12/14/2024] Open
Abstract
Background Pain is one of the most prevalent symptoms that disrupt daily functioning and has been increasing in prevalence. Sleep disturbances frequently occur in individuals with pain, making it difficult to initiate and maintain sleep. This study aims to examine the bidirectional correlation between pain and sleep quality/duration among middle-aged and older Chinese adults. Participants and setting This study analyzed data from individuals aged 45 years and above who participated in both the 2018 and 2020 baseline surveys of China Health and Retirement Longitudinal Study (CHARLS). Methods The bidirectional association between pain and sleep disturbance was assessed using multivariate logistic regression models, adjusting for various covariates. Results Among individuals without pain, those with unsatisfactory sleep quality were more likely to experience future pain, with an adjusted odds ratio (OR) of 1.74 (95% CI: 1.57 - 1.92). Conversely, among individuals with satisfactory sleep quality, those with pain were more likely to develop unsatisfactory sleep quality in the future, with an adjusted OR of 1.87 (95% CI: 1.69 - 2.07). Additionally, shorter sleep duration (<6 hours) was significantly associated with pain status (OR=1.39; 95% CI: 1.28 - 1.50). The incidence of developing short sleep duration in individuals with pain was also higher (OR=1.49; 95% CI: 1.38 - 1.61). Conclusions This research revealed a bidirectional relationship between pain and sleep disturbance in middle-aged and older Chinese adults, where each condition exacerbated the other. Recognizing and addressing this interconnected relationship was essential for effective management of both pain and sleep quality in this population.
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Affiliation(s)
- Duan Yi
- Department of Pain Medicine, Peking University Third Hospital, Beijing, China
| | - Mingyuan Yang
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, China
| | - Qipeng Luo
- Department of Pain Medicine, Peking University Third Hospital, Beijing, China
| | - Hong Li
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, China
| | - Liang Kong
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, China
| | - Qinghao Cheng
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, China
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Ang L, Lee MS, Song E, Lee HW, Cao L, Zhang J, Wang Q, Jung J, Jang S, Gastaldon C, Reynolds CF, Cuijpers P, Patel V, Barbui C, Yao L, Papola D. Psychotherapeutic treatments for depression in older adults. Cochrane Database Syst Rev 2024; 11:CD015976. [PMID: 39601297 PMCID: PMC11600498 DOI: 10.1002/14651858.cd015976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of psychotherapeutic interventions in the treatment of older adults with depression and whether the effects of different types of psychotherapeutic treatments vary for older adults with depression.
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Affiliation(s)
- Lin Ang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South
| | - Eunhye Song
- Global Cooperation Center, Korea Institute of Oriental Medicine, Daejeon, Korea, South
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South
| | - Liujiao Cao
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Jingyi Zhang
- Guangdong Second Provincial General Hospital, Guangdong, China
| | - Qi Wang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Jeeyoun Jung
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South
| | | | - Chiara Gastaldon
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Davide Papola
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Esposito E, Lemes IR, Salimei PS, Morelhão PK, Marques LBF, Martins MDS, Cynthia G, Franco MR, Pinto RZ. Chronic Musculoskeletal Pain is Associated With Depressive Symptoms in Community-Dwelling Older Adults Independent of Physical Activity. Exp Aging Res 2024:1-13. [PMID: 39499529 DOI: 10.1080/0361073x.2024.2397322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/09/2024] [Indexed: 11/07/2024]
Abstract
BACKGROUND Prevalence of chronic musculoskeletal pain and depressive symptoms in adults is high; however, whether there is an association between these conditions in older adults is unknown. OBJECTIVE The aim of this study was to investigate the association of depressive symptoms with chronic musculoskeletal pain, and specifically with chronic LBP and knee osteoarthritis (OA), in community-dwelling older adults. In addition, we explored whether physical activity can mitigate these associations. METHODS A cross-sectional study design. A cross-sectional study design. Participants recruited were older adults (age ≥60 years) living in the community. Chronic musculoskeletal pain was assessed by specific questions regarding the presence of chronic LBP and knee OA. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Multivariable regression model adjusted for potential confounders (i.e., age, sex, economic status, body composition, and physical activity) was used to investigate the association between chronic musculoskeletal pain and depressive symptoms. Separate analyses were also conducted for older adults with LBP and with knee OA. RESULTS A total of 509 (69% women) older adults were recruited. The regression analysis showed that musculoskeletal pain was associated with higher depressive symptoms (β = 2.52, 95% CI: 0.50 to 4.54; p-value < .05) compared with older adults without chronic musculoskeletal pain. Similarly, in the fully adjusted model, which included physical activity, LBP was associated with higher depressive symptoms (β = 2.80, 95% CI: 0.82 to 4.79; p-value < .01). The association between knee OA and depressive symptoms was not statistically significant after adjusting for physical activity (β = 2.00, 95% CI: -0.13 to 4.13; p-value = .06). CONCLUSION Older adults with chronic musculoskeletal pain have higher depressive symptoms scores, when compared to those without musculoskeletal pain. Physical activity does not seem to influence this association.
