Combined impact of concomitant arthritis and back problems on health status: results from a nationally representative health survey.

OBJECTIVE: To investigate whether people who report both arthritis and back problems report poorer health outcomes than those who have either condition alone. METHODS: We performed an analysis of the 2005 Canadian Community Health Survey (n = 126,049, age ≥15 years). Respondents were asked about long-term chronic health conditions diagnosed by a health professional and lasting 6 months or more. The risks of reporting 4 health outcomes (activity limitation, fair/poor self-rated overall health, fair/poor self-rated mental health, and ≥4 doctor consultations in the previous 12 months) were estimated using log Poisson regression analysis adjusting for sociodemographic and lifestyle factors for 5 analytic groups (arthritis and back problems, arthritis only, back problems only, any other chronic condition, and no chronic condition). RESULTS: Arthritis and back problems were reported by 6% of the population (10.5% arthritis only and 13% back problems only). The arthritis and back problems and arthritis only groups had a higher prevalence in women, those of older age, and those who were overweight or obese. For all health outcomes, prevalence ratios showed higher risks of poor outcome for the arthritis and back problem group than for arthritis only or back problems only groups, which had similar risk. Risks were lowest for the any other chronic conditions group and the no chronic conditions group. CONCLUSION: Chronic back problems were reported by one-third of people with arthritis, who had increased risks of activity limitation, poorer self-rated overall and mental health, and higher health care use. The findings suggest that concomitant back problems are a major contributor to a range of health outcomes in arthritis.

An overview of traumatic brain injury and suicide.

PURPOSE: There is concerning evidence that people with traumatic brain injury (TBI) may be at increased risk for suicide. This paper aims to provide an overview of traumatic brain injury and suicide in order to enhance the ability of professionals to recognize and manage suicidality in patients with TBI. METHODS: First, the association between TBI and suicide is reviewed. Proposed psychological, psychosocial and neuropathological factors are included in the discussion. Next, identifiable risk factors for suicide in TBI are presented. Suicide assessment tools are then discussed. Assessment is emphasized as the mainstay of suicide prevention and clinicians are encouraged to be vigilant for potential suicidality in their patients with TBI. Finally, biopsychosocial interventions for suicidality are reviewed. CONCLUSIONS: This paper concludes that increasing awareness of depression and suicide risk assessment in the TBI population should be aimed towards staff involved in neuro-rehabilation as well as other professionals who are involved in the care of patients with TBI, because psychoeducation of those most likely to come in contact with at-risk individuals have been shown to increase identification of suicidal patients, lowering suicide rates.