Quality of life and oral potentially malignant disorders: Critical appraisal and prospects

Quality of life(QoL) is a vital and often required health outcome measure that is relevant to patient care. A healthy oral cavity enables person to perform daily activities without any limitations. However, any disturbance may result in impaired QoL. The oral health-remains an essential element of people's health and well-being. In recent years, the tradition of clinical practice and research has been changed by incorporating QoL assessment, as it helps in assessment of patients' needs and monitoring treatment responses. Oral potentially malignant disorders(OPMDs) are a group of chronic disorders including oral leukoplakia(OL), oral lichen planus and oral submucous fibrosis(OSF). It is evident that patients with OPMDs experience significant health-related symptoms, functional limitations and psycho-social impairment, compromising their Qo L. Moreover, the worsening of Qo L has been associated with advanced stages of OPMDs. Despite of increasing number of OPMD cases in recent decades, limited literature is available regarding QoL in this population. Although, there is higher prevalence of habit-related OPMDs, particularly OSF and OL in Southern Asian countries, only a few studies have been performed in these populations. Moreover, these studies administered generic Qo L instruments, which offer less sensitivity to clinical changes. However, condition-specific instruments are more sensitive and allows better measurement of QoL. As the impacts of different conditions on OHRQoL may vary, the development and validation of a QoL instrument specific to each clinical entity of OPMDs is currently needed.

Assessing the quality of life of children with mental disorders using a computer-based self-reported generic instrument (KidIQoL)—Quality of life of children with mental disorders

OBJECTIVE: To assess the self-reported quality of life (Qol) of children with various mental disorders and compare the scores in this population with those in children without such problems. METHODS: Self- reported Qol was assessed using KidiQoL, a generic computer-based tool with 44 items exploring four domains (Physical and psychological health, Family life, School life and Social and physical environment). The study group consisted of 139 children (111 boys and 28 girls) aged between 6 and 12 years (mean age 9.1 years) referred to an outpatient mental health unit for mental disorders, 29 of whom completed the questionnaire about 2 weeks later in order to assess test-retest reliability. The comparison group consisted of 130 children from the general population, aged 6 to 12 years (mean age 9.0 years) and attending main- stream schools in the same geographical area. RE- SULTS: The test-retest reliability of the instrument was very good with an intraclass correlation coefficient of 0.97 for the total score and above 0.90 in all domains. No significant differences in domain and total scores were observed according to gender or developmental age. Children with developmental disorders or schizophrenia reported significantly lower QoL in the Health domain than children with other types of mental disorders. In all domains and for the total score, the children with mental disorders re- ported significantly lower QoL than the children from the general population;CONCLUSION: KidIQoL has been found suitable and psychometrically valid in children with mental disorders. Its use could help the assessment and adaptation of psychiatric care.

Influence of Metabolic Syndrome versus Musculoskeletal Disorders on Saudi Health-Related Quality of Life

Aim: This work aimed to study the influence of two chronic health conditions, metabolic syndrome (MetS) and musculoskeletal disorders (MSDs), on the health-related quality of life (HRQoL) of Saudis. Method: The Medical Outcomes Study Short Form-36 (SF-36) health status questionnaire was used to measure the HRQoL and compare the mean scores of the questionnaire subscales and physical and mental component summaries (PCS and MCS) of 33 patients with MetS, 18 patients with MSDs, and 30 apparently healthy (AH) subjects. Regression analysis was used to measure the prediction power of the study group, age and gender of the participants in estimating the HRQoL. Results: Results showed that the mean scores of the physical subscales, the PCS, the mental subscales and MCS were arranged in descending order from AH subjects, patients with MetS, to patients with MSDs. The mean scores difference among the 3 study groups were statistically significant with the only exception for the general mental health (GMH) subscale (P = 0.404). The study group and age accounted for 41.8% of the variability of PCS while the study group accounted for 19.6% of the variability in the MCS. The resulted equation to estimate the PCS score was as follows: PCS = 113.18 - 12.85 (Group: 0 for AH, 1 for MetS, and 2 for MSDs) - 0.67 age. On the other hand the resulted equation to estimate the MCS score was as follows: MCS = 76.203 - 10.426 (Group: 0 for AH, 1 for MetS, and 2 for MSDs). Conclusion: Patients with MetS and patients with MSDs had lower HRQoL than AH subjects. All the physical and mental dimensions of HRQoL are negatively influenced with MetS and with MSDs with the only exception for the GMH subscale. The physical and mental burden of MSDs is more dominant. The study group and age can be used to predict the PCS while the study group can be used to predict the MCS.

