Psychological Functioning Of Patients Research Articles

Shared Decision-Making in the Treatment of Multiple Sclerosis: Results of a Cross-Sectional, Real-World Survey in Europe and the United States.

Multiple sclerosis (MS) is a neurodegenerative disease characterized by progressive deterioration of cognitive and physical functioning, reducing activities of daily living and quality of life (QoL). Several treatments are available that modify the course of the disease and reduce the frequency of relapses. Although effective, all treatment options are accompanied by adverse events, and this study aimed to assess the extent to which patients were involved in the choice of treatment. Data were drawn from the Adelphi Multiple Sclerosis Disease Specific Program (DSP)™, a cross-sectional survey of healthcare practitioners (HCP) and their patients with MS in real-world clinical settings in Europe and the United States (US) between December 2020 and July 2021. HCPs reported patient demographics, clinical characteristics, current and previous treatment, and treatment outcomes. Patients voluntarily completed questionnaires reporting the physical and psychological impact of their MS and its treatment. Regression analysis with inverse probability of treatment weighting was used to compare treatment outcomes in patients actively involved in their current treatment choice with those who were not. Of a total of 692 patients, median age 40 years and 64% female, mostly diagnosed with relapsing-remitting MS, those who were involved in shared decision-making tended to choose oral therapies such as dimethyl fumarate more often than HCPs. MS had greater impact on physical and psychological functioning in patients whose HCP made treatment decisions solely. Patients involved in decision-making reported greater satisfaction with their treatment and a better QoL. Because no single optimal therapy exists for patients with MS, treatments should be individualized with consideration of patients' preferences. Our study shows that shared decision-making is under-utilized in the management of MS and supports the benefits of patient involvement. Patients who have an active role in treatment decision-making show improved wellbeing and QoL, and overall treatment satisfaction.

Assessment of Cerebral Hypoxemia and Its Impact on Cognitive and Psychological Functions in Patients With Obstructive Sleep Apnea Syndrome

Background and Objective The precise pathophysiology of cognitive impedance and mental illness in obstructive sleep apnea (OSA) patients remains elusive. Therefore, there is a need for studies on novel diagnoses and therapeutic strategies for cognitive impairment in OSA patients. This work aimed to evaluate cerebral hypoxemia, its consequences on brain metabolism, and local and systemic inflammation, and their subsequent impact on cognitive and psychological functioning.Methods This cross-sectional case-control study was conducted on 30 eligible OSA patients and 20 age/sex-matched healthy controls. All the participants underwent one-night polysomnography, and cognitive evaluation was done using the Mini-Mental State Examination, Montreal Cognitive Assessment, Brief Kingston Standardized Cognitive Assessment, D2 Test of Consideration (to evaluate attention problems), and Wisconsin card sorting test. The psychiatric assessment included the Arabic form of the Hamilton Depression Rating Scale and Beck Depression Inventory-II. A radiology assessment was done using proton magnetic resonance spectroscopy. Neurophysiological assessment was done using the potential cortical (N20) latency and amplitude of somatosensory evoked potential. Laboratory examinations included serum levels of NF-κB, HMGB1, and HIF-1α.Results Polysomnography demonstrated noteworthy increase in the apnea-hypopnea index, respiratory disturbance index, arousal index, snoring index, and wake after sleep onset. It also showed diminished sleep efficiency, total sleep time, and SaO2 nadir in the OSA group. Neuropsychological scales demonstrated poor performance in global cognitive tests, particular cognitive domains impedance, and depression in the OSA group, with noteworthy differences within the group. Magnetic resonance spectroscopy highlighted that OSA patients had a noteworthy bilateral decrement in N-acetylaspartate (NAA) peak, creatine peak, and NAA/choline proportion and an increment in choline peak, lipid peak, lactate peak, choline/creatine proportion, and NAA/creatine proportion in the frontal white matter, hippocampus, and parieto-occipital cortex. Moreover. OSA patients had either missing or decreased amplitude and delayed latency of N20. There was a noteworthy rise of serum inflammatory marker NF-κB, HMGB1, and oxidative stress marker HIF-1α in OSA patients.Conclusions Chronic intermittent hypoxia with resulting amplified inflammatory and oxidative stress in OSA patients may affect brain metabolism; consequently, leading to cognitive and psychological dysfunctions.

