Bullying,Depression, and Suicidal Ideation Among Adolescents in the Fujian Province of China: A Cross-sectional Study

The relationship of bullying with suicidal ideation among adolescents is controversial. Although depression has been related to bullying and suicidal ideation, little is known about the combined impacts of depression and bullying on suicidal ideation.A sample of 20,509 high school students from Fujian Province were selected randomly by multistage stratified sampling. All participants completed an adolescent health status questionnaire. Three categories of bullying were assessed: perpetration, victimization, and both (victimization and perpetration). The associations of these 3 categories of bullying with depression and their interaction with suicidal ideation were examined in logistic models.After adjustment for potential confounders, all 3 categories of bullying (perpetration, victimization, and both) were related to increased risk of suicidal ideation with odds ratios (ORs) of 1.66 (95% confidence interval [CI] 1.20–2.30), 2.74 (95% CI 2.29–3.29), and 2.83 (95% CI 2.27–3.52), respectively. There was an interaction between depression and bullying (P = 0.001). Subgroup analyses showed a stronger association between perpetration and suicidal ideation in students with depression (odds ratio [OR] 2.97; 95% CI 1.44–6.09) than in those without depression (OR 1.65; 95% CI 1.19–2.28). The association between victimization and suicidal ideation was weaker in students with depression (OR 1.49; 95% CI 1.07–2.07) than in those without (OR 2.69; 95% CI 2.24–3.23). The association of both victimization and perpetration with suicidal ideation was weaker in students with depression (OR 2.22, 95% CI 1.43–3.47) than those without (OR 2.78; 95% CI 2.23–3.47).We observed an independent association of bullying with increased risk of suicidal ideation among adolescent students, and this association was affected by depression. Prospective studies should be conducted to confirm these findings.     

Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders

Purpose

This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression.

Methods

Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO₂ max), respectively.

Results

All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff?=????1.57 [95% CI???2.40 to???0.73], P?=?0.001), PSQI score (diff?=????1.20 [95% CI???2.10 to???0.32], P?=?0.008), and CPET VO₂ max (diff?=?0.95 [95% CI 0.62–1.28], P?=?0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO₂ max (Cohen’s d?=?0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen’s d?=????0.41 and???0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen’s d?=?0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training.

Conclusions

HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.

     

Perceived sleep quality is associated with depression in a Korean elderly population

Our study aimed to examine the relationship between perceived sleep quality and depression using Pittsburgh Sleep Quality Index (PSQI) and Cole's model to materialize the concept of perceived sleep quality in the non-cognitively impaired elderly. Older adults aged 60+ were recruited from the baseline study of Suwon Project (SP) between 2009 and 2011 (n = 2040). Perceived sleep quality was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K), and depression was accessed using the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K). We excluded the cognitively impaired elderly using the Korean version-Mini Mental Status Examination (K-MMSE) score less than or equal to 17. In multivariable adjusted logistic regression related to PSQI-K components, poor perceived sleep quality, including poor subjective sleep quality (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.01–1.61), longer sleep latency (OR = 1.32, 95% CI = 1.13–1.55) and the frequent use of sleeping medication (OR = 1.30, 95% CI = 1.10–1.53) were significantly associated with depression after adjusting for age, sex, education, living status, current smoking and current alcohol drinking, the number of comorbidity and Beck Anxiety Inventory (BAI). PSQI-K global score also had greater odds of reporting depression (OR = 1.12, 95% CI = 1.07–1.16). These results suggested that poor perceived sleep quality was associated with a greater level of depression in the elderly.     