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Affiliation(s)
- Eleonora Esposito
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Department of Systems Medicine, University of Rome 'Tor Vergata' (UNIROMA2), Rome, Italy
| | - Italo Ribeiro Lemes
- Department of Physical Therapy, Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, Brazil
- Department of Physical Therapy, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil
| | | | - Priscila Kalil Morelhão
- Department of Physical Therapy, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | | | - Gobbi Cynthia
- Department of Physical Therapy, Centro Universitario de Ensino Superior (UNICESUMAR), Brazil
| | | | - Rafael Zambelli Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Chudek A, Kotyla P, Kozak-Szkopek E, Mossakowska M, Wieczorowska-Tobis K, Sulicka-Grodzicka J, Olszanecka-Glinianowicz M, Chudek J, Owczarek AJ. Inflammation in Older Poles with Localized and Widespread Chronic Pain-Results from a Population-Based PolSenior Study. J Clin Med 2024; 13:5870. [PMID: 39407930 PMCID: PMC11478211 DOI: 10.3390/jcm13195870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 09/17/2024] [Accepted: 09/26/2024] [Indexed: 10/20/2024] Open
Abstract
Background: Inflammation leads to a decrease in the excitation threshold and the sensitization of peripheral nociceptors. However, little is known about the effect of inflammation on the sensing of regional (CRegP) and widespread chronic pain (CWP) in older adults. This analysis aimed to characterize the prevalence and associates of both types of chronic pain in a population-based cohort. Methods: Our analysis was based on the Polish nationwide PolSenior study database. We excluded participants with moderate-to-severe dementia. Respondents answered questions concerning the occurrence of pain in 10 regions. CWP was defined as chronic pain present in the axial region (neck, upper back, lower back) and any part of both the lower (lower leg, hip, knee, foot) and upper (shoulder, hand) extremities. Inflammatory status was divided into three subgroups: no inflammation (CRP < 3 mg/dL), mild inflammation (CPR 3-10 mg/dL and IL-6 < 10 ng/mL), and significant inflammation (CRP ≥ 10 mg/dL or IL-6 ≥ 10 ng/mL). Results: CRegP was more frequent (33.9%) than CWP (8.8%). The occurrence of CWP was more frequent in subgroups with significant inflammation than in both subgroups with mild or no inflammation (11.4% vs. both 8.4%). Women (OR 3.67; 95% CI: 2.58-5.21) and subjects with major depression symptoms were more likely to experience CWP (OR 2.85; 95% CI: 1.68-4.82), while, malnourished participants were more likely to report CRegP (OR 2.00; 95% CI: 1.52-2.62). Conclusions: Significant inflammation is associated with increased occurrence of CWP in older adults. Female sex and major depression are the most significant associates of CWP, while malnutrition is the most significant associate of CRegP.
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Affiliation(s)
- Anna Chudek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.O.-G.); (A.J.O.)
| | - Przemysław Kotyla
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
| | - Elżbieta Kozak-Szkopek
- Department of Geriatric Nursing, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Department of Internal Diseases and Cardiology, Centre for Management of Venous Thromboembolic Disease, Medical University of Warsaw, 02-005 Warsaw, Poland
| | - Małgorzata Mossakowska
- Study on Ageing and Longevity, International Institute of Molecular and Cell Biology, 02-109 Warsaw, Poland;
| | | | - Joanna Sulicka-Grodzicka
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, 30-698 Cracow, Poland;
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.O.-G.); (A.J.O.)
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, 40-029 Katowice, Poland;
| | - Aleksander J. Owczarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.O.-G.); (A.J.O.)
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Brewer JR, McDermott KA, Greenberg J, Presciutti AM, LaCamera DE, Ritchie CS, Vranceanu AM. Patient and staff perspectives on pain treatment experiences in a community clinic serving under-resourced older adults. Pain Manag 2024; 14:549-556. [PMID: 39601034 PMCID: PMC11633828 DOI: 10.1080/17581869.2024.2432852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Accepted: 11/19/2024] [Indexed: 11/29/2024] Open
Abstract
AIMS Chronic pain affects up to 37.8% of older adults with higher prevalence among those in under-resourced communities. While there are many treatments for chronic pain, there are complexities to treating under-resourced older adults in community clinics, including multimorbidity, barriers to treatment access, and varying degrees of openness to different treatment approaches. Understanding patient and clinic staff perceptions of treatment options for chronic pain is critical for implementing treatment approaches that will work sustainably in the community. This study aimed to understand clinic staff and patients' perspectives on chronic pain treatment experiences. METHODS Focus groups and individual interviews were analyzed using a hybrid inductive-deductive approach. RESULTS Themes are: (1) Limited patient and clinic resources and availability affecting pain treatment experiences (e.g., copays, transportation challenges, and conflicting responsibilities), (2) Discrepancies in patient and staff approaches to treatment and the importance of trialing different pain management techniques to alleviate pain (e.g., trialing multiple treatments with varied success), and (3) Conflict between patients' desire for pain elimination vs. staffs' focus on symptom reduction and function (e.g., patient-staff disconnect). CONCLUSIONS These findings are important for determining how treatments can best fit the needs of under-resourced older adults with chronic pain.
