0170 Shift work and hypertension: prevalence and analysis of disease pathways in German car manufacturing workers

Abstract

Method We completed searches of MEDLINE and PSYCInfo from inception of each database to June 2013, to identify primary studies evaluating symptom exaggeration among patients with mental health disorders. Teams of reviewers completed title and abstract screening of citations, full text review of potentially eligible articles, data extraction, and quality assessment of eligible studies. Findings from our review and input from content experts informed the development of a summary instrument. Results We identified 8435 unique citations; 102 studies were eligible. Studies reported on 55 different instruments to assess symptom exaggeration; 42% of studies used the MMPI-2. Quality of studies ranged from low to moderate. Items that comprise our summary instrument will be presented at EPICOH. Conclusions Multiple instruments are available to assess symptom exaggeration among patients presenting with mental illness; however, no instrument has shown ideal psychometric properties. We are hopeful that our instrument will facilitate the testing and development of a novel tool with superior sensitivity and specificity for detecting symptom exaggeration. 0161DEVELOPMENT Objectives Of workers approved for long-term disability benefits, 31.6% suffer from a primary mental illness. Negative patient recovery expectations are associated with worse outcome in many conditions. Our objectives were: 1) to complete a systematic review to identify measures that assess patient recovery expectations, and 2) using the results from our review, develop an instrument designed to assess recovery expectations in individuals receiving disability benefits secondary to a mental health disorder.Method We completed searches of MEDLINE and PSYCInfo from inception of each database to June 2013, to identify primary studies evaluating patient's recovery expectations across all clinical populations. Teams of reviewers completed title and abstract screening of citations, full text review of potentially eligible articles, data extraction, and quality assessment of eligible studies. Findings from the review and input from content experts informed the development of a comprehensive list of items that captured patient's recovery expectations.Results We identified 12 599 unique citations; 46 studies were eligible. Studies reported on 20 different instruments assessing patient's recovery expectations. A minority (20%) of studies included measurement properties of reported instruments; 11% evaluated mental health conditions. No instruments were validated among patients receiving disability benefits or explored associations with return to work. Generalizability to disabled patients receiving wage replacement benefits is therefore unclear.Items that comprise our summary instrument will be presented at EPICOH. Conclusions Our instrument holds promise for identifying claimants holding negative recovery expectations, which may be associated with prolonged recovery. These unhelpful beliefs may be a useful target for early interventional therapies. Objectives Triggered by...

Irregular 24-hour activity rhythms and the metabolic syndrome in older adults

“…Moreover, they build upon an existing body of epidemiological studies showing associations between shift-work and the incidence and prevalence of these factors in working age adults (Barbadoro, Santarelli et al, 2013; Karlsson, Knutsson et al, 2001; Kim, Son et al, 2013; Kirsh, Cotterchio et al, 2014; Knutsson & Kempe, 2014; Lieu, Curhan et al, 2012; Monk & Buysse, 2013; Niedhammer, Lert et al, 1996; Ohira, Tanigawa et al, 2000; Ohlander, Keskin et al, 2014; Oishi, Suwazono et al, 2005; Pan, Schernhammer et al, 2011; van Amelsvoort, Schouten et al, 1999; Yamasaki, Schwartz et al, 1998). Our results extend these previous findings in several respects.…”

“…Experiments in model organisms and in humans suggest potential links between irregular circadian rhythms and a number of key risk factors for cardiovascular disease including hypertension, obesity, diabetes, and dyslipidemia – the “metabolic syndrome” (Buxton, Cain et al, 2012; Karatsoreos, Bhagat et al, 2011; Leproult, Holmback et al, 2014; Scheer, Hilton et al, 2009; Shi, Ansari et al, 2013; Turek, Joshu et al, 2005). Moreover, several epidemiological studies have demonstrated an association between self-reported shift-work and components of the metabolic syndrome (Barbadoro, Santarelli et al, 2013; Karlsson, Knutsson et al, 2001; Kim, Son et al, 2013; Kirsh, Cotterchio et al, 2014; Knutsson & Kempe, 2014; Lieu, Curhan et al, 2012; Monk & Buysse, 2013; Niedhammer, Lert et al, 1996; Ohira, Tanigawa et al, 2000; Ohlander, Keskin et al, 2014; Oishi, Suwazono et al, 2005; Pan, Schernhammer et al, 2011; van Amelsvoort, Schouten et al, 1999; Yamasaki, Schwartz et al, 1998). …”

Circadian clock-mediated regulation of blood pressure

“…Shift work that causes circadian disruption is associated with increased risk for a number of diseases in humans including cancer and cardiovascular disease [24-28] . In an effort to study the phenomenon of increased inflammation, increased hypertension, and increased CVD risk due to shift work, a recent randomized crossover study was carried out by Morris et al [29].…”

Development of hypertension – clinical impact of dysregulation of circadian rhythms and implications for treatment

“…In a study looking at over 25,000 German car manufacturers 16-64 years old, Ohlander et al concluded that hypertension was lowest among people who did not work in shifts and highest in those who did not work night shifts. 80 After the authors adjusted for behavioral factors, they report no increased risk of hypertension for any shift work category. A Finnish study looked at over 20,000 pairs of twins (the Finnish Twin Cohort) and found no correlation between shift work and increased risk of CVD or hypertension.…”