Suicidal ideation in primary care

OBJECTIVE: To describe the prevalence and clinical characteristics of primary care patients who report suicidal ideation during the month before their medical visit. DESIGN: Analysis of a self-administered suicidal ideation screening item using sociodemographic data, treatment history, and clinical data from structured interviews. SETTING: Three Rhode Island private family practices, a South Carolina family medicine residency, and a California prepaid internal medicine group practice. PATIEJVTS: Adult primary care patients [N=2,749), 18 to 70 years old, who are able to read and write English, able to complete study forms, and willing to provide informed consent. RESULTS: Sixty-seven (2.44%) of the patients reported suicidal ideation (“feeling suicidal”) during the past month, and most of these patients (58.2%) received no mental health care during that time. The adjusted risk of suicidal ideation was significantly elevated for patients with self-reported fair or poor physical health (odds ratio [OR] 2.5; 95% confidence interval [CI1 1.5, 4.1), fair to poor emotional health (OR 18.0; 95% CI 8.8, 37.0), marital distress (OR 4.4; 95% CI 2.2, 8.8), and recent mental health-related work loss (OR 6.3; 95% CI 3.7, 10.5). In the California sample, patients with major depression (OR 31.2; 95% CI 12.8, 76.1), generalized anxiety disorder (OR 23.4; 95% CI 8.1, 67.1), and drug abuse or dependence (OR 9.6; 95% CI 2.9, 31.6) were at increased risk of suicidal ideation. The “feeling suicidal” item identified 10 of 12 patients who acknowledged a recent plan to kill themselves. CONCLUSIONS: In these primary care patients, suicidal ideation is strongly associated with mental disorder and mental health-related functional impairment, and can be detected with a single self-report “feeling suicidal” item. This research was supported by the Upjohn Company.     

Poor sleep is responsible for the impaired nocturnal blood pressure dipping in elderly hypertensive: A cross-sectional study of elderly

Objective: This study was aimed to assess whether sleep disorder was associated with an increased risk of less nocturnal blood pressure (BP) dipping in elderly patients with hypertension.

Methods: Cases were 1006 patients, aged >60 years, who were admitted to hospital with diagnosed hypertension during 2016–2017, and were divided into three groups with the systolic nocturnal BP dipping of 10%, and 0% as the cut-off value. The patients’ sleep was evaluated by Pittsburgh sleep quality index (PSQI).

Results: Compared to non-dipper BP rhythm patients (n = 382) and dipper BP rhythm patients (n = 132), reverse dipper patients (n = 492) exhibited higher PSQI score and had higher scores on six components with the exception of use sleep drug (p < 0.05). Multivariate logistic regression indicated that poor sleep, which was defined as high score of PSQI or its seven components, was associated with prevalence of reverse dipper in elderly hypertensive (odds ratio (OR) = 1.17, (95% confidence interval (CI), 1.13–1.21, p < 0.05) after adjusting for risk factors of hypertension. Multiple linear regression analysis showed that there was a significant negative correlation between PSQI score (include its seven components) and nocturnal BP dipping value after adjusting for risk factors of hypertension (β = ?0.584, p < 0.001).

Conclusions: In elderly patients with hypertension, poor sleep quality individuals were more prone to reverse dipper BP rhythm. Even adjusting for the effect of known risk factors of hypertension, poor sleep may contribute to attenuated BP dipping in elderly hypertensive.     

Quality of sleep in rheumatoid arthritis patients: Relationship with disease activity,depression and functional status

Aim of the workTo assess sleep quality in Egyptian patients with rheumatoid arthritis (RA) and its relationship with disease activity, depression and functional status.Patients and methodsThis cross-sectional study included 133 RA patients and 76 age and sex matched controls. Sleep using the Pittsburg Sleep Quality Index (PSQI), Beck depression inventory (BDI), functional status using health assessment questionnaire (HAQ), visual analogue scale-pain (VAS), and disease activity score (DAS28) were assessed.ResultsPatients were 125 females and 8 males with a mean age of 42.5 ± 9.5 years and disease duration of 3.9 ± 1.3 years. 76 age and sex matched control were also included. Poor sleep quality was detected in 54.1% of patients. Patients had significantly higher scores in the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, day-time dysfunction domains and in terms of the total PSQI score compared to the control (p < 0.05). A significant difference was found between RA patients with poor sleep quality and those with good sleep quality as regards marital status, HAQ, erythrocyte sedimentation rate (ESR), VAS, DAS28, morning stiffness duration, anti-cyclic citrullinated peptide (anti-CCP) (p < 0.05), and the BDI (p < 0.001). The multivariate regression analysis found that disease activity, functional disability and depression were predictors for poor sleep quality (p = 0.04, p = 0.01 and p < 0.001; respectively).ConclusionThe sleep quality is impaired in RA patients. The poor sleep quality is associated with disease activity, depression and functional disability. Systemic psychiatric screening, holistic assessment and targeted interventions are required to improve sleep quality and quality of life.     