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Affiliation(s)
- Julie R. Brewer
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Katherine A. McDermott
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Alexander M. Presciutti
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Danielle E. LaCamera
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Christine S. Ritchie
- Harvard Medical School, Boston, MA, USA
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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36
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McElroy IE, Suarez L, Tan TW. The Impact of Mental Health on Patient Outcomes in Peripheral Arterial Disease and Critical Limb Threatening Ischemia and Potential Avenues to Treatment. Ann Vasc Surg 2024; 107:181-185. [PMID: 38582197 DOI: 10.1016/j.avsg.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 04/08/2024]
Abstract
The physical consequences of peripheral artery disease (PAD) are well established; however, the impact of comorbid mental health disorders such as depression and anxiety are not well understood. The impact of psychological stress is not only associated with worse perioperative morbidity and mortality but also with a physiologic cascade that accelerates plaque formation. Increasing screening to identify and subsequently treat comorbid mental health disorders is an integral next step in improving outcomes in PAD management. Failure to adequately address social and psychological impact on PAD patients will further widen the gap in disparities faced by high-risk and disenfranchised populations. Integration of mental health professionals, addiction specialists, and community navigators into multidisciplinary care teams can bolster support for PAD patients and improve outcomes.
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Affiliation(s)
- Imani E McElroy
- Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Luis Suarez
- Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Tze-Woei Tan
- Division of Vascular Surgery, Keck School of Medicine at University of Southern California, Los Angeles, CA.
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Topmiller M, Mallow PJ, Byun H, Carrozza M, Jabbarpour Y. The Impact of Primary Care Physician Capacity on Preventable Hospitalizations: Identifying Bright Spots in the Appalachian & Mississippi Delta Regions. JOURNAL OF APPALACHIAN HEALTH 2024; 6:66-78. [PMID: 39534736 PMCID: PMC11552677 DOI: 10.13023/jah.0603.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
Introduction Several studies have documented that higher rates of primary care physicians are associated with lower rates of preventable hospitalizations. Counties with higher rates of preventable hospitalizations are found in the Appalachian and Mississippi (MS) Delta Regions. Purpose (1) To determine if the association of primary care capacity with preventable hospitalizations is different in the Appalachian and MS Delta regions compared to the rest of the U.S., and (2) to explore primary care capacity in counties with lower-than-expected preventable hospitalization rates. Methods This study modeled preventable hospitalizations with primary care physicians (PCP) per 100,000 (PCP capacity) while controlling for several factors. A spatial regime variable was also included, which modeled Appalachian and MS Delta regions separately. Next, PCP capacity was removed from the model and a geospatial residual analysis was performed to identify geographic clusters of counties with lower-than-expected rates of preventable hospitalizations (bright spots). PCP capacity in bright spots was then compared to that in counties with higher-than-expected rates (cold spots). Results Higher PCP capacity was significantly associated with lower rates of preventable hospitalizations in the rest of U.S. model, though was not significant for the Appalachian or MS Delta models. The residual analysis showed that compared to counties with higher-than-expected rates (cold spots), counties with lower-than-expected rates (bright spots) had significantly higher PCP capacity, though not in the MS Delta region. Implications Consistent with previous literature, it was found that the factors associated with preventable hospitalizations vary by region, though the results are mixed when looking at the Appalachian and MS Delta regions separately. Future research should explore characteristics of bright spots within the Appalachian and MS Delta regions.
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Affiliation(s)
- Michael Topmiller
- American Academy of Family Physicians, The Robert Graham Center for Policy Studies in Family Medicine
| | - Peter J Mallow
- Xavier University, Department of Health Services Administration
| | - Hoon Byun
- American Academy of Family Physicians, The Robert Graham Center for Policy Studies in Family Medicine
| | - Mark Carrozza
- American Academy of Family Physicians, The Robert Graham Center for Policy Studies in Family Medicine
| | - Yalda Jabbarpour
- American Academy of Family Physicians, The Robert Graham Center for Policy Studies
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Angeli E, Zambelli A, Corli O, Bestetti G, Landonio S, Merli S, Cheli S, Rizzardini G. High Symptom Burden in Patients With Advanced Chronic or Prolonged Infectious Diseases: Not Only Pain. Cureus 2024; 16:e71751. [PMID: 39553071 PMCID: PMC11569390 DOI: 10.7759/cureus.71751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2024] [Indexed: 11/19/2024] Open
Abstract
INTRODUCTION The growing evidence of increased life expectancy in the future reveals the high relevance of frailty in patients with chronic-degenerative diseases; identification and management of symptoms may improve significantly their quality of life. The objective of our study was to assess the symptom burden in patients with advanced chronic or prolonged infectious diseases. MATERIALS AND METHODS A cross-sectional study was performed enrolling 88 patients, referred to palliative care consultation for chronic pain, and evaluated using the Edmonton Symptom Assessment System to define Total Symptom Distress Score (TSDS) and high symptom burden (HSB) when more than six symptoms along with Numerical Rating Scale ≥4 were present. RESULTS All participants reported moderate to severe pain; in addition, 86 (97.7%) experienced a lack of well-being, 81 (92%) tiredness, 67 (76.1%) lack of appetite, 66 (75%) drowsiness, 66 (75%) depression, 56 (63.6%) anxiety, 49 (55.6%) nausea, and 39 (44.3%) shortness of breath. Forty-four patients (50%) had high TSDS, greater than 40.5, and presented lower Karnofsky Performance Scale (KPS) (median 40 vs. 70, p=0.0005), higher comorbidities (median 7 vs. 4, p=0.00001), and higher drug burden (median 9 vs. 6, p=0.0003) than those with low TSDS. Furthermore, considering symptom intensity, 40 patients (45.4%) had HSB and presented lower KPS (median 50 vs. 70, p=0.0005), higher comorbidities (median 7 vs. 4, p=0.00001), and higher drug burden (mean 9 vs. 6, p=0.01) compared to patients without HSB. CONCLUSION Our population had an HSB, in addition to pain, revealing high frailty. A correct assessment of symptoms is, therefore, required to manage patients with chronic infectious diseases. In this setting, attention should be given to identifying patients at high risk of HSB through a correct diagnosis and effective management, which should be based on a multi-professional approach.
