Burden of Illness Associated With Painful Diabetic Peripheral Neuropathy Among Adults Seeking Treatment in the US: Results From a Retrospective Chart Review and Cross-Sectional Survey.
Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.
Filed under: Depression Treatment
Diabetes Metab Syndr Obes. 2013; 6: 79-92
Sadosky A, Schaefer C, Mann R, Bergstrom F, Baik R, Parsons B, Nalamachu S, Nieshoff E, Stacey BR, Anschel A, Tuchman M
The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN) seeking treatment in the US.This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%), depressive symptoms (41.1%), and anxiety (35.7%). The mean pain severity score was 5.2 (0-10 scale), and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0-10 scale) overall, with 2.0 among mild, 5.1 among moderate, and 7.0 among severe. The mean Medical Outcomes Study sleep problems index score was 48.5 (0-100 scale). The mean health state utility score was 0.61. Among subjects employed for pay, mean overall work impairment was 43.6%. Across all subjects, mean overall activity impairment was 52.3%. In total, 81.3% were prescribed at least one medication for their pDPN; 50.9% reported taking at least one nonprescription medication. Adjusted mean annualized total direct and indirect costs per subject were $ 4841 and $ 9730, respectively. Outcomes related to pain interference with function, sleep, health status, activity impairment, prescription medication use, and direct and indirect costs were significantly worse among subjects with more severe pain (P < 0.0020).Subjects with pDPN exhibited high pain levels, which were associated with poor sleep, function, and productivity. Health care resource utilization in pDPN was prevalent and costs increased with greater pain severity. The burden of pDPN was greater among subjects with greater pain severity. HubMed – depression
Psychological factors: anxiety, depression, and somatization symptoms in low back pain patients.
Filed under: Depression Treatment
J Pain Res. 2013; 6: 95-101
Bener A, Verjee M, Dafeeah EE, Falah O, Al-Juhaishi T, Schlogl J, Sedeeq A, Khan S
To determine the prevalence of low back pain (LBP), investigate the sociodemographic characteristics of patients with LBP, and examine its association with psychological distress such as anxiety, depression, and somatization.Of the 2742 patients approached, 2180 agreed to participate in this cross-sectional study (79.5% response rate). The survey was conducted among primary health care visitors from March to October 2012 and collected sociodemographic details and LBP characteristics. General Health Questionnaire-12 was used to identify the probable cases. Anxiety was assessed with Generalized Anxiety Disorder-7, depression was assessed with Patient Health Questionnaire-9, and somatization was measured with Patient Health Questionnaire-15.The study sample consisted of 52.9% males and 47.1% females. The prevalence of LBP was 59.2%, comprising 46.1% men and 53.9% women. LBP was significantly higher in Qataris (57.9%), women (53.9%), housewives (40.1%), and individuals with higher monthly income (53.9%). Somatization (14.9%) was observed more in LBP patients, followed by depression (13.7%) and anxiety disorders (9.5%). The most frequently reported symptoms were “headaches” (41.1%) and “pain in your arms, legs, or joints” (38.5%) in LBP patients with somatization. The most frequent symptoms among depressed LBP patients were “thinking of suicide or wanting to hurt yourself” (51.4%) and “feeling down, depressed, or hopeless” (49.2%). “Not being able to stop or control worrying” (40.2%), “worrying too much about different things” (40.2%), and “feeling afraid as if something awful might happen” (40.2%) were the most common anxiety symptoms in LBP patients. Psychological distress such as anxiety (9.5% versus 6.2%), depression (13.7% versus 8.5%), and somatization (14.9% versus 8.3%) were significantly higher in LBP patients.The prevalence of LBP in this study sample was comparable with other studies. Furthermore, psychological distress such as anxiety, depression, and somatization were more prevalent in LBP patients compared to patients without LBP.
HubMed – depression
Migration of children and impact on depression in older parents in rural Thailand, southeast Asia.
Filed under: Depression Treatment
JAMA Psychiatry. 2013 Feb 1; 70(2): 226-33
Abas M, Tangchonlatip K, Punpuing S, Jirapramukpitak T, Darawuttimaprakorn N, Prince M, Flach C
CONTEXT Migration is feared to be associated with abandonment and depression in older parents “left behind” in rural areas of low- and middle-income countries. OBJECTIVE To test for prospective associations between (1) out-migration of all children and subsequent depression in parents and (2) having a child move back and an improvement in parents’ depression. DESIGN A cohort study with a 1-year follow-up. SETTING A population-based study nested in a demographic surveillance site of 100 villages in rural Thailand. Most out-migration is to the capital city. PARTICIPANTS A stratified random sample of 1111 parents 60 years and older (1 per household) drawn from all 100 villages, of whom 960 (86%) provided depression data at follow-up. MAIN OUTCOME MEASURES Scoring 6 or more on the Thai version of the EURO-D depression scale at follow-up. RESULTS Depression prevalence was 22%. At baseline, 155 (16%) had all their children migrated from the district and 806 (84%) had at least 1 child living in the district. Having all children out-migrated at baseline, compared with having none or some children out-migrated, predicted a smaller odds of depression, after controlling for baseline sociodemographic and health measures (odds ratio [OR], 0.43; 95% CI, 0.20-0.92). Having a child move back in the study year was associated with greater odds of depression at follow-up when adjusted for baseline measures (OR, 1.75; 95% CI, 1.04-2.94), although this was no longer significant after adjusting for changes in disability and marital status since baseline (OR, 1.72; 95% CI, 0.99-2.98). CONCLUSIONS Contrary to our hypothesis, parents whose children are not migrants may be at greater risk of depression than those with migrant children. More understanding is needed about the risks for depression in older rural populations and about the effectiveness of interventions.
HubMed – depression
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