A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications

Bolton, Derek

doi:10.1017/s0033291723002660

Cited by 7 publications

(3 citation statements)

References 83 publications

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“…The most recent literature review highlighted the efficacy range of Cognitive Behavioral Therapy (CBT), Relaxation Training (RT), and Biofeedback (BF) as the most commonly applied non-pharmacological interventions, ranging from 20 to 67% ( 15 , 31 ). According to the biopsychosocial model, pharmacotherapy and behavioral therapy may complement each other, with the most significant reduction in headache frequency achieved by implementing a combination of the two ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective

Guerra,

Di Giacomo,

Ranieri

et al. 2024

Front. Neurol.

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BackgroundEpisodic migraine (EM) is the second most prevalent neurological disorder worldwide and is responsible for more disability than all other neurological disorders combined. Triggers for the development of migraine include, stress, emotional burden, low blood sugar levels, tobacco, skipped meals, anxious and depressive feelings. Migraine affects both children and adults, occurring three times more frequently in women than in men.ObjectiveThe aim of this study was to evaluate the psychological profile of EM patients and the relationship among negative emotions in EM patients, analyzing self-efficacy measures in pain management.DesignWe performed an observational study in 60 outpatients aged 18–55 years (mean age 33.8; SD ±10.4) with EM.MethodsAll patients have been enrolled at the Headache Center of the San Salvatore Hospital of L’Aquila. The assessment comprised five standardized psychological self-assessments investigating relevant emotional dimensions and pain self-efficacy, along with two questionnaires assessing migraine-related disability. A network analysis of negative emotions was performed to evaluate which emotional traits and relationships play a crucial role in pain coping and management.ResultsOur findings indicate that migraine significantly impairs the quality of life of patients in their daily lives. Over half of the patients reported experiencing severe disability, with negative emotions significantly influencing their ability to cope with pain and maintain productivity during migraine attacks. Dysphoric variables (irritability, interpersonal resentment, and surrender) were correlated with difficulties in emotion regulation ability and with the capacity of engaging in goal-directed behaviors despite experiencing pain. The ability to regulate one’s emotions and manage dysphoria were positively correlated with pain self-efficacy, whereas positive mental health was associated with individuals’ confidence in performing activities despite experiencing pain.ConclusionNegative emotions had a negative correlation with positive mental health and were linked to a lower capacity to carry out daily activities despite experiencing migraine pain. This suggests that psychological interventions could improve mental health and potentially surpassing the effects of pharmacological interventions alone in migraine management. An integrated, patient-centered approach may represent an effective paradigm to address and reduce the burden of migraine, leading to a reduction in healthcare costs.

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Section: Discussionmentioning

confidence: 99%

Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective

Guerra,

Di Giacomo,

Ranieri

et al. 2024

Front. Neurol.

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“…Disease activity is gauged using the DAS28 score, which reflects tender and swollen joint counts, patient health reports, and inflammatory markers like ESR or CRP (3)(4)(5)(6)(7). Effective management needs a holistic approach integrating pharmacological treatments and psychological support, considering the high prevalence of depression and anxiety among RA patients, which significantly impact their quality of life and treatment adherence (8)(9)(10)(11)(12)(13). This study aims to examine how DAS 28 scores and adherence to treatment correlate with depression and anxiety in patients with rheumatoid arthritis (RA).…”

Section: Introductionmentioning

confidence: 99%

Correlation of DAS 28 Score and Treatment Compliance with Depression and Anxiety in Rheumatoid Arthritis

Hussain Shakeel,

Aflak Rasheed,

Muhammad Shiraz Niaz

et al. 2024

JHRR

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Background: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by synovial inflammation, joint destruction, and significant disability. Psychological factors, particularly depression and anxiety, are prevalent among RA patients and can impact disease management and treatment adherence. Understanding the relationship between disease activity, treatment compliance, and mental health is essential for comprehensive RA management. Objective: To investigate the correlation between Disease Activity Score 28 (DAS28) and treatment compliance with levels of depression and anxiety in patients with rheumatoid arthritis. Methods: This cross-sectional study was conducted at the Department of Rheumatology and Immunology, Sheikh Zayed Hospital, Lahore, over six months. A total of 130 RA patients were enrolled using non-probability convenience sampling. Inclusion criteria were adults aged 18 years and above, diagnosed with RA based on ACR/EULAR criteria, and compliant with medication for at least three months prior to the study. Exclusion criteria included other autoimmune diseases, significant concurrent medical conditions, history of substance abuse, and recent initiation of biologic treatments. Data collection involved demographic details, RA onset and duration, and assessments of depression and anxiety using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales, respectively. RA disease activity was measured using DAS28, and systemic inflammation markers (ESR and CRP) were recorded. Data analysis was performed using SPSS version 25.0, employing descriptive statistics, correlation analysis, and regression analysis to determine the relationships between variables. Results: The study included 59 males (45.4%) and 71 females (54.6%), with a mean age of 49.69 years (SD = 18.82). The mean duration of RA diagnosis was 14.07 years (SD = 8.69). Higher PHQ-9 scores were associated with lower treatment adherence (B = -1.264, p < 0.001), and higher GAD-7 scores also negatively impacted adherence (B = 0.870, p < 0.01). The regression model explained 40.3% of the variance in treatment adherence (R² = 0.403, F(7, 122) = 11.779, p < 0.001). Weak negative correlations were observed between DAS28 ESR and treatment adherence (r = -0.150), indicating that higher disease activity slightly reduced adherence. Conclusion: The study highlighted the significant role of mental health in the management of RA. Depression and anxiety were found to be major barriers to treatment adherence, underscoring the need for integrating psychological care into RA management. Addressing mental health issues could enhance treatment adherence and improve overall disease outcomes. Keywords: Rheumatoid Arthritis, DAS28, Treatment Adherence, Depression, Anxiety, Psychological Factors, Systemic Inflammation, PHQ-9, GAD-7, Chronic Disease Management, SPSS 25.0, Cross-Sectional Study, ACR/EULAR Criteria

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“…The general empirical hypothesis of the existence of BPSM has now been confirmed with years of research in the field of BPSM. [ 4 ]…”

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confidence: 99%

Is it time to incorporate the biopsychosocial model into medical practice: A call for action for medical practitioners across specialties

Mamtani

2024

Journal of Education and Health Promotion

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A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications

Cited by 7 publications

References 83 publications

Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective

Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective

Correlation of DAS 28 Score and Treatment Compliance with Depression and Anxiety in Rheumatoid Arthritis

Is it time to incorporate the biopsychosocial model into medical practice: A call for action for medical practitioners across specialties

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