Individual tailored physical training in patients with postural orthostatic tachycardia syndrome after COVID-19 - a feasibility study

Abstract Background A significant proportion of patients with COVID-19 have developed persistent symptoms, described as post-acute COVID-19 syndrome (PACS ). A specific PACS variant is the postural orthostatic tachycardia syndrome (POTS). POTS is a cardiovascular autonomic dysfunction characterized by an excessive increase in heart rate in standing, deconditioning and low quality of life. Studies that have evaluated the effect and feasibility of individual tailored physical training in POTS associated with COVID-19 are sparse. Purpose To evaluate the effects and feasibility of individualized exercise on physical and psychological function in patients with POTS after COVID-19. Method Patients with POTS + PACS were enrolled between Dec 2021 and Dec 2022. The intervention consisted of individually tailored training, including endurance and muscle-strengthening exercises with a gradual progression of time, dose and position. The training was based on the study subject's heart rate and/or self-estimated exertion using BORG RPE. The intervention lasted 12 weeks. Progression of the exercise was halted if the study subject described increased symptoms >24h after the last exercise session. Measurements were carried out at baseline and after intervention: 6-minute walking test (6MWT), Active Standing Test (AST) and self-assessment of symptoms through forms; Malmö POTS scale (MaPS), Vanderbilt Orthostaic Symptom Score (VOSS), Fatigue Severity Scale (FSS) health-related quality of life (EQ-5D-5L), anxiety (GAD) and depression (PHQ-9). Physical activity and time in different positions (lying, sitting, standing and walking) were measured using accelerometers (ActivPAL). Recruitment rate, compliance and adverse events was registered as feasibility. Results A total of 24 patients were enrolled and 23 patients completed the intervention (19 women; mean age, 40.9 years (SD 10.7). No severe adverse events occurred however some of the patients described symptoms as post exertion malaise (PEM). After the intervention, patients demonstrated improvement in physical (6MWT, p<0.005) and psychological functions (PHQ-9, p<0.001), less symptoms related to POTS (MaPS p<0.01, VOSS p<0.02, FSS p<0.045) and improved HrQoL (EQ-5D p<0.001) (Table 1). The primary outcome, time spent in upright position increased by 1.5h/day i.e. by 49% (Figure 1). Conclusion In patients with COVID-19-related POTS, an individually tailored training seem to contribute to increased time in upright position, reduction of POTS-specific symptoms and improved functions. The intervention seems to be feasible in terms of recruitment, compliance and safety. Further studies are needed to verify these results and compare disease progression with and without intervention.Table 1Figure 1

Colonoscopy: body and psyche. Can psychiatry contribute to the quality of the examination?

Introduction: The relationship between a state of a body and mind is well known, although difficult to grasp. Its existence is reflected in subsequent editions of the classifications of mental disorders. One important and frequently performed medical procedure that significantly interferes with the patient's somatic state is colonoscopy. The aim of this study was to review the literature on the patient's psychological functioning in the context of colonoscopy. Material and methods: A review of literature in PubMed and Scopus databases was conducted. Keywords used were: colonoscopy, psychiatry, mental disorders, psychogastroenterology, gut-brain axis, anxiety, depression, cognitive functions, pain perception, limiting the search scope to 2013-2023. Discussion: The bidirectional relationship between psychological factors and a range of functional gastrointestinal disorders, contributed to the introduction of the term psychogastroenterology. One of its important areas is the research on the gut-brain axis. The interplay between the gut microbiome and mental functioning is apparent. Colonoscopy disrupts the composition of the intestinal microflora. However, despite its invasiveness, it is still often irreplaceable for the diagnosis and treatment of bowel diseases (including colorectal cancer). Higher adherence is needed, which could be achieved by improving patient comfort. An increased level of anxiety before the procedure and its negative impact on cognitive functioning is observed. Negative affect amplifies the experience of pain. Colonoscopy technique continues to be developed. A comprehensive description of the patient's psychological functioning in a colonoscopy situation is still lacking. Conclusions: A comprehensive description of the patient's affective and cognitive determinants in the context of colonoscopy and the associated pain and discomfort would be advisable. Keywords: psychiatry, gastroenterology, colonoscopy, gut-brain axis

