Co-morbid Psychological Distress Research Articles

The association between conditioned pain modulation and psychological factors in people with chronic spinal pain: A systematic review.

Chronic spinal pain has negative effects on physical and mental well-being. Psychological factors can influence pain tolerance. However, whether these factors influence descending modulatory control mechanisms measured by conditioned pain modulation (CPM) in people with chronic spinal pain is unclear. This systematic review investigated the association between CPM response and psychological factors in people with chronic spinal pain. Published and unpublished literature databases were searched from inception to 23rd October 2023 included MEDLINE, EMBASE, CINAHL, and PubMed. Studies assessing the association between CPM response and psychological factors in people with chronic spinal pain were eligible. Data were pooled through meta-analysis. Methodological quality was assessed using the AXIS tool and the certainty of evidence measured through GRADE. From 2172 records, seven studies (n = 598) were eligible. Quality of included studies was moderate. There was very low certainty of evidence that depression (r = 0.01 [95% CI -0.10 to 0.12], I2 = 0%), and anxiety (r = -0.20 [95% CI -0.56 to 0.16], I2 = 84%), fear avoidance (r = -0.10 [95% CI -0.30 to 0.10], I2 = 70%) had no statistical associations with CPM responder status. Higher pain catastrophising was associated with CPM non-responder status (r = -0.19; 95% CI: -0.37 to -0.02; n = 545; I2: 76%) based on a very low certainty of evidence measured by GRADE. There is currently limited available evidence demonstrating an association between CPM response and psychological factors for people with chronic pain. Managing an individual's chronic pain symptoms irrespective of comorbid psychological distress, should continue until evidence offer insights that more targeted interventions are needed.

0665 Mindfulness as a Protective Factor for Chronic Insomnia in College Students

Abstract Introduction College students are at high risk for developing insomnia and co-morbid psychological distress. The aim of this research was to assess whether the lack of endogenous mindfulness was a risk factor for insomnia. Methods In order to address this issue, an archival analysis was conducted with a data set from MUN where the relationship between chronotype, mental health, sleep quality, and social support was assessed (n=3,160; 2,266 women; X̅age=22 years). The proband subsample of interest were subjects that completed the HADS, MEQ, the ISI, and the Mindful Attention Awareness Scale (MAAS). The MAAS is a 15 item self-report measure, where each item is scored on a six-point Likert scale. Scores range from 15-90, higher scores are indicative of greater mindfulness. In order to evaluate the relevance of mindfulness, the overall sample was split into two groups (endogenous mindfulness [average score of ≥4.2]): n=647; X̅age=22.4 years; nonendogenous mindfulness [average score of ≥4.2]: n=1,505; X̅age=22.04 years). Results Subjects (n=2,152) were between the ages of 18-35 (X̅=22+/- 3.72) and included primarily Caucasian individuals (86.6 %) and individuals who identified as female (71.7%). The means and ranges for the ISI, MAAS, and HADS were as follows: 9.0 + 5.6 (0-28), 3.7+.98 (1-6), and 5.3 + 3.9 (0-21), respectively. A correlation of -0.27 (p<0.001) was found for endogenous mindfulness (scale score range 1-6) and insomnia (scale score range 0-28) and -0.25 (p<0.001) for non-endogenous mindfulness (scale score range 1-6) and insomnia. Moderator analyses were conducted, and it was found that depression moderates the relationship between mindfulness and insomnia, (HADS depression, ΔR2 = .2, ΔF(3, 643)=57.6, p=.012, b=-.3, t(643)=-2.5 p< .05. Results should be interpreted with caution as the effect size was less than 0.1. Conclusion There was a relationship found, in both groups, between mindfulness and the ISI, where the scores on the ISI were lower when mindfulness was high. This suggests that there is a moderate linear relationship between mindfulness and insomnia. This association needs to be further evaluated in samples that have a broader range of ISI scores and with analyses that more carefully parse the moderating influence of depression. Analyses are ongoing. Support (If Any) Support: K24AG055602

Substances and your senses: The sensory patterns of young people within an alcohol and drug treatment service

