Correction: Hair cortisol concentrations in a Spanish sample of healthy adults.

[This corrects the article DOI: 10.1371/journal.pone.0204807.].

Hair cortisol concentrations in a Spanish sample of healthy adults.

BACKGROUND: Hair cortisol concentration (HCC), as a novel promising method to retrospectively measure hypothalamic-pituitary-adrenal (HPA) axis activation, is being increasingly studied. We tested the relationships between HCC and a range of possible confounding variables in a Spanish sample of healthy adults and pregnant women. METHODS: The number of healthy adults who participated in the study was 529, being 270 males and 259 females, with a combined mean age of 37.88 years (SD = 15.66). Additionally, a separate sample of 62 pregnant women was also recruited with a mean age of 32.95 (SD = 3.67), and in the first trimester of pregnancy. Each participant was interviewed before the study to obtain sociodemographic and lifestyle variables, and a hair sample was taken from the posterior vertex of the head, cut as close to the scalp as possible. Assuming the average growth rate of head hair is 1 cm per month, a 3-cm segment was analysed, in order to measure the cortisol concentrations from a three-month period. For the pregnant women, hair samples for each trimester of pregnancy were analysed. RESULTS: The mean hair cortisol concentration was 127.91 (111.52) pg/mg for the general sample. The variables of age, education, employment status, use of hair dyes, use of oral contraceptives, and physical exercise had a significant relation to HCC. When adjusted for further variables, only education and physical exercise remained statistically significant. When including the use of oral contraceptives and only with respect to females, only physical exercise remains statistically significant. For the subsample of pregnant woman, the mean hair cortisol concentration was 334.51 (409.77) pg/mg for the first trimester, 302.18 (270.24) pg/mg for the second trimester, and 331.31 (295.46) pg/mg for the third trimester of pregnancy. None of the assessed confounding variables (age, body mass index, previous miscarriages, employment status, hair dyes, dependent children and physical exercise), except education level, was related to HCC. CONCLUSIONS: In this sample of healthy Spaniards, results suggested an association between HCC and physical exercise and educational level. In pregnant women, the prevalence of HCC was higher than in non-pregnant woman, and was related to educational level. This study emphasises the need to determine the relationship between HCC and confounders such as sociodemographic and lifestyle variables in the general population and specific groups formed by individuals such as pregnant women.

Association between perceived level of stress, clinical characteristics and psychopathological symptoms in women with systemic lupus erythematosus.

OBJECTIVES: To evaluate psychopathological status and stress level from a sample with SLE; compare mental functioning and stress levels between women with SLE and healthy women; determine whether disease duration, disease activity, cumulative organ damage and stress have an influence on psychopathological symptoms in SLE patients; and evaluate whether perception of stress is related to SLE severity. METHODS: We conducted a cross-sectional study of 425 participants; 202 women with SLE, with an average age (SD) of 36.61 (10.15), and 223 healthy women, with age-matched controls. The assessment included the clinical characteristics (disease duration, SLE activity, cumulative organ damage, pharmacotherapy), the Symptom Checklist-90-Revised (SCL-90-R) and the Perceived Stress Scale. Descriptive, comparative, univariate and multivariate analysis were performed. RESULTS: SLE patients showed psychopathological alterations in the somatisation, obsessive-compulsive and positive discomfort subscales of SCL-90-R. Women with SLE reported significantly higher scores on the psychopathological dimensions and perceived stress compared to healthy women, except for paranoid ideation. Disease duration, SLE activity, cumulative organ damage, and perceived stress were shown to be significant predictors of psychopathological manifestations, explaining a range, between 20 and 43%, of variance across SCL-90-R dimensions. Moreover, perceived stress was related to SLE activity, after controlling for psychopathological dimensions. CONCLUSIONS: The psychopathological manifestations in SLE appeared to be influenced by perceived stress, disease duration, disease activity and cumulative organ damage. In turn, perceived stress was associated with disease severity. This knowledge may contribute to a more comprehensive perspective of these manifestations in the SLE population in the clinical setting.

Association between burnout and cortisol secretion, perceived stress, and psychopathology in palliative care unit health professionals.

