Cognitive/behavioral and environmental variables are significant predictors of patient adjustment in chronic pain. Using a biopsychosocial template and selecting several pain-relevant constructs from physical, cognitive/behavioral, and environmental predictors, outcomes of pain and disability in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were explored. Men (n = 253) from a North American multi-institutional NIH-funded Chronic Prostatitis Cohort Study in 6 US and 1 Canadian centers participated in a survey examining pain and disability. Measures included demographics, urinary symptoms, depression, pain, disability, catastrophizing, control over pain, pain-contingent rest, social support, and solicitous responses from a significant other. Regressions showed that urinary symptoms (beta = .20), depression (beta = .24), and helplessness catastrophizing (beta = .29) predicted overall pain. Further, affective pain was predicted by depression (beta = .39) and helplessness catastrophizing (beta = .44), whereas sensory pain was predicted by urinary symptoms (beta = .25) and helplessness catastrophizing (beta = .37). With regard to disability, urinary symptoms (beta = .17), pain (beta = .21), and pain-contingent rest (beta = .33) were the predictors. These results suggest cognitive/behavioral variables (ie, catastrophizing, pain-contingent rest) may have significant impact on patient adjustment in CP/CPPS. Findings support the need for greater research of such pain-related variables in CP/CPPS.
This article explores predictors of patient adjustment in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Cognitive/behavioral variables of catastrophizing and pain-contingent rest respectively predicted greater pain and disability. Catastrophic helplessness was a prominent pain predictor. These findings inform clinicians and researchers on several new variables in CP/CPPS outcomes and suggest future research.
Factors associated with low self-esteem in non-depressive subjects increase the individual's vulnerability to depression (causal risk factors), and factors correlated to low self-esteem in depressive subjects make the current disorder more severe (pathoplastic risk factors). Using the Rosenberg Self-Esteem Scale and Depression Scale we intended to explore correlates of low self-esteem in non-depressive and depressive subjects in a random sample of 1643 individuals attending community health centres in Central Finland. According to our study, self-esteem in non-depressive men was affected mainly by poor socioeconomic situation; in depressive men particularly low self-esteem was associated with negative family factors. Low self-esteem in non-depressive women was correlated to poor socioeconomic situation, poor health, and negative family factors. In depressive women self-esteem was affected by poor physical and poor mental health. Taking into consideration causal and pathoplastic risk factors, general practitioners can improve recognition of depression. By paying attention to pathoplastic factors, it is possible to improve detection of more severe forms of depression.
Increased knowledge about families with a malformed child affects nursing practice. This study illuminates the experiences and psychosocial situation of 3 patients with imperforate anus and their parents. A qualitative method has been used to analyze the data. We found that the parents' experiences of suffering were overwhelming and that the 3 patients had been depressed during periods. The patients were not as open as their parents; we need to devise better tools to explore and understand children's experiences. The children and their parents need special care and an opportunity to express their anxieties.
The presence of neck-shoulder pain as a predictor of depression is not widely studied.
To analyse the association of neck-shoulder pain at baseline with depressive symptomatology after a 7-year follow-up.
A total of 604 subjects who had not had depressive symptomatology at baseline participated in 7-year follow-up survey. The number of subjects with depressive symptomatology (Beck Depression Score10) after 7-year follow-up were measured in three groups - subjects without neck-shoulder pain, with infrequent neck-shoulder pain and with daily neck-shoulder pain at baseline.
A total of 77 (13%) participants had developed depressive symptomatology by the follow-up. Prevalence of depressive symptomatology in follow-up in subjects without neck-shoulder pain, with infrequent neck-shoulder pain and with daily neck-shoulder pain at baseline pain was 9.5%, 11.2% and 28.4%. In multivariate logistic regression analysis odds for having depressive symptomatology in daily neck-shoulder pain subjects was almost three fold higher (OR, 2.64, 95% CI, 1.27-5.48) compared to those without neck-shoulder pain.
Frequent neck-shoulder pain is a preceding symptom for the depressive symptomatology in adults.
Six patients with seasonal affective disorder showed marked improvement in depressive symptoms after following three different 2-hour schedules of bright artificial light, and they relapsed when the light was withdrawn.
In a sample of 1663 female and 707 male Finnish university students in their first study year, the female students reported less negative and less positive consequences of alcohol drinking than their male counterparts. The female students also drank less, less frequently and less often for intoxication. However, the profile of negative and positive consequences of drinking was similar for both genders; 74.6% of the female students and 80.0% of the males had more positive than negative experiences from alcohol. Both the positive and negative consequences of drinking correlated positively to alcohol consumption and drinking for intoxication. About half of the students who had many positive consequences of drinking were not heavy drinkers and did not report many negative consequences. Depression, anxiety, stress or psychosomatic symptoms did not correlate with either with positive or negative consequences of drinking, nor with alcohol consumption. Drinking for anxiety, depression, stress or the reduction of tension appeared to be infrequent. Young Finnish university students mostly drink for the positive consequences of drinking.
Stressful childhood environments arising from deficient nurturing attitudes are hypothesized to contribute to later stress vulnerability. We examined whether deficient nurturing attitudes predict adulthood work stress. Participants were 443 women and 380 men from the prospective Cardiovascular Risk in Young Finns Study. Work stress was assessed as job strain and effort-reward imbalance in 2001 when the participants were from 24 to 39 years old. Deficient maternal nurturance (intolerance and low emotional warmth) was assessed based on mothers' reports when the participants were at the age of 3-18 years and again at the age of 6-21 years. Linear regressions showed that deficient emotional warmth in childhood predicted lower adulthood job control and higher job strain. These associations were not explained by age, gender, socioeconomic circumstances, maternal mental problems or participant hostility, and depressive symptoms. Deficient nurturing attitudes in childhood might affect sensitivity to work stress and selection into stressful work conditions in adulthood. More attention should be paid to pre-employment factors in work stress research.
This study aims to assess (a) women's awareness of the human papillomavirus (HPV), (b) women's health-related quality of life (HRQoL) and levels of anxiety and depression symptoms, and (c) to compare the outcomes between women who are aware of the sexually transmitted nature of the HPV infection and women who are not. Swedish women who have been notified of an abnormal Pap smear result completed a questionnaire. This questionnaire consisted of sociodemographic characteristics, items on awareness of HPV, and how to cope with the Pap smear result and the instruments: the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using descriptive statistics, Student's t-test, ?-tests, Fisher's exact test, the Mann-Whitney U-test, and Fisher-Freeman-Halton exact test. In total, 122 women participated. The women reported a median (quartile 1-quartile 3) score of 87.6 on the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (81.8-107.0), compatible with a good HRQoL. The median (quartile 1-quartile 3) scores on HADS-anxiety and HADS-depression were 7.0 (4.0-10.0) and 3.0 (1.0-5.3), respectively; however, 48.4% of the women reported anxiety (compared with 20% in a normal population). There were no statistically significant differences in the median scores in any of the scales, including the prevalence of distress between the subgroups. Women with abnormal Pap smear results have a good HRQoL; they can become anxious, but not depressed. Awareness of HPV as a sexually transmitted infection is low, but being aware does not impact on women's HRQoL or on anxiety and depression.