Type D personality is associated with an increased morbidity and mortality risk in cardiovascular disease patients, but the mechanisms explaining this risk are unclear. We examined whether Type D was associated with coronary artery disease (CAD) risk factors, estimated risk of developing CAD, and previous cardiac events.
Cross-sectional study in the general Icelandic population.
A random sample of 4753 individuals (mean age 49.1 ± 12.0 years; 49% men) from the REFINE-Reykjavik study completed assessments for Type D personality and conventional CAD risk factors. Ten-year risk of developing CAD was estimated with the Icelandic risk calculator.
Type D personality (22% of sample) was associated with a higher prevalence of hypertension (35 vs. 31%, p = 0.009), but less use of hypertension medication (58 vs. 65%, p = 0.013) in hypertensives, more diabetes (6 vs. 4%, p = 0.023), wider waist circumference (p = 0.007), and elevated body mass index (p = 0.025) and blood lipids (p
The aim of this study was to assess the associations between child maltreatment (CM), psychopathological symptoms, and onset of diabetes mellitus, hypothyroidism (i.e., low metabolism), and chronic bronchitis/emphysema/COPD in adulthood.
The present analysis used cross-sectional data collected in 2007-2008 within the Tromsø Study, Norway (N?=?12,981). CM was measured with a single item, and self-reported information on psychopathological symptoms and physical health outcomes was used. The associations between CM, psychopathological symptoms, and physical health outcomes were assessed with linear and Poisson regression models. Mediation was assessed with difference-in-coefficients method.
In the fully-adjusted models, CM was associated with higher levels of anxiety and depression, psychological distress, difficulty in sleeping, insomnia, and use of sleeping pills and antidepressants in adulthood (p?
Eating disorders (ED) are serious disorders that have a negative impact on both the psychological and the physiological well-being of the afflicted. Despite the fact that ED affect both genders, males are often underrepresented in research and when included the sample sizes are often too small for separate analyses. Consequently we have an unclear and sometimes contradictory picture of the clinical characteristics of males with ED. The aim of the present study was to improve our understanding of the clinical features of adolescent males with eating disorders.
We compared age at presentation, weight at presentation, history of significantly different premorbid weight and psychiatric (Attention Deficit Hyperactivity Disorder (ADHD)) and somatic comorbidity (celiac disease and diabetes) of 58 males to 606 females seeking medical care for eating disorders at the Children's Hospital in Uppsala, Sweden during the years 1999-2012. As all boys were diagnosed with either AN or Other Specified Feeding or Eating Disorder (OSFED) atypical AN, the age and weight comparisons were limited to those girls fulfilling the diagnostic criteria for AN or OSFED atypical AN.
There was no significant difference in age at presentation. Differences in weight at presentation and premorbid weight history were mixed. A significantly higher percentage of males had a history of a BMI greater than two standard deviations above the mean for their corresponding age group. As well, there was a higher prevalence of ADHD among the males whereas celiac disease and diabetes only was found among the females.
A better understanding of the clinical characteristics of males with ED at presentation should improve our ability to identify males with ED and thereby aid in tailoring the best treatment alternatives.
Cites: Am J Psychiatry. 2001 Apr;158(4):570-411282690
Cites: Int J Eat Disord. 2012 Nov;45(7):883-9022570093
Focusing on wellness and adopting perspectives from positive and perceptual psychology, perceptions about health and illness were studied in 55 families with diabetic children, their siblings (8-17 years old) and mothers. Individual interviews were conducted on definitions of wellness, rationale for children's self-evaluation of wellness, consequences of wellness and definition of diabetes. Content analysis revealed that respondents have a comprehensive definition of wellness focusing on adaptation and performance. Significant role-specific differences emerged. Mothers' perceptions reflected their role in caregiving and socializing children. Children emphasized school performance and absence of health problems. Siblings focused on harmonious relationships. In accordance with the perspective of positive psychology, adults' as well as children's perceptions are congruent with the pursuit of wellness despite chronic illness.
To assess the socio-economic distribution of comorbid depression and diabetes among the Danish workforce using national registry data.