ABSTRACTObjective:A high incidence of burnout has been reported in health professionals working in palliative care units. Our present study aims to determine whether there are differences in the secretion of salivary cortisol between palliative care unit health professionals with and without burnout, and to elucidate whether there is a relationship between burnout syndrome and perceived stress and psychopathological status in this population. METHOD: A total of 69 health professionals who met the inclusion criteria participated in our study, including physicians, nurses, and nursing assistants. Some 58 were women (M = 29.65 years, SD = 8.64) and 11 men (M = 35.67 years, SD = 11.90). The level of daily cortisol was registered in six measurements taken over the course of a workday. Burnout syndrome was evaluated with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the level of perceived stress was measured using the Perceived Stress Scale, and psychopathological status was gauged using the SCL-90-R Symptoms Inventory. RESULTS: There were statistically significant differences in secretion of cortisol in professionals with high scores on a single subscale of the MBI-HSS [F(3.5) = 2.48, p < 0.03]. This effect was observed 15-30 minutes after waking up (p < 0.01) and at bedtime (p < 0.06). Moreover, the professionals with burnout showed higher scores on the psychopathology and stress subscales than professionals without it. SIGNIFICANCE OF RESULTS: A higher score in any dimension of the burnout syndrome in palliative care unit health professionals seems to be related to several physiological and psychological parameters. These findings may be relevant for further development of our understanding of the relationship between levels of burnout and cortisol secretion in the health workers in these units.

Adaptación y validación de la versión española de una medida específica de la calidad de vida en los pacientes con lupus eritematoso sistémico: el Lupus Quality of Life / Adaptation and validation of the Spanish version of a disease-specific quality of life measure in patients with systemic lupus erythematosus: The Lupus Quality of Life

Fundamento y objetivo: El lupus eritematoso sistémico (LES) es una enfermedad autoinmunitaria que afecta la calidad de vida. Hay varios instrumentos específicos que miden la calidad de vida relacionada con la salud (CVRS), pero ninguno se ha adaptado al español. El objetivo de este trabajo fue adaptar y validar en la población española una medida específica de la CVRS en los pacientes con LES. Pacientes y métodos: La adaptación se basó en el método de traducción y retrotraducción de la versión inglesa del LupusQoL (Lupus Quality of Life) y su aplicación en 115 adultos con LES. Resultados: El análisis factorial identificó 5 dominios del LupusQoL; la fiabilidad evidenció un alto coeficiente en el alfa de Cronbach de 0,977 y en el método de las 2 mitades de Guttman de 0,936; las correlaciones significativas del LupusQoL con el Medical Outcome Survey muestran alta validez convergente del cuestionario, mientras que las correlaciones con el Systemic Lupus Erythematosus Disease Activity Index y el System Lupus International Collaborating Clinics fueron bajas, lo que evidencia su validez discriminante. Conclusión. La versión española del LupusQoL cuenta con estables propiedades psicométricas para medir la CVRS en las personas con LES en ámbitos clínicos y de investigación en la población hispanoparlante (AU)

Background and objective: Systemic Lupus Erythematosus (SLE) is an auto-immune disease that seriously affects quality of life. There are various specific instruments that measure health-related quality of life (HRQOL), but none of them has been adapted to Spanish. We intended to adapt and validate in a Spanish population a specific HRQOL measure in patients with SLE. Patients and methods: The adaptation was carried out using the translation and back-translation method of the English version of the LupusQoL, with its subsequent application to 115 adults with SLE. Results: The factorial analysis identified 5 domains of the LupusQoL; the reliability tests showed a high Cronbach α coefficient of 0.977 and a high Guttman two-halves coefficient of 0.936; the significant correlations of the LupusQoL with the SF-36 showed a high convergent validity of the questionnaire; in addition, the correlations with the SLEDAI and SLICC were low, which showed its discriminated validity. Conclusion: The Spanish version of the LupusQoL has stable psychometric properties to measure HRQOL in people with SLE in clinical and research settings in a Spanish-speaking population (AU)

[Adaptation and validation of the Spanish version of a disease-specific quality of life measure in patients with systemic lupus erythematosus: the Lupus quality of life]. / Adaptación y validación de la versión española de una medida específica de la calidad de vida en los pacientes con lupus eritematoso sistémico: el Lupus Quality of Life.

BACKGROUND AND OBJECTIVE: Systemic Lupus Erythematosus (SLE) is an auto-immune disease that seriously affects quality of life. There are various specific instruments that measure health-related quality of life (HRQOL), but none of them has been adapted to Spanish. We intended to adapt and validate in a Spanish population a specific HRQOL measure in patients with SLE. PATIENTS AND METHODS: The adaptation was carried out using the translation and back-translation method of the English version of the LupusQoL, with its subsequent application to 115 adults with SLE. RESULTS: The factorial analysis identified 5 domains of the LupusQoL; the reliability tests showed a high Cronbach alpha coefficient of 0.977 and a high Guttman two-halves coefficient of 0.936; the significant correlations of the LupusQoL with the SF-36 showed a high convergent validity of the questionnaire; in addition, the correlations with the SLEDAI and SLICC were low, which showed its discriminated validity. CONCLUSION: The Spanish version of the LupusQoL has stable psychometric properties to measure HRQOL in people with SLE in clinical and research settings in a Spanish-speaking population.