Background: Substance use disorders (SUD) and trauma histories in adults have been linked with sensory processing patterns that are significantly different from the general population. Nevertheless, no studies have investigated sensory patterns, or the variables with which they are related, in youth with SUD. This study aimed to compare sensory patterns of this sample with normative data and consider associations between sensory patterns and: substance use, trauma, quality-of-life, mental and physical health. Methods: A cross-sectional quantitative research design was employed with a sample of 87 young people (mean age = 20.8 years) with SUD voluntarily attending a specialist youth outpatient alcohol and other drug (AOD) service. For participants, the Adolescent Adult Sensory Profile was added to measures routinely collected at the service. Results: Participants’ sensory processing patterns for low registration, sensory sensitivity, and sensation avoiding were significantly higher than the normative population, while sensation seeking was both lower and higher. Ninety-one percent reported atypical scores on one or more sensory patterns. High rates of probable Post-Traumatic-Stress-Disorder (PTSD), psychological distress, and low quality-of-life were also reported, which were meaningfully related with sensory patterns. Conclusion: Young people reported complex combinations of sensory processing patterns, with comorbid probable PTSD, psychological distress, and low quality-of-life. Findings reflect studies with adult AOD, trauma, and other clinical conditions, and highlight the potential value of screening for sensory patterns and applying transdiagnostic approaches which simultaneously address substance use, mental health, trauma and sensory needs to optimize outcomes for young people with SUD.

Psychological and Demographic Determinants of Substance Use and Mental Health During the COVID-19 Pandemic.

Background: Alcohol consumption and distress have increased among Canadians since the start of the COVID-19 pandemic.Methods: We examined whether sociodemographic and COVID-19-related worries are associated with various combinations of alcohol consumption and comorbid psychological distress variables among a Canadian sample of adults. Data were derived from a sample of Canadian adults (N = 1,005, 49.6% female) who participated in an online survey in May 2020. Four multivariate ordinal logistic regression models were used to estimate the odds of binge drinking, increased alcohol consumption during the pandemic, and psychological distress. Predictor variables used in the analyses included self-reported sociodemographic characteristics, financial worries, COVID-19 impact on work, and worrying about getting ill.Results: Women were found to have higher odds of increased drinking and anxiety. Also being divorced, separated, or widowed was associated with higher odds of binge drinking and anxiety, and binge drinking and depression. Furthermore, being 60 or older was associated with lower odds of binge drinking and depression and increased drinking and depression, as well as lower odds of increased drinking and depression and increased drinking and anxiety. High income groups were associated with higher odds of binge drinking, increased drinking, and mental distress. Compared to those less worried, being very worried about finances were associated with higher odds of binge drinking and anxiety, increased drinking and anxiety, and increased drinking and depression. Also, being very worried about getting ill with COVID was associated with higher odds of binge drinking and anxiety and increased drinking and anxiety.Conclusion: Our findings identify several demographic and COVID-related worries for increased odds of alcohol intake and co-morbid psychological distress during the COVID-19 pandemic, including identifying as a woman, high income groups, being divorced, separated or widowed, and experiencing financial worries and COVID illness worries. These characteristics should be considered when developing prevention and treatment programs for adults with problematic alcohol use and comorbid anxiety and depression.

Magnitude, Symptom Presentation and Correlates of Psychological Distress Among People with Epilepsy in Southern Ethiopia: A Cross-Sectional Study.

BackgroundPsychological distress is a common co-morbid condition among people with epilepsy. Untreated comorbid psychosocial problems are associated with increased morbidity and health-care costs, and negatively affects treatment outcome of people with epilepsy. Therefore, the aim of this study was to describe the prevalence of psychological distress and to identify its associated factors among people with epilepsy attending outpatient treatment in Gedeo zone public hospitals, Southern Ethiopia.Patients and MethodsThis was an institution-based cross-sectional study conducted at Gedeo zone public hospitals from July 1st to October 1st, 2019. Self-reporting questionnaire was used to screen individuals with epilepsy for the presence of co-morbid psychological distress. A face to face interview was conducted among 321 anti-epileptic medication followers. The collected data were entered into Epi-Data version 3.1 and then exported to SPSS version 20 for further analysis. Binary logistic regression was computed to identify factors associated with psychological distress. Statistically, significant association was set at p-values of <0.05 in the final model with a corresponding 95% confidence interval.ResultsThe prevalence of psychological distress was found to be 38.3% with 95% CI (34.1, 42.7) among people with epilepsy attending outpatient follow-up in Gedeo zone public hospitals. Being female [OR=1.57 (95% CI: 1.01–4.80)], uncontrolled seizures [OR=1.96 (95% CI: 1.21–3.18)], and longer duration of illness [OR= 3.16 (95% CI: 1.75–5.73)] were variables found to have statistically significant association with psychological distress.ConclusionThe findings of this study revealed that more than one-third of people with epilepsy screened positive for psychological distress. Therefore, this demonstrates a need to design and implement programs focusing on the prevention, early screening, and providing appropriate interventions for psychological distress among people with epilepsy.