Kinesthetic treatment on stiffness, quality of life and functional independence in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease of unknown etiology that primarily affects the joints, causing joint destruction, deformity and functional disability. Genetic, immunological, environmental, psychological and endocrine factors are believed to contribute to its development. The diagnosis of RA is based on the confrontation of clinical manifestations and laboratory tests, with classification criteria established by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR). Treatment has evolved significantly in recent years, focusing on obtaining and maintaining clinical remission to prevent structural and systemic complications. Rehabilitation plays a crucial role in the management of RA, relieving pain, preventing deformities and improving quality of life. Physical therapy programs include joint mobility exercises, resistance exercises, therapeutic massage, aerobic exercises and stretching, among others. RA can have different patterns of evolution, such as acute, cyclic or progressive. Physiotherapy helps to improve the physical and psychological function of patients, adapting to the stages of the disease. In addition, a multidisciplinary approach including pharmacological treatment, orthopedic surgery when necessary and personal care is recommended. Rehabilitation is essential to maintain the functional independence of RA patients and improve their quality of life. Physical therapy programs should be tailored to the individual needs of each patient and consider the stage of the disease. Physiotherapy has been shown to reduce pain, improve muscle function and strength, and contribute to the overall well-being of RA patients

The intervention effect of Suzhou folk art on patients with mood disorders in vocational art education

BackgroundMood disorder is a common mental health problem, which has a negative impact on the quality of life and work of patients. The intervention methods of educational psychology have been widely used in the treatment of patients with mood disorders. Suzhou folk art is a unique cultural tradition with rich artistic expression and emotional expression, which may play a positive role in the psychological function of patients with mood disorders.Subjects and MethodsSixty patients diagnosed with mood disorders were randomly divided into an experimental group and a control group. The experimental group received a 12-week Suzhou folk art intervention to improve their mental health through learning and participating in Suzhou folk art forms, and the control group received regular treatment and nursing. Both groups were evaluated using the Stanford Acute Stress Response Questionnaire (SASRQ) and the Three-Minute Delirium Diagnostic Scale (3D-CAM) before and after the intervention.ResultsThe results showed that there was a statistical difference compared with the control group (significance level less than 0.05). In the experimental group, the degree of mood disorder was significantly reduced, and the mental health status was also significantly improved. At the same time, the experimental group showed more positive emotional expression and participation in artistic creation activities during the intervention period.ConclusionsSuzhou folk art can promote the emotional release of patients with mood disorders and enhance their mental toughness. The introduction of Suzhou folk art into local higher vocational art education is helpful in improving the mental health level and quality of life of patients with mood disorders.AcknowledgementResearch achievements of key projects in the 13th Five-Year Plan of Jiangsu Education Science in 2016 (No. T-a/2016/03); Suzhou Higher Vocational Education Teachers’ Innovation Team; Chongqing Humanities and Social Sciences Research Project (No. 19SKGH225).

Association Between Activity Pacing and Negative Emotions in Patients With Chronic Pain: A Systematic Review.

Chronic pain is a major health problem given its high prevalence and its multiple consequences on the physical and psychological functioning of patients. It is therefore important to determine the relation between these consequences and pain management strategies such as activity pacing. This review aimed to examine the association between activity pacing and the level of negative emotions in chronic pain. A second objective was to explore sex differences in this association. A systematic review of the literature was conducted following the PRISMA guidelines. Three independent reviewers used a combination of keywords within four databases to include studies examining the link between pacing and negative emotions in chronic pain. Results showed that pacing was associated with less negative emotions when measured using multidimensional tools, distinguishing it from avoidance, and highlighting the major components of pacing such as maintaining a constant activity or conserving energy. Data did not allow examination of sex differences. Pacing is multidimensional and consists of various strategies of pain management which are not equally associated with negative emotions. It is important to use measures reflecting this conception to strengthen knowledges about the role of pacing in the development of negative emotions.