Using national registers, all eligible Danish adults aged 18-59 years on 1 January 1996 were followed until 31 December 2010. Diabetes status was obtained from the Danish National Diabetes Register and information on purchase of prescription antidepressants from the Register of Medicinal Product Statistics. Data were also obtained on people's occupational status and gross annual income. The people included in the study were stratified according to their highest occupational group during the study period. Annual incomes were adjusted to 2013 levels and, using the distribution of the study population's incomes, we stratified participants into income quintiles.
A total of 3 434 420 individuals met the inclusion criteria at baseline, with 98 006 developing diabetes during follow-up. There were 603 498 new prescriptions of antidepressants during follow-up; 19 849 (20.3%) among people with diabetes and 583 649 (17.5%) among those without. People with diabetes in all income quintiles (risk ratio 1.65; 95% CI 1.62-1.67) and all occupational groups (risk ratio 1.70; 95% CI 1.68- 1.73) had a significantly elevated risk compared with the general population. Risk ratios were significantly higher among the lowest occupational groups and income quintiles.
Our results provide robust data underlining the associations between diabetes, depression and socio-economic status. They highlight and encourage further focus on the issue of comorbid diabetes and depression, particularly among the most disadvantaged.
Concomitant psychiatric disorders in people with diabetes affect morbidity and mortality. We aimed to study psychiatric morbidity in people with diabetes and the general population using administrative health care data in Stockholm County.
The study population included all living persons who resided in Stockholm County, Sweden, on January 1, 2011 (N=2,058,408). Subjects with a diagnosis of diabetes were identified with data from all consultations in primary health care, specialist outpatient care and inpatient care during the time span 2009-2013. As outcome, information was obtained on all consultations due to any psychiatric diagnosis as well as, specifically, schizophrenia, bipolar disorders, depression, and anxiety disorders, in 2011-2013. Analyses were performed by age group and gender. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for women and men with diabetes, using individuals without diabetes as referents, were calculated.
Age-adjusted OR for all psychiatric diagnoses among people with diabetes was 1.296 (95% CI 1.267-1.326) for women and 1.399 (95% CI 1.368-1.432) for men. The greatest excess risk was found for schizophrenia, with OR 3.439 (95% CI 3.057-3.868) in women and 2.787 (95% CI 2.514-3.089) in men, with ORs between 1.276 (95% CI 1.227-1.327) and 1.714 (95% CI 1.540-1.905) for the remaining diagnoses.
The prevalence of psychiatric disorders is elevated in people with diabetes, which calls for preventive action to be taken to minimize suffering and costs to society.
To determine the household food insecurity (HFI) prevalence in Canadians with diabetes and its relationship with diabetes management, self-care practices, and health status.
We analyzed data from Canadians with diabetes aged >or=12 years (n = 6,237) from cycle 3.1 of the Canadian Community Health Survey, a population-based cross-sectional survey conducted in 2005. The HFI prevalence in Canadians with diabetes was compared with that in those without diabetes. The relationships between HFI and management services, self-care practices, and health status were examined for Ontarians with diabetes (n = 2,523).
HFI was more prevalent among individuals with diabetes (9.3% [8.2-10.4]) than among those without diabetes (6.8% [6.5-7.0]) and was not associated with diabetes management services but was associated with physical inactivity (odds ratio 1.54 [95% CI 1.10-2.17]), lower fruit and vegetable consumption (0.52 [0.33-0.81]), current smoking (1.71 [1.09-2.69]), unmet health care needs (2.71 [1.74-4.23]), having been an overnight patient (2.08 [1.43-3.04]), having a mood disorder (2.18 [1.54-3.08]), having effects from a stroke (2.39 [1.32-4.32]), lower satisfaction with life (0.28 [0.18-0.43]), self-rated general (0.37 [0.21-0.66]) and mental (0.17 [0.10-0.29]) health, and higher self-perceived stress (2.04 [1.30-3.20]). The odds of HFI were higher for an individual in whom diabetes was diagnosed at age
The prevalence of diabetes in Canada is increasing. Multiple factors have been identified in the development of disability in diabetic patients, but the interaction of those risk factors is not clear.
The purpose of this paper was to assess the association between diabetes severity, health behavior, socioeconomic status, social support, depression, and disability simultaneously in a population-based study of individuals with diabetes in Quebec, Canada.