Protective and risk factors associated with comorbid mental health disorders and psychological distress among Latinx subgroups

ABSTRACT Psychological distress, often coupled with comorbid mental illnesses, affects Latinxs at higher rates and severity than other ethnic groups. This study examined differences in the association between comorbid mental illnesses and psychological distress between Latinx subgroups. Using a sample of 28,630 adults from the National Health Interview Survey, this study used hierarchical multiple regression models to test for differences in psychological distress among various Latinx subgroups and interactions effects between Latinx subgroups and psychological distress. The presence of multiple mental health disorders and comorbid mental health disorders were associated with greater rates of psychological distress. The relationship between mental health disorders and psychological distress varied by Latinx subgroup. An interaction test yielded a significant interaction between being Puerto Rican and having no mental health disorders. Puerto Ricans with no mental health disorders report higher rates of psychological distress when compared to other Latinx subgroups. The implications of the study findings for mental health services for Latinx groups and for future research are discussed.

Co-morbid psychological distress groups among incarcerated men

Purpose This study aims to examine the behavioral health disorders and trauma exposure are disproportionately represented among incarcerated men. Historically, prisons have been inadequately equipped to respond to the behavioral health needs of incarcerated people. Given the abundance of behavioral health need and the relatively limited availability of prison-based treatment resources, population health management strategies, particularly need stratification, are vital. Design/methodology/approach A sample of 943 male inmates from three Spanish prisons completed a structured questionnaire. Need groups are based on current depression, anxiety and stress symptoms assessed by the DASS-21 and were validated using adverse childhood experiences (ACE), prison-based abuse, prison-based substance use, social support and resilience. Findings Three need groups were identified, namely, minimal, mild/moderate and severe, each representing about one-third of the sample. The severe group had the highest level of all three types of psychological distress, ACE and prison-based adversity and substance use. No statistical differences in social support and resilience were found among the groups. These findings provide a platform for future research to explore how the complexity of behavioral health care need can be identified and stratified for strategic and rational treatment matching. Proving whether a population health management approach improves behavioral health and personal safety outcomes within funding-constrained carceral environments is the next research priority. Originality/value This study is the first to group co-morbid psychological distress into need categories using a social determinants of health framework for validation.

Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review.

Comorbid psychological distress (i.e. insomnia and depression) is experienced by 20-40% of patients with cardiovascular disease. This has a considerable impact on their health and quality of life, leading to frequent re-hospitalisations, higher healthcare costs and a shorter life expectancy. Internet-based cognitive behavioural therapy shows great potential for treating psychological distress in cardiovascular disease. Effective and feasible treatments can, however, only benefit patients if they are fully implemented in clinical care. This scoping review aimed to explore the literature for internet-based cognitive behavioural therapy in cardiovascular disease and for strategies to implement the intervention. We searched electronic databases, journals and internet sources to find original studies about internet-based cognitive behavioural therapy in cardiovascular disease, adhering to scoping methodology guidelines. After identifying 267 titles, we screened 40 abstracts and chose 11 full-text articles for full-text screening. The results sections in four articles were searched for outcomes that related to the effectiveness and implementation of internet-based cognitive behavioural therapy by directed qualitative content analysis using an implementation framework. Three of the four articles fulfilling the inclusion criteria concerned internet-based cognitive behavioural therapy for treating mild to moderate depressive symptoms in cardiovascular disease, and none focused on insomnia. The studies showed evidence for the effectiveness of internet-based cognitive behavioural therapy, and/or described patient factors influencing clinical effectiveness. Our qualitative content analysis showed that many implementation aspects and stakeholder perspectives remain unexplored. Internet-based cognitive behavioural therapy promises to alleviate patient suffering in cardiovascular disease. There is, however, little research about internet-based cognitive behavioural therapy for cardiovascular disease, and about how this evidence-based intervention is implemented.

Sexual functioning among young adult cancer patients: A 2-year longitudinal study.