Системный анализ клинических, нейрофизиологических и психометрических особенностей пациентов с фармакорезистентной эпилепсией

INTRODUCTION: Drug-resistant epilepsy (DRE) is associated with a high incidence of comorbidities, psychiatric comorbidity, and early mortality in patients, which permits to consider epilepsy a systemic dysfunction of the body as a whole. AIM: Was to describe the features and relationships of clinical, neurophysiological and psychometric parameters of patients with DRE from a systemic standpoint. MATERIALS AND METHODS: A comprehensive clinical and neurophysiological study was conducted in 60 patients diagnosed with epilepsy, who were divided into 2 groups: 30 patients with DRE and 30 patients with remission of seizures. A clinical study was carried out including electroencephalography (EEG) with the calculation of the spectral power of the α-rhythm, the coherence coefficient and the cross-correlation coefficient for each pair of leads. The psychometric study included Eysenck, Strelau tests, the Taylor Anxiety Scale, the Freiburg Personality Inventory (FPI), the Toronto Alexithymia Scale, and the Self-Destructive Tendency Test. An analysis of correlations between clinical, psychometric and neurophysiological parameters in the initial state and with functional load was carried out. Based on the data obtained, graphical models were constructed. RESULTS: In patients with DRE, the clinical features of the disease, consisting in a longer duration of the disease and higher frequency of attacks, negatively correlated with the parameters of the spectral power of the α-rhythm, and with the levels of neuroticism and self-destructive behavior, and the low values of these characteristics can be associated with an unfavorable course of the disease. Rigid, systemic organization of psychological functions in patients with DRE, deficit of inhibitory processes in the nervous system were manifested in numerous correlations between psychometric parameters that negatively affect the quality of life, and also of psychometric parameters and spectral power of the EEG α-rhythm in different functional conditions. Numerous correlations between parameters may evidence a high level of conjugation of neurophysiological mechanisms with parameters in patients with DRE. CONCLUSION: Clinical, psychological and neurophysiological characteristics of patients with DRE are a reflection of a systemic phenomenon consisting in the mobilization of resources of the motivational-emotional, physiological spheres of patients not for external activity, but for inadequate defense reactions, which are subjective in nature.

Individual tailored physical training in patients with postural orthostatic tachycardia syndrome associated with post-acute COVID-19 syndrome - a feasibility study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Hjärt-Lungfonden Vetenskapsrådet Background The number of people that has been affected by COVID-19 is high and has continued to increase throughout the pandemic. A significant proportion of patients with COVID-19 have developed persistent symptoms, described as post-acute COVID-19 syndrome (PACS). A specific PACS variant is the postural orthostatic tachycardia syndrome (POTS). POTS is a cardiovascular dysautonomia characterized by an excessive increase in heart rate in standing and deconditioning. Studies evaluating effect and feasibility of individual tailored physical exercises in POTS associated with PACS are sparse. Purpose To evaluate the effects and feasibility of a individually tailored exercise on physical and psychological function in patients with POTS associated with PACS. Method Patients with POTS + PACS and diagnosed between Dec 2021-Sep 2022 were enrolled. Measurements were carried out at baseline and after intervention: 6-minute walking test (6MWT), Active Standing Test (AST) and self-assessment of symptoms through forms; Malmö POTS scale (MaPs), Vanderbilt Orthostatic Symptom Score (VOSS), health-related quality of life (EQ-5D-5L), anxiety (GAD) and depression (PHQ-9). Physical activity and time in different positions (lying, sitting, standing and walking) were measured using accelerometers (ActivPAL). The intervention consisted of 12 weeks individually tailored training, including both endurance and muscle-strengthening exercises with a gradual progression of time, dose, and position (supine-upright). The training was adapted based on the study subject's heart rate and/or self-estimated exertion using BORG reported perceived excertion. Progression of the exercise was halted if the study subject described increased symptoms >24h after the last exercise session indicating post exertional malaise (PEM). Recruitment rate, compliance and adverse events was registered. Results A total of 15 patients were enrolled and 14 patients completed the intervention (9 women; mean age, 41.6 years (SD 12.3). No severe adverse events occurred however some of the patients’ described PEM. After completing the intervention period, patients demonstrated improvement in physical (6MWT p<0.004) and psychological functions (PHQ-9 p<0.001) and less symptoms related to POTS (MaPS p<0.03) (Table 1). The primary outcome, time spent in upright position increased by 1.5h/day (Figure 1). Conclusion In patients with COVID-19-related POTS, individually tailored exercise was associated with increased time in upright position, reduction of POTS-specific symptoms and improved function. The intervention seems to be feasible in terms of recruitment, compliance and safety. Further studies are needed to verify these results and compare disease progression with and without intervention.

