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Mental health and protective strategies among community-based health workers in region 3, Philippines during COVID-19 pandemic. 新冠肺炎大流行期间,菲律宾第3地区社区卫生工作者的心理健康和保护策略。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2022-05-09 DOI: 10.1080/08964289.2022.2069666
Sherna G Bangalan
The COVID-19 crisis in the Philippines posed both physical and psychological threats to health workers. It is vital to determine practices to protect them. This study determined the prevalence of mental health outcomes among community-based health workers during the COVID-19 pandemic and examined the association of protective strategies with symptoms of mental health outcomes. A cross-sectional study design was applied to the records of community-based health workers conducted through online psychological assessment by Department of Health - Central Luzon between September 1-30, 2020. Respondents' age, sex, mental health status, and protective strategies were extracted using Abstraction Form, and analyses were done using OpenEpi. A total of 324 records of community-based health workers were included in the analysis. Ten percent of the respondents present symptoms of stress, 26% anxiety symptoms, and 18% depressive symptoms. The majority of the respondents were using deep breathing techniques, having a constant social connection with family and friends, and engaging in their regular spiritual/religious activities as protective strategies during the pandemic. Engagement in regular spiritual/religious practices was found associated with symptoms of stress through Fisher's exact test. Participants who engaged in religious/spiritual practices were less likely to report symptoms of stress. Community-based health workers showed evident rates of symptoms of stress, anxiety, and depression. The majority of the participants engaged in various protective strategies but only engagement in regular religious/spiritual practices was found associated with symptoms of stress.
菲律宾的新冠肺炎危机对卫生工作者构成了身体和心理威胁。确定保护他们的做法至关重要。这项研究确定了新冠肺炎大流行期间社区卫生工作者心理健康结果的流行率,并检查了保护策略与心理健康结果症状的关系。2020年9月1日至30日,中央吕宋卫生部通过在线心理评估对社区卫生工作者的记录进行了横断面研究设计。使用抽象表提取受访者的年龄、性别、心理健康状况和保护策略,并使用OpenEpi进行分析。共有324份社区卫生工作者的记录被纳入分析。10%的受访者有压力症状,26%有焦虑症状,18%有抑郁症状。大多数受访者在疫情期间使用深呼吸技术,与家人和朋友保持持续的社交联系,并定期进行精神/宗教活动作为保护策略。通过Fisher的精确测试,发现定期进行精神/宗教活动与压力症状有关。参与宗教/精神实践的参与者不太可能报告压力症状。社区卫生工作者表现出明显的压力、焦虑和抑郁症状。大多数参与者采取了各种保护策略,但只有定期的宗教/精神实践与压力症状有关。
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引用次数: 2
Association of Midday Napping with All-Cause Mortality in Chinese Adults: A 8-Year Nationwide Cohort Study. 中国成年人中午小睡与全因死亡率的相关性:一项为期8年的全国队列研究。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2022-04-22 DOI: 10.1080/08964289.2022.2061411
Lu Wang, Yiting Wang, Hainan Shu, K. Wang, Yaru Wang, Peixuan Zhou, Ke Wang, Siqi Luo, Yunquan Zhang
This study aimed to investigate the longitudinal association of estimated daytime nap duration with all-cause mortality in Chinese adults. We conceived a prospective cohort design using adult survey data of the baseline and four follow-up waves (2010-2019) from China Family Panel Studies. Cox frailty models with random intercepts for surveyed provinces were used to estimate risks of all-cause mortality associated with midday napping. Trend and subgroup analyses were also performed stratified by demographic, regional and behavioral factors. Compared with non-nappers, those who reported a long napping duration (≥60 min/day) had an increased risk of all-cause mortality, while shorter napping (<60 min) showed no association with mortality. We observed significant trends for greater risks of mortality associated with longer nap duration. Long nap-associated higher risk of all-cause mortality was seen in a group of nocturnal sleep duration ≥9 h. We identified stronger associations of long nap with mortality among adults aged over 50 years, those with lower BMI (<24 kg/m2), residents in rural regions and unregular exercisers. Long midday napping is independently associated with higher risks of all-cause mortality in Chinese adults.
本研究旨在调查中国成年人日间小睡时间与全因死亡率的纵向相关性。我们使用中国家庭小组研究的基线和四个随访波(2010-2019年)的成人调查数据进行了前瞻性队列设计。采用随机截取的受访省份Cox虚弱模型来估计与午休相关的全因死亡率风险。趋势和亚组分析也按人口、地区和行为因素进行了分层。与不打盹的人相比,那些报告打盹时间长(≥60 分钟/天)的全因死亡率增加,而小睡时间较短(<60 min)与死亡率无关。我们观察到,小睡时间越长,死亡率越高的显著趋势。在夜间睡眠时间≥9的人群中,发现长时间小睡与全因死亡率相关的风险更高 h.我们发现,在50岁以上的成年人中,长时间小睡与死亡率之间存在更强的相关性 年,那些BMI较低(<24 kg/m2)、农村地区居民和不定期锻炼者。在中国成年人中,午觉时间过长与全因死亡率较高独立相关。
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引用次数: 2
One Year of COVID-19 in Spain, Longitudinal Study on Mental and Physical Health. 西班牙新冠肺炎一年,心理和身体健康纵向研究。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2022-04-18 DOI: 10.1080/08964289.2022.2064415
Enrique G. Fernández-Abascal, María Dolores Martín-Díaz
The objective of this longitudinal study carried out with the same participants, with two repeated measurements, the first taken in March 2020 (M1) and the second measurement in March 2021 (M2), is to investigate the impact of the COVID-19 pandemic throughout one year on the levels of Affect, Psychological Well-being, Depression and Mental and Physical Health, as well as to learn about the evolution of those levels from M1 to M2. Comparison of the mean scores of the variables analyzed between the two measurements (M1 and M2) show significant differences in the following scales: Positive Affect (PANAS), with lower scores at M2; Total Depression (BDI-II) and the two Cognitive-Affective and Somatic-Motivational factors, with higher scores at M2; the physical and mental health scales (SF-36) of Physical Functioning, Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health, and the two Physical and Mental Health components, with lower scores at M2 in all of them; and the Purpose in Life (PWB) scale, with a lower score at M2. We can conclude that the one-year pandemic situation has affected all the variables analyzed in this work, showing a decrease in positive affect, an increase in the score of the depression inventory, worse physical and mental health, and less psychological well-being. Throughout the pandemic year, the results show that age has a moderation effect on the Somatic-Motivational factor and on the Total Depression, Physical Functioning, Vitality, and Role Emotional scales. Gender shows no moderation effect on any of the four variables analyzed.
这项对同一参与者进行的纵向研究的目的是调查新冠肺炎大流行在一年中对情感、心理健康、抑郁和身心健康水平的影响,其中第一次测量于2020年3月进行(M1),第二次测量于2021年3月(M2),以及了解这些水平从M1到M2的演变。两种测量(M1和M2)之间分析的变量的平均得分比较显示,在以下量表中存在显著差异:积极情感(PANAS),M2的得分较低;全面抑郁(BDI-II)和两种认知情感和躯体动机因素,M2得分较高;身体功能、角色身体、活力、社会功能、角色情感和心理健康的身心健康量表(SF-36),以及两个身体和心理健康组成部分,所有这些部分的M2得分都较低;以及生活目的量表,M2分较低。我们可以得出结论,一年的疫情影响了这项工作中分析的所有变量,显示出积极影响的减少,抑郁量表的得分增加,身心健康状况恶化,心理健康状况下降。在整个疫情年,研究结果表明,年龄对身体动机因素和全面抑郁、身体功能、活力和角色情绪量表有适度影响。性别对所分析的四个变量中的任何一个都没有调节作用。
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引用次数: 2
The Role of COVID-19, Race and Social Factors in Pregnancy Experiences in New York State: The CAP Study. COVID-19、种族和社会因素在纽约州怀孕经历中的作用:CAP研究
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2022-04-01 Epub Date: 2021-11-08 DOI: 10.1080/08964289.2021.1997893
Diana Romero, Meredith Manze, Dari Goldman, Glen Johnson