Defecation disorders are crucial sequelae that impairs the quality of life of patients after conventional gastrectomy

BACKGROUND Defecation disorders are obscure sequelae that occurs after gastrectomy,and its implication on daily lives of patients have not been sufficiently investigated.AIM To examine the features of defecation disorders after gastrectomy and to explore its implication on daily lives of patients in a large cohort using the Postgast rectomy Syndrome Assessment Scale(PGSAS)-45.METHODS We conducted a nationwide multi-institutional study using PGSAS-45 to examine the prevalence of postgastrectomy syndrome and its impact on daily lives of patients after various types of gastrectomy.Data were obtained from 2368 eligible patients at 52 institutions in Japan.Of these,1777 patients who underwent total gastrectomy(TG;n=393)or distal gastrectomy(DG;n=1384)were examined.The severity of defecation disorder symptoms,such as diarrhea and constipation,and their correlation with other postgastrectomy symptoms were examined.The importance of defecation disorder symptoms on the living states and quality of life(QOL)of postgastrectomy patients,and those clinical factors that affect the severity of defecation disorder symptoms were evaluated using multiple regression analysis.RESULTS Among seven symptom subscales of PGSAS-45,the ranking of diarrhea was 4th in TG and 2nd in DG.The ranking of constipation was 5th in TG and 1st in DG.The symptoms that correlated well with diarrhea were dumping and indigestion in both TG and DG;while those with constipation were abdominal pain and mealrelated distress in TG,and were meal-related distress and indigestion in DG.Among five main outcome measures(MOMs)of living status domain,constipation significantly impaired four MOMs,while diarrhea had no effect in TG.Both diarrhea and constipation impaired most of five MOMs in DG.Among six MOMs of QOL domain,diarrhea impaired one MOM,whereas constipation impaired all six MOMs in TG.Both diarrhea and constipation equally impaired all MOMs in DG.Male sex,younger age,division of the celiac branch of vagus nerve,and TG,independently worsened diarrhea,while female sex worsened constipation.CONCLUSION Defecation disorder symptoms,particularly constipation,impair the living status and QOL of patients after gastrectomy;therefore,we should pay attention and adequately treat these relatively modest symptoms to improve postoperative QOL.

Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.

Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study

AIM To find the association between asthma and different types of functional abdominal pain disorders(FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated selfadministered questionnaires(Rome Ⅲ questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTS Of the 1101 children included in the analysis, 157(14.3%) had asthma and 101(9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain(FAP)(8.9% vs 3.3% in nonasthmatics), functional dyspepsia(FD)(2.5% vs 0.7%), and abdominal migraine(AM)(3.2% vs 0.4%) were higher in those with asthma(P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome(4.5% vs 3.1%, P = 0.2). Severe abdominal pain(10.8% vs 4.6%), bloating(16.6% vs 9.6%), nausea(6.4% vs 2.9%), and anorexia(24.2% vs 16.2%) were more prevalent among asthmatics(P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life(HRQoL) were lower in those with asthma and FAPDs(P < 0.05, unpaired t-test).CONCLUSION Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.

Contribution of attachment insecurity to health-related quality of life in depressed patients

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life(HRQo L) in patients diagnosed with adjustment disorder(AJD) with depressed mood. METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance(ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package(SPSS Inc., Chicago, IL, United States).RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggestthat depressive symptoms were more severe(F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer(F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQo L, accounting for 21.4% and 29.7% of the total variance, respectively [R2 = 0.79; Adjusted R2 = 0.77; F(5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQo L outcome in AJD with depressed mood.

Sleep disturbances are associated with anxiety,depression,and decreased quality of life in patients with coronary heart disease