The association between sleep duration,napping, and stroke stratified by self-health status among Chinese people over 65 years old from the China health and retirement longitudinal study

Purpose

Stroke is a major cause of death in China. This study aimed to investigate the association between sleep duration (nighttime sleep and daytime napping) and stroke in elderly Chinese individuals with self-reported health status.

Methods

A total of 4785 Chinese adults over 65 years from the 2011 China Health and Retirement Longitudinal Study (CHARLS) were included. Binary logistic regression was used to estimate odds ratios and 95% confidence intervals of the association between sleep duration and stroke stratified by self-reported health status.

Results

A significant association between short sleep duration (< 7 h per day) and the risk of stroke (aOR?=?2.05; 95% CI 1.31–3.19), after controlling for sociodemographic characteristics, lifestyle factors, health status, and comorbidities. There was no significant association between short and long sleep duration and stroke in the individuals who reported good general health status. However, in individuals who reported poor health status, short sleep duration (aOR?=?2.11; 95% CI 1.30–3.44) and long sleep duration (aOR?=?1.86; 95% CI 1.08–3.21) were significantly associated with increased risk of stroke, compared with normal sleep duration (7–8 h per day). Disability was significantly associated with stroke in both self-reported good and poor health groups. Rural residence was significantly associated with a lower risk of stroke among individuals who reported poor health status.

Conclusions

Both short and long sleep duration were significantly associated with stroke among individuals who reported poor health. Stroke prevention should be focused on elderly individuals who believe that they have health problems.

     

Association between depression and sleep quality in patients with systemic lupus erythematosus: a systematic review and meta-analysis

Background

Currently, there is no consistent understanding of the relationship between depression and sleep quality in patients with systemic lupus erythematosus (SLE). This study aimed to explore the correlation between depression and sleep quality in SLE patients.

Methods

Five English (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) databases were systematically searched from inception to January 12, 2021. Two authors independently screened publications and extracted data according to set inclusion and exclusion criteria. Statistical analyses were performed with STATA 16.0. Data were pooled using a random-effects model.

Results

A total of 9 identified studies matched the inclusion criteria, reporting on 514 patients with SLE in the analysis. A moderate correlation of depression with sleep quality was found (pooled r?=?0.580 [0.473, 0.670]). Compared to good sleepers, patients with SLE and poor sleep quality had higher levels of depression (standardized mean difference?=????1.28 [??1.87,???0.69]). Depression was associated with subjective sleep quality (r?=?0.332 [0.009, 0.592]), sleep latency (r?=?0.412 [0.101, 0.649]), sleep disturbances (r?=?0.405 [0.094, 0.645]), daytime dysfunction (r?=?0.503 [0.214, 0.711]), the four dimensions of Pittsburgh Sleep Quality Index (PSQI), while no significant correlation was found in the other three PSQI dimensions.

Conclusion

Depression had a moderate correlation with sleep quality in patients with SLE. Patients with poor sleep quality tended to have higher level of depression than that of good sleepers. Awareness of the correlation may help rheumatology physicians and nurses to assess and prevent depression and improve sleep quality in patients with SLE.

     

Sleep Quality,Depression, and Quality of Life in Patients with Pulmonary Hypertension

Pulmonary hypertension is a disabling disease characterized by progressive functional worsening, right heart failure, and death. Although pulmonary hypertension has been associated with poor quality of life, sleep quality has not been investigated in pulmonary hypertension patients. This was a cross-sectional study in which patients (N = 40) were asked to complete standardized questionnaires to assess sleep quality [using Pittsburgh Sleep Quality Index (PSQI)], insomnia, sleepiness, dyspnea, depression, restless leg syndrome, and quality of life [using Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR)] during routine office visits. Baseline hemodynamics, pulmonary function tests, exercise capacity, and transthoracic echocardiogram were analyzed. Pulmonary hypertension functional class was World Health Organization class II [20 (50%)], III [18 (45%)], and IV [2 (5%)], and 29 (72.5%) had poor sleep quality. PSQI score was associated with CAMPHOR symptoms score (R = 0.61, P < 0.001), CAMPHOR activities score (R = 0.38, P = 0.016), CAMPHOR quality-of-life score (R = 0.45, P = 0.004), depression (R = 0.42, P = 0.007), and dyspnea (R = 0.36, P = 0.02). Sleep quality was not associated with age, gender, other comorbidities, pulmonary hypertension etiology, baseline hemodynamics, pulmonary function testing, echocardiographic parameters, or exercise capacity. Poor sleep quality is common in patients with pulmonary hypertension and correlates with depression, dyspnea, and poor quality of life. Improving sleep quality in patients with pulmonary hypertension may improve quality of life.     