Given that New York State's (NYS) was the first epicenter of the COVID-19 pandemic in the United States (US), we were interested in potential racial/ethnic differences in pregnancy-related experiences among women pregnant during versus prior to the pandemic. We surveyed 1,525 women (18-44 years) proportionate to geographic and sociodemographic distribution between June 9, 20 and July 21, 20. We carried out bivariate analysis of various social and pregnancy-related factors by racial/ethnic identity (White, Black, Hispanic) and binary logistic and linear regression assessing the association between race/ethnicity, pregnancy prior to/during the pandemic, demographic characteristics, health and social wellbeing, and employment as an essential worker with pregnancy-related healthcare delays and changes. Overall, Black and Hispanic women were significantly more likely to experience a host of negative prenatal and postpartum experiences. In general, multivariate analyses revealed that individuals who were pregnant during the pandemic, lived in NYC, participated in social welfare programs, lacked health insurance, and/or were essential workers were more likely to report delays in prenatal and postpartum care and/or more changes/negative experiences. In light of previous evidence of racial disparities in birth experiences, the higher rates of negative pregnancy/birth-care and postpartum/newborn-care experiences among Black and Hispanic women in bivariate analysis warrant further inspection given that their aggregation for multivariate analysis may have obscured differences at the level of individual events. Findings support continued efforts for universal health insurance and improved social welfare programs. Guidelines are needed to protect essential workers' access to health services, particularly related to pregnancy given the time-sensitive nature of this care.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1997893 .

