Going beyond sadness
When it comes to assessing for and treating depression in clients, counselors must be careful to steer clear of one-size-fits-all thinking.
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Osteoarthritis May Play a Role in Social Isolation
When older adults become socially isolated, their health and well-being can suffer. Now a new study suggests a link between being socially isolated and osteoarthritis (arthritis), a condition that causes joint pain and can limit a person’s ability to get around.
The findings are published in the Journal of the American Geriatrics Society.
Arthritis patients often have other health issues which may increase their risk of becoming socially isolated. These include anxiety and depression, being afraid to move around (because arthritis makes moving painful), physical inactivity and being unable to take care of themselves.
About 30 percent of adults over 65 have arthritis to some degree, especially in their leg joints. Despite that, until now there has been little research on the link between arthritis and social isolation.
Researchers analyzed data from the European Project on OSteoArthritis (EPOSA) study. They wanted to examine any potential links between arthritis and social isolation, and to identify the disease’s contribution to social isolation.
EPOSA is a study of 2,942 adults between the ages of 65 to 85 years old who live in six European countries: Germany, Italy, the Netherlands, Spain, Sweden, and the UK. In all, 1,967 people, around the age of 73, participated in the study. Half of the participants were women, and almost 30 percent had arthritis.
The researchers looked at whether the participants were socially isolated at the beginning of the study as well as 12 to 18 months later. The participants completed questionnaires that kept track of how often they connected socially with friends and family members and how often they volunteered or participated in social activities.
At the start of the study, almost 20 percent were socially isolated. Those who weren’t socially isolated tended to be younger, had higher incomes and more education. They were also more likely to be physically active, had less physical pain, had faster walking times and were in better all-around health.
Of the 1,585 participants who weren’t considered socially isolated at the beginning of the study, 13 percent had become socially isolated 12 to 18 months later. They reported that their health and osteoarthritis had worsened, they were in more pain, had become less physically active, had slower walking times, and had depression and problems with thinking and making decisions.
The researchers say the findings suggest that osteoarthritis can increase the risk of social isolation. In particular, having problems with thinking and making decisions, as well as having slower walking times, is associated with an increased risk of becoming socially isolated.
Since social isolation can lead to poorer health, the researchers suggest that older adults with arthritis may benefit from engaging in physical activity and social activities. Specifically, they suggest that health care providers might refer people to senior centers where activities are specially designed for people with arthritis.
Source: American Geriatrics Society
Emotional Eating After Bad Breakup May Not Lead to Weight Gain
Going for that pint of ice cream after a bad breakup may not do as much damage as you think. A new study shows that despite the emotional turmoil, people on average do not report gaining weight after a breakup.
The study, which included researchers from Penn State, investigated the German concept of “kummerspeck” — excess weight gain due to emotional eating — which literally translates to “grief bacon.”
According to the researchers, although hoarding food after a breakup may have made sense for humans thousands of years ago, modern humans may have grown out of the habit.
“Food was much scarcer in the ancestral environment, so if your partner abandoned you, it could have made gathering food much harder,” said Dr. Marissa Harrison, associate professor of psychology at Penn State Harrisburg.
“It may have made sense if our ancestors hoarded food after a breakup. But our research showed that while it’s possible people may drown their sorrows in ice cream for a day or two, modern humans do not tend to gain weight after a breakup.”
The findings are published in the Journal of the Evolutionary Studies Consortium.
The researchers say it is well documented that people sometimes use food as a way to cope with negative feelings and that emotional eating can lead to unhealthy food choices. Because breakups can be stressful and emotional, it could potentially trigger emotional eating.
In addition, ancient relationship dynamics may have made packing on the pounds after a breakup evolutionarily advantageous.
“Modern women of course have jobs and access to resources now, but back then, it was likely that women were smaller and needed more protection and help with resources,” Harrison said.
“If their partner left or abandoned them, they would be in trouble. And the same could have gone for men. With food not as plentiful in the ancestral world, it may have made sense for people to gorge to pack on the pounds.”
Harrison also noted that the existence of the word “kummerspeck” itself suggested that the phenomenon existed.
The research team conducted two studies to test the theory that people may be more likely to gain weight after a relationship breakup. In the first experiment, they recruited 581 people to complete an online survey about whether they had recently gone through a breakup and whether they gained or lost weight within a year of that breakup.