Sleep disturbances and risk of falls in an old Chinese population-Rugao Longevity and Ageing Study

BackgroundTo explore the relationship between sleep disturbances and falls in an elderly Chinese population.MethodsData from 1726 individuals aged 70–87 years from the Rugao Longevity and Ageing Study were used. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep variables. Outcomes were falls ≥1 time per year and falls ≥2 times per year.ResultsA total of 22.7% of the participants experienced ≥1 fall, and 9.8% experienced ≥2 falls per year. Poor sleep quality was associated with ≥1 fall (OR 1.08, 95% CI 1.05–1.12; OR 1.27, 95% CI 1.14–1.41) and ≥2 falls (OR 1.08, 95% CI 1.03–1.14; OR 1.28, 95% CI 1.10–1.48), with an increase per PSQI score and SD PSQI score, respectively. In addition, sleep quality, sleep latency, sleep efficiency, and sleep disturbance subcomponents were associated with an increased risk of ≥1 fall with ORs of 1.44 (95% CI, 1.21–1.72), 1.23 (95%CI,1.09–1.40), 1.12 (95%CI, 1.01–1.23) and 1.70 (95% CI,1.35–2.14), respectively, and were associated with an increased risk of ≥2 falls with ORs 1.54 (95%CI, 1.22–1.96), 1.21(95%CI, 1.02–1.44), 1.17 (95% CI 1.02–1.33), and 1.78 (95%CI, 1.31–2.44), respectively. Further, participants slept ≤5 h per night had an increased risk of ≥1 fall (OR 2.34; 95%CI, 1.59–3.46) and ≥2 falls (OR 2.19; 95%CI, 1.30–3.69).ConclusionsPoor sleep quality and several subcomponent sleep symptoms were consistently associated with increased risk of falls ≥1 time and ≥2 times in Chinese elderly. The identification of sleep disturbances may help identify high-risk Chinese elders who may benefit from fall prevention education.     

Sleep duration and self-rated health in Chinese university students

Purpose

Little is known about the association between sleep duration and health status in Chinese university students. This study examined the association between sleep duration and self-rated health in university students in China.

Methods

Altogether, 2312 subjects (928 in Macao, 446 in Hong Kong, and 938 in mainland China) were recruited. Standardized measures of sleep and self-reported health were administered. Sleep duration was categorized in the following way: <?6 h/day, 6 to <?7 h/day, 7–9 h/day, and >?9 h/day.

Results

Overall, 71% of university students reported poor health, 53% slept 7–9 h/day, 14% slept less than 6 h/day, 32% slept 6 to <?7 h/day, and 1% slept >?9 h/day. Univariate analysis revealed that compared to students with medium sleep duration (7–9 h/day), those with short sleep duration (<?6 h/day and 6 to <?7 h/day) were more likely to report poor health. Multivariate logistic regression analysis found that after controlling for age, gender, body mass index, university location, being a single child, religious beliefs, interest in academic major, academic pressure, nursing major, pessimism about the future, and depression, sleep duration of less than 6 h/day (odds ratio (OR) 1.98, 95% confidence interval (CI) 1.34–2.92, p?<?0.01) was independently and significantly associated with poor self-reported health.

Conclusions

Poor health status is common in Chinese university students, which appears to be closely associated with short sleep duration. Further longitudinal studies are warranted to gain a better understanding of the interaction between sleep patterns and health status in university students.

     

Insomnia,Poor Sleep Quality and Sleep Duration,and Risk for COVID-19 Infection and Hospitalization