Physiological Factors Affecting Diabetes in Women using Binary Logit Regression Model

The purpose is to use statistical methods to analysis some female data, trying to figure out what physiological factors will affect the occurrence of diabetes on female and how. Method: using dataset from “AKSHAY DATTATRAY KHARE” in Kaggle, which comes from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in original. In particular, all patients here are females of Pima Indian descent who are at least 21 years old. Use binary logit regression model to analysis. Result: Pregnancies, skin thickness, insulin and blood pressure, as long as age can’t be taken into account (p>0.05). The remaining three elements, which is glucose (OR=1.039), BMI(OR=1.073), diabetes pedigree function (OR=3.130), are all risk factors. The overall correct rate is 78.3%. The conclusion is using binary logit regression model can analysis factors related diabetes well. The logistic regression model among the influencing factors of diabetes shows that glucose, BMI, and diabetes pedigree function are likely to cause diabetes, and diabetes pedigree function has a greater impact on the psychological function of patients.

Inflammatory Bowel Disease: Clinical Diagnosis and Pharmaceutical Management.

Inflammatory bowel disease has an enormous impact on public health, medical systems, economies, and social conditions. Biologic therapy has ameliorated the treatment and clinical course of patients with inflammatory bowel disease. The efficacy and safety profiles of currently available therapies are still less that optimal in numerous ways, highlighting the requirement for new therapeutic targets. A bunch of new drug studies are underway in inflammatory bowel disease with promising results. This is an outlined guideline of clinical diagnosis and pharmaceutical therapy of inflammatory bowel disease. Outline delineates the overall recommendations on the modern principles of desirable practice to bolster the adoption of best implementations and exploration as well as inflammatory bowel disease patient, gastroenterologist, and other healthcare provider education. Inflammatory bowel disease encompasses Crohn's disease and ulcerative colitis, the two unsolved medical inflammatory bowel disease-subtypes condition with no drug for cure. The signs and symptoms on first presentation relate to the anatomical localization and severity of the disease and less with the resulting diagnosis that can clinically and histologically be non-definitive to interpret and establish criteria, specifically in colonic inflammatory bowel disease when the establishment is inconclusive is classified as indeterminate colitis. Conservative pharmaceuticals and accessible avenues do not depend on the disease phenotype. The first line management is to manage symptoms and stabilize active disease; at the same time maintenance therapy is indicated. Nutrition and diet do not play a primary therapeutic role but is warranted as supportive care. There is need of special guideline that explore solution of groundwork gap in terms of access limitations to inflammatory bowel disease care, particularly in developing countries and the irregular representation of socioeconomic stratification with a strategic plan, for the unanswered questions and perspective for the future, especially during the surfaced global COVID-19 pandemic caused by coronavirus SARS-CoV2 impacting on both the patient's psychological functioning and endoscopy services. Establishment of a global registry system and accumulated experiences have led to consensus for inflammatory bowel disease management under the COVID-19 pandemic. Painstakingly, the pandemic has influenced medical care systems for these patients. I briefly herein viewpoint summarize among other updates the telemedicine roles during the pandemic and how operationally inflammatory bowel disease centers managed patients and ensured quality of care. In conclusion: inflammatory bowel disease has become a global emergent disease. Serious medical errors are public health problem observed in developing nations i.e., to distinguish inflammatory bowel disease and infectious and parasitic diseases. Refractory inflammatory bowel disease is a still significant challenge in the management of patients with Crohn's disease and ulcerative colitis. There are gaps in knowledge and future research directions on the recent newly registered pharmaceuticals. The main clinical outcomes for inflammatory bowel disease were maintained during the COVID-19 pandemic period.

