General Well-Being Questionnaire Research Articles

Gastrointestinal Symptoms Increase the Burden of Illness in Dermatitis Herpetiformis: A Prospective Study.

Dermatitis herpetiformis (DH) is an extraintestinal manifestation of coeliac disease. The burden of illness in untreated coeliac disease is known to be considerable, but corresponding evidence for DH is lacking. In this study the burden of DH was evaluated prospectively in 52 patients newly diagnosed with DH using a study questionnaire and a validated Psychological General Well-Being (PGWB) questionnaire. The PGWB scores were compared with those of 110 healthy controls. Quality of life was significantly (p < 0.001) lower among patients with DH at the time of diagnosis, but after 1 year on a gluten-free diet their quality of life was at same level as that of the controls. The presence of gastrointestinal symptoms was shown to significantly increase the burden of untreated DH. We conclude that there is a significant burden related to untreated, but not to treated, DH, and the burden is even greater among DH patients with gastrointestinal symptoms.

Psychosocial outcome in adult men born with hypospadias

Hypospadias, which is a surgically treated congenital malformation of the male urethra, may have a negative impact on quality of life. This aspect has previously been subject to limited research. This study examined the long-term psychosocial outcome of a large cohort of adult males born with hypospadias. The purpose of this case-control study was to assess a possible negative influence on the psychosocial outcome in adult males with hypospadias. Males with hypospadias treated in Sweden and aged ≥18 years old participated in this follow-up study. Age-matched men and university students were recruited as controls. The participants answered a questionnaire designed to reflect the subjective quality of life, social factors, need of support and follow-up, and the perceived impact of the disease upon upbringing. It also looked at the validated Psychological General Well-Being (PGWB) questionnaire and Relationship Questionnaire (RQ). A total of 167 patients (median age 34 years, 63% distal, 24% mid, and 13% proximal hypospadias) and 169 controls (median age 33 years) participated in the study. Patients had their first operation at 4 years of age (median) and the median follow-up time was 29 years following the first surgery. Men with hypospadias had a comparable total quality of life level with a mean total PGWB score of 82 (normal range 78-83) compared with 85.6 in controls. Scores on wellbeing and vitality were lower, even if the differences were small. Hypospadias did not affect marital status, presence of children in the family, frequency of employment or experience of bullying. These men more often lived at home with their parents (P=0.001) and had a lower level of education (P=0.004), even if the educational level in both patients and controls was high compared with the general Swedish population. Patients with proximal hypospadias were shorter compared with controls (P=0.003), which was consistent with the prenatal growth restriction associated with hypospadias. The group with proximal hypospadias expressed a greater need for medical (45.5%) follow-up compared with mid (28.2%) and distal (18.1%) cases (P=0.001). Patients with proximal hypospadias tended to avoid close relationships because of fear of being hurt. The findings suggested that patients treated for hypospadias have a good HRQoL, can be expected to have a normal psychosocial life, and marry and have children. Repeated follow-up and psychological support during childhood/adolescence is however of great importance for patients with more proximal hypospadias.

PP.01.30] PSYCHOLOGICAL STATUS SCORES RELATED WITH LEFT VENTRICULAR MASS INDEX AND MEAN AMBULATORY BLOOD PRESSURE VARIABLES IN PATIENTS WITH ARTERIAL HYPERTENSION