BACKGROUND Studies have shown that sleep disorders are closely related to anxiety and depression,and the quality of life(QoL)of patients with sleep disorders is generally poor.AIM To examine the occurrence of sleep disorders in people with coronary heart disease(CHD)and their relationships with QoL,depression,and anxiety.METHODS As per the sleep condition,240 CHD individuals were separated into two groups:non-sleep disorder group(n=128)and sleep disorder group(n=112).The selfrating anxiety scale(SAS),self-rating depression scale(SDS),and World Health Organization criteria for the Quality of Life Brief scale(WHOQOL-BREF)scores of the two groups were compared.Logistic regression method was used to analyze the independent risk factors of CHD patients with sleep disorders.Multivariate logistic regression analysis was employed to develop the risk prediction model.The association among the Pittsburgh Sleep Quality Index,SAS,and SDS was examined using Spearman’s correlation analysis.RESULTS The incidence of sleep disorder was 46.67%in 240 patients.The scores of SAS and SDS in the sleep disorder group were higher than those in the non-sleep disorder group,and the WHOQOL-BREF scores were lower than those in the non-sleep disorder group(P<0.05).The risk prediction model of sleep disturbances in CHD patients was constructed using the outcomes of multivariate logistic regression analysis,P=1/[1+e(-2.160+0.989×(female)+0.001×(new rural cooperative medical insurance)+2.219×(anxiety)+2.157×depression)].The results of a Spearman’s correlation study revealed that sleep quality was strongly adversely connected with the physiological field,psychological field,and social relation scores in QoL,and was considerably positively correlated with SAS and SDS(P<0.05).CONCLUSION A multivariate logistic regression model can better predict the occurrence of sleep disorders in CHD patients.Sleep disorders in CHD patients are significantly correlated with QoL,depression,and anxiety.

A Review of Systemic Lupus Erythematosus (SLE): Symptoms, Risk Factors, Treatment, and Health Related Quality of Life Issues

In this paper, we present a thorough review of one of the most life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.

Psychological Nursing Combined with Biofeedback to Promote the Rehabilitation of Patients with Anxiety Disorders

Objective:To explore the effect of psychological nursing combined with biofeedback on the rehabilitation of patients with anxiety disorders.Methods:100 patients with anxiety disorders in our hospital from January to December 2021 were randomly divided into two groups:control group(n=50)and study group(n=50).The control group was given routine nursing,while the study group was given psychological nursing combined with biofeedback.The changes of self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,symptom score,and quality of life of the two groups were compared before and after nursing.Results:Before nursing,there was no significant difference in the scores of SAS and SDS between the two groups,but after nursing,the scores of SAS and SDS in the study group were lower than those in the control group,and the degree of improvement in the study group was higher than that of the control group.Before nursing,there was no significant difference in the scores of symptoms between the two groups(P>0.05),but after nursing,the scores of stress,crying spells,tremor,and general discomfort in the study group were lower than those of the control group(P<0.05).Besides,before nursing,there was no significant difference in the quality of life between the two groups(P>0.05),but after nursing,the scores of physical function,psychological activity,social ability,and material life in the study group were higher than those in the control group(P<0.05).Moreover,the degree of improvement after nursing in the study group was better than that of the control group.Conclusion:Psychological nursing combined with biofeedback to promote the rehabilitation of patients with anxiety disorders effectively improves the negative emotion of patients,reduces stress,depression,tremor,and general discomfort,and improve the overall quality of life.Therefore,it is worth further popularization.

Clinical Observations on the Effects of a Dietary Supplement (GI Regenerate^TM) on Patients’ Gastrointestinal Symptoms and Quality of Life Assessments

Background: Different treatments have been developed and used to control symptoms and improve quality of life in patients with digestive diseases and disorders. Although the use of drugs or alternative approaches has improved symptom severity in some but not all patients, often these improvements were not sustainable. Objectives: An open label clinical study was initiated to determine if oral capsules containing a dietary supplement of herbs and oils (GI RegenerateTM) could reduce self-reported gastrointestinal symptoms and improve quality of life (QOL) indicators in patients with gastrointestinal conditions. Methods: Participants included 50 patients (40 females and 10 males) of mean age of 51.1 ± 12.7 years (range, 24 - 77 years) with a diagnosis of a gastrointestinal disorder or gastrointestinal symptoms. These patients consumed five soft-gels containing the test supplement 30 minutes before each meal for 90 days. Symptoms were evaluated by medical staff, and patient health status was self-reported using a validated quality of life questionnaire (Quality of Life Digestive Survey) designed for functional digestive disorders. Exit interviews (Patient Global Impression of Change, PGIC) were conducted by the medical staff. Results: Participants in the study responded with improved symptom severities and QOL scores to the test dietary supplement within the 90 day period;most improvements occurred within 20 days on the test dietary supplement. By the end of the study there were significant overall global improvements in the symptoms and QOL health surveys (p = 0.0183), with significant improvements in symptom discomfort (p = 0.0004), daily activities (p = 0.029) and anxiety (p = 0.018). In contrast, there were insignificant improvements in diet (p = 0.398), sleep (p = 0.136), health perception (p = 0.686), coping with the disease (p = 0.309) and impact of stress (p = 0.785). Using the PGIC exit interview that measured each patient’s impression of overall global change in symptoms and QOL these data also indicated overall significant improvements in symptoms and in satisfaction with the test supplement (moderately better improvements in symptoms and QOL or score of 4.8 ± 0.169, p 50 years) versus younger (Conclusions: The GI RegenerateTM natural dietary supplement safely and significantly reduced gastrointestinal symptoms and improved quality of life in subjects with a broad spectrum of gastrointestinal disorders and symptoms.