鉴于纽约州是美国COVID-19大流行的第一个震中,我们对在大流行期间和之前怀孕的妇女在怀孕相关经历方面的潜在种族/民族差异感兴趣。在20年6月9日至7月21日期间,我们调查了1525名女性(18-44岁),与地理和社会人口分布成比例。我们通过种族/民族身份(白人、黑人、西班牙裔)对各种社会和妊娠相关因素进行了双变量分析,并进行了二元逻辑回归和线性回归,评估种族/民族、大流行前/期间的妊娠、人口统计学特征、健康和社会福利以及作为基本工作者的就业与妊娠相关的医疗保健延迟和变化之间的关系。总体而言,黑人和西班牙裔女性更有可能经历一系列负面的产前和产后经历。总的来说,多变量分析显示,在大流行期间怀孕、住在纽约、参加社会福利计划、缺乏医疗保险和/或必不可少的工作人员更有可能报告产前和产后护理的延误和/或更多的变化/负面经历。根据之前关于生育经历中种族差异的证据,在双变量分析中,黑人和西班牙裔妇女中较高的孕期/分娩护理和产后/新生儿护理经历率值得进一步检查,因为它们的多变量分析汇总可能掩盖了个体事件水平上的差异。调查结果支持继续为全民健康保险和改善社会福利计划而努力。需要制定准则,以保护基本工作人员获得保健服务,特别是与怀孕有关的保健服务,因为这种护理具有时间敏感性。本文的补充数据可在https://doi.org/10.1080/08964289.2021.1997893上在线获得。
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引用次数: 3
Arterial Stiffness and Cardiorespiratory Fitness Are Associated With Cognitive Function in Older Adults. 动脉僵硬和心肺健康与老年人认知功能相关
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2022-01-01 DOI: 10.1080/08964289.2020.1825921
Justin R Mason, Gershon Tenenbaum, Salvador Jaime, Nelson Roque, Arun Maharaj, Arturo Figueroa

Age-related cognitive impairment has been associated with arterial stiffening and decreased cardiorespiratory fitness. The aims of this cross-sectional study were to compare cognitive function domains and cardiovascular parameters in older adults (≥ 65 years old) with high and normal aortic stiffness (via carotid-femoral pulse wave velocity, cfPWV) and to explore relationships among cfPWV, carotid intima-media thickness, cardiorespiratory fitness, and cognitive function. Vascular and cognitive function were measured in older adults with either normal or high cfPWV. Cognitive function was measured via an intensive one-time neuropsychological battery, while cfPWV by applanation tonometry, carotid intima-media thickness and function (i.e., distensibility) by ultrasonography, and cardiorespiratory fitness (i.e., VO2peak) by a submaximal exercise test. Correlations among age, VO2peak, carotid intima-media thickness, cfPWV, and cognitive function were performed along with a series of multivariate analyses of variance. Compared with NAS, participants with HAS had greater aortic, carotid, and brachial blood pressures but similar cardiorespiratory fitness and carotid intima-media thickness and distensibility. Participants with NAS exhibited better neuropsychological performance in executive function and attention and overall cognitive function than those with HAS. When controlling for age, visual scanning and perception scores were correlated with cfPWV and VO2peak. Our findings suggest that certain cognitive domains for older adults are associated with their cardiorespiratory fitness and aortic stiffness.