BackgroundMedical comorbidities increase the risk of severe acute COVID-19 illness. Although sleep problems are common after COVID-19 infection, it is unclear whether insomnia, poor sleep quality, and extremely long or short sleep increase risk of developing COVID-19 infection or hospitalization.MethodsThe study used a cross-sectional survey of a diverse sample of 19,926 US adults.ResultsCOVID-19 infection and hospitalization prevalence rates were 40.1% and 2.9%, respectively. Insomnia and poor sleep quality were reported in 19.8% and 40.1%, respectively. In logistic regression models adjusted for comorbid medical conditions and sleep duration but excluding participants who reported COVID-19-associated sleep problems, poor sleep quality, but not insomnia, was associated with COVID-19 infection (adjusted odds ratio [aOR] 1.16; 95% CI, 1.07-1.26) and COVID-19 hospitalization (aOR 1.50; 95% CI, 1.18-1.91). In comparison with habitual sleep duration of 7-8 hours, sleep durations <7 hours (aOR 1.14; 95% CI, 1.06-1.23) and sleep duration of 12 hours (aOR 1.61; 95% CI, 1.12-2.31) were associated with increased odds of COVID-19 infection. Overall, the relationship between COVID-19 infection and hours of sleep followed a quadratic (U-shaped) pattern. No association between sleep duration and COVID-19 hospitalization was observed.ConclusionIn a general population sample, poor sleep quality and extremes of sleep duration are associated with greater odds of having had a COVID-19 infection; poor sleep quality was associated with an increased requirement of hospitalization for severe COVID-19 illness. These observations suggest that inclusion of healthy sleep practices in public health messaging may reduce the impact of the COVID-19 pandemic.     

Sleep impairment: Is it an overlooked burden in painful diabetic peripheral neuropathy? A single-centre,cross-sectional study from south India

Background and aimsPainful diabetic peripheral neuropathy (PDPN) is a common complication of type 2 diabetes. The unrelenting pain associated with PDPN adversely affects a patient's quality of life. Recognizing the crucial role that sleep plays in the metabolic control of diabetes, this study aims to estimate the prevalence of sleep impairment in painful diabetic peripheral neuropathy (PDPN) and identify the factors associated with it.MethodsWe conducted a cross-sectional study among 156 patients in a tertiary care hospital in south India. We recruited consenting adults with PDPN. Sleep quality was analyzed using the Pittsburg sleep quality index (PSQI), a self-rating scale. Hba1c served as a measure of glycemic control. Anxiety and depression were assessed using the hospital anxiety and depression (HAD) scale. Data were analyzed in SPSS 26.0.ResultsA total of 156 patients were included in the study with a mean age of 58.39 ± 9.12 years. In 151 (96.79%) patients demonstrated sleep impairment with a global PSQI score of 10.92 ± 2.87. Female sex, ischemic heart disease (IHD), high anxiety levels and use of insulin, pregabapentin, and duloxetine; were significantly associated with poor sleep quality (p < 0.05). The median Hba1c was high (9% [7.46–11.1]). However, there was no statistical correlation between the degree of sleep impairment and glycemic control.ConclusionWe found a high prevalence of sleep impairment in patients with PDPN. Female sex, IHD, high anxiety levels and use of neuropathic drugs were predictors of poor sleep quality.     

Effect of body weight on pain,sleep quality,and depression in patients with primary fibromyalgia syndrome

Aim of the workObesity and fibromyalgia syndrome (FMS) are two diseases, which are becoming more common and have an impact on social life. This study aimed to evaluate the effect of body weight on pain, sleep quality, and depression in patients with primary FMS and to assess its impact on the functional status.Patients and methodsThe study included 234 patients with primary FMS. The body mass index (BMI) was determined. The visual analog scale (VAS), Beck depression inventory (BDI), and the Pittsburgh sleep quality index (PSQI) were used for evaluating the patients. The Fibromyalgia impact questionnaire (FIQ) was assessed. The patients were divided into 3 groups: normal weight, overweight and obese.ResultsThe mean age of the patients was 40.3 ± 11.01 years (19–65 years); 206 (88%) were female, and 28 (22%) were males. The mean BMI was 28.8 ± 7.1 (17.7–49.1): 80 (34.2%) had a normal weight (24.4 ± 1.8), 76 (32.5%) were overweight (26.4 ± 1.6), and 78 (33.3%) were obese (37.9 ± 5.9) (p < 0.001). The FIQ, BDI, and PSQI were significantly higher in the obese patients compared to the normal and overweight (p < 0.001). The BMI, VAS, BDI, and FIQ were comparable between females and males while only the PSQI was significantly reduced in males (p = 0.004). A significant correlation was found between BMI with the PSQI, BDI, and FIQ (r = 0.11, p = 0.009; r = 0.41, p < 0.001 and r = 0.35p < 0.001 respectively).ConclusionObesity in primary FMS patients was significantly related to pain, sleep disorders, and depression. The importance of movement and weight control in FMS is emphasized.     