What influences psychological functioning in patients with mood disorders? The role of clinical, sociodemographic, and temperamental characteristics in a naturalistic study

BackgroundThe present study aims to assess clinical and psychological correlates of psychological functioning in patients with mood disorders, in a naturalistic setting. In particular, we aimed to describe which sociodemographic, clinical, and temperamental dispositions are more frequently associated with poor psychological functioning, and to describe the association between cognitive and psychological functioning in euthymic patients with major depression and bipolar disorder.MethodsInclusion criteria were as follows: (1) diagnosis of major depression, or bipolar disorder type I or II; (2) age between 18 and 65 years; and (3) being in a stable phase of the disorder. Patients’ psychiatric symptoms, quality of life, affective temperaments, and impulsivity were investigated with validated assessment instruments.Results166 patients have been recruited, mainly female (55.4%), whose mean age was 47.1 ± 14.2 years. 42.6% of individuals reported a diagnosis of major depression. According to regression analyses, poor cognitive performance (p < 0.05), reduced perceived quality of life (p < .0001), lifetime suicide attempts (p < 0.01), and increased trait-related impulsivity (p <0 .001) strongly correlated with poor psychological functioning. Moreover, cyclothymic and irritable dispositions were also associated with poor social functioning (p < 0.01), whereas hyperthymic affective disposition was associated to a better psychological performance (p < 0.01).ConclusionsOur results support the evidence that patients with mood disorders should be assessed for psychological functioning and affective dispositions, to identify patients at higher risk to develop worse long-term outcomes and to develop targeted interventions.

Comparison of the effect of computerized multidomain cognitive training and pen‐and‐paper educational program in older adults with mild cognitive impairment: a preliminary randomized controlled trial

AbstractBackgroundCognitive intervention is accepted as a potential therapy to prevent the incident dementia. It was found that computerized cognitive training might be effective for older adults with mild cognitive impairment (MCI) in previous studies. We aimed to find the effect of multidomain cognitive training using tablet computer on the cognitive and psychological function in patients with MCI.MethodParticipants in training group (n = 15) conducted a multidomain cognitive training program using table computer and those in control group (n = 13) conducted an educational book reading twice a week for eight weeks. They were evaluated of their cognitive and psychiatric function before and after the program. The differences of the pre‐ and post‐ scores were compared between training and control groups.ResultParticipants in training group showed improvement in cognitive domains such as language (p = 0.012), memory (p = 0.050), and frontal executive function (p = 0.017), and psychiatric symptoms such as apathy (p = 0.001) and quality of life (p = 0.035) after the training. Control group participants showed improvements in frontal executive function (p = 0.013), positive affect (p = 0.019), apathy (p = 0.022) and mild behavioral impairment score (p = 0.049). Between group comparison of the pre‐ and post‐training difference showed significant improvement in training group compared to control group in memory (p = 0.020), frontal executive function (p = 0.024), positive affect (p = 0.037), apathy (p = 0.048), and quality of life (p = 0.047).ConclusionWe found the effect of multidomain cognitive training using tablet computer in cognitive domain including memory and executive function, positive affect, apathy, and quality of life in MCI patients. Tablet computer cognitive training may be effective in multidomain cognitive training with transfer effect in the prodromal stage of dementia. Future trials with larger sample size and various devices would find the effect of the computerized cognitive training.

Does Guided Written Disclosure Reduce Distress and Improve Psychological Functioning in Patients with Skin Diseases?

