Pain-Related Cognitive Processes, Pain Interference, and Alexithymia in Patients With Primary Headaches.

Objectives This study aims to investigate the effects of pain-related cognitive processes (PRCPs) and emotional state on pain-related disability (PRD) and pain interference (difficulty in performing daily routines, difficulty in engaging in social activities [the enjoyment of life], and the impact on work and/or school performance) in patients with primary headaches (PHs). Methodology PRCPs were evaluated with the Pain Anxiety Symptom Scale-20 (PASS-20), Pain Catastrophizing Scale (PCS), and Pain Belief Questionnaire (PBQ). Anxiety, depression, and alexithymia were investigated to assess the emotional state. PRD was assessed by Headache Impact Test-6 (HIT-6). Health-related quality of life (HRQoL) was evaluated under three headings: daily activities (with Short Form-36 [SF-36] Question [Q] 22), social activities (with Graded Chronic Pain Scale-Revised [GCPS-R] Q 4), as well as the working ability (with GCPS-R Q 5). Two separate models were constructed to identify the factors influencing PRD and HRQoL in PHP: M1 to reveal the factors affecting PRD and M2 to determine the independent factors affecting pain interference. In both models, correlation analysis was applied first and the significant data were then evaluated with regression analysis. Results A total of 364 participants (74 healthy controls [HCs] and 290 PHPs) completed the study. In M1, the following domains were significantly associated with PRD: cognitive anxiety (ß = 0.098; 95% confidence interval [CI] = 0.001-0.405; P = 0.049); helplessness (ß = 0.107; 95% CI = 0.018-0.356; P = 0.031); alexithymia (ß = 0.077; 95% CI = 0.005-0.116; P = 0.033); depression (ß = 0.083; 95% CI = 0.014-0.011; P = 0.025). In M2, factors associated with impairment in daily activities for PHP were as follows: duration of pain, pain intensity, alexithymia, escape-avoidance response, psychological anxiety, anxiety, and poor sleep quality (R = 0.770; R2 = 0.588). The independent factors affecting social activities for PHP were pain intensity and pain-related anxiety (R = 0.90; R2 = 0.81). Independent risk factors that affected the ability to work for PHP were pain intensity, cognitive anxiety, escape-avoidance response, and pain anxiety (R = 0.90; R2 = 0.81). Conclusions This study highlights the importance of cognitive and emotional processes that help increase our understanding of the patient with PHs. This understanding may help to reduce disability and improve the quality of life in this population by helping to guide multidisciplinary treatment goals.

Sleep quality and depression in patients with ankylosing spondylitis and their associations with clinical parameters: A cross-sectional, case-control study.

OBJECTIVES: This study aimed to explore sleep quality in patients with ankylosing spondylitis (AS) and to reveal the clinical parameters that predict sleep quality and depression in AS. METHODS: This study included 100 AS patients and 100 age/sex-matched healthy individuals. The AS activity was assessed by Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS-ESR, ASDAS-CRP), and Visual Analog Scale (VAS). The functional status was assessed by the Bath AS Functional Index (BASFI). AS Quality of Life Questionnaire was administered for the assessment of the disease-related quality of life. Pittsburgh Sleep Quality Index for sleep assessment and Beck Depression Inventory for psychological assessment were administered to all participants. RESULTS: Sleep problems and depressive symptoms were significantly higher in AS patients compared to healthy individuals. All of the AS clinical parameters were significantly higher in AS patients with poor sleep quality than in AS patients with good sleep quality. In the correlation analysis, it was determined that poor sleep quality, depressive symptoms and low quality of life were strongly correlated with each other and AS clinical parameters. The most effective predictor for sleep problems was higher BASDAI scores, followed by higher BASFI, VAS, ASDAS-ESH scores, and younger age. Higher BASFI and VAS scores were predictors for depressive symptoms. CONCLUSION: The findings indicate that poor sleep, depressive symptoms and low quality of life may negatively affect the AS clinic, and therefore sleep quality and depression should not be ignored in the examinations of AS patients.

High-impact chronic pain: evaluation of risk factors and predictors.

Background: The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods: Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results: One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions: This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.