Effects of volume-assured pressure support noninvasive ventilation in stable COPD with chronic respiratory failure: Meta-analysis and literature review

BackgroundPatients receiving long-term home noninvasive ventilation (NIV) may slow down the progression to acute exacerbation of chronic obstructive pulmonary disease (AECOPD), however, the problem with respiratory instability during sleep diminished was persisted, which may reduce the effectiveness of NIV and the patient's quality of life. A novel NIV mode with volume-assured pressure support (VAPS) has been gradually applied to improve sleep quality in COPD patients with chronic respiratory failure. This meta-analysis aimed to evaluate the efficacy of VAPS in stable COPD patients with chronic respiratory failure.MethodsWe performed an electronic literature search for RCTs from January 2008 to October 2018. Studies investigating the effects of VAPS in stable COPD patients with chronic respiratory failure were conducted, and the following primary outcomes were reviewed: effectiveness of ventilation, sleep quality, and quality of life.ResultsFive studies with 150 subjects were identified. While questionnaire scores showed significant improvements in the VAPS mode, no significant difference was found in the effectiveness of ventilation (pH, MD = 0.01 [95% CI -0.01 to 0.02, P = 0.27]; PaCO₂, MD = 1.25 [95% CI -1.45 to 3.95, P = 0.37]; PaO₂, MD = 3.14 [95% CI -0.76 to 7.05, P = 0.11]; mSaO₂, MD = 0.23 [95% CI -1.22 to 1.67, P = 0.76]; mPtcCO₂, MD = 3.03 [95% CI -6.06 to- 0.60, P = 0.10]). The VAPS mode did not seem to ameliorate sleep quality and quality of life.ConclusionThe VAPS mode had similar efficacy as the pressure-support (PS) mode. However, VAPS could significantly improve the patients’ subjective feelings.     

Prevalence,awareness, treatment,control and correlates of prevalence and control of hypertension among older adults in Kerala: A mixed methods study

IntroductionWe conducted this study among older adults with the following objectives: (1) To find out the prevalence, awareness, treatment and control of hypertension, (2) To understand the factors associated with hypertension prevalence and control.MethodsA mixed-methods study employing a sequential explanatory design was conducted with a survey of 300 participants aged ≥60 years, and 15 in-depth interviews. Blood Pressure (BP) and waist circumference were measured using standard protocol. Survey data were analysed using univariate and multivariate procedures. In-depth interviews were analysed employing thematic analysis.ResultsHypertension prevalence was 72.3% (95% CI = 67.1–77.2), 68.2% (CI = 61.8–74.2) were aware, 65.4% (CI = 59.0–71.6) were treated and 24% (CI = 18.6–29.9) achieved adequate control. Inadequate physical activity [(adjusted odds ratio (AOR)] = 2.34; CI = 1.19–4.59), current alcohol use (AOR = 2.28; CI = 1.06–4.91) and self-reported diabetes (AOR = 2.02; CI = 1.15–3.52) were associated with hypertension prevalence. Those who reported diabetes (AOR = 2.72, CI = 1.34–5.55), with education level up to high school (AOR = 2.58, CI = 1.11–6.00) and who were in the age group 60–70 years (AOR = 2.14, CI = 1.09–4.20) were more likely to have controlled hypertension compared to their counterparts. From the in-depth interviews it was found that availability and accessibility of services, family support, financial wellbeing, habits and beliefs and conducive environment played a role in hypertension diagnosis and management.DiscussionPrevalence of hypertension was high in this population along with poor control. Efforts are required to improve hypertension control focussing on older adults with low education and those who are aged 70 years and above.     

Overlap of Dyspepsia in Patients with Gastroesophageal Reflux Disease: Impact of Clinical,Metabolic, and Psychosocial Characteristics

Background

Gastroesophageal reflux disease (GERD) and dyspepsia are highly prevalent in the general population with significant symptom overlap, while the interaction between both remains poorly understood.

Aim

To examine whether GERD overlapping dyspepsia would have an impact on clinical and psychological features as compared with GERD alone.