年龄相关的认知障碍与动脉硬化和心肺功能下降有关。本横断面研究的目的是比较主动脉硬度高和正常的老年人(≥65岁)的认知功能域和心血管参数(通过颈动脉-股动脉脉冲波速度,cfPWV),并探讨cfPWV、颈动脉内膜-中膜厚度、心肺健康和认知功能之间的关系。在cfPWV正常或高的老年人中测量血管和认知功能。认知功能通过强化的一次性神经心理学电池测量,cfPWV通过压平测压法测量,颈动脉内膜-中膜厚度和功能(即扩张性)通过超声检查,心肺功能(即vo2峰值)通过次最大运动测试。年龄、vo2峰值、颈动脉内膜-中膜厚度、cfPWV和认知功能之间的相关性以及一系列的多变量方差分析。与NAS相比,HAS患者的主动脉、颈动脉和肱动脉血压更高,但心肺功能和颈动脉内膜-中膜厚度和扩张性相似。NAS患者在执行功能、注意力和整体认知功能方面表现出比HAS患者更好的神经心理表现。在控制年龄的情况下,视觉扫描和知觉评分与cfPWV和vo2峰值相关。我们的研究结果表明,老年人的某些认知领域与他们的心肺健康和主动脉僵硬有关。
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引用次数: 8
Are Sexual Minority Stressors Associated with Young Men who Have Sex with Men's (YMSM) Level of Engagement in PrEP? 性少数压力源与年轻男男性行为者(YMSM)的PrEP参与水平有关吗?
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2021-07-01 Epub Date: 2020-05-13 DOI: 10.1080/08964289.2020.1731675
Steven Meanley, Cristian Chandler, Jessica Jaiswal, Dalmacio D Flores, Robin Stevens, Daniel Connochie, José A Bauermeister

Sexual minority stressors (community homophobia, sexuality-related discrimination, and internalized homonegativity) are negatively associated with accessing HIV prevention services among men who have sex with men (MSM). Few studies have tested minority stressors' associations with PrEP engagement among high-HIV risk young MSM (YMSM). Therefore, we assessed the associations between PrEP-indicated YMSM's progression along the PrEP continuum and their experiences of minority stress. N = 229 YMSM completed a web-survey on PrEP-related behaviors and minority stress. Adjusted for covariates, we developed two partial-proportional odds models examining the associations between PrEP continuum progression and minority stressors, as a composite, and community homophobia, sexuality-related discrimination, and internalized homonegativity, respectively. Our multivariable model demonstrated minority stress levels to be negatively associated with PrEP continuum location (AOR = 0.76, 95% CI: 0.58-0.99). Broken down, discrimination was positively associated with reporting being at an advanced location along the continuum (AOR = 1.39, 95% CI: 1.06-1.82). Internalized homonegativity was negatively associated with continuum location between PrEP-aware participants with no intention to initiate and participants who intended to initiate PrEP (AOR = 0.45, 95% CI: 0.27-0.77) and between those who intended to initiate and those who had ever used PrEP (AOR = 0.39, 95% CI: 0.22-0.69). Our findings suggest that minority stress, especially internalized homonegativity, remains a barrier to PrEP among PrEP-indicated YMSM. Sexuality-related discrimination was associated with PrEP continuum progression, suggesting potentially well-developed, adaptive coping skills (e.g., ability to locate sexuality-affirming providers). Coupled with stigma reduction efforts, HIV prevention services aiming to promote PrEP should incorporate internalized homonegativity screenings and referrals into sexuality-affirming resources for PrEP-indicated YMSM.