Objective: Objective: The aim of our study was to determine correlations between psychological status and quality of life scores with left ventricular mass index and mean ambulatory blood pressure variables in patients with arterial hypertension (AH). Design and method: We analyzed 76 ambulatory blood pressure monitoring (ABPM) data of AH patients. ABPM monitor (Spacelabs 90207) was applied after the washout period. After ABPM session patients completed the QL questionnaire “General Well-Being Questionnaire” (J.Siegrist et al.). Left ventricular mass index (LVMI) (L. Teichholtz et all., 1976) was measured using echocardiography (Acuson 128XP). We assessed the following QL scale scores: I - physical well-being, II - physical performance, III - positive psychological well-being, IV - negative psychological well-being, V - psychological performance, VI - social well-being, VII - social performance. Also, patients completed the psychological questionnaire “Minnesota Multiphasis Personality Inventory” (MMPI). We analyzed the following MMPI scales: L – lie scale, F – aggravation scale, K – correction scale, 1 (Hs) – hypochondria, 2 (D) – depression, 3 (Hy) – hysteria, 4 (Pd) – psychopathy, 6 (Pa) – rigidity of affect, 7 (Pt) – psychasthenia, 8 (Sc) – schrizothemia, 9 (Ma) – hypomania. We used Spearman Partial Coefficient for correlation analysis adjusted for age, sex and duration of AH. Results: The mean ambulatory systolic BP (SBP) was 136.1 ± 11.2; diastolic (DBP) - 89.1 ± 9.0 mmHg (M ± SD). LVMI – 122,1 ± 24,9 g/m2. We found the following correlations: 1) 9 MMPI scale scores (energy, optimism, good mood) were negatively correlated with LVMI (r = -0.33, p < 0.05); 2) 9 MMPI scale scores had the negative relationships with clinical and ambulatory SBP levels (r = -0.23, r = -0.24 respectively, p < 0.05) and with SBP load variables (r = -0.25, p < 0.05). There were no significant links between QL scales scores and LVMI, ambulatory BP indices. Thus, energy, optimism, good mood (9 MMPI scale scores) had a negative correlation with LVMI, also to SBP indices. Conclusions: It was identified inverse correlation between energy, optimism, good mood and LVMI indices, and also with clinical and ambulatory SBP variables of AH patients. There were no links between QL scores and LVMI, ambulatory BP indices.

Psychometric Evaluation of the Adolescent Lifestyle Profile-Revised 2 for Middle Adolescents.

The purposes of this methodological study were to factor analyze the Adolescent Lifestyle Profile-Revised 2 (ALP-R2) and to assess construct validity of the instrument with a sample of middle adolescents. A sample of 311 urban middle adolescents responded to the ALP-R2, to the Adolescent General Well-Being Questionnaire, and to the Anticipation of a Personal Future subscale on the Hopefulness Scale for Adolescents. Data obtained on the ALP-R2 were subjected to principal components factor analysis with varimax rotation. A 5-factor solution was accepted. Construct validity was provided by statistically significant positive correlations between the ALP-R2 and two theoretically relevant variables. Based on the results of this study, the ALP-R2 is a reliable and valid instrument for assessing health-promoting lifestyle in adolescents.

Moderate-severely bothersome vasomotor symptoms are associated with lowered psychological general wellbeing in women at midlife

ObjectivesThe extent to which menopause influences wellbeing is unclear. We investigated the association between moderate-severely bothersome vasomotor symptoms (VMS) and psychological general wellbeing in women, aged 40–65 years, taking into account socio-demographic and lifestyle factors. Study design/Main outcome measuresThis was a cross-sectional survey of 2020 Australian women, aged 40–65 years, recruited from the community between July 2013 and March 2014. Wellbeing was assessed by the Psychological and General Wellbeing questionnaire (PGWB) and VMS by the Menopause-specific Quality of Life Questionnaire. ResultsModerate-severely bothersome VMS had a strong significant negative association with psychological general wellbeing [regression coefficient (β)=−8.17, 95% confidence interval (CI) −10.90 to −5.45]. Socio-demographic factors associated with lower wellbeing included being un-partnered (β=−2.80, 95% CI −4.74 to −0.86), obese (β=−5.46, 95% CI −7.24 to −3.68) and a smoker (β=−3.47, 95% CI −6.10 to −0.84). Older age (β=0.29, 95% CI 0.06–0.42) and participation in paid and/or volunteer work (β=2.72, 95% CI 0.61–4.82) were positively associated with wellbeing. For those with insecure housing, being a carer was associated with better wellbeing. ConclusionsModerate-severely bothersome VMS are significantly and independently negatively associated with psychological general wellbeing in women at midlife. This is an important consideration when assessing psychological wellbeing in women during this life phase.

Quality of life measures in Italian neurosurgical patients: validity of the EUROHIS-QOL 8-item index.