Cancer-related sexual dysfunction has been reported among adolescents and young adults (AYAs); however, its prevalence over time has not been examined. This longitudinal study investigated sexual dysfunction in AYAs over the course of 2 years after the initial diagnosis. Young adult patients (18-39 years old) completed the Medical Outcomes Study Sexual Functioning Scale within the first 4 months of their diagnosis (n = 123) and again 6 (n = 107) and 24 months later (n = 95). An ordered multinomial response model analyzed changes in the probability of reporting sexual dysfunction over time and the independent effects of demographic, clinical, and psychosocial variables. More than half of the participants reported sexual functioning to be problematic at each assessment. The probability of reporting sexual dysfunction increased over time (P < .01) and was greater for cancer patients who were female (P < .001), older (P < .01), married or in a committed relationship (P < .001), treated with chemotherapy (P < .05), and reporting comorbid psychological distress (P < .001) and lower social support (P < .05). For women, being in a relationship increased the likelihood of reporting sexual problems over time; for men, the likelihood of reporting sexual problems increased regardless of their relationship status. A substantial proportion of young adults report ongoing problems with sexual functioning in the first 2 years after their cancer diagnosis. These findings justify the need to evaluate and monitor sexual functioning throughout a continuum of care. Cancer 2018;124:398-405. © 2017 American Cancer Society.

Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness

ABSTRACTNarcissistic Personality Disorder (NPD) is characterized by a persistent pattern of grandiosity, fantasies of unlimited power or importance, and the need for admiration or special treatment. Individuals with NPD may experience significant psychological distress related to interpersonal conflict and functional impairment. Research suggests core features of the disorder are associated with poor prognosis in therapy, including slow progress to behavioral change, premature patient-initiated termination, and negative therapeutic alliance. The current manuscript will explore challenges of working with NPD within the context of life-limiting illness for two psychotherapy patients seen in a behavioral health clinic at a large academic health science center. The ways in which their personality disorder affected their illness-experience shared significant overlap characterized by resistance to psychotherapeutic change, inconsistent adherence to medical recommendations, and volatile relationships with providers. In this manuscript we will (1) explore the ways in which aspects of narcissistic personality disorder impacted the patients' physical health, emotional well-being, and healthcare utilization; (2) describe psychotherapeutic methods that may be useful for optimizing psychosocial, behavioral, and physical well-being in individuals with co-morbid NPD and life-limiting disease; and (3) review conceptualizations of NPD from the DSM-5 alternative model for assessing personality function via trait domains.

532 - One-Day Behavioral Intervention for Patients with Inflammatory Bowel Disease and Co-Morbid Psychological Distress and a Pilot Study

532 - One-Day Behavioral Intervention for Patients with Inflammatory Bowel Disease and Co-Morbid Psychological Distress and a Pilot Study

Prevalence and correlates of psychological distress symptoms among patients with substance use disorders in drug rehabilitation centers in urban Nepal: a cross-sectional study.

BackgroundThe burden of substance misuse in developing countries is large and increasing, with negative consequences for physical and psychological health. Substance use disorders and psychological distress commonly co-exist, however few studies have examined this relationship in developing countries, including Nepal. Our aim was to investigate the prevalence of psychological distress symptoms and associated factors among patients with substance use disorders attending drug rehabilitation centers in Nepal.MethodsWe conducted a cross-sectional study including 180 patients attending drug rehabilitation centers in the Kathmandu Valley region of Nepal. We used the 6-item Kessler scale (K6) to measure symptoms of psychological distress, and data on socio-demographics, behavioral and psychosocial factors. Multivariable analyses were used to identify factors associated with distress.ResultsThe prevalence of high psychological distress symptoms among patients with substance use disorder was 51.1 %. The mean score found on the K6 was 12.22 (SD = 5.87). Outcomes of multivariable analyses demonstrated various factors associated with symptoms of psychological distress, including age (β = −0.122, 95 % CI = −0.218; −0.026), education (β =2.694, 95 % CI = 0.274; 5.115), severity of drug abuse (Drug Abuse Screening Test-10-DAST10)(β = 0.262, 95 % CI = 0.022;0.502), and family functioning (Adaptability, Partnership, Growth, Affection and Resolve-APGAR) (β = −0.525, 95 % CI = −0.787; −0.264).ConclusionsHigh psychological distress symptoms are common in patients with substance use disorder in Nepal. Demographics (age, education), behavioral (drug abuse severity), and psychosocial factors (family functionality) were associated with psychological distress symptoms. If confirmed by future longitudinal studies such characteristics may assist in identifying groups at risk for co-morbid psychological distress symptoms among patients with substance use disorders. Future treatment approaches for substance use disorders should address co-existing mental illness in Nepal.