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Affiliation(s)
- Elena Angeli
- Infectious Diseases Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
| | - Agostino Zambelli
- Infectious Diseases Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
| | - Oscar Corli
- Pain Therapy and Palliative Care Unit, Institute for Pharmacological Research Mario Negri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ITA
| | - Giovanna Bestetti
- Infectious Diseases Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
| | - Simona Landonio
- Infectious Diseases Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
| | - Stefania Merli
- Infectious Diseases Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
| | - Stefania Cheli
- Pharmacovigilance and Clinical Research, Biomedical and Clinical Sciences Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
| | - Giuliano Rizzardini
- Infectious Diseases Department, Fatebenefratelli-Sacco University Hospital, Milan, ITA
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García-López H, García-Giménez MT, Obrero-Gaitán E, Lara-Palomo IC, Castro-Sánchez AM, Rey RRD, Cortés-Pérez I. Effectiveness of balneotherapy in reducing pain, disability, and depression in patients with Fibromyalgia syndrome: a systematic review with meta-analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1935-1951. [PMID: 39008110 PMCID: PMC11493822 DOI: 10.1007/s00484-024-02732-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024]
Abstract
Balneotherapy, using heated natural mineral waters at 36-38 °C, presents a comprehensive treatment approach for Fibromyalgia Syndrome (FMS). This study aims to assess the effect of balneotherapy in reducing pain intensity, disability, and depression in patients with FMS. We want to assess this effect at just four time-points: immediately at the end of the therapy, and at 1, 3, and 6 months of follow-up. Following PRISMA guidelines, we conducted an aggregate data meta-analysis, registered in PROSPERO CRD42023478206, searching PubMed Medline, Science Direct, CINAHL Complete, Scopus, and Web of Science until August 2023 for relevant randomized controlled trials (RCTs) that assess the effect of balneotherapy on pain intensity, disability, and depression in FMS patients. Methodological quality was assessed using the Cochrane methodology, and the pooled effect was calculated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. Sixteen RCTs were included in the meta-analysis. Balneotherapy is effective in reducing pain intensity (SMD - 1.67; 95% CI -2.18 to -1.16), disability (SMD - 1.1; 95% CI -1.46 to -0.7), and depression (SMD - 0.51; 95% CI -0.93 to -0.9) at the end of the intervention. This effect was maintained at 1, 3, and 6 months for pain intensity and disability. Balneotherapy improves both pain intensity and disability in patients with FMS, providing evidence that its positive effects are sustained for up to 6 months of follow-up. Nevertheless, it is important to note that the improvement in depression varies across different temporal phases.
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Affiliation(s)
- Héctor García-López
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Carr. Sacramento, s/n, La Cañada, Almería, 04120, Spain
| | - María Teresa García-Giménez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Carr. Sacramento, s/n, La Cañada, Almería, 04120, Spain
| | - Esteban Obrero-Gaitán
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Carr. Sacramento, s/n, La Cañada, Almería, 04120, Spain
| | - Inmaculada Carmen Lara-Palomo
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Carr. Sacramento, s/n, La Cañada, Almería, 04120, Spain
| | - Adelaida María Castro-Sánchez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Carr. Sacramento, s/n, La Cañada, Almería, 04120, Spain
| | - Raúl Romero-Del Rey
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Carr. Sacramento, s/n, La Cañada, Almería, 04120, Spain.
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, Jaén, 23071, Spain
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Zhao Y, Chen GY, Fang M. Research Trends of Rheumatoid Arthritis and Depression from 2019 to 2023: A Bibliometric Analysis. J Multidiscip Healthc 2024; 17:4465-4474. [PMID: 39308796 PMCID: PMC11416121 DOI: 10.2147/jmdh.s478748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 09/09/2024] [Indexed: 09/25/2024] Open
Abstract
Background The co-occurrence of rheumatoid arthritis and depression typically exacerbates pain and leads to a range of adverse consequences, becoming a research hotspot in recent years. This study conducted the systematic retrieval of relevant articles within the past five years and employed bibliometric methods for scientometric analysis. Methods Setting the keywords "Rheumatoid arthritis", "Depression" and "Depressive Disorder", relevant literature published between 2019 and 2023 was retrieved from the Web of Science database. Subsequently, the core information from the literature was subjected to visual analysis via CiteSpace software and bibliometric techniques. Results A total of 974 articles related to rheumatoid arthritis and depression were identified through the search strategy, and 877 articles were retained for further analysis after duplicates. The United States (n=173), England (n=82), China (n=69), Canada (n=68), and Germany (n=54) ranked top five countries by publication count. The King's College London was the leading institution with the highest number of publications (n = 20). LANCET PSYCHIATRY was the most frequently cited journal (n = 72) despite having only one article. The top five authors with the largest number of publications include CHARLES N BERNSTEIN (n=14), RUTH ANN MARRIE (n=13), JOHN D FISK (n=12), CAROL A HITCHON (n=12) and SCOTT B PATTEN (n=12), and all these are based in Canada. The keywords with a centrality score exceeding 0.1 were depression, rheumatoid arthritis, symptom, quality of life, impact, fibromyalgia, disease activity, prevalence, inflammation, health, anxiety, pain, fatigue, disease, arthritis and disability. Conclusion Related research between the co-occurrence of rheumatoid arthritis and depression was a persistent hotspot, but it still lacks of international collaboration and in-depth mechanistic exploration.
