Older adults with schizophrenia have some of the highest rates of both medical and psychiatric comorbidities. Despite this, little is known about comorbid pain and depressive symptoms in schizophrenia research. This study aimed to examine the associations between levels of pain intensity and depressive symptoms among community-dwelling adults aged 50 years and older with schizophrenia spectrum disorders. Recruited from U.S. community mental health centers, participants reported on pain and depressive symptoms at the onset of the Helping Older People Experience Success (HOPES) study. Unadjusted and adjusted regression analyses were conducted. Higher pain intensity was associated with elevated depressive symptoms in all analyses, which is consistent with other studies in the general population. Given the widespread efforts to manage pain and related mental health complications in older adults without serious mental illnesses, it is likewise important that community-based mental health professionals monitor and address intense pain and related depressive symptoms among older adults with schizophrenia.
PurposeTest hope as mediator of relationships between attachment and depressive symptoms for trauma patients, and evaluate relationships among psychological variables (i.e., attachment, hope, and depression) and medical variables (i.e., patient admission disposition, length of intensive care unit (ICU) stay, discharge status, intubation, and days on ventilator).DesignQuantitative descriptive design using multiple regression and correlational techniques.Participants106 participants were recruited from among admitted patients at a nationally verified university Level I trauma center.ResultsHope was a significant mediator of the relationship between attachment and depression. Admission to the ICU instead of less intensive care was associated with lower secure attachment and elevated avoidant attachment. Longer ICU stays were related to lower secure attachment, elevated anxious attachment, low hope, and elevated depression. Discharge to a facility (rather than home) was associated with elevated anxious attachment and elevated depression. Intubation and days on a ventilator were associated with elevated anxious attachment. Secure attachment, anxious attachment, and hope were related to depression.Conclusionscreening trauma patients for personality and psychological characteristics that hamper recovery may improve outcomes. Hope-enhancing interventions may decrease attachment-predicted depression and improve recovery for trauma patients.
Pain is a complex, multidimensional experience but often is measured as a unidimensional experience. This study aimed to separately assess the sensory and affective components of pain and identify their relations to important pain-related outcomes, particularly in terms of opioid misuse risk and emotion dysregulation among patients with chronic pain receiving treatment in Appalachia. Two hundred and twelve patients presenting to a multidisciplinary pain center completed the Difficulties in Emotion Regulation Scale (DERS-18), Screener and Opioid Assessment for Patients with Pain—Revised (SOAPP-R), and short-form McGill Pain Questionnaire (SF-MPQ). The sensory experience of pain was unrelated to emotion dysregulation (r = 0.06, p = 0.57 ) and weakly related to opioid misuse risk (r = 0.182, p < 0.05 ). In contrast, the affective experience of pain was moderately related to emotion dysregulation (r = 0.217, p < 0.05 ) and strongly related to opioid misuse risk (r = 0.37, p < 0.01 ). In addition, emotion dysregulation predicted variance in opioid misuse risk above and beyond the affective and sensory experiences of pain ((b = 0.693, p < 0.001 ). The results suggest patients with a strong affective experience versus sensory experience of pain and challenges with emotion regulation may require a more comprehensive intervention to address these underlying components in order to reduce their risk of misusing opioid medications.
The development of highly active antiretroviral therapy (HAART) has shifted human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) from an acute to a chronic condition. Due to reduced fatality, approximately 1.1 million people living with HIV/AIDS (PLWHA) are faced with increased longevity in conjunction with functional consequences associated with chronic disability. Employment has been associated with increased treatment adherence, quality of life (QoL), and mental and physical health for people living with HIV/AIDS. The purpose of this study was to determine the relationship between employment status and QoL for PLWHA. Participants included 115 patients receiving services from two Ryan White HIV/AIDS Program (RWHAP) clinics in a rural Mid Atlantic Appalachian region of the U.S. Findings revealed statistically significant differences in employment status on six domains of the World Health Organization’s Quality of Life scale for PLWHA (WHOQOL-HIV-Bref), except for spirituality/religion/personal beliefs. Implications for practice and research are discussed.
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