性少数压力源(社区同性恋恐惧症、性相关歧视和内化同性恋消极情绪)与男男性行为者(MSM)获得艾滋病毒预防服务呈负相关。很少有研究测试了少数压力源与艾滋病毒高风险年轻男同性恋者(YMSM)参与PrEP的关系。因此,我们评估了PrEP指示的YMSM沿着PrEP连续体的进展与他们的少数民族压力经历之间的关系。N = 229名YMSM完成了预科相关行为和少数民族压力的网络调查。对协变量进行调整后,我们建立了两个部分比例的优势模型,分别检验了PrEP连续进展和少数民族压力源(作为一个复合因素)以及社区同性恋恐惧症、性相关歧视和内化同性恋负性之间的关系。我们的多变量模型显示,少数族裔压力水平与PrEP连续体位置呈负相关(AOR = 0.76, 95% CI: 0.58-0.99)。细分来看,歧视与报告处于连续体的高级位置呈正相关(AOR = 1.39, 95% CI: 1.06-1.82)。内化同质性与意识到PrEP的、无意开始PrEP的参与者和打算开始PrEP的参与者(AOR = 0.45, 95% CI: 0.27-0.77)以及打算开始PrEP的参与者和曾经使用过PrEP的参与者(AOR = 0.39, 95% CI: 0.22-0.69)之间的连续位置呈负相关。我们的研究结果表明,少数民族压力,特别是内化的同质性负性,仍然是PrEP指示的YMSM中PrEP的障碍。与性取向相关的歧视与PrEP的持续进展有关,这表明潜在的良好发展的适应性应对技能(例如,找到性取向确认提供者的能力)。结合减少耻辱感的努力,旨在促进PrEP的艾滋病毒预防服务应将内部化的同性恋阴性筛查和转介到PrEP指示的YMSM的性取向确认资源中。
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引用次数: 12
Older People's Health-Related Behaviors: Evidence from Three Cohorts of the Lc65+ Study. 老年人健康相关行为:来自Lc65+研究的三个队列的证据
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2021-07-01 Epub Date: 2020-02-20 DOI: 10.1080/08964289.2019.1684234
Laurence Seematter-Bagnoud, Brigitte Santos-Eggimann, David Nanchen, Juan-Manuel Blanco, Christophe Büla, Armin von Gunten, Jean-Francois Démonet, Yves Henchoz

Baby-boomers might be more health-conscious than earlier birth cohorts, but limited evidence has been produced so far. To investigate such changes, this study compared health-related behaviors at age 65 to 70 among three successive five-year birth cohorts (pre-war: born 1934-1938; war: born 1939-1943 and baby-boom: born 1944-1948) representative of the community-dwelling population. Information about alcohol use, smoking, physical activity, and nutrition was compared across the three cohorts (n = 4,270 participants) using Chi-squared test. Alcohol and the mean nutritional intake score did not vary across cohorts, whereas the consumption of nonalcoholic drinks increased significantly from pre-war to war and to baby-boom cohort (p<.001). Other differences across cohorts were observed only in women: the proportion of women who never or rarely engaged in sports decreased from 52.9% in the pre-war cohort to around 43% in subsequent cohorts (p<.001), while the proportion of women who had never smoked was higher in the pre-war cohort (56.1%) than in the war and the baby-boom cohorts (49.8% and 46.8%, respectively, p<.001). Overall, these results show some positive changes in older persons' health behaviors over time. Nevertheless, considerable room remains for improving lifestyles through public health interventions.

婴儿潮一代可能比更早出生的同龄人更注重健康,但迄今为止,这方面的证据有限。为了调查这些变化,本研究比较了三个连续5年出生队列(战前:出生于1934-1938年;战争时期:生于1939-1943年,婴儿潮时期:生于1944-1948年)社区居住人口的代表。使用卡方检验比较了三个队列(n = 4270名参与者)的饮酒、吸烟、体育活动和营养信息。酒精和平均营养摄入得分在不同队列中没有变化,而非酒精饮料的消费量从战前到战争和婴儿潮队列显著增加(p
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引用次数: 2
Opioid Misuse among Smokers with Chronic Pain: Relations with Substance Use and Mental Health. 慢性疼痛吸烟者阿片类药物滥用:与物质使用和心理健康的关系
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2021-07-01 Epub Date: 2020-06-17 DOI: 10.1080/08964289.2020.1742642
Michael J Zvolensky, Andrew H Rogers, Lorra Garey, Justin M Shepherd, Joseph W Ditre