To assess the validity, reliability and factor structure of the Italian version of the EUROHIS-QOL (European Health Interview Survey-Quality of Life) 8-item index in patients who are potential candidates for neurosurgical procedures. Cross-sectional study. Patients completed the EUROHIS-QOL 8-item index, a disability and general well-being questionnaire; the Karnofsky performance status scale (KPS) was used as a general measure of functional status. Factor analysis was used to confirm the one-factor structure of the EUROHIS-QOL 8-item index. Reliability was measured using Cronbach's alpha coefficient, item-total correlation and inter-item correlation. Construct validity was assessed with Pearson's coefficient (expected to be below 0.70) and known-group analysis, dividing patients between those KPS >90 and KPS ≤90 (the latter expected to report lower QoL). The one-factor structure was partly confirmed, with two items having low loadings. Cronbach's alpha was 0.78; item-total correlations were below 0.70; and average inter-item correlation was 0.309. Correlations were all significant and moderate; known-group analysis shows that QoL scores were lower in patients with active symptoms (KPS ≤90). Our findings partly confirm the factor structure and reliability of the EUROHIS-QOL 8-item index, which suggests that it may be a useful and straightforward quality of life measurement technique in neurosurgical departments.

Quality of life and well-being of people receiving haemodialysis treatment in Scotland: A cross-sectional survey

End-stage renal disease is a complex, progressive and debilitating illness that affects patients' quality of life, physical and mental health, well-being, social functioning and emotional health. A cross-sectional survey was carried out in renal dialysis centres in Scotland to assess patients' health status and the impact of haemodialysis treatment on quality of life and well-being. Participants scored considerably lower than the UK general population in all domains of health-related quality of life, although mental health components were nearer to general population norms than physical health components. However, nearly half of the participants achieved a score on a general well-being questionnaire that was indicative of stress and anxiety. Increasing age was associated with better overall mental health but worse physical functioning. Increasing levels of hope and support were associated with improved general well-being.

Correlation between breastfeeding and maternal health status

ABSTRACTObjective:To examine the relation between breastfeeding efficacy and health status in a sample of 88 mothers from Southern Brazil.Methods:Research participants completed the Portuguese version of the General Health Questionnaire and the Personal Health Scale. Breastfeeding efficacy was evaluated using the Breastfeeding Self-Efficacy Scale. Correlations between breastfeeding and health status scores were examined using Pearson's correlation coefficient.Results:The results of this study revealed significant correlations between the scores of the two general health and well-being questionnaires and the Breastfeeding Self-Efficacy Scale. Bivariate regression analyses revealed that both health status instruments significantly predicted Breastfeeding Self-Efficacy Scale scores.Conclusion:Breastfeeding efficacy is significantly related to maternal health status in Southern Brazil.

Predictors of persistent symptoms and reduced quality of life in treated coeliac disease patients: a large cross-sectional study.

BackgroundEvidence suggests that many coeliac disease patients suffer from persistent clinical symptoms and reduced health-related quality of life despite a strict gluten-free diet. We aimed to find predictors for these continuous health concerns in long-term treated adult coeliac patients.MethodsIn a nationwide study, 596 patients filled validated Gastrointestinal Symptom Rating Scale and Psychological General Well-Being questionnaires and were interviewed regarding demographic data, clinical presentation and treatment of coeliac disease, time and place of diagnosis and presence of coeliac disease-associated or other co-morbidities. Dietary adherence was assessed by a combination of self-reported adherence and serological tests. Odds ratios and 95% confidence intervals were calculated by binary logistic regression.ResultsDiagnosis at working age, long duration and severity of symptoms before diagnosis and presence of thyroidal disease, non-coeliac food intolerance or gastrointestinal co-morbidity increased the risk of persistent symptoms. Patients with extraintestinal presentation at diagnosis had fewer current symptoms than subjects with gastrointestinal manifestations. Impaired quality of life was seen in patients with long duration of symptoms before diagnosis and in those with psychiatric, neurologic or gastrointestinal co-morbidities. Patients with persistent symptoms were more likely to have reduced quality of life.ConclusionsThere were a variety of factors predisposing to increased symptoms and impaired quality of life in coeliac disease. Based on our results, early diagnosis of the condition and consideration of co-morbidities may help in resolving long-lasting health problems in coeliac disease.