Prediction of symptomatic improvement after exposure-based treatment for irritable bowel syndrome

BackgroundSeveral studies show that psychological treatments relieve symptoms for patients suffering from irritable bowel syndrome (IBS). However, there are no consistent findings that show what patient characteristics make a psychological treatment more or less likely to result in improvement. We have previously conducted a study of a newly developed internet-delivered cognitive behavioral therapy (ICBT) that emphasized exposure to IBS symptoms and IBS-related situations and reduced symptom-related avoidance. The study showed that the treatment led to improvement in IBS symptoms compared to a waiting list and that treatment gains were maintained over a 15–18 month follow-up period. The aim of the present study was to investigate several possible predictors of short- and long-term treatment outcome in terms of symptom improvement, based on data collected in the previously conducted treatment trial.MethodsDemographics, comorbid psychological distress, IBS-related fear and avoidance behaviors, and IBS-related disability were investigated as predictors of treatment outcome in the sample consisting of 79 participants diagnosed with IBS who had undergone 10 weeks of ICBT. Predictors that were significantly correlated with symptom levels at post-treatment and follow-up were entered into multiple regression analyses that controlled for pre-treatment symptom levels.ResultsThere were measures within each domain, i.e., comorbid psychological distress, IBS-related fear and avoidance behaviors, and IBS-related disability, with the exception of demographic data, that were correlated with the symptom levels at post-treatment and follow-up. However, when these were entered into a multiple regression analyses that controlled for pre-treatment levels, none remained a significant predictor of the post-treatment and follow-up symptomatic status.ConclusionsThe study did not find any individual characteristics that made patients more or less likely to respond to the exposure-based ICBT. The finding that comorbid psychological distress did not predict outcome is in accordance with previous studies. Reliable predictors for response to any type of psychological treatment for IBS remain to be established.

Poor Sleep Quality in Australian Adults With Comorbid Psychological Distress and Physical Illness

A population-based questionnaire study of 1,818 Australian adults investigated associations of sleep quality with psychological distress and comorbid physical health disorders. The Kessler Psychological Distress Scale and the Behavioral Risk Factor Surveillance System assessed psychological distress and physical health. The Pittsburgh Sleep Quality Index assessed sleep quality. Participants with physical illness or psychological distress had increased odds for reporting poor sleep quality, compared to those with no illness (odds ratios [ORs] = 2.22, for both; 95% confidence intervals [CIs] = 1.53–3.23 and 3.54–10.36, respectively), but those with comorbid illness had markedly higher odds for poor sleep quality (OR = 11.99, 95% CI = 7.90–18.20). Adults with comorbid psychological distress and physical health disorders are at substantially increased risk of poor sleep quality.

Anxiety and the patient with breast cancer: a review of current research and practice

Breast cancer is one of the most common cancers worldwide. Statistics reveal that the number of women diagnosed with breast cancer is increasing in South Africa. In particular, there appears to be a growing incidence in younger, black women in urban areas. Family practitioners and oncology healthcare professionals are going to be treating an increasing population of patients with breast cancer. Research has shown that in many instances, the psychological needs of patients with breast cancer are not adequately addressed, and that often the physical crisis is seen as more immediate. Also, healthcare professionals and oncologists may not be aware of the prevalence of co-morbid psychological distress, and thus do not focus on this aspect of the diagnosis. As a result, women who experience psychological distress during and after treatment may not be referred for psychological management. This may have a significant impact on their quality of life during this period and may even affect their compliance with treatment. This ultimately has implications for their ongoing health and survival. This review of the available literature aims to heighten awareness of healthcare professionals to the current situation, with a view of improving the mental health care of South African patients with breast cancer.

