The epidemiology of back pain and its relationship with depression, psychosis, anxiety, sleep disturbances, and stress sensitivity: Data from 43 low- and middle-income countries

Cendoroglo

Rev. bras. geriatr. gerontol.

2017

Objectives: to evaluate the frequency of anxiety disorders in older elderly persons with chronic pain and identify associated factors. Method: a descriptive, analytical and cross section study of the "Projeto Longevos" ("Long-Lived Elderly Persons Project") was carried out, featuring elderly persons living in the community who were aged 80 or over. Older elderly persons with chronic pain were selected, and data regarding their sociodemographic characteristics and factors related to pain was gathered, especially with regard to the multidimensional nature of pain, according to the "Geriatric Pain Measure-p" (GPM-p). Self-perception of health was also recorded and functionality assessments were carried out, along with the screenings for depression and anxiety disorders, according to the Geriatric Depression Scale and the State-Trait Anxiety Inventory, respectively. Associations were analyzed by Pearson correlation, the ANOVA Test and Tukey multiple comparisons. Results: the sample was composed of 41 elderly persons with a mean age of 85.7 years, most of whom were female, white, widowed and had a low education. A high prevalence of anxiety disorders was observed, being 53.6% and 68.3%, respectively, for trait and state anxiety. A significant, but not high, correlation was found between the anxiety trait and chronic pain according to the GPM-p (r=31.5%; p=0.048), and there was a significant and high correlation between the same type of anxiety and depression (r=61.3%; p<0.001). Conclusion: anxiety disorders were very prevalent in older elderly persons with chronic pain, and these correlated significantly with pain and depression, which could justify the need for varied multidisciplinary therapeutic measures against the persistent pain conditions of the elderly.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anxiety disorder in elderly persons with chronic pain: frequency and associations

Cendoroglo

Rev. bras. geriatr. gerontol.

2017

“…Moreover, the condition of one can exacerbate the other. Chronic pain patients with depression are more likely to have higher severity and longer duration of pain, and the presence of pain is associated with increased depressive symptoms and possible relapses [4][5][6][7] . The detailed epidemiological information about the comorbidity of pain and depression was reviewed by Bair et al, (2003).…”

Section: Introductionmentioning

confidence: 99%

Comorbidity of Depression and Pain: a review of shared contributing mechanisms

Li¹

2017

J Neurol Neuromedicine

Pain and depression are two major health issues that we are currently facing. Chronic pain is the main reason that people seek medical care; and numerous people commit suicide each year because of depression. These two pathological conditions often coexist. Chronic pain patients are more likely to develop major depressive symptoms, while depressed patients reported more pain symptoms than normal healthy population. Understanding the common mechanisms associated with depression and pain is important for developing the effective strategy to treat this comorbidity. In this review, the potential mechanisms that contribute to both depression and pain are discussed from four perspectives, the morphological changes in the brain, monoamine deficiency, brain-derived neurotrophic factor (BDNF) reduction in the hippocampus, and the hypothalamicpituitary-adrenocortical (HPA) axis dysfunction.

“…Comparability across studies would be enhanced by use of standardised PA and SB questionnaires designed for use, and validated, with adults with mental illness. Medical comorbidities may influence engagement in PA and SB through pain and mobility restrictions 353,354 . Further, some psychiatric medications have side-effects, such as sedation, cognitive impairment, and emotional flattening 11,12 , which may influence PA and SB.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, medical comorbidities may affect PA barriers, preferences and enablers due to pain and mobility restrictions 353,354 . Medications and medical comorbidities were not assessed in this study, so it is unknown how they may have influenced the results.…”

Section: Discussionmentioning

confidence: 99%

Measuring and positively influencing physical activity and sedentary behaviour in adults with mental illness

Chapman¹

Background: Mental illness has a high global prevalence, and is associated with higher risk of chronic physical conditions, and reduced psychosocial functioning and life expectancy. Physical activity (PA) protects against chronic disease and mortality risk, and reduces depression and anxiety. Prolonged sedentary behaviour (SB) can have deleterious metabolic consequences, and may be associated with poor mental health.Accurate measurement of PA and SB is important for assessing health risk, and evaluating behaviour change interventions. Objective measures (e.g. accelerometers) allow for unbiased measurement, but do not assess the context of participation, which may be important for intervention planning. Questionnaires can assess context, however, they are prone to reporting errors. The feasibility of using these measures, and the impact of standard data management procedures, has not been assessed in adults with mental illness.PA interventions may positively influence PA levels of adults with mental illness. It is important to understand PA attitudes when designing interventions, as well as the acceptability and efficacy of different exercise approaches. Aims and objectives:The overarching aim of this PhD was to measure, understand, and positively influence the PA patterns of non-institutionalised adults with mental illness. Specific objectives were to: i) assess the utility of questionnaires and accelerometers for measuring PA and SB; ii) investigate questionnaire and accelerometer data management procedures; iii) measure PA and SB levels; iv) assess PA attitudes and opinions; and v) assess the feasibility and acceptability of two exercise protocols. Data from two research studies are presented in six thesis chapters. Study 1Design: Cross-sectional.Method: Participants were adult clients of mental health services. Participants completed self-administered questionnaires on the time spent in PA and SB in different contexts, wore an ActiGraph GT3x+ accelerometer on the hip for 7-days, and rated the ease/difficulty of completing the questionnaires and accelerometry. Participants also completed self-administered questionnaires on PA attitudes and opinions.Results: 142 participants completed the questionnaires (mean age=40yrs, female=43%); of these, 99 (70%) completed the accelerometry (mean age=40yrs, female=47%).ii Participants found it easier to report PA than SB, and to complete accelerometry than questionnaires. Defining a valid day of accelerometry using standard absolute criteria biased the sample by excluding participants with short waking hours; defining a valid day relative to waking hours prevented this bias. The median self-reported time spent in moderate-to-vigorous physical activity (MVPA) and SB was 4.5 hours/week and 10.7 hours/day respectively. Walking for transport, and sitting to watch TV, contributed most to these self-report estimates. The median accelerometer-derived time spent in MVPA and SB was 26 minutes/day and 9.2 hours/day respectively; 7% of MVPA time was in bouts of 10 minutes or ...