Background. Skin diseases (e.g., psoriasis and systemic sclerosis) are generally associated with negative psychosocial outcomes. Although different psychological interventions have been used to improve the quality of life of dermatological patients, the effects of the guided written disclosure (GWD) protocol have not been previously examined in these patients. Moreover, little attention has been paid to positive psychology constructs. Methods. This study investigates the effectiveness of GWD on positive and negative functioning in dermatological patients. Pre- and 1-month post-intervention measures included emotion regulation, sense of inner peace, skin-related symptoms and functioning, sense of coherence, and psychological distress. Results. A total of 196 consecutive outpatients were randomly assigned to GWD and active control groups, of whom 60 (30.6%) completed the study and 45 (GWD: n = 24; AC: n = 21) provided complete data. Our results did not show any significant difference between the experimental and control groups in the outcome variables, whereas non-completers reported higher levels of distress, unpleasant skin-related emotions, and lower cognitive reappraisal compared to completers. Conclusions. These findings show a poor compliance, and suggest that expressive writing is not well accepted by patients and is not effective in improving positive and negative psychological functioning in dermatological patients.

Psychological functioning in paediatric patients with single ventricle heart disease: a systematic review.

Patients with single ventricle heart disease are living into adulthood due to medical and surgical advancements but have significant physical comorbidities and an increased risk for psychological comorbidities compared to healthy subjects or those with other CHD diagnoses. This study aimed to systematically review psychological functioning in paediatric single ventricle heart disease. Literature was searched using PubMed, Embase, PsycInfo, CINAHL Complete and Scopus. Peer-reviewed articles that included patients ages 0-25 years with single ventricle heart disease, and quantitative measures of psychological outcomes were included. Meta-analysis using a fixed-effect model was conducted for internalising and externalising t-scores, utilised by the Achenbach Child Behavior Checklist. Twenty-nine records met the criteria for inclusion. 13/24 studies demonstrated increased risk for internalising disorders, such as anxiety/depression; 16/22 studies demonstrated risk for externalising disorders, such as attention or behavioural problems. Meta-analysis of four studies revealed that paediatric single ventricle heart disease patients had no significant difference in internalising and externalising t-scores compared to normative values. The current review demonstrates the need for further studies to better understand psychological functioning in patients with single ventricle heart disease, with a majority of studies showing increased risk for psychological problems despite no difference seen in a small meta-analysis. This summary of the literature underscores the need for regular psychological screening, earlier intervention and integrated mental health therapies in paediatric single ventricle heart disease.

Physical and psychological functioning of patients with chronic limb ischemia during a 1-year period after endovascular revascularization

ObjectiveSymptoms of peripheral artery disease (PAD) and patients’ physical and psychological status are related in a vicious circle. The aim of this study was to determine the relationships between improvement in parameters of PAD after endovascular procedures and changes in patients’ physical and psychological status. MethodsWe studied 140 consecutive patients with PAD: 50 patients with chronic limb-threatening ischemia (CLTI), 50 patients with intermittent claudication (IC) undergoing an endovascular procedure, and 40 patients with IC who were not qualified for leg revascularization. All participating patients were assessed at the beginning of the study and at 3 and 12 months of follow-up; scores taken included ankle-brachial index, 6-minute walking test distance, Barthel Index, activities of daily living index, instrumental activities of daily living (IADL) index, Mini-Mental State Examination, and Hospital Anxiety and Depression Scale. ResultsAfter 12 months of follow-up, an improvement in PAD-related symptoms following leg revascularization had been maintained in 56% of the patients with CLTI and in 68% of those with IC. Twelve months after endovascular leg revascularization, the scores in respect of activities of daily living, IADL, and Mini-Mental State Examination had increased, and scores for Hospital Anxiety and Depression Scale had decreased in patients with both CLTI and IC. A higher baseline score in the IADL index was associated with a reduction in the 1-year cardiovascular event risk (odds ratio, 95% confidence interval, 0.70; 0.54-0.91; P < .01). ConclusionsIn patients with PAD, endovascular procedures not only improved PAD-related symptoms, but also ameliorated patients’ physical state, improved cognitive function, and reduced depression.