Psychological and Physical Co-Morbidity among Urban South African Women

ObjectivesThere is substantial evidence for the links between poverty and both physical and mental health; but limited research on the relationship of physical and mental health problems exists in low- and middle-income countries. The objective of this paper is to evaluate the prevalence and co-morbidity of psychological distress among women with common physical diseases in a socio-economically disadvantaged urban area of South Africa.MethodsWomen enrolled in the Birth to twenty (Bt20) cohort study were evaluated for this paper. Bt20 was founded in 1990 and has followed more than 3,000 children and their caregivers since birth; this study evaluates the health of the caregivers (average age 44) of these children. Psychological distress was evaluated by administering the General Health Questionnaire (GHQ-28) and we evaluated the presence of physical disease by self-report.ResultsForty percent of the sample presented with psychological distress using the GHQ scoring method. More than half of the women who reported a history of a physical disease, including diabetes, heart attack, asthma, arthritis, osteoporosis, epilepsy, and tuberculosis, reported psychological disorder. Presence of one physical disease was not associated with increased rates of psychological distress. However, women who reported two diseases had increased rates of psychological symptoms, and this upward trend continued with each additional physical disease reported (measured to five).ConclusionsThese data indicate high prevalence rates of co-morbid psychological distress among women with physical disease. This argues for the need of greater mental health support for women living with physical diseases.

Sa1421 The Effect of Comorbid Psychological Distress on Baseline Irritable Bowel Syndrome With Constipation Symptoms and Response to Linaclotide Treatment

Introduction: There is evidence to suggest that comorbid psychological distress can influence symptoms and the response to therapy in IBS patients. Linaclotide is a guanylate cyclaseC agonist that has been shown to improve the symptoms of IBS with constipation (IBS-C). Aim: To assess the influence of comorbid anxiety and depression on baseline IBS-C symptom severity and response to therapy with linaclotide using the Hospital Anxiety and Depression Scale (HADS). Methods: HADS consists of 14 statements that patients rate based on their experience over the previous week: 7 related to anxiety (HADS-A) and 7 related to depression (HADS-D). Based on possible scores of 0-21, patients from 2 Phase 3 IBS-C trials of linaclotide (pooled data) were categorized as normal (0-7), borderline (8-10), or abnormal (11-21) for HADS-A and HADS-D. Analyses by HADS category included percent of patients in each category (baseline and post-treatment), demographics, baseline symptom scores, efficacy, and treatment-emergent adverse events (TEAEs). P-values comparing linaclotide vs placebo were determined using an analysis of covariance (ANCOVA) model. A logistic analysis using stepwise variable selection was performed to identify demographic and baseline characteristics that are associated with an abnormal HADS score. Results: At baseline, 25% and 22% of patients were categorized as Borderline and Abnormal for anxiety and 10% and 6% were similarly categorized for depression; proportions of patients with comorbid anxiety and depression were similar between treatment groups. Of the demographic and baseline characteristics evaluated, only IBS severity, McGill subscale of affective descriptors, and age >65 (HADS-A only) were associated with abnormal HADS-D and HADS-A (Table 1). Patients with abnormal HADS tended to have higher baseline abdominal symptom scores vs patients categorized as normal, particularly for HADS-D. Mean changes from baseline to week 12 in all abdominal and bowel symptoms were statistically significant for linaclotide vs placebo in all HADS categories, except abdominal symptoms in patients categorized as abnormal for HADS-D (which had similar treatment differences but notably smaller subgroup sample size; Table 2). Diarrhea was the most common TEAE among linaclotide patients in all HADS categories, ranging from 16-26%. Conclusions: Almost half of the study population had some degree of anxiety but only 16% had evidence of depression. Baseline anxiety had little effect on the end of treatment score or magnitude of response for abdominal symptoms. Though patients with baseline depression tended to have higher abdominal symptom scores at baseline and at the end of treatment with linaclotide, the magnitude of response was not influenced by comorbid depression. Baseline anxiety or depression did not influence the response to linaclotide for bowel symptoms. Table 1. Demographics and Baseline Characteristics Associated with Abnormal HADS (IBS-C Patients)

Patient or Physician - Who Is Able to Evaluate Gastroesophageal Reflux Disease Symptoms Better?

Patient or Physician - Who Is Able to Evaluate Gastroesophageal Reflux Disease Symptoms Better?

Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians

BackgroundThe health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005.MethodsWe used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively.ResultsFor both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without.ConclusionsCo-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

Prevalence and Impact of Co-Morbid Psychological Distress on Response to PPI Therapy in Patients with GERD

Prevalence and Impact of Co-Morbid Psychological Distress on Response to PPI Therapy in Patients with GERD