Most of the participants — 62.7 percent — reported no weight change. The researchers were surprised by this result and decided to perform an additional study.
For the second experiment, the researchers recruited 261 new participants to take a different, more extensive survey than the one used in the first study. The new survey asked whether participants had ever experienced the dissolution of a long-term relationship, and whether they gained or lost weight as a result.
The survey also asked about participants’ attitudes toward their ex-partner, how committed the relationship was, who initiated the breakup, whether the participants tended to eat emotionally, and how much participants enjoy food in general.
While all participants reported experiencing a break up at some point in their lives, the majority of participants — 65.13 percent — reported no change in weight after relationship dissolution.
“We were surprised that in both studies, which included large community samples, we found no evidence of kummerspeck,” Harrison said. “The only thing we found was in the second study, women who already had a proclivity for emotional eating did gain weight after a relationship breakup. But it wasn’t common.”
Harrison added that the results may have clinical implications.
“It could be helpful information for clinicians or counselors with patients who tend to eat emotionally,” Harrison said. “If your client is going through a breakup and already engages in emotional eating, this may be a time where they need some extra support.”
Victoria Warner, a Penn State Harrisburg graduate student, was the lead author of this study. Samantha Horn from Penn State Harrisburg and Susan Hughes from Albright College also participated in this work.
Source: Penn State
Solitary Confinement Tied to Greater Risk of Death After Prison Release
Prisoners who are held in restrictive housing (i.e., solitary confinement) face an increased risk of death after their release, according to a new study led by researchers from the University of North Carolina (UNC) at Chapel Hill.
The findings show that incarcerated individuals who were placed in restrictive housing in North Carolina from 2000 to 2015 were 24% more likely to die in the first year after their release, compared to those who were not held in restrictive housing.
In addition, those held in restrictive housing were 78% more likely to die from suicide, 54% more likely to die from homicide, and 127% more likely to die from an opioid overdose in the first two weeks after their release.
Further, the number of restrictive housing placements and spending more than 14 consecutive days in restrictive housing were associated with an even greater increase in the risk of death and reincarceration.
“For the first time ever, using data shared with us from our partners at the North Carolina Department of Public Safety, we’ve been able to demonstrate a connection between restrictive housing during incarceration and increased risk of death when people return to the community,” said lead author Lauren Brinkley-Rubinstein, PhD, an assistant professor of social medicine in the UNC School of Medicine.
“In addition, our study found that the more time people spent in restrictive housing the higher the risk of mortality after release. This study provides empirical evidence to support ongoing nationwide reforms that limit the use of restrictive housing.”
“North Carolina is a leader in this thinking as the Department of Public Safety has preemptively implemented multiple reforms that have resulted in the limited use of restrictive housing.”
“We appreciate this research collaboration and recognize the importance of these results in shaping policy and practice,” said Gary Junker, PhD, Director of Behavioral Health for the N.C. Department of Public Safety Adult Correction and Juvenile Justice.
“Since 2015, the department has initiated several programs to divert people from restrictive housing, including Therapeutic Diversion Units for those with mental illness. While safety and security must remain our top priority, we recognize that reduced use of restrictive housing will likely improve post-release outcome.”
These findings, published in the journal JAMA Network Open, are from a retrospective cohort study conducted by Brinkley-Rubinstein and co-authors from UNC, Emory University, the N.C. Department of Public Safety and the N.C. Department of Public Health.
Incarceration data for people who were confined in North Carolina between 2000 and 2015 were matched with death records from 2000 to 2016.
“We also found that non-white individuals were disproportionately more likely to be assigned to restrictive housing than their white counterparts,” said co-author Shabbar Ranapurwala, PhD, MPH, an assistant professor of epidemiology in the UNC Gillings School of Global Public Health and a core faculty member of the UNC Injury Prevention Research Center.
“In fact, the mortality and reincarceration outcomes after release were also quite different between these racial groups. The post-release opioid overdose and suicide death outcomes among those receiving restrictive housing were more pronounced among white individuals compared to non-whites, while the all-cause and homicide death and reincarceration outcomes were higher among non-white Americans compared to whites.”
Given the observational nature of the study, establishing cause and effect may be difficult, yet, the strength and consistency of the findings points to the fact that restrictive housing is an important marker of increased mortality risk among formerly incarcerated individuals.
Eczema in Children Linked to Anxiety, Depression in Parents
A new study has found that a majority of family members and caregivers of children with atopic dermatitis, the most common form of eczema, suffer from anxiety and depression.