Transcutaneous vagus nerve stimulation in tinnitus: a pilot study

Conclusions: This pilot study shows that transcutaneous vagus nerve stimulation (tVNS), if combined with sound therapy (ST), reduces the severity of tinnitus and tinnitus-associated distress. Our magnetoencephalography (MEG) results show that auditory cortical activation can be modulated by the application of tVNS. Thus, tVNS might offer a new avenue to treat tinnitus and tinnitus-associated distress. Objectives: Recent studies suggest that tinnitus can be improved by tailored ST or by VNS plus ST. Our aims were to study whether tVNS has therapeutic effects on patients with tinnitus and, additionally, if tVNS has effects on acoustically evoked neuronal activity of the auditory cortex. Methods: The clinical efficacy was studied by a short-term tVNS plus ST trial in 10 patients with tinnitus using disease-specific and general well-being questionnaires. tVNS was delivered to the left tragus. The acute effects of tVNS were evaluated in eight patients in the MEG study in which the N1m response was analyzed in terms of source level amplitude and latency in the presence or absence of tVNS. Results: The treatment with tVNS plus ST produced improved mood and decreased tinnitus handicap scores, indicating reduced tinnitus severity. The application of tVNS decreased the amplitude of auditory N1m responses in both hemispheres.

Discontinuing Long-Term GH Replacement Therapy—A Randomized, Placebo-Controlled Crossover Trial in Adult GH Deficiency

Adult GH deficiency (GHD) is associated with impaired quality of life (QoL) and increased cardiovascular risk. Continued long-term efficacy in terms of QoL and cardiovascular risk factors has been indicated in open surveillance studies. The aim was to study the impact of discontinuation of long-term GH replacement on QoL, body composition, and metabolism. We conducted a randomized, double-blind, placebo-controlled 4-month crossover trial in a referral center. Sixty adult hypopituitary patients with GHD and more than 3 yr of continuous GH replacement therapy (mean treatment duration, 10 yr) participated in the study. Patients received GH or placebo. We measured QoL using validated questionnaires; body composition using computer tomography, dual-energy x-ray absorptiometry, and bioelectrical impedance spectroscopy; and insulin sensitivity using the short insulin tolerance test. Mean serum IGF-I decreased from 168 ± 52 to 98 ± 47 μg/liter during the placebo period (P < 0.001). Two QoL domains (emotional reactions and positive well-being) in the Nottingham Health Profile and Psychological General Well-Being questionnaires deteriorated during placebo, compared with GH treatment (P < 0.05). Waist circumference and sc and visceral fat mass increased, and extracellular water and muscle area decreased during the placebo period (all P < 0.05). C-reactive protein and total-, low-density lipoprotein-, and high-density lipoprotein-cholesterol increased, and insulin sensitivity improved during placebo, compared to GH treatment (P < 0.05). After more than 3 yr of GH replacement therapy, a 4-month period of placebo treatment caused self-perceived deterioration in QoL and increased abdominal fat accumulation. Moreover, markers of systemic inflammation and lipid status deteriorated, whereas insulin sensitivity improved. Long-term continuous GH replacement is needed to maintain therapeutic effects of GH on QoL and cardiovascular risk factors.

Breast reconstruction following mastectomy for invasive breast cancer is strongly influenced by demographic factors in women in Victoria, Australia

This study explored factors associated with the likelihood of reconstruction after unilateral mastectomy and the wellbeing of women after reconstruction.Data were from a questionnaire completed on average 1.8 years after diagnosis by 1429 women in the BUPA Health and Wellbeing After Breast Cancer Study. Logistic regression was used to model factors associated with reconstruction. The Psychological General Wellbeing Questionnaire was used to assess wellbeing.A total of 25.4% of 366 women who had a unilateral mastectomy had undergone a reconstruction nearly two years after diagnosis. Being younger (p<0.001), educated beyond school (p<0.04), living in the metropolitan area (p<0.001), having private health insurance (p=0.003), not having dependent children (p=0.004) and not having radiotherapy (p<0.001) explained just over 40% of the variation in reconstruction status. There was a modest difference between women who did and did not have a reconstruction in terms of wellbeing. Demographic factors strongly influence the likelihood of reconstruction after mastectomy.