Random digit dialing was used to select a sample of 2,003 adults with self-reported diabetes in Quebec. Health status was assessed by the World Health Organization Disability Assessment Schedule II and the CDC Healthy Days Measures. The Patient Health Questionnaire (PHQ-9) was used to assess depression. Potential risk factors included diabetes severity, social support, socioeconomic status, and health behavior factors. Structural equation models were used to identify risk factors that contributed to both depressive symptoms and disability.
The prevalence of major and minor depression was 8.7% and 10.9%, respectively, while the prevalence of severe disability was 6.7%. Diabetes severity and health behavior factors were associated with both depression and disability. Social support was associated with depression for women but not for men.
Our results suggest a complex interaction between health behavior factors, diabetes severity, social support, depression, and disability. Behavioral factors and diabetes-specific factors might have a direct effect on both depression and physical functioning.
This study investigated the prevalence of schizophrenia (ICD-10 F 20) and of other non-affective psychosis (NAP, ICD-10 F 21 - F 29) in Sweden. It further assessed health care use, comorbidity and medication for these patient groups. Most studies either have a study population of patients with strictly defined schizophrenia or a psychosis population of which strict schizophrenia cases form a smaller set. The present study permits comparison of the two mutually exclusive patient groups using data at the individual level in the diagnosis of non-affective psychosis, use of health care, medical treatment and comorbidity by diagnosis or medical treatment.
In 2012, data were extracted from a regional registry containing patient-level data on consultations, hospitalisations, diagnoses and dispensed drugs for the total population in the region of Stockholm (2.1 million inhabitants). The size of the total psychosis population was 18,769, of which 7284 had a diagnosis of schizophrenia. Crude prevalence rates and risk rates with 95% confidence intervals were calculated.
In 2012, the prevalence of schizophrenia and NAP was 3.5/1000 and 5.5/1000, respectively. Schizophrenia was most common among patients aged 50-59 years and NAP most common among patients aged 40-49 years. Schizophrenia patients used psychiatric health care more often than the NAP patients but less overall inpatient care (78.6 vs. 60.0%). The most prevalent comorbidities were substance abuse/dependence (7.9% in the schizophrenia group vs. 11.7% in the NAP group), hypertension (7.9 vs. 9.7%) and diabetes (6.9 vs. 4.8%). The parenteral form of long-acting injectable antipsychotics was more often dispensed to patients with schizophrenia (10 vs. 2%).
This study, analysing all diagnoses recorded in a large health region, confirmed prevalence rates found in previous studies. Schizophrenia patients use more psychiatric and less overall inpatient health care than NAP patients. Differences between the two patient groups in comorbidity and drug treatment were found. The registered rates of a substance abuse/dependence diagnosis were the most common comorbidity observed among the patients investigated. The observed differences between the schizophrenia and the NAP patients in health care consumption, comorbidity and drug treatment are relevant and warrant further studies.
Health related quality of life (HRQoL) is an important subjectively evaluated outcome of adolescents physical, mental, and social functioning. It gives us the possibility to assess the disease impact on life of adolescents, and to sort out target groups of adolescents for future psychological interventions. The objective of this cross-sectional survey was to study HRQoL in 173 adolescents with chronic physical illness (CPI - diabetes, asthma, and epilepsy), and to find HRQoL predictors in each disease group.
Disease-specific questionnaires were completed by each adolescent recruited from the local outpatient clinic; mothers answered the questions on socioeconomic status (SES); and the patients' clinicians evaluated the severity of the disease.
A high proportion of adolescents in each disease specific sample reported moderate to high levels of HRQoL. Gender was the most prominent predictor of HRQoL in all three studied groups, while disease severity predicted HRQoL in the diabetic group and to some extent in the asthma group.
Our results provide evidence that adolescents with diabetes, asthma, and epilepsy in northern Russia maintain relatively moderate to high levels of HRQoL. The domains affecting HRQoL were related to both disease-specific (severity) and non-disease factors (gender and SES). Our study suggests that future psychosocial interventions should focus on aspects of CPI impacting adolescents in gendered ways, furthermore taking into account disease specific factors.