Disasters and combat experience substantially increase the risk of depression. Whether psychological trauma per se or bereavement is on the causal path is unresolved.

This review updates earlier work by including prospective studies published within the past five years and extends earlier work by inclusion of studies with late follow-up. Addition of some recent large studies to this review brings the combined number of participants in the meta-analysis to more than five times higher than in the latest review (Smid et al, 2009).Affiliation:

Purpose: Lipid-lowering medications are often prescribed to decrease the risk of micro-and macro-cardiovascular complications related to dyslipidaemia. Despite widespread prescription of lipid-lowering drugs, including statins, adherence to therapy is a challenge worldwide. This systematic review of reviews aimed to conduct a critical appraisal and synthesis of review findings and to provide an overview of the factors that were found to affect adherence to lipid-lowering drugs, focusing on statins, in the reviews. Patients and Methods: A systematic review methodology was used. MEDLINE, Embase, and Epistemonikos databases were searched for relevant publications. AMSTAR 2 criteria were used to assess the quality of the selected publications. Results: From a total of 763 screened publications, 9 met all inclusion criteria and were included in this synthesis. Several factors were identified as being associated with adherence to lipid-lowering agents. Among them, high socio-economic and educational position, and middle age had a positive effect on adherence to lipid-lowering agents. Contrary, female sex, older and younger age, non-white race, low socio-economic position, high co-payments, being a new statin user, comorbidities, side effects, regimen complexity, type and intensity of statin dose, smoking, alcohol consumption, imperceptible benefits, and medical distrust contributed to non-adherence. The overall quality of the included reviews was considered critically low to moderate. Conclusion: This review of reviews has evaluated the impact of factors on adherence statins. Further research related to modifiable predictors for non-adherence is warranted.

Aims: The aim of this study was to investigate the relationship between diabetes stigma as experienced by adults with type 1 diabetes and diabetes outcomes using the novel, validated measure of the Type 1 Diabetes Stigma Assessment Scale. Methods: A total of 1594 adults with type 1 diabetes completed a questionnaire on socio-economic factors, psychosocial health, and diabetes stigma and these self-reported data were linked with data from electronic clinical records on glycaemic control, diabetes duration, age, and diabetes-related complications. Bivariate analyses and multivariate linear regressions were performed to assess the relationship between diabetes stigma as measured by three subscales, Identity concern, Blame and judgement, and Treated differently on the one hand, and patient characteristics and diabetes outcomes on the other. Results: Endorsement of the stigma statements ranged from 3.6–78.3% of respondents. Higher stigma scores in relation to Identity concern and Blame and judgement were significantly associated with being female, of lower age, lower diabetes duration, and having at least one complication. Those who reported higher levels of perceived stigma reported significantly higher levels of diabetes distress (β = 0.37 (95% CI: 0.33–0.40), 0.35 (95% CI: 0.30–0.39), 0.41 (95% CI: 0.35–0.46)), and HbA1c levels (β = 0.11 (95% CI: 0.02–0.21), 0.28 (95% CI: 0.16–0.40), 0.26 (95% CI: 0.14–0.42) for Identity concern, Blame and judgement, and Treated differently, respectively). Conclusions: The findings demonstrated that diabetes stigma is negatively associated with both diabetes distress and glycaemic control and should be considered part of the psychosocial burden of adults with type 1 diabetes.