Gliadin antibodies in older population and neurological and psychiatric disorders

A variety of neurological and psychiatric disorders have recently been linked to coeliac disease and gluten sensitivity. We here explored whether persistently positive gliadin antibodies (AGA) and coeliac-type HLA increase the risk of gluten sensitivity-related neurological and psychiatric manifestations. The study was carried out in an older population who had consumed gluten for decades but who had no previous coeliac disease diagnosis. The original study population comprised 4272 randomly selected older individuals, of whom 2089 had AGA and transglutaminase 2 antibodies (antiTG2) measured twice within a 3-year interval. Forty-nine persistently AGA-positive but antiTG2-negative subjects with coeliac-type HLA and 52 randomly selected persistently AGA- and antiTG2-negative age- and sex-matched controls were clinically examined for neurological disorders. The Psychological General Well-Being (PGWB) questionnaire, the SF-36 health survey questionnaire and the Depression Scale (DEPS) were employed to evaluate psychological well-being. The medical files of all the study subjects were analysed for previous illnesses. Persistently AGA-positive but antiTG2-negative older subjects carrying coeliac disease-type HLA did not evince significantly more neurological symptoms or diseases than AGA-negative control subjects (P = 0.682, P = 0.233). There were no statistically significant differences between AGA-positive and AGA-negative groups in psychological well-being and quality of life when measured by PGWB (P = 0.426), SF-36 questionnaires (P = 0.120) and DEPS (P = 0.683). At population level, persistent AGA positivity did not indicate gluten sensitivity-related neurological and psychiatric disorders.

Clinical benefit of gluten-free diet in screen-detected older celiac disease patients

BackgroundThe utility of serologic screening for celiac disease is still debatable. Evidence suggests that the disorder remains undetected even in the older population. It remains obscure whether screening makes good or harm in subjects with long-standing gluten ingestion. We evaluated whether older subjects benefit from active detection and subsequent gluten free dietary treatment of celiac disease.MethodsThirty-five biopsy-proven patients aged over 50 years had been detected by serologic mass screening. We examined the disease history, dietary compliance, symptoms, quality of life and bone mineral density at baseline and 1-2 years after the commencement of a gluten-free diet. Symptoms were evaluated by gastrointestinal symptom rating scale and quality of life by psychological general well-being questionnaires. Small bowel biopsy, serology, laboratory parameters assessing malabsorption, and bone mineral density were investigated.ResultsDietary compliance was good. The patients had initially low mean serum ferritin values indicating subclinical iron deficiency, which was restored by a gluten-free diet. Vitamin B12, vitamin D and erythrocyte folic acid levels increased significantly on diet. Celiac patients had a history of low-energy fractures more often than the background population, and the diet had a beneficial effect on bone mineral density. Alleviation in gastrointestinal symptoms was observed, even though the patients reported no or only subtle symptoms at diagnosis. Quality of life remained unchanged. Of all the cases, two thirds would have been diagnosed even without screening if the family history, fractures or concomitant autoimmune diseases had been taken carefully into account.ConclusionsScreen-detected patients benefited from a gluten-free diet. We encourage a high index of suspicion and active case-finding in celiac disease as an alternative to mass screening in older patients.

Diet Improves Perception of Health and Well-being in Symptomatic, but Not Asymptomatic, Patients With Celiac Disease

The benefits of serologic screening and early diagnosis of celiac disease in asymptomatic patients are not known. We investigated the impact of a gluten-free diet on self-perceived health and well-being in symptomatic and asymptomatic patients with celiac disease. We performed a prospective study of 698 consecutive adults newly diagnosed with celiac disease because of classic (n = 490) or extraintestinal (n = 62) symptoms or through screening of at-risk groups (n = 146; 23 were asymptomatic and analyzed separately). The survey included questions on health and well-being; quality of life was evaluated by the psychological general well-being (PGWB) questionnaire. Patients were followed for 1 year of treatment; 110 healthy subjects served as controls. On a gluten-free diet, self-perceived health improved significantly among patients with classic symptoms and those detected by screening. Patients in all groups were equally concerned about their health before the diagnosis, but anxiety was alleviated by the gluten-free diet. At diagnosis, the quality of life reduced among all 3 groups but improved significantly among patients on the diet. Among the 23 asymptomatic patients, perception of health worsened and concern about health increased while they were on the diet. Self-perceived health and well-being were low among patients at the time they were diagnosed with celiac disease. Most patients benefited from a gluten-free diet, so it is important to identify patients with celiac disease. Perception of health decreased among asymptomatic cases, which discourages population-based screening.

