Independent Influences of Current and Childhood Socioeconomic Status on Health Outcomes in a North-Carolina Family-Practice Sample of Arthritis Patients.

Independent influences of current and childhood socioeconomic status on health outcomes in a North-Carolina family-practice sample of arthritis patients.

Filed under: Depression Treatment

Arthritis Care Res (Hoboken). 2013 Feb 11;
Baldassari AR, Cleveland RJ, Callahan LF

OBJECTIVES: Compelling evidence suggests that socioeconomic status (SES) is a determinant of health outcomes among persons with arthritis. SES in early-life has likewise been associated with various aspects of health, but the connection between childhood SES and health among people with arthritis remains to be investigated. The purpose of this study is to determine the influences of current and childhood SES on self-reported disability, depression, and physical and mental health among people with self-reported doctor-diagnosed arthritis. METHODS: Data originated from a North Carolinian network of primary care centers. Participants with self-reported arthritis with complete sociodemographic and relevant health information were retained in our sample (n = 782). We created summary measuresfor current and childhood SES from indicators of education, occupation and homeownership, using parental SES as a proxy for participants’ childhood SES. Linear regression models were used to assess the associations between health outcomes and SES variables separately and together, adjusting for key covariates. RESULTS: Lower childhood and current SES scores were associated with worse disability and physical health. Current SES was furthermore associated with mental health and depressive symptoms. Associations of low current and childhood SES with health outcomes remained significant when concurrently included in a linear model. CONCLUSION: Childhood and current SES are both determinants of health among persons with arthritis. This underscores the importance of childhood SES as a determinant of adult health among individuals with arthritis.Further studies should focus on these associations in different populations and across different types of arthritis. © 2013 by the American College of Rheumatology.
HubMed – depression


Screening for depression and anxiety in women with breast and gynaecologic cancer: course and prevalence of morbidity over 12?months.

Filed under: Depression Treatment

Psychooncology. 2013 Feb 12;
Stafford L, Judd F, Gibson P, Komiti A, Mann GB, Quinn M

OBJECTIVE: This study aims to investigate the course and prevalence of anxiety and depression symptoms over 56?weeks in women with newly diagnosed breast and gynaecologic cancer and determine the acceptability and efficiency of incorporating routine screening into practice. METHODS: Participants completed the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) and Centre for Epidemiological Studies Depression Scale (CES-D) at diagnosis and again every 8?weeks for 56?weeks. Changes over time were analysed with repeated measures ANOVA adjusted for post hoc comparisons. Thresholds for caseness/referral to mental health were ?11 and ?16 on the HADS-A and CES-D, respectively. RESULTS: Participants were 167 women (101 breast, 66 gynaecologic). Mean?±?SD age was 57.63?±?22.66 years. Rates of anxiety (17.7%), depression (32.5%) and combined anxiety and depression (35%) symptoms were highest at diagnosis. Mean?±?SD scores of anxiety (6.43?±?3.83) and depression symptoms (12.68?±?9.47) were highest at diagnosis with significant improvements observed by 8 and 24?weeks, respectively, and maintained thereafter. Overall rates of anxiety, depression and combined symptoms were 7.5%, 23.4% and 24.1%, respectively. Patients with breast and gynaecologic cancer did not differ. Referral was offered at least once to 94 women (56.3%), of whom 45 (47.9%) declined, 23 (24.5%) accepted and 26 (27.7%) were already receiving treatment. Patient evaluation was favourable. CONCLUSIONS: Women are most vulnerable to psychological morbidity at diagnosis. Symptoms improve significantly over time. Reported rates are lower than those in the literature. Regular screening by self-report is acceptable to patients but may not be the most efficient method of improving patient outcomes. Copyright © 2013 John Wiley & Sons, Ltd.
HubMed – depression


Adolescent survivors of childhood cancer: are they vulnerable for psychological distress?

Filed under: Depression Treatment

Psychooncology. 2013 Feb 11;
Gianinazzi ME, Rueegg CS, Wengenroth L, Bergstraesser E, Rischewski J, Ammann RA, Kuehni CE, Michel G,

OBJECTIVES: We aimed to (i) evaluate psychological distress in adolescent survivors of childhood cancer and compare them to siblings and a norm population; (ii) compare the severity of distress of distressed survivors and siblings with that of psychotherapy patients; and (iii) determine risk factors for psychological distress in survivors. METHODS: We sent a questionnaire to all childhood cancer survivors aged <16?years when diagnosed, who had survived ?5?years and were aged 16-19?years at the time of study. Our control groups were same-aged siblings, a norm population, and psychotherapy patients. Psychological distress was measured with the Brief Symptom Inventory-18 (BSI-18) assessing somatization, depression, anxiety, and a global severity index (GSI). Participants with a T-score ?57 were defined as distressed. We used logistic regression to determine risk factors. RESULTS: We evaluated the BSI-18 in 407 survivors and 102 siblings. Fifty-two survivors (13%) and 11 siblings (11%) had scores above the distress threshold (T???57). Distressed survivors scored significantly higher in somatization (p?=?0.027) and GSI (p?=?0.016) than distressed siblings, and also scored higher in somatization (p???0.001) and anxiety (p?=?0.002) than psychotherapy patients. In the multivariable regression, psychological distress was associated with female sex, self-reported late effects, and low perceived parental support. CONCLUSIONS: The majority of survivors did not report psychological distress. However, the severity of distress of distressed survivors exceeded that of distressed siblings and psychotherapy patients. Systematic psychological follow-up can help to identify survivors at risk and support them during the challenging period of adolescence. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression


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