Opioid misuse is a significant public health concern with substantial medical, social, and economic costs. Cross cutting the personal and societal effects of this current crisis, opioid misuse is associated with poorer physical and mental health outcomes that impair function across numerous life domains. Importantly, opioid misuse disproportionately affects persons with chronic pain and individuals who smoke tobacco. Despite the higher risk for smokers with chronic pain to engage in opioid misuse, little work has examined how opioid misuse may be related to mental health problems, including other substance use, among this vulnerable group. The current study examined opioid misuse as a predictor of substance use and mental health problems among 187 (Mage = 39.02, SD = 9.94, 74.9% female) daily cigarette smokers with chronic pain who currently use opioids. Results indicated that opioid misuse is associated with greater tobacco (13% of variance), alcohol (27% of variance), and cannabis (22% of variance) problems, as well as anxiety (26% of variance) and depressive symptoms (26% of variance). These results highlight the potential importance of opioid misuse in terms of concurrent substance and mental health problems among smokers with chronic pain. Future work is needed to explicate directionality and temporal ordering in the observed relations.

阿片类药物滥用是一个重大的公共卫生问题,具有巨大的医疗、社会和经济成本。纵观当前这场危机对个人和社会的影响,阿片类药物滥用与身心健康状况恶化有关,损害了许多生活领域的功能。重要的是,阿片类药物滥用对慢性疼痛患者和吸烟个体的影响不成比例。尽管患有慢性疼痛的吸烟者滥用阿片类药物的风险较高,但很少有工作研究阿片类药物滥用如何与这一弱势群体的心理健康问题(包括其他物质使用)相关。本研究调查了187例(Mage = 39.02, SD = 9.94, 74.9%女性)每日吸烟且目前使用阿片类药物的慢性疼痛患者中阿片类药物滥用作为物质使用和精神健康问题的预测因子。结果表明,阿片类药物滥用与更严重的烟草(方差的13%)、酒精(方差的27%)和大麻(方差的22%)问题以及焦虑(方差的26%)和抑郁症状(方差的26%)有关。这些结果强调了阿片类药物滥用在慢性疼痛吸烟者中并发物质和精神健康问题方面的潜在重要性。需要进一步的工作来解释观察到的关系中的方向性和时序性。
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引用次数: 0
Blunted Pain Modulation Response to Induced Stress in Women with Fibromyalgia with and without Posttraumatic Stress Disorder Comorbidity: New Evidence of Hypo-Reactivity to Stress in Fibromyalgia? 伴有或不伴有创伤后应激障碍合并症的纤维肌痛患者对诱导应激的疼痛调节反应变钝:纤维肌痛患者对应激反应低的新证据?
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2021-07-01 Epub Date: 2020-05-01 DOI: 10.1080/08964289.2020.1758611
A López-López, B Matías-Pompa, J Fernández-Carnero, A Gil-Martínez, M Alonso-Fernández, J L Alonso Pérez, J L González Gutierrez

There is evidence regarding the presence of alterations in both the stress response and the endogenous pain modulation systems of people with fibromyalgia (FM). However, research on pain modulation under induced stress on FM patients is scarce and contradictory. The present study analyzes stress-induced changes in pain and intolerance thresholds among FM patients, examining the possible existence of differences linked to PTSD comorbidity and gaining insights into the role of cardiovascular reactivity. Eighteen women diagnosed with FM and comorbid PTSD (FM + PTSD), 18 women diagnosed with FM and no PTSD (FM-PTSD), and 38 healthy women (HC) were exposed to the Social Stress Test task. Pressure pain thresholds and intolerance thresholds were measured before and during stress induction, and after a recovery period, while systolic blood pressure and heart rate were simultaneously recorded. Overall, while pain thresholds decreased during stress and recovery for HC, no significant changes were observed for women with FM. The intolerance threshold decreased for HC during stress, but was maintained at basal level during recovery. FM-PTSD women exhibited a delayed response, with a drop at recovery. For FM + PTSD, tolerance levels remained unchanged. In addition, cardiovascular reactivity did not seem to explain these results. This performance of the pain modulation system seems to follow the same pattern of hypoactive responsiveness under stressors that has previously been observed in FM patients on the autonomic and neuroendocrine axes. Such a hypoactive pattern may involve a non-adaptive response that may contribute to the development and maintenance of chronic pain.