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Affiliation(s)
- Yan Zhao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Guang-Yao Chen
- Department of TCM Rheumatology, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China
| | - Meng Fang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
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41
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Baker MB, Liu EC, Bully MA, Hsieh A, Nozari A, Tuler M, Binda DD. Overcoming Barriers: A Comprehensive Review of Chronic Pain Management and Accessibility Challenges in Rural America. Healthcare (Basel) 2024; 12:1765. [PMID: 39273789 PMCID: PMC11394986 DOI: 10.3390/healthcare12171765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/17/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
In the United States (U.S.), chronic pain poses substantial challenges in rural areas where access to effective pain management can be limited. Our literature review examines chronic pain management in rural U.S. settings, identifying key issues and disparities. A comprehensive search of PubMed, Web of Science, and Google Scholar identified high-quality studies published between 2000 and 2024 on chronic pain management in the rural U.S. Data were categorized into thematic areas, including epidemiology, management challenges, current strategies, research gaps, and future directions. Key findings reveal that rural populations have a significantly higher prevalence of chronic pain and are more likely to experience severe pain. Economic and systemic barriers include a shortage of pain specialists, limited access to nonpharmacologic treatments, and inadequate insurance coverage. Rural patients are also less likely to engage in beneficial modalities like physical therapy and psychological support due to geographic isolation. Additionally, rural healthcare providers more often fulfill multiple medical roles, leading to burnout and decreased quality of care. Innovative approaches such as telehealth and integrated care models show the potential to improve access and outcomes. Our review highlights the need for increased telehealth utilization, enhanced provider education, and targeted interventions to address the specific pain needs of rural populations.
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Affiliation(s)
- Maxwell B Baker
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
- Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Eileen C Liu
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Micaiah A Bully
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Adam Hsieh
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Ala Nozari
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Marissa Tuler
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Dhanesh D Binda
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
- Department of Anesthesiology, Montefiore Medical Center, Bronx, NY 10467, USA
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Liu J, Jin H, Yon DK, Soysal P, Koyanagi A, Smith L, Shin JI, Li YS, Rahmati M, Zhang J. Risk Factors for Depression in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. Orthopedics 2024; 47:e225-e232. [PMID: 39208396 DOI: 10.3928/01477447-20240821-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a widespread chronic condition. Depression frequently occurs among patients with KOA. The objective of this meta-analysis was to identify risk factors associated with comorbid depression in patients with KOA. MATERIALS AND METHODS A comprehensive search of the PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science databases was conducted for studies related to comorbid depression in patients with KOA. We conducted statistical analyses to obtain relevant results, followed by heterogeneity tests and assessment for publication bias. RESULTS The prevalence of comorbid depression among patients with KOA was 34% (95% CI, 28%-41%). Notable risk factors linked to comorbid depression in patients with KOA included female sex (relative risk [RR], 1.17; 95% CI, 1.11-1.23), obesity (mean difference [MD], 1.30; 95% CI, 0.88-1.71), use of analgesics (RR, 1.50; 95% CI, 1.38-1.63), comorbidities (MD, 0.20; 95% CI, 0.10-0.31), unmarried or widowed status (RR, 1.72; 95% CI, 1.56-1.91), bilateral knee pain (RR, 1.38; 95% CI, 1.11-1.71), high total Western Ontario and Mc-Master Universities Arthritis Index (WOMAC) score (MD, 14.92; 95% CI, 10.02-19.82), high WOMAC pain score (MD, 5.76; 95% CI, 2.86-8.67), low gait velocity (MD, -0.12; 95% CI, -0.16 to -0.09), and extended duration in the Timed Up and Go Test (MD, 1.56; 95% CI, 0.87-2.25). CONCLUSION Based on the current evidence, female sex, obesity, use of analgesics, comorbidities, unmarried or widowed status, bilateral knee pain, high total WOMAC score, high WOMAC pain score, low gait velocity, and prolonged time on the Timed Up and Go Test were identified as risk factors for depression in patients with KOA. Focus should be given to these aspects when preventing depression among these patients. [Orthopedics. 2024;47(5):e225-e232.].
