Our aim was to study the associations between life satisfaction and treatment factors and how depression affects these associations among patients with schizophrenia ( n= 403), major depression ( n = 349) and anxiety disorder ( n = 139) from a defined area. Treatment satisfaction and compliance were high, but life satisfaction was low regardless of diagnostic group. Patients with schizophrenia recorded better life satisfaction than patients with the other disorders. There were few independent associations between life satisfaction and treatment factors. Fortunately, factors amenable to treatment intervention, such as depression, problem‐solving ability and social support. were independently related to life satisfaction in every diagnostic group. Depression decreased these associations significantly only in patients with schizophrenia. Life satisfaction and treatment satisfaction should be included as separate variables in treatment outcome studies.
AbstractPurpose: To investigate the relationships of severe health disorders (SHD) with bone loss, grip strength (GS) and mobility in postmenopausal women. Method: The study sample consisted of 2227 Finnish women (mean age 53.2) from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) cohort. Postal inquiries and clinical measurements were completed during the 15-year follow-up at 5-year intervals between 1989 and 2004. Femoral neck bone mineral density (BMD) and GS were measured. Life-style factors and mobility were obtained via postal inquiries. Work disability pension according to the ICD-9 was an indicator of a SHD. Results: At the baseline 242 women had SHD, 506 got late SHD during 1989–1995, whereas 1479 women had none until 1996. The women with baseline SHD had higher annual bone loss (0.44%) than those without SHD (0.34%) (p < 0.05), those with late SHD (0.39%) no difference was seen. Bone loss was highest with respiratory diseases, but BMD was lowest throughout the follow-up in nervous and sense organ diseases. Lower GS and mobility was also associated with SHD. Conclusion: Effects of SHDs on BMD, GS, and mobility are disease-specific. Thus, rehabilitation should be encouraged in postmenopausal women with SHD, especially in case of diseases of respiratory and nervous system.Implications for RehabilitationOsteoporosis, muscle strength and co-morbidityWomen with severe health disorders (SHD) leading to work disability have impaired musculoskeletal health.Active monitoring of the musculoskeletal health is advised for those with SHD.Women with SHD may benefit from rehabilitative treatment in order to avoid complications of musculoskeletal impairments.Keywords: Co-morbiditydisability leavedisability pensiongrip strengthosteoporosispostmenopause
Mental disorders (MDs) and musculoskeletal disorders (MSDs) are the main causes of disability. Yet, their comorbidity has not received the deserved attention.To investigate the extent of the comorbidity between MDs and MSDs in ageing women using national registries on prescription medications and work disability pensions (DPs).The study included 7,809 Finnish women, born during 1932-41, from the population-based Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort, established in 1989. Lifetime permanent DPs due to: 1) 'MDs only' (n = 359), 2) 'MSDs only' (n = 954), 3) 'MDs + MSDs' (n = 227), were recorded till 2003. The reference group was 'no DP' (n = 6,269). Data from the OSTPRE questionnaires was obtained in 1994. Use of medications was recorded in 1995 and 2003. The use of musculoskeletal or psychotropic medications by women having a DP or medication due to MD, or MSD diagnoses, respectively, was considered as an indicator of comorbidity.In 1995, all DP groups had used psychotropic and musculoskeletal medications more often than the referents. Use of musculoskeletal medications was associated with a higher use of psychotropic medications, and vice versa (OR=2.45; 95% CI 2.17-2.77), compared with non-use. The 'MSDs only' group was more likely to use psychotropic (OR=1.79; 95% CI 1.50-2.12), and the 'MDs only' group musculoskeletal medications (OR=1.38; 95% CI 1.09-1.74), compared with those without DPs. The proportions of medication users were similar in 1995 and 2003; however, the amounts used increased.There was strong evidence for comorbidity between MDs and MSDs in ageing women. Further research concerning their longitudinal relationships is warranted.
PURPOSE: The purpose of this study was to compare health-related quality of life (HRQL) of healthy subjects and those with psychiatric or somatic diseases. DESIGN AND METHODS: Eight dimensions of the RAND 36-Item Health Survey 1.0 (RAND-36) were investigated in a population-based sample. FINDINGS: Scores in all 8 RAND dimensions were lower in subjects with psychiatric diagnoses than in healthy subjects. In logistic regression models, poor social functioning (odds ratio [OR] 1.07–1.12) associated with psychiatric diagnoses. Lowered energy (OR 1.06) associated with major depression, poor general health with personality disorders (OR 1.06) and heart disease (OR 1.06), and physical limitations with heart (OR 1.04) and musculoskeletal disease (OR 1.07). PRACTICE IMPLICATIONS: Acknowledging the lowest HRQL dimensions among subjects with psychiatric diagnoses may help to promote mental, physical, and social well-being more efficiently.
We studied the concurrent, predictive, and discriminate validity of psychopathology scales (e.g., schizotypal and depressive) and temperament traits for hospitalisations due to major depression. Temperament, perceptual aberration, physical and social anhedonia, Depression Subscale of Symptom Checklist (SCL-D), Hypomanic Personality Scale, Schizoidia Scale, and Bipolar II Scale were completed as part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort (n=4941; 2214males). Several of the scales were related to depression. Concurrent depression was especially related to higher perceptual aberration (effect size when compared to controls,d=1.29), subsequent depression to high scores in SCL-D (d=0.48). Physical anhedonia was lower in subjects with subsequent depression than those with other psychiatric disorders (d=−0.33, nonsignificant). Participants with concurrent (d=0.70) and subsequent (d=0.54) depression had high harm avoidance compared to controls, while differences compared to other psychiatric patients were small. Subjects with depression differed from healthy controls in most of the scales. Many of the scales were useful predictors for future hospital treatments, but were not diagnosis-specific. High harm avoidance is a potential indicator for subsequent depression.
We examined whether personality disorders (PDs) (any, cluster A/B/C) were associated with bone mineral density (BMD) in a population-based sample of Australian women ( n = 696). Personality and mood disorders were assessed using semi-structured diagnostic interviews. BMD was measured at the spine, hip, and total body using dual-energy x-ray absorptiometry (GE-Lunar Prodigy). Anthropometrics, medication use, physical conditions, and lifestyle factors were documented. The association between PDs (any, cluster A/B/C) and BMD (spine/hip/total body) was examined with multiple linear regression models. The best models were identified by backward elimination including age, weight, physical activity, smoking status, alcohol consumption, dietary calcium intake, mood disorders, physical multimorbidity, socioeconomic status, and medications affecting bone. The variables were retained in the model if p < 0.05. All potential interactions in final models were tested. Those with cluster A PD, compared to those without, had 6.7% lower hip BMD [age, weight adjusted mean 0.853 (95% CI 0.803–0.903) vs. 0.910 (95% CI 0.901–0.919) g/cm 2 , p = 0.027] and 3.4% lower total body BMD [age, weight, smoking, alcohol, calcium adjusted mean 1.102 (95% CI 1.064–1.140) vs. 1.139 (95% CI 1.128–1.150) g/cm 2 , p = 0.056]. No associations were observed between cluster B/C PDs and hip/total body BMD or between any of the PD clusters and spine BMD. To our knowledge, this study is the first to investigate the bone health of women with PD in a population-based sample. Given the paucity of literature, replication and longitudinal research including the examination of underlying mechanisms and sex differences are warranted.
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