Quality of Life and Psychological Distress in Women with Mayer-Rokitansky-Küster-Hauser Syndrome and Individuals with Complete Androgen Insensitivity Syndrome

Purpose: This study examines quality of life and psychological distress in individuals with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) and Complete Androgen Insensitivity Syndrome (CAIS), two syndromes belonging to the field of “disorders of sex development”. Methods: Fifty women with MRKHS and eleven individuals with CAIS participated. The German versions of the World Health Organization Quality of Life Questionnaire (short version, WHOQOL-Bref), the Brief Symptom Inventory (BSI), and the Patient Health Questionnaire (PHQ-D) were used as standardized instruments to measure quality of life and psychopathology. Additional questions concerning demographic variables and suicidality were included. Results: In both patient samples examined, general quality of life reported was in the average range (CAIS: mean z-score = ﹣0.43, SD = 1.05;MRKHS: mean z-score = ﹣0.11, SD = 1.06). The standardized instrument assessment revealed increased psychological distress (proportion of clinical cases according to the BSI: CAIS: 54.5%;MRKHS: 55.1%). A correlation between psychological distress and time span from first suspicion to diagnosis was found in women with MRKHS (Spearman’s rho = 0.35, p = 0.018). Conclusions: The results illustrate the importance of individualised and thorough diagnostics when dealing with patients with MRKHS or CAIS. Psychological distress might be an issue for these individuals and therefore should be considered in treatment and counselling.

The Effect of Allergic Rhinitis on Quality of Life in Patients Suffering from the Disease: A Case Control Study

Background: Apart from nasal symptoms allergic rhinitis was associated with ocular or other symptoms affecting social and somatic activities or sleep. In the literature, only a few prospective studies regarding allergic rhinitis and holistic consideration of quality of life were reported. Methods: The aim of this case control study was to investigate prospectively the effect of allergic rhinitis on quality of life. 103 patients (50 males and 53 females) with mean age 30.8 &plusmn;13.4 years, range 18 - 55 years, diagnosed with the disease with skin prick testing, were evaluated regarding quality of life by using the General Health Questionnaire-28, the Athens Insomnia Scale (AIS) and the mini Rhinocon-junctivitis Quality of Life Questionnaire. 50 participants without history or al-lergic symptoms during the last 12 months formed the control group. Inde-pendent sample t-tests were conducted to assess significant differences between patients with allergic rhinitis and controls regarding all the examined parameters concerning quality of life. Data was analyzed using Windows statistical package of SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). Statistical significance was set a priori at 0.05. Results: Dust mite, mixed grass and pollens were the most common allergens found in patients with allergic rhinitis. It was also observed that the examined patients showed statistically worse results concerning not only physical and social activities but also quality of sleep and nasal or other symptoms as compared to healthy controls (p 0.05). Conclusion: Allergic rhinitis negatively affected the quality of life especially the parameters that were related to psychosocial activities and sleep, which might have an impact on daily living.

Quality of life of elderly nursing home residents and its correlates in Kayseri. A descriptive-analytical design: A cross-sectional study

Purpose: To define the level of quality of life in an elderly population and to investigate the effects of selected variables, such as anemia, fatigue, depression and sleep disorders, on the quality of life. Design and Methods: The study was conducted in Gazio?lu Nursing Home, located in the city center of Kayseri, on 136 subjects ≥65 in the year 2008-2009. Data were collected using the Geriatric Depression Scale (GDS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life-OLD (WHOQOL- OLD) Module. In the statistical analysis mean ± standard deviation, student’s t-test, ANOVA and Spearman correlation analysis were used. Re- sults: The mean total score of quality of life was 43.45 ± 10.30. Of the residents 47.0% had a poor quality of life. Autonomy had the lowest (35.70 ± 19.96) and intimacy had the highest (48.75 ± 17.96) subdomain scores. Fatigue significantly decreased the total and autonomy, social par- ticipation and death and dying subdomain scores. Anemia had a significant adverse effect on intimacy, depression on autonomy and intimacy and sleep disorder on death and dying. There were negative correlations between fatigue with past-present-future activities and social participation, depression with social participation, intimacy, death and dying and glucose levels with social participation and intimacy. Implications: About half of the subjects had a poor quality of life. Fatigue was the sole factor to negatively affect the total score in WHOQOL-OLD. Depression, anemia and sleep disorder adversely affected the autonomy, social participation, intimacy, death and dying subdomain scores but not in all.