PREVALENCE OF MASKED HYPERTENSION IN DIFFERENT GROUPS OF MEDICATED PATIENTS: PP.25.24

Objective: The problem of masked hypertension (MH) in medicated patients is very important due to their high cardiovascular risk. The aim of our study was to determine the prevalence of MH in various patients’ groups. Design and Method: Two groups of patients with the stable hypertension grade 1-2 were compared. Group I included 219 patients with the single measurement of clinical (CBP) and 24h ambulatory blood pressure (ABP) after 4-8 weeks of monotherapy by 9 antihypertensive drugs. Group II included 39 patients from cross-over randomized trial of amlodipine and spirapril. These participants underwent at least 7 visits to the clinic for CBP control. ABP monitoring was performed at the end of each treatment course (4 weeks). The additional diagnostic methods were: ECG (in group II), General Well-Being Questionnaire (GWBQ). MH was determined as CBP<140/90 mm Hg and daytime ABP>=135/85 mm Hg. To summarize the data the analysis of 2x2 contingency tables was done. The multivariate logistic procedure in stepwise mode and Spearman correlation analysis were used for assessment of MH predictors in groups I and II respectively. The analysis models were sex and age adjusted. Results: The prevalence of MH in group I was 11.5%, in group II - 37.5-41.9%. We found initial differences between groups: age (57.7 ± 0.6 and 53.7 ± 1.6 years, p < 0.05), body mass index (BMI; 29.0 ± 0.3 and 30.3 ± 0.8, p < 0.05), GWBQ scale III (7.7 ± 0.3 and 9.1 ± 0.5, p < 0.01) and VI (7.9 ± 0.3 and 9.0 ± 0.5, p < 0.05). MH in group I was associated with: GWBQ scales II, V, VI; intake of metoprolol and amlodipine (positive correlation [+]). MH in group II correlated with: increased orthostatic BP, ECG criteria of left ventricular hypertrophy, GWBQ scales I, IV, VI (+); age, BMI, previous antihypertensive medication, alcohol intake (negative correlation). Conclusions: The prevalence of MH in medicated hypertensive patients may depend on initial patients’ characteristics, prescribed drugs and the factor of repeated visits to the clinic (due to CBP regression to the mean).

Cuestionario de Bienestar Laboral General: Estructura y Propiedades Psicométricas

The general work well-being questionnaire (qBLG) was developed with the aim of providing a measurement tool particularly sensitive to the psychosocial dimension of work well-being of care workers, and to the bipolar nature of the well-being experience. 1252 professionals of health care (medical and nursing) and of higher education employed in hospitals and universities from Brazil, Chile, Colombia and Spain, respectively, answered a series of closed items from a questionnaire organized according with a theoretical model of general work well-being. Factor analysis found two independent factors in the qBLG, the first one including three scales of psychosocial well-being and the second three scales of collateral effects. All scales showed high internal consistency. The qBLG faithfully reproduces the structure of the proposed theoretical model, and combines the required psychometric properties for the evaluation of work well-being of health care and of higher education professionals.