Psychological Aspects of Obesity and Obesity Surgery: A Simple Review

Grade III and IV obese patients had higher levels of depression than grade II obese patients, lower self-esteem, and lower quality of life. Thus, an important but often overlooked outcome is the assessment of the impact of surgery on mental health. This is an important outcome measure because it can contribute to a patient's concept of overall well-being. Although British Columbia has an edge in managing obesity, psychosocial and behavioral factors can influence postoperative outcomes. According to some authors, mental illness severe enough to require treatment may be a negative predictor of surgical outcome. This review reviews the literature on the impact of liposuction surgery on the psychological functioning of patients with obesity. Most studies have shown that people with obesity, especially those requiring surgery, report significantly worse quality of life. This may be due to impaired physical and psychosocial functioning, discrimination and psychiatric consequences, or it may be due to overweight and associated morbidity. Finally, most research and clinical experience shows that people with obesity who seek surgical treatment for obesity are more likely to have psychological problems, abnormal eating behaviors, and quality of life. Life declines more than the average person, but bariatric surgery can help improve your mental state. Patients, improve the patient's quality of life.

The impact of disease severity on the psychological well-being of youth affected by an inborn error of metabolism and their families: A one-year longitudinal study

Background:Inborn errors of metabolism (IEMs) refer to rare heterogeneous genetic disorders with various clinical manifestations that can cause serious physical and psychological sequelae. Results of previous studies on the impact of an IEM on health-related quality of life (HR-QoL) were incongruent and only few studies considered more broadly the psychological well-being of children with IEM and their families. Our objectives were to examine: (1) the impact of the IEM severity on the HR-QoL and psychological functioning of patients and their parents at baseline; and (2) its evolution over time; and (3) the correlation between parental and children's perspectives.Methods: The sample included 69 pediatric patients (mean age = 7.55 y, SD = 4.59) with evaluations at baseline and after one year. We collected data on HR-QoL, child mental health and emotional regulation as well as on parental mood and stress using different validated questionnaires. IEM severity was rated by a clinician through the biological subdomain of the pediatric INTERMED instrument.Results: Two groups of patients based on IEM severity scores were created (n = 31 with low and n = 38 with moderate/high IEM severity). The two groups differed with respect to age, diet and supplement intake. IEM severity had an impact on HR-QoL and behavioral symptoms in children, as well as on HR-QoL and stress in parents. For patients with moderate/high IEM severity, child and parental HR-QoL improved after 1-year of follow-up. We did not observe any significant difference between evaluations by patients versus parents.Conclusions: Our findings demonstrate that moderate/high IEM severity altered child and parental psychological well-being, but also revealed a significant improvement after one-year follow-up. This observation suggests that patients with a moderate/high IEM severity and their families benefit from the care of an interdisciplinary team including a child psychologist specialized in IEMs. Moreover, in patients with higher IEM severity there may also be more room for improvement compared to patients with low IEM severity. Future studies should focus on observations over a larger time span, particularly during adolescence, and should include objective measurements.

Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

Background: Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. Objectives: Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (n = 126), diamorphine (n = 85), or buprenorphine (n = 37) were recruited in 6 German therapy centers. Methods: Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the Profile of the Quality of Life in the Chronically Ill (PLC) questionnaire. Results: Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (p < 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (p < 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (p < 0.001, η² = 0.141). Diamorphine patients reported a higher psychological functioning (p < 0.001, η² = 0.078) and overall life improvement (p < 0.001, η² = 0.060) compared to methadone, but not compared to buprenorphine patients (both p > 0.25). Conclusion: Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

Impact of Age on Cognitive and Psychological Functioning in Patients with Diabetes

Diabetes mellitus is a chronic and non-communicable disease which is also termed as “sugar” emerged as one of the leading causes of global health deterioration. It is associated with decreased physiological and psychological functioning. Age is a significant predictor to evolve diabetes mellitus. Cognitive changes due to diabetes and psychosocial distress are prominent among the population and the risk is high with increasing age range. The aim of the present study is to find out any association between age and cognitive and psychological functioning of patients with diabetes. In the present study, age range of the sample was selected as 40–60 years. A total of 60 individuals of both genders were selected; 30 individuals with diagnosis of diabetes mellitus and equal number of normal controls were included. The cognitive functioning was measured by neuropsychological tools and the psychological functioning was measured by Psychological General Well-being Index. The results indicate that in case of diabetes patients, age was found to be mostly significant and negatively correlated with cognitive and psychological functioning in comparison to normal controls. Findings from the present study suggest that age could be a predictor in changed cognitive and psychological functioning of patients with diabetes and increased age showed poorer cognitive and psychological functioning.