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43
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Niu G, Zheng X, Deng B, Yang Q, Du Y. Effects of exercise dosage on the treatment of fibromyalgia: A meta-analysis of randomised controlled trials. Musculoskeletal Care 2024; 22:e1918. [PMID: 39004771 DOI: 10.1002/msc.1918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Exercise intensity is a key component of an exercise prescription. This meta-analysis aimed to investigate the treatment effect of different exercise doses on fibromyalgia syndrome. METHODS PubMed, Embase, Web of Science, and the Cochrane Library were searched from their inception until 29 December 2023. The studies were subjected to screening using a 2-phase approach by 2 independent reviewers. Reference lists of the included studies were manually searched. Two independent reviewers extracted information regarding the origin, characteristics of study participants, eligibility criteria, characteristics of interventions, outcome measures, and main results using a pre-defined template. RESULTS This meta-analysis encompassed a total of 19 randomized controlled trials comprising 857 patients. Compared with the low compliance/uncertain group according to ACSM, the high compliance group showed better effectiveness in general condition improvement (SMD: -1.15 > -0.71), pain relief (SMD: -1.29 > -1.04), sleep quality enhancement (SMD: -1.66 > -1.08), and fatigue relief (SMD: -1.72 > -1.32). However, there was no difference in the improvement of mental health between the two groups (SMD: -0.93 > -0.92). CONCLUSION Compared to the ACSM group with compliance uncertainty (<70%), the high compliance group showed improvement in general conditions, pain, sleep quality, and fatigue. However, there was no difference in terms of mental health.
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Affiliation(s)
- Guoweng Niu
- Department of Anesthesiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Xiaozhu Zheng
- Department of Anesthesiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Bigao Deng
- Department of Anesthesiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Qianhong Yang
- Department of Anesthesiology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - YongSheng Du
- Department of Orthopedics, Yubei District Hospital of TCM, Chongqing, China
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Liu Q, Huang Y, Wang B, Li Y, Zhou W, Yu J, Chen H, Wang C. Joint trajectories of pain, depression and frailty and associations with adverse outcomes among community-dwelling older adults: A longitudinal study. Geriatr Nurs 2024; 59:26-32. [PMID: 38981205 DOI: 10.1016/j.gerinurse.2024.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/12/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
This study aimed to examine joint trajectories of pain, depression and frailty and their associations with adverse outcomes. Four waves of national data from the China Health and Retirement Longitudinal Study (CHARLS 2011-2018) were used, involving 4217 participants aged ≥60 years. Joint trajectories were fit using parallel-process latent class growth analysis, and their associations with adverse outcomes were evaluated using modified Poisson regression. Four joint trajectories were identified. Compared with most favorable group, other three joint trajectory groups had higher risk of functional disability and hospitalization. Slowly progressive pain, depression and frailty and persistent combination of pain, depression and frailty were also associated with cognitive decline, while slowly reduced pain and depression but persistent frailty was associated with all-cause mortality. The findings highlight unique characteristics and health impacts of concurrent changes in pain, depression and frailty over time, implicating the integrated physical and psychological care for older adults.
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Affiliation(s)
- Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yuli Huang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Binlin Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Wendie Zhou
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Hejing Chen
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
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Imanpour S. Biopsychosocial factors associated with pain management in older adults with limited English proficiency. Geriatr Nurs 2024; 59:590-597. [PMID: 39173433 DOI: 10.1016/j.gerinurse.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/17/2024] [Accepted: 08/05/2024] [Indexed: 08/24/2024]
Abstract
Chronic pain is a prevalent issue among older adults, and effective communication plays a crucial role in accurately conveying the nature of their pain. However, older immigrant adults with limited English proficiency (LEP) encounter significant challenges in expressing the severity and type of pain they experience, creating additional obstacles in their interactions with healthcare providers. This study explored the experience of managing pain among 26 Farsi-speaking older adults with chronic pain. Semi-structured interviews were conducted and data were analyzed using grounded theory methodology. Using the biopsychosocial framework, three main categories of psychological, social, and biological factors arose from data. Depression, stress, sleep disturbances, lack of social support, health literacy, and misdiagnosis or underdiagnosis affected managing pain among older immigrants with LEP. Providing culturally and linguistically competent healthcare providers, particularly in states with a higher number of LEP immigrants, will help maximize the quality of care for patients with chronic pain.
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Affiliation(s)
- Sara Imanpour
- School of Public Affairs, Penn State Harrisburg, 777 West Harrisburg Pike, W 153 Olmsted, Middletown, PA, USA.
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46
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Kuo CC, McCall JG. Neural circuit-selective, multiplexed pharmacological targeting of prefrontal cortex-projecting locus coeruleus neurons drives antinociception. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.08.598059. [PMID: 38895281 PMCID: PMC11185789 DOI: 10.1101/2024.06.08.598059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Selective manipulation of neural circuits using optogenetics and chemogenetics holds great translational potential but requires genetic access to neurons. Here, we demonstrate a general framework for identifying genetic tool-independent, pharmacological strategies for neural circuit-selective modulation. We developed an economically accessible calcium imaging-based approach for large-scale pharmacological scans of endogenous receptor-mediated neural activity. As a testbed for this approach, we used the mouse locus coeruleus due to the combination of its widespread, modular efferent neural circuitry and its wide variety of endogenously expressed GPCRs. Using machine learning-based action potential deconvolution and retrograde tracing, we identified an agonist cocktail that selectively inhibits medial prefrontal cortex-projecting locus coeruleus neurons. In vivo, this cocktail produces synergistic antinociception, consistent with selective pharmacological blunting of this neural circuit. This framework has broad utility for selective targeting of other neural circuits under different physiological and pathological states, facilitating non-genetic translational applications arising from cell type-selective discoveries.