Development of a Disease-Specific Quality of Life Questionnaire in Addison’s Disease

Patients with Addison's disease reproducibly self-report impairment in specific dimensions of general well-being questionnaires, suggesting particular deficiencies in health-related quality-of-life (HRQoL). We sought to develop an Addison's disease-specific questionnaire (AddiQoL) that could better quantify altered well-being and treatment effects. Design, Setting, Patients, Intervention, and Outcomes: We reviewed the literature to identify HRQoL issues in Addison's disease and interviewed patients and their partners in-depth to explore various symptom domains. A list of items was generated, and nine expert clinicians and five expert patients assessed the list for impact and clarity. A preliminary questionnaire was presented to 100 Addison's outpatients; the number of items was reduced after analysis of the distribution of the responses. The final questionnaire responses were assessed by Cronbach's alpha and Rasch analysis. Published studies of HRQoL in Addison's disease indicated reduced vitality and general health perception and limitations in physical and emotional functioning. In-depth interviews of 14 patients and seven partners emphasized the impact of the disease on the emotional domain. Seventy HRQoL items were generated; after the expert consultation process and pretesting in 100 patients, the number of items was reduced to 36. Eighty-six patients completed the final questionnaire; the responses showed high internal consistency with Cronbach's alpha 0.95 and Person Separation Index 0.94 (Rasch analysis). We envisage AddiQoL having utility in trials of hormone replacement and management of patients with Addison's disease, analogous to similar questionnaires in GH deficiency (AGHDA) and acromegaly (AcroQoL).

A Randomized Trial of Oral DHEA Treatment for Sexual Function, Well-Being, and Menopausal Symptoms in Postmenopausal Women with Low Libido

IntroductionDehydroepiandrosterone (DHEA) and its sulfate DHEAS, which are the most abundant steroids in women, decline with age. We have shown association between low sexual function and low circulating DHEAS levels in women. AimThe aim of this study was to evaluate whether restoration of circulating DHEA levels in postmenopausal women to the levels seen in young individuals improves sexual function. MethodsNinety-three postmenopausal women not using concurrent estrogen therapy were enrolled in a 52-week randomized, double-blind, placebo controlled trial and received either DHEA 50 mg or placebo (PL) daily. Main Outcome MeasuresEfficacy was assessed through 26 weeks. The main outcome measures were the change in total satisfying sexual events (SSE) and the change in the Sabbatsberg Sexual Self-Rating Scale (SSS) total score. Secondary measures were the Psychological General Well-Being Questionnaire (PGWB), and the Menopause—Specific Quality of Life Questionnaire (MENQOL). Hormonal levels, adverse events (AEs), serious adverse events (SAEs) and clinical labs were evaluated over 52 weeks. ResultsEighty-five participants (91%) were included in the 26-week efficacy analysis. There were no significant differences between the DHEA and PL groups in the change in total SSE per month or the SSS, PGWB, and MENQOL change scores. Overall AE reports and number of withdrawals as a result of AEs were similar in both groups; however more women in the DHEA group experienced androgenic effects of acne and increased hair growth. ConclusionsIn this study treatment of postmenopausal women with low sexual desire with 50 mg/day DHEA resulted in no significant improvements in sexual function over PL therapy over 26 weeks. Panjari M, Bell RJ, Jane F, Wolfe R, Adams J, Morrow C, and Davis SR. A randomized trial of oral DHEA treatment for sexual function, well-being and menopausal symptoms in postmenopausal women with low libido. J Sex Med 2009;6:2579–2590.

Incontinence quality of life questionnaire (I-QOL): translation and validation study of the Iranian version

Because of the importance and prevalence of incontinence among women, there is increasing interest in the development and use of well-constructed questionnaires studying quality of life. Also, there is a paucity of information on QOL in non-Western women suffering from urinary incontinence. The aim of this study was to translate the original English version of the I-QOL and to assess the reliability and validity of this questionnaire in Iranian patients with urinary incontinence. Four hundred women with urinary incontinence completed the Persian version of the questionnaire. By Cronbach's alpha coefficient, the intraclass correlation coefficient, and confirmatory factor analysis, the reliability and validity of the questionnaire were assessed. The median age of the respondents was 48 years (range 27-90). The overall I-QOL summary score showed internal consistency of 0.96 (Cronbach's alpha). The intraclass correlation coefficient was 0.96 for the total score. The range of correlation between the I-QOL total score and the subscales of the Sf-36 and the Psychological General Well-Being (PGWB) questionnaires were between 0.47 to 0.59 and 0.52 to 0.61 respectively. The Persian version of the I-QOL can be used for measuring QOL in urinary incontinent women in Iran.