Methods

We performed a cross-sectional study in a GERD cohort (n = 868) that was previously recruited from a population-based GERD survey (n = 2752). We compared the clinical and psychological factors between patients with and without dyspeptic symptoms “epigastric pain or burning.” All participants were evaluated with Reflux Disease Questionnaire score, Pittsburgh Sleep Quality Index score, Taiwanese Depression Questionnaire score, and State-Trait Anxiety Inventory score. Endoscopic findings were classified according to the Los Angeles classification.

Results

Among the GERD population, 107 subjects had overlapping “epigastric pain or burning” (GERD-D), and 761 did not have these symptoms (GERD alone). GERD-D subjects had more severe GERD symptoms and were more often associated with irritable bowel syndrome (IBS) (OR 3.54, 95% CI 1.92–6.52) as compared subjects with GERD alone. In addition, GERD-D subjects had lower quality of sleep (OR 1.11, 95% CI 1.01–1.21), higher depression (OR 1.06, 95% CI 1.02–1.10), lower blood pressure (OR 0.45, 95% CI 0.22–0.95), and higher serum total cholesterol levels (OR 2.78, 95% CI 1.36–5.67) than GERD alone.

Conclusions

GERD-D subjects are characterized with worsening clinical symptoms as well as higher psychosocial, IBS, and metabolic comorbidities, but less erosive esophagitis. Our results indicate that clinical awareness of such overlapping condition would help optimize the management of GERD in clinical practice.

     

Factors associated with depression and suicidal ideation among individuals with arthritis or rheumatism: Findings from a representative community survey

Objective

To investigate factors associated with depression and suicidal ideation among individuals with arthritis or rheumatism.

Methods

The nationally representative Canadian Community Health Survey 2000–2001 included 130,880 respondents (response rate 84.7%). Respondents were diagnosed as depressed using a subset of items from the Composite International Diagnostic Interview. There were 23,405 respondents age ≥20 years who reported that they had been diagnosed with arthritis or rheumatism by a health professional. Logistic regression analyses were conducted to investigate depression and suicidal ideation.

Results

One in 10 Canadians with arthritis had clinically relevant levels of major depression. The age‐ and sex‐adjusted odds ratios (ORs) of major depression (OR 2.24, 95% confidence interval [95% CI] 2.11–2.38) and suicidal ideation (OR 2.01, 95% CI 1.75–2.31) among those with arthritis were approximately twice that of those without arthritis. The adjusted ORs of major depression among those with arthritis were significantly higher among women, the unmarried, younger, and poorer individuals. Individuals in pain, with limitations in activities of daily living, with limitations in instrumental activities of daily living, and with greater numbers of chronic conditions had higher odds of major depression. Less than half of those with major depression had consulted a mental health professional. One in 5 individuals with arthritis and major depression had been suicidal in the past year.

Conclusion

The majority of individuals with arthritis and major depression were not receiving adequate treatment for major depression. Clients should be screened for major depression and suicidal ideation, particularly if they fall into the identified vulnerable groups.     

Factors associated with poor therapeutic response in outpatients with irritable bowel syndrome: a multicenter study in Japan

Background

Some patients with irritable bowel syndrome (IBS) show poor response to treatment. However, risk factors associated with poor therapeutic response have not been determined.

Methods

This multicenter trial evaluated consecutive outpatients with IBS undergoing treatment for more than 1 month. Mental health status and physical function were evaluated using the Japanese version of the SF-8. Therapeutic response was evaluated using the IBS severity index-Japanese version (IBS-SIJ). Patients with IBS-SIJ scores ≥175 were defined as poor responders to treatment, whereas those with IBS-SIJ scores <175 were defined as good responders. The demographic and clinical characteristics of these two groups, along with medications, were compared.

Results

The study enrolled 131 participants, 75 with IBS-SIJ scores ≥175–56 with IBS-SIJ scores <175. Multiple logistic regression analysis showed that female sex [odds ratio (OR) 2.67, 95 % confidence interval (CI) 1.19–5.97, p = 0.0167] and mental component summary (MCS) of the SF-8 <40 (OR 2.58, 95 % CI 1.12–5.97, p = 0.0263) were independent risk factors for poor therapeutic response in patients with IBS.

Conclusions

Lower MCS and female sex were risk factors for poor therapeutic response in patients with IBS. Ascertaining the mechanisms by which lower MCS and female sex are associated with poor therapeutic response in IBS may help design better treatments (Trial registration number: UMIN000016804).