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Affiliation(s)
- Chao-Cheng Kuo
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA; Center for Clinical Pharmacology, University of Health Sciences and Pharmacy in St. Louis and Washington University School of Medicine, St. Louis, MO, USA; Washington University Pain Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Jordan G. McCall
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA; Center for Clinical Pharmacology, University of Health Sciences and Pharmacy in St. Louis and Washington University School of Medicine, St. Louis, MO, USA; Washington University Pain Center, Washington University in St. Louis, St. Louis, MO, USA
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47
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Han T, Xi R, Wang J, Yan H, Li L. Adherence to ACSM exercise guidelines and its influence on Fibromyalgia treatment outcomes: a meta-analysis of randomized controlled trials. Front Physiol 2024; 15:1413038. [PMID: 39100274 PMCID: PMC11294170 DOI: 10.3389/fphys.2024.1413038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024] Open
Abstract
Background The Fibromyalgia Syndrome (FMS) is a multifaceted chronic pain disorder that exerts a substantial impact on the overall state of health and quality of life of patients. Purpose Investigate the effects of exercise therapy and adherence to the American College of Sports Medicine (ACSM) guidelines on treatment outcomes in FMS patients. Methods The literature search, which concluded in October 2023, encompassed studies investigating the impact of exercise interventions on patients diagnosed with FMS and providing adequate data for calculating standardized mean difference (SMD). The primary outcome measures encompassed the Fibromyalgia Impact Questionnaire (FIQ) and Health Assessment Questionnaire (HAQ), while secondary outcome measures comprised pain levels, sleep quality, fatigue, and mental health. Results Among 4,008 records, 19 studies (patients = 857) were eligible for qualitative synthesis. The meta-analysis revealed that the SMD for overall state of health impact was -0.94 (95%CI -1.26, -0.63), and the pooled SMD for the subgroup with high adherence to ACSM guidelines was -1.17 (95%CI -1.65, -0.69). The SMD for the subgroup with low or uncertain adherence was -0.73 (95%CI -1.12, -0.34). The overall effects included a -1.21 (95%CI -1.62, -0.79) SMD for pain relief, with high adherence achieving a -1.32 (95%CI -2.00, -0.64) SMD and low adherence a -1.06 (95%CI -1.55, -0.57) SMD. Mental health improvements showed a -0.95 (95%CI -1.32, -0.57) overall SMD, with high and low adherence subgroups at -0.96 (95%CI -1.62, -0.30) and -0.94 (95%CI -1.29, -0.60), respectively. Sleep quality impact was -1.59 (95%CI -2.31, -0.87) overall, with high adherence at -1.71 (95%CI -2.58, -0.83) and low adherence at -1.11 (95%CI -1.88, -0.33). Fatigue impact had a -1.55 (95%CI -2.26, -0.85) overall SMD, with -1.77 (95%CI -3.18, -0.36) for high adherence and -1.35 (95%CI -2.03, -0.66) for low adherence. Conclusion Exercise therapy can improve the overall state of health, pain, sleep, and fatigue of FMS patients, particularly when adhering to ACSM guidelines. However, adherence levels do not affect mental health gains, indicating a need for future research on psychological impact. Systematic Review Registration https://inplasy.com/inplasy-2024-3-0106/, identifier INPLASY202430106.
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Affiliation(s)
- Tianran Han
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
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McHugh MC, Fowler CA, Philbin S, Schneider T, Ballistrea LM, Klanchar SA, Smith BM, Benzinger RC, French DD, Saenger MS, Haun JN. Qualitative Evaluation Informs the Implementation of a Telehealth Program to Manage Chronic Pain. THE JOURNAL OF PAIN 2024; 25:104493. [PMID: 38336029 DOI: 10.1016/j.jpain.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
In response to the opioid epidemic and high rates of chronic pain among the veteran population, the U.S. Department of Veterans Affairs implemented the TelePain-Empower Veterans Program (EVP), a nonpharmacological pain management program for veterans. Delivered virtually, TelePain-EVP incorporates integrated health components (Whole Health, Acceptance and Commitment Therapy, and Mindful Movement) through interdisciplinary personalized coaching. The objective of this quality improvement project was to evaluate the implementation of TelePain-EVP to identify determinants to implementation, benefits and challenges to participation, and recommendations for future direction. We used a qualitative descriptive design to conduct semistructured telephone interviews with TelePain-EVP leaders (n = 3), staff (n = 10), and veterans (n = 22). The interview guides aligned with the Consolidated Framework for Implementation Research (CFIR). Thematic content analysis organized and characterized findings. Several CFIR domains emerged as determinants relevant to program implementation, including innovation (eg, design); individuals (eg, deliverers, recipients); inner (eg, communications) and outer settings (eg, local conditions); and implementation process (eg, reflecting and evaluating). Identified determinants included facilitators (eg, virtual delivery) and barriers (eg, staff shortages). Participants reported improvements in pain management coping skills, interpersonal relationships, and sense of community, but no self-reported reductions in pain or medication use. Program improvement recommendations included using centralized staff to address vacancies, collecting electronic data, offering structured training, and providing course materials to veteran participants. Qualitative data can inform the sustained implementation of TelePain-EVP and other similar telehealth pain management programs. These descriptive data should be triangulated with quantitative data to objectively assess participant TelePain-EVP outcomes and associated participant characteristics. PERSPECTIVE: A qualitative evaluation of a telehealth program to manage chronic pain, guided by the CFIR framework, identified determinants of program implementation. Additionally, participants reported improvements in pain management coping skills, interpersonal relationships, and sense of community, but no self-reported reductions in pain or medication use.
