Depression Treatment: Predictors of Pain for Patients With Early Inflammatory Polyarthritis.

Predictors of pain for patients with early inflammatory polyarthritis.

Filed under: Depression Treatment

Arthritis Care Res (Hoboken). 2012 Dec 19;
Dobkin PL, Liu A, Abrahamowicz M, Carrier N, de Brum-Fernandes AJ, Cossette P, Boire G

OBJECTIVES: To identify predictors of pain at one year in patients with early inflammatory polyarthritis (EIA). METHODS: Using a prospective design, patients were examined by a rheumatologist, and completed questionnaires at baseline and at one year after symptom onset. Separate regression analyses were run for pain intensity, sensory pain, and affective pain. Age and gender were adjusted in cross-sectional and longitudinal analyses; baseline potential predictors were: measures for corresponding pain values; disease activity, depression, coping scores, medication use, RA criteria being met, and duration of symptoms. RESULTS.: 211 patients were enrolled in the study (mean age =58.8, SD =14.2; 63% female). There were significant improvements at one year for: disease activity, instrumental coping, emotional coping, depression, and all three pain measures. At baseline, disease activity and depression were positively associated with all types of pain; in addition, instrumental coping was positively associated with sensory pain and palliative coping was positively associated with affective pain. At one year, pain intensity was predicted by the baseline pain intensity, duration of symptoms, DMARD use emotional coping. Sensory pain was predicted by baseline sensory pain, and DMARD use. Affective pain was predicted by baseline affective pain, DMARD use, and emotional coping. CONCLUSIONS.: The majority of treated EIA patients can expect improvements in clinical and psychosocial variables over the first year of their illness. Emotional coping at baseline may contribute to pain in the future and therefore it may be useful for patients to learn other means of dealing with this chronic disease. © 2012 by the American College of Rheumatology.
HubMed – depression

 

The influence of family environment on long-term psychosocial functioning of adolescents with juvenile fibromyalgia.

Filed under: Depression Treatment

Arthritis Care Res (Hoboken). 2012 Dec 19;
Sil S, Lynch-Jordan A, Ting TV, Peugh J, Noll J, Kashikar-Zuck S

Little is known about the impact of family environment on the long-term adjustment of patients with juvenile-onset fibromyalgia (JFM). OBJECTIVE: To evaluate whether family environmentin early adolescence predictedlater physical functioning and depressive symptoms of adolescents with JFM as they transition to early adulthoodin the context of a controlled long-term follow-up study. METHOD: Participants were 39 youth(M(age) = 18.7 years) with JFM and 38 healthy matched controls who completed web-based surveys about their health status (SF-36 Health Survey) and depressive symptoms (Beck Depression Inventory II) approximately 4 years after a home-based, in-person assessment of child and family functioning. During the initial assessment, parents of participants (94% mothers) completed the Family Environment Scale, and adolescents (M(age) = 14.8 years) completed self-report questionnaires about pain (Visual Analog Scale) and depressive symptoms (Children’s Depression Inventory). RESULTS: Results indicated that family environment during early adolescence significantly predicted greater depressive symptoms in early adulthood for both the JFM group and healthy controls. In particular, a controlling family environment (use of rules to control the family and allowing little independence) during early adolescence was the driving factor in predicting poorer long-term emotional functioning for patients with JFM. Family environment did not significantly predict longer-term physical impairment for either group. CONCLUSIONS: Adolescents with JFM from controlling family environments are at increased risk for poorer emotional functioning in early adulthood. Behavioral and family interventions should foster independent coping among adolescents with JFM and greater parenting flexibility to enhance successful long-term coping. © 2012 by the American College of Rheumatology.
HubMed – depression

 

Global and focal white matter integrity in breast cancer survivors 20 years after adjuvant chemotherapy.

Filed under: Depression Treatment

Hum Brain Mapp. 2012 Dec 20;
Koppelmans V, Groot MD, de Ruiter MB, Boogerd W, Seynaeve C, Vernooij MW, Niessen WJ, Schagen SB, Breteler MM

OBJECTIVES: To date, only four small studies have investigated the effects of adjuvant chemotherapy for breast cancer on the microstructure of cerebral white matter with magnetic resonance imaging (MRI). These studies, which were conducted shortly up to 10 years post-treatment, showed that chemotherapy is associated with focal loss of microstructural white matter integrity. We investigated the long-term effect of chemotherapy on white matter microstructural integrity by comparing the brains of chemotherapy-exposed breast cancer survivors to those of a population-based sample of women without a history of cancer. EXPERIMENTAL DESIGN: Diffusion tensor imaging (DTI) MRI (1.5 T) was performed in 187 CMF (cyclophosphamide, methotrexate, and 5-flourouracil) chemotherapy-exposed breast cancer survivors, mean age 64.2 (sd = 6.5) years, who had been diagnosed with cancer on average 21.2 (sd = 4.4) years before, and 374 age-matched cancer-free reference subjects from a population-based cohort study. Outcome measures were whole-brain microstructural integrity as measured by fractional anisotropy and mean/axial/radial diffusivity and focal white matter integrity, which was analyzed with tract-based spatial statistics. All analyses were adjusted for age, cardiovascular risk factors, education, and symptoms of depression. PRINCIPAL OBSERVATIONS: No significant group differences were observed in white matter integrity. However, within the breast cancer survivors, time since treatment was inversely associated with lower global and focal white matter integrity. CONCLUSIONS: This cross-sectional study suggests that among chemotherapy-exposed breast cancer survivors white matter microstructural integrity deteriorates with accumulating time since treatment. This warrants further investigation. Hum Brain Mapp, 2012. © 2012 Wiley Periodicals, Inc.
HubMed – depression

 

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