Saffron (Crocus sativus L.) and major depressive disorder:a meta-analysis of randomized clinical trials

Due to safety concerns and side effects of many antidepressant medications, herbal psychopharmacology research has increased, and herbal remedies are becoming increasingly popular as alternatives to prescribed medications for the treatment of major depressive disorder （MDD）. Of these, accumulating trials reveal positive effects of the spice saffron （Crocus sativus L.） for the treatment of depression. A comprehensive and statistical review of the clinical trials examining the effects of saffron for treatment of MDD is warranted. OBJECTIVE： The purpose of this study was to conduct a meta-analysis of published randomized controlled trials examining the effects of saffron supplementation on symptoms of depression among participants with MDD. SEARCH STRATEGY： We conducted electronic and non-electronic searches to identify all relevant randomized, double-blind controlled trials. Reference lists of all retrieved articles were searched for relevant studies. INCLUSION CRITERIA： The criteria for study selection included the following： （1） adults （aged 18 and older） with symptoms of depression, （2） randomized controlled trial, （3） effects of saffron supplementation on depressive symptoms examined, and （4） study had either a placebo control or antidepressant comparison group. DATA EXTRACTION AND ANALYSIS： Using random effects modeling procedures, we calculated weighted mean effect sizes separately for the saffron supplementation vs placebo control groups, and for the saffron supplementation vs antidepressant groups. The methodological quality of all studies was assessed using the Jadad score. The computer software Comprehensive Meta- analysis 2 was used to analyze the data. RESULTS： Based on our pre-specified criteria, five randomized controlled trials （n = 2 placebo controlled trials, n = 3 antidepressant controlled trials） were included in our review. A large effect size was found for saffron supplementation vs placebo control in treating depressive symptoms （M ES = 1.62, P 〈 0.001）, revealing that saffron supplementation significantly reduced depression symptoms compared to the placebo control. A null effect size was evidenced between saffron supplementation and the antidepressant groups （M ES = -0.15） indicating that both treatments were similarly effective in reducing depression symptoms. The mean Jadad score was 5 indicating high quality of trials. CONCLUSION： Findings from clinical trials conducted to date indicate that saffron supplementation can improve symptoms of depression in adults with MDD. Larger clinical trials, conducted by research teams outside of Iran, with long-term follow-ups are needed before firm conclusions can be made regarding saffron＇s efficacy and safety for treating depressive symptoms.

Posttraumatic stress disorder after liver transplantation

BACKGROUND: Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010. METHODS: Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires. RESULTS: The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD. CONCLUSIONS: PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.

Prevalence of pelvic floor disorders and the associated quality of life among institutionalized and noninstitutionalized elderly women:A cross-sectional study

Background:An increase in life expectancy has led to an increased elderly population.In turn,this aging population is more likely to develop health conditions,such as pelvic floor disorders(PFDs).This study aimed to assess the prevalence of these disorders and the associated quality of life in institutionalized and noninstitutionalized elderly women.Materials and methods:A cross-sectional study was conducted with 80 female participants older than 60 years,divided into 2 groups:institutionalized and noninstitutionalized participants.The Pelvic Floor Distress Inventory Short-Form and a sociodemographic questionnaire were used.A chi-squared test was used to assess the differences in prevalence between groups.Results:There was no statistically significant difference between the groups in the prevalence of PFDs or quality of life.In this study,the prevalence of PFDs was higher than that reported previously.In institutionalized women,a higher prevalence of PFDs and impaired quality of life were expected,although not observed.Conclusions:There was a higher prevalence of pelvic disorders and impaired quality of life due to these disorders in elderly women.

Health-related quality of life and stress-related disorders in COVID-19 ICU survivors:Are they worse than with other causes of ARDS?