有证据表明,纤维肌痛(FM)患者的应激反应和内源性疼痛调节系统都存在改变。然而,关于FM患者在诱导应激下疼痛调节的研究很少,而且存在矛盾。本研究分析了应激引起的FM患者疼痛和不耐受阈值的变化,研究了与PTSD合并症相关的差异的可能存在,并深入了解心血管反应性的作用。在社会压力测试中,有18名FM合并PTSD的女性(FM + PTSD)、18名FM合并无PTSD的女性(FM-PTSD)和38名健康女性(HC)接受社会压力测试任务。测量应激诱导前、应激诱导中、应激恢复期后的压痛阈值和不耐受阈值,同时记录收缩压和心率。总体而言,虽然HC患者在应激和康复期间疼痛阈值降低,但FM患者的疼痛阈值没有明显变化。应激期间HC的不耐受阈值降低,但在恢复期间维持在基础水平。FM-PTSD女性表现出延迟反应,在恢复时有所下降。对于FM + PTSD,耐受水平保持不变。此外,心血管反应性似乎也不能解释这些结果。疼痛调节系统的这种表现似乎与之前在FM患者的自主神经和神经内分泌轴上观察到的应激源下的低活性反应模式相同。这种低活动模式可能涉及非适应性反应,这可能有助于慢性疼痛的发展和维持。
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引用次数: 5
Effects of Multiple Detoxifications on Withdrawal Symptoms, Psychiatric Distress and Alcohol-Craving in Patients with an Alcohol Use Disorder. 多重解毒对酒精使用障碍患者戒断症状、精神困扰和酒精渴望的影响
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2021-07-01 Epub Date: 2020-05-12 DOI: 10.1080/08964289.2020.1760777
Martha Ooms, Hendrik G Roozen, Juul H Willering, Wobbe P Zijlstra, Ranne de Waart, Anna E Goudriaan

Previous studies have shown an association between the number of withdrawal attempts and increased severity of withdrawal symptoms in patients with an alcohol use disorder (AUD). An underlying allostatic neuroadaptive response may negatively affect the withdrawal pathology after alcohol discontinuation. The objective of the present research is to examine the intensification of psychiatric distress, craving, and post-detoxification drinking outcomes, which may result from these neurobehavioral alternations. Fifty-two AUD inpatients were divided into two groups: <2 previous detoxifications and ≥2 previous detoxifications. Patients completed the Dutch version of the Severity of Withdrawal Scale (SWS), Depression Anxiety Stress Scales (DASS-21), VAS Craving, and Desires for Alcohol Questionnaire (DAQ). Linear mixed effects models were applied, controlling for the number of drinks consumed in the past 30 days and alcohol drinking history (years). Patients who had undergone ≥2 detoxifications reported statistically significantly higher scores on SWS withdrawal and DASS psychiatric symptoms. Also, craving patterns were different between groups, as shown by a statistically significant interaction effect for VAS craving for the time of day factor (morning vs. evening). No statistically significant group differences were found for DAQ scores and post-detoxification drinking outcomes. Due to relatively low 1-month follow-up rates our power was limited to detect such a difference. The present study contributes to the existing body of evidence that multiple detoxifications are associated with aggravated withdrawal/psychiatric pathology, and distinct diurnal patterns of VAS craving. Several clinical implications are discussed and alternative strategies are provided to manage repeated cycles of detoxifications.

先前的研究表明,在酒精使用障碍(AUD)患者中,戒断尝试的次数与戒断症状的严重程度增加之间存在关联。潜在的适应神经适应反应可能会对戒酒后的戒断病理产生负面影响。本研究的目的是检查精神痛苦、渴望和解毒后饮酒结果的加剧,这可能是由这些神经行为改变引起的。52例AUD住院患者分为两组:
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引用次数: 3
期刊
Behavioral Medicine
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