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Affiliation(s)
- Megan C McHugh
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Department of Veterans Affairs, Hines, Illinois; Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Christopher A Fowler
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida
| | - Sarah Philbin
- Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Tali Schneider
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - Lisa M Ballistrea
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - S Angelina Klanchar
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - Bridget M Smith
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Department of Veterans Affairs, Hines, Illinois
| | - Rachel C Benzinger
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida
| | - Dustin D French
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Department of Veterans Affairs, Hines, Illinois; Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Departments of Ophthalmology and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael S Saenger
- Anesthesia Service Line, Atlanta Veterans Administration Health Care System, Decatur, Georgia; Division of Internal Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Jolie N Haun
- Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
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Cao X, Zhu M, Xu G, Li F, Yan Y, Zhang J, Wang J, Zeng F, Bao Y, Zhang X, Liu T, Zhang D. HCN channels in the lateral habenula regulate pain and comorbid depressive-like behaviors in mice. CNS Neurosci Ther 2024; 30:e14831. [PMID: 38961317 PMCID: PMC11222070 DOI: 10.1111/cns.14831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/12/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024] Open
Abstract
AIMS Comorbid anxiodepressive-like symptoms (CADS) in chronic pain are closely related to the overactivation of the lateral habenula (LHb). Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels have been implicated to play a key role in regulating neuronal excitability. However, the role of HCN channels in the LHb during CADS has not yet been characterized. This study aimed to investigate the effect of HCN channels in the LHb on CADS during chronic pain. METHODS After chronic neuropathic pain induction by spared nerve injury (SNI), mice underwent a sucrose preference test, forced swimming test, tail suspension test, open-field test, and elevated plus maze test to evaluate their anxiodepressive-like behaviors. Electrophysiological recordings, immunohistochemistry, Western blotting, pharmacological experiments, and virus knockdown strategies were used to investigate the underlying mechanisms. RESULTS Evident anxiodepressive-like behaviors were observed 6w after the SNI surgery, accompanied by increased neuronal excitability, enhanced HCN channel function, and increased expression of HCN2 isoforms in the LHb. Either pharmacological inhibition or virus knockdown of HCN2 channels significantly reduced LHb neuronal excitability and ameliorated both pain and depressive-like behaviors. CONCLUSION Our results indicated that the LHb neurons were hyperactive under CADS in chronic pain, and this hyperactivation possibly resulted from the enhanced function of HCN channels and up-regulation of HCN2 isoforms.
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Affiliation(s)
- Xue‐zhong Cao
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Meng‐ye Zhu
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Gang Xu
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Fan Li
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Yi Yan
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Jin‐jin Zhang
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Jianbing Wang
- Department of AnesthesiologyJiangxi Cancer HospitalNanchangJiangxiChina
| | - Fei Zeng
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Yang Bao
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Xue‐xue Zhang
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Tao Liu
- Department of Pediatricsthe First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityNanchangJiangxiChina
| | - Da‐ying Zhang
- Department of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
- Key Laboratory of Neuropathic Pain, the First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityHealthcare Commission of Jiangxi ProvinceNanchangJiangxiChina
- Jiangxi Key Laboratory of Pain Medicine, the First Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
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Mu J, Ravindran AV, Cuijpers P, Shen Y, Yang W, Li Q, Zhou X, Xie P. Stroke depression: a concept with clinical applicability. Stroke Vasc Neurol 2024; 9:189-193. [PMID: 37793901 PMCID: PMC11221293 DOI: 10.1136/svn-2022-002146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
Stroke is a common neurological condition and among the leading causes of death and disability worldwide. Depression is both a risk factor for and complication of stroke, and the two conditions may have a complex reciprocal relationship over time. However, the secondary effects of depression on stroke are often overlooked, resulting in increased morbidity and mortality. In the previous concept of 'poststroke depression', stroke and depression were considered as two independent diseases. It often delays the diagnosis and treatment of patients. The concept 'stroke depression' proposed in this article will emphasise more the necessity of aggressive treatment of depression in the overall management of stroke, thus to reduce the incidence of stroke and in the meantime, improve the prognosis of stroke. Hopefully, it will lead us into a new era of acute stroke intervention.
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Affiliation(s)
- Jun Mu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Arun V Ravindran
- Campbell Family Mental Health Research Centre, Centre for Addiction and Mental Health; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Yiqing Shen
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wensong Yang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Li
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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