Prognostic Factors for Work Ability in Women With Chronic Low Back Pain Consulting Primary Health Care: A 2-Year Prospective Longitudinal Cohort Study.

Prognostic Factors for Work Ability in Women With Chronic Low Back Pain Consulting Primary Health Care: A 2-Year Prospective Longitudinal Cohort Study.

Clin J Pain. 2013 Jul 24;
Nordeman L, Gunnarsson R, Mannerkorpi K

To investigate prognostic factors for future work ability in women with chronic low back pain (CLBP) consulting primary health care.A 2-year prospective longitudinal cohort study of female patients with CLBP within the primary health care was conducted. Patients were assessed at the first assessment and after 2 years. Prognostic factors for work ability (yes/no) were analyzed by multivariate regression.A total of 130 patients were included at first assessment. After 2 years, 123 patients (95%) were followed up. The 6-minute walk test, depression, and earlier work ability predicted work ability at the 2-year follow-up. A nomogram was constructed to assess the probability of future work ability.The 6-minute walk test, work ability, and depression predicted work ability for women with CLBP after 2 years. HubMed – depression

Predictors of Suicidal Ideation in Chronic Pain Patients: An Exploratory Study.

Clin J Pain. 2013 Jul 24;
Racine M, Choinière M, Nielson WR

To explore whether chronic pain (CP) patients who report suicidal ideation (SI) present a distinctive profile with regard to their sociodemographic characteristics, physical health, psychological well-being, cognitions, and use of antidepressants, illicit drugs, and alcohol for pain relief.Eighty-eight CP patients completed self-administered questionnaires during their intake assessment at 3 pain clinics located in the province of Québec (Canada). Patients reporting active or passive SI on the Beck Depression Inventory were compared with patients reporting no SI. Between-group univariate analyses were performed using profile variables to compare patients with and without SI. Significant variables were then entered into multiple logistic regression analyses to identify significant independent predictors of SI.Twenty-four percent of patients reported having had SI. Unemployed/disabled patients were 6 times more likely to report SI. Poor sleep quality was the only predictor of SI among the physical variables. For psychological well-being, depressive symptoms did not significantly predict SI. However, the poorer the patients perceived their mental health to be the more likely they were to report SI. Pain-related helplessness was the only predictor for SI among the cognitive variables. Patients who had used illicit drugs as a form of pain relief at any time since pain onset were 5 times more likely to report SI. Similar results were obtained for those who were on antidepressants.Some factors associated with SI seem pain specific, whereas others are more generally associated with SI. Better identification and understanding of these factors is essential for the development of targeted suicide prevention programs for at-risk CP patients. HubMed – depression

Education and the public’s desire for social distance from people with depression and schizophrenia: The contribution of emotional reactions and causal attributions.

Int J Soc Psychiatry. 2013 Jul 25;
von dem Knesebeck O, Angermeyer MC, Kofahl C, Makowski AC, Mnich E

Association between education and desire for social distance from people with mental illness is unclear.(1) Is there an association between education and social distance from people with a depression or schizophrenia? (2) Can this association be explained by beliefs about causes of and emotional reactions to the mental disorders? (3) Are there differences between the two mental disorders?Analyses are based on a telephone survey in two large German cities (Hamburg and Munich, N = 2,014, response rate 51%). Vignettes with typical signs and symptoms suggestive of depression and schizophrenia were presented. Respondents were asked about beliefs about causes of the mental disorders, their emotional reactions and their desire for social distance.Lower education is significantly associated with a stronger tendency for social distance in the case of depression but not in case of schizophrenia, when age and gender are controlled. In case of depression, the association decreases when beliefs about possible causes are additionally controlled. In terms of schizophrenia, associations between education and social distance become stronger when emotional reactions are introduced.Our results underline that campaigns aimed at reducing stigma and social distance should consider specific emotional reactions and information needs of people with low education regarding different mental disorders. HubMed – depression

Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia.

BMJ Open. 2013; 3(7):
Gao Y, O’Caoimh R, Healy L, Kerins DM, Eustace J, Guyatt G, Sammon D, Molloy DW

There is growing evidence that antihypertensive agents, particularly centrally acting ACE inhibitors (CACE-Is), which cross the blood-brain barrier, are associated with a reduced rate of cognitive decline. Given this, we compared the rates of cognitive decline in clinic patients with dementia receiving CACE-Is (CACE-I) with those not currently treated with CACE-Is (NoCACE-I), and with those who started CACE-Is, during their first 6 months of treatment (NewCACE-I).Observational case-control study.2 university hospital memory clinics.817 patients diagnosed with Alzheimer’s disease, vascular or mixed dementia. Of these, 361 with valid cognitive scores were included for analysis, 85 CACE-I and 276 NoCACE-I.Patients were included if the baseline and end-point (standardised at 6 months apart) Standardised Mini-Mental State Examination (SMMSE) or Quick Mild Cognitive Impairment (Qmci) scores were available. Patients with comorbid depression or other dementia subtypes were excluded. The average 6-month rates of change in scores were compared between CACE-I, NoCACE-I and NewCACE-I patients.When the rate of decline was compared between groups, there was a significant difference in the median, 6-month rate of decline in Qmci scores between CACE-I (1.8 points) and NoCACE-I (2.1 points) patients (p=0.049), with similar, non-significant changes in SMMSE. Median SMMSE scores improved by 1.2 points in the first 6 months of CACE treatment (NewCACE-I), compared to a 0.8 point decline for the CACE-I (p=0.003) group and a 1 point decline for the NoCACE-I (p=0.001) group over the same period. Multivariate analysis, controlling for baseline characteristics, showed significant differences in the rates of decline, in SMMSE, between the three groups, p=0.002.Cognitive scores may improve in the first 6 months after CACE-I treatment and use of CACE-Is is associated with a reduced rate of cognitive decline in patients with dementia. HubMed – depression