Background:There are insufficient data regarding the impact of acute respiratory distress syndrome related to coronavirus disease 2019(C-ARDS)–caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)–on health-related quality of life(HRQoL)and the occurrence of stress-related disorders in coronavirus disease 2019(COVID-19)intensive care unit(ICU)survivors.The aim of this study is to assess HRQoL and the occurrence of stress-related disorders(acute stress disorder[ASD]and post-traumatic stress disorder[PTSD])in C-ARDS ICU survivors at 1 and 6 months following hospital discharge.Methods:This prospective observational study included 90 patients treated for C-ARDS between March and May 2020 in the ICU and discharged alive from the hospital.All patients included in the study were contacted by telephone 1 month and 6 months post-hospital discharge to assess the presence of symptoms of stress-related disorders and HRQoL using the 8-item Treatment Outcome Post-traumatic Stress Disorder scale(TOP-8)and 36-item Short Form survey(SF-36).We performed univariate analyses to evaluate differences between patients who developed stress and those who did not.We also compared SF-36 scores in our sample with data from the general Spanish population and from cohorts of non–C-ARDS and severe acute respiratory syndrome coronavirus-1(SARS-CoV-1)survivors.Results:There are 24.1%of patients showed symptoms of ASD;in 13.5%of cases the symptoms persisted 6 months later.Risk factors for the development of symptoms of ASD and PTSD are younger age,female sex,obesity,a previously diagnosed psychiatric disease and disease severity at ICU admission(P<0.05).HRQoL was greatly affected by C-ARDS;however,there was improvement on all scales of the SF-36 at the 6-month follow-up(P<0.05).The mean SF-36 score of our sample was higher than those previously reported in non–C-ARDS survivors(P<0.05)for physical functioning(78.0 vs.52.0),role functioning/physical(51.0 vs.31.0),bodily pain(76.1 vs.57.0),vitality(58.6 vs.48.0),social function(72.6 vs.63.0)and role emotional(77.4 vs.55.0),except on the general health scale.C-ARDS survivors also scored better than SARS-CoV-1 survivors on all scales except for body pain(P<0.05).Conclusions:The impact of C-ARDS on HRQoL is substantial,with frequent occurrence of PTSD symptoms.Patients are heavily affected in all areas of health in the first month of post-hospital discharge but show a dramatic improvement within 6 months,especially in terms of physical health.

焦虑障碍患者的焦虑水平、述情障碍程度对其生活质量的影响

目的·评估焦虑障碍患者的焦虑水平、述情障碍程度与其生活质量之间的关系。方法·选择2020年10月1日-2023年3月31日期间在上海交通大学医学院附属精神卫生中心门诊收治的焦虑障碍患者为研究对象,经排除后最终纳入患者438例;其中,广泛性焦虑障碍患者271例,惊恐障碍患者101例,社交焦虑障碍患者48例,场所恐惧症患者12例,特定恐惧症患者6例。分别采用汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表-17项(Hamilton Depression Scale-17,HAMD-17)、多伦多述情障碍量表-20项(the twenty-item Toronto Alexithymia Scale,TAS-20)、世界卫生组织生活质量测定简表(World Health Organization Quality of Life Scale-Brief Form Questionnaire,WHOQOL-BREF)评估患者的焦虑水平、抑郁水平、述情障碍程度及生活质量,并对不同亚型焦虑障碍患者的量表得分进行评估。采用Spearman相关系数对焦虑障碍患者的焦虑水平、抑郁水平、述情障碍程度与生活质量进行相关分析,并使用逐步回归模型探索影响焦虑障碍患者生活质量的关键变量。结果·不同亚型焦虑障碍患者在HAMA评分、HAMD-17评分、TAS-20评分间的差异无统计学意义,但在WHOQOL-BRIEF评分上差异具有统计学意义(H=10.076,P=0.039)。Spearman相关分析的结果显示,焦虑障碍患者的WHOQOL-BRIEF评分与HAMA评分、HAMD-17评分、TAS-20评分均呈负相关(r=−0.256,P=0.000;r=−0.311,P=0.000;r=−0.342,P=0.000)。逐步回归分析的结果显示,年龄、HAMA评分、HAMD-17评分及TAS-20评分均对患者的生活质量有较大影响(均P<0.05)。结论·不同亚型焦虑障碍患者的生活质量有所不同,焦虑水平、抑郁水平及述情障碍程度均是影响焦虑障碍患者生活质量的关键变量。