For the study, researchers from the PHI University Clinic of Dermatology assessed the impact of an atopic dermatitis diagnosis on the families of 35 children between the ages of 1 and 6. The researchers, who evaluated 83 family members and caregivers, found that all of them reported at least mild severity anxiety, with some showing moderate severity anxiety. Almost three in four — 74 percent — were also found to have depression.
According to the study’s findings, depression and anxiety scores were associated with the persistence and longevity of atopic dermatitis.
The researchers noted they did not find an association between scores and the severity of the disease, meaning that depression or anxiety was not observed to increase where atopic dermatitis was more severe.
Atopic dermatitis, the most common form of eczema, affects between 10 and 20 percent of the pediatric population of Europe. It causes the skin to become itchy, red, dry, and cracked. It is a chronic condition that most often occurs in people who have allergies and can develop alongside asthma and hay fever.
Patients with the condition are also known to suffer insomnia, anxiety, and psychosocial stress, linked to the physical manifestation of their eczema, according to the researchers.
For the study, researchers used the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating scale (HAM-A).
The researchers also asked participants what their greatest concerns were. The most frequent worry was the information families and caregivers receive about the nature of the disease, since atopic dermatitis is a long-term condition that requires complex and costly medical treatments.
“The chronicity and complexity of chronic dermatitis often leads to overlooked anxiety and depression in family members and caregivers, but our results show the extent of this cannot be overstated,” said lead researcher Dr. Vesna Grivcheva-Panovska.
“In the future, we must take a widened approach to the management of atopic dermatitis, not only of the patients but of their families as well.”
The research was presented at the 2019 European Academy of Dermatology and Venereology (EADV) Congress.
Source: Spink Health
Heart Patients With Depression, Anxiety More Likely to Quit Cardiac Rehab
Heart patients with depression, anxiety or stress are more likely to drop out of cardiac rehabilitation, according to a new Australian study published in the European Journal of Preventive Cardiology.
Cardiac rehabilitation is a medically supervised program designed to improve cardiovascular health for patients who have experienced a heart attack, heart failure, angioplasty or heart surgery.
For the study, researchers examined the prevalence and impact of depression, anxiety and stress in patients attending cardiac rehabilitation at two hospitals in Sydney, Australia between 2006 and 2017. A total of 4,784 patients completed the Depression Anxiety Stress Scale questionnaire.
The findings show that approximately 18%, 28% and 13% of participants had moderate to extremely severe depression, anxiety or stress, respectively.
Patients with moderate symptoms of depression (24% versus 13%), anxiety (32% versus 23%) or stress (18% versus 10%) were significantly more likely to quit cardiac rehabilitation compared to those with no or mild symptoms.
“Heart patients living with depression are more likely to feel despondent and hopeless, which reduces their ability to manage their symptoms,” said study author Angela Rao, of the University of Technology Sydney, Australia.
“They may minimize successes and exaggerate failures, thereby reducing their motivation to exercise and complete a cardiac rehabilitation program.”
“Anxiety may lead to fear of another cardiac event and stop people from being active,” she continued. “Depression and anxiety can also impair the ability to retain new information needed to make health-related behavior changes.”
After a heart attack or procedure to open blocked arteries, patients should be encouraged to quit smoking, take up exercise, improve their diet, reduce stress, and control blood pressure and cholesterol; these can be achieved through cardiac rehabilitation.
“Depression can dampen positive intentions to exercise even when receiving support from health professionals and being aware of the benefits,” said Rao.
“People with anxiety may underestimate their abilities, for example to walk on a treadmill during a rehabilitation class.”
Around one half of patients with moderate depression or anxiety who completed cardiac rehabilitation did not show significant improvements in these conditions.
Depression, anxiety and stress were related, with one increasing the likelihood of the other. Patients with anxiety or stress were more than four times more likely to be depressed than those without.
Anxiety was three times more common in patients with (versus without) depression and more than five times more frequent in patients with (versus without) stress.
“These relationships were independent of age, sex, clinical characteristics, medication use and quality of life,” said Rao.
Rao urges clinicians to screen for depression and anxiety at the beginning and end of rehabilitation to identify those needing extra help. Stress management, cognitive-behavioral therapies, meditation and mindfulness can be included to improve mental health and raise participation.
Source: European Society of Cardiology