Unconscious loss processing in diabetes: associations with medication adherence and quality of care

Marchini, Francesco; Langher, Viviana; Napoli, Angela; Balonan, Jerilyn Tan; Fedele, Fabiola; Martino, Gabriella; Amorosi, Francesca Romana; Caputo, Andrea

doi:10.1080/02668734.2021.1922492

Cited by 11 publications

(9 citation statements)

References 61 publications

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“…In this regard, it could be speculated that higher education levels could have supported compliance and adherence in more anxious women, with a deeper consciousness of their bone metabolic disease and the need for long-term medical treatment. Indeed, previous studies on chronic conditions showed that minimizing the role of illness and lowering anxiety and painful feelings made patients less likely to enact concern for their health and consequent self-restoration strategies, thus negatively affecting treatment adherence [71][72][73]. Similarly, we assume that a lower education level, found in less anxious women, could have negatively influenced compliance, adherence, and illness consciousness, leading to a higher percentage of treatment discontinuation and consequent poorer BMD improvements.…”

Section: Discussionmentioning

confidence: 99%

Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

Martino

Bellone

Vicario

et al. 2021

IJERPH

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Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

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Section: Discussionmentioning

confidence: 99%

Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

Martino

Bellone

Vicario

et al. 2021

IJERPH

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“…Several studies in the literature have focused on variables such as alexithymia and intolerance of uncertainty, but there is a lack of knowledge regarding the relationship between emotional experience and pathology [18][19][20][21][22]. Authors such as Gibson and colleagues [19] have described the characteristics of intolerance of uncertainty in people suffering from diabetes, highlighting that prospective and inhibitory anxiety have an impact on these individuals through reduced quality of life and adverse biological factors.…”

Section: Introductionmentioning

confidence: 99%

Type 1 Diabetes Mellitus, Psychopathology, Uncertainty and Alexithymia: A Clinical and Differential Exploratory Study

Merlo,

Tutino,

Myles

et al. 2024

Healthcare

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Type 1 diabetes mellitus (T1DM) represents a complex pathology affecting a large number of people. Research suggests that psychological factors influence coping with T1DM. This study aimed to investigate the presence and role of psychopathology, alexithymia and uncertainty in people affected by T1DM. The sample consisted of 137 patients (88 females, 49 males) affected by T1DM aged from 11 to 19 years old (Mean: 13.87; SD: 2.40). The diagnostic protocol consisted of a sociodemographic questionnaire, Self-administration Psychiatric Scales for Children and Adolescents (SAFA), Toronto Alexithymia Scale-20 (TAS-20) and Intolerance to Uncertainty Scale-12 (IUS-12). Descriptive, differential, correlational and regression analyses were performed in order to examine the relationships between these variables. The results suggested the sample had high levels of psychopathological indexes, alexithymia and intolerance of uncertainty. Also, there were significant differences between TAS-20 and IUS-12 distributions with respect to psychopathology. Correlations and multivariate linear regressions indicated age, gender and education significantly predicted alexithymia and intolerance of uncertainty. This data suggest the presence of elevated psychopathology, alexithymia and uncertainty in people with diabetes.

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“…The literature suggests that various psychological and psychopathological variables impact complex medical conditions (1)(2)(3)(4)(5)(6). The extension of this knowledge concerns an ever-increasing number of pathologies, including type 1 and 2 diabetes mellitus (T1DM and T2DM), whose understanding in terms of psychological manifestations and role is particularly relevant (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Alexithymia, Intolerance to Uncertainty and Psychopathological Dynamics in Subjects Suffering from Type 1 Diabetes Mellitus: A Preliminary Exploratory Study

Merlo

Tutino

Myles

et al. 2023

Preprint

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Background Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Psychopathology, alexithymia and uncertainty can be considered as clearly present in this population, and known to be harmful for the onset, maintenance and worsening of disorders. This study aimed to highlight the presence and directions assumed by these phenomena in subjects suffering from T1DM. Methods 105 subjects (F: 60%), aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included. To assess the presence of psychopathology, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, respectively, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample. Results A concerning presence of anxiety, depression and somatic symptoms was found in the sample. Psychopathology appeared to be consistently represented in the sample, often overcoming pathological indexes. Alexithymia and uncertainty were common, highlighting their role in the light of the main pathology (T1DM). Continuity with current state of the art emerged, underlining the need for interventions. Conclusions Active psychopathology together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample. Adolescent subjects suffering from diabetes demonstrated its impact on psychological functioning while the results underlined some psychological phenomena possibly exacerbating general health status.

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Unconscious loss processing in diabetes: associations with medication adherence and quality of care

Cited by 11 publications

References 61 publications

Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

Type 1 Diabetes Mellitus, Psychopathology, Uncertainty and Alexithymia: A Clinical and Differential Exploratory Study

Alexithymia, Intolerance to Uncertainty and Psychopathological Dynamics in Subjects Suffering from Type 1 Diabetes Mellitus: A Preliminary Exploratory Study

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