Dietary patterns and eating behaviors on the border between healthy and pathological orthorexia.

PURPOSE: The obsession with healthy eating associated with restrictive behaviors is called Orthorexia Nervosa (OrNe). Nevertheless, some studies suggest that orthorexia can also be a non-pathological interest in healthy eating which is called Healthy Orthorexia (HeOr). First, one of the main objectives of this study is to compare HeOr, OrNe and eating behaviors in different dietary patterns (vegan, vegetarian and omnivore). Second is to reveal the relationship between HeOr, OrNe and eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating). Lastly, to determine the potential predictors of HeOr and OrNe. METHODS: Participants (N = 426 with an omnivorous diet; N = 415 with a vegan diet, N = 324 with a vegetarian diet) completed a web-based descriptive survey, the Teruel Orthorexia Scale and the Three-Factor Eating Questionnaire-R 21. RESULTS: HeOr and OrNe were more common in individuals following both vegan and vegetarian diets. Individuals following a vegan or a vegetarian diet had lower body mass index and higher body image satisfaction than individuals following an omnivorous diet. Cognitive restraint and following a vegan or a vegetarian diet were the two main predictors of both HeOr and OrNe. Cognitive restraint was positively associated with both HeOr and OrNe (more strongly correlated with OrNe), whereas uncontrolled eating and emotional eating behaviors were positively related to OrNe and negatively related to HeOr. CONCLUSION: The present study contributes to a better understanding of the some similarities and differences between HeOr and OrNe. It also points to higher rates of orthorexia in individuals following a vegan or vegetarian diet and represents a further step towards developing prevention and intervention programs by identifying risk factors for OrNe. Level V Cross-sectional descriptive study.

Validation, reliability, and cross-cultural adaptation study of Graded Chronic Pain Scale Revised into Turkish in patients with primary low back pain.

OBJECTIVE: This study aims to assess the adaptation of the Graded Chronic Pain Scale-Revised to the Turkish language and psychometric properties in patients with primary low back pain. METHODS: The translation from the original text into the Turkish language was carried out step by step in accordance with the recommendations. Structural validity was analyzed by exploratory factor analysis (EFA). Reliability was carried out by internal consistency and test-retest analysis. Convergent validity was evaluated through scales composed in accordance with the research standards for chronic low back pain with the National Institutes of Health Task Force recommendations. RESULTS: One hundred thirty-five patients, 58 (43%) men and 77 (57%) women, completed the study. A two-factor structure was obtained according to EFA. The first factor consisted of questions 3, 4, and 5, and the same questions constitute the Pain, Enjoyment of Life, and General Activity scale. Cronbach α coefficient r = 0.814 (good internal consistency) was calculated for internal consistency. CONCLUSION: In this article, we presented the cross-cultural adaptation process of Graded Chronic Pain Scale-Revised to the Turkish language and evidence of its validity and reliability in a sample of patients with primary low back pain.

Predictors of depression, anxiety and stress among remote workers during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has had a massive impact on work and home life, changing all daily routines of remote workers. It is extremely important to figure out some changes in home and work life that may affect the mental health of remote workers more. OBJECTIVES: The first aim of the study was to investigate the predictors of depression, anxiety, and stress among first-time remote workers during the COVID-19 pandemic. The second aim was to explore sex differences regarding work and home life during the COVID-19 pandemic. METHODS: The sample consisted of 459 participants who have been working from home for the first time during the COVID-19 pandemic. An online survey used included questions relating to sociodemographic characteristics, changes in work and home life, Depression Anxiety Stress Questionnaire-Short Form, Jenkins Sleep Scale, and Leisure-Time Exercise Questionnaire. RESULTS: The prevalence of depression, anxiety, and stress was 17.9%, 19.6%, and 19.6% of the participants, respectively. Poor sleep quality, trouble focusing at work, being female, workplace loneliness, low levels of control over working hours, and low levels of physical activity were predictors of depression. Poor sleep quality, increased workload, and being female were predictors of anxiety. Poor sleep quality, trouble focusing at work, being female, financial concern, and workplace loneliness were predictors of stress. It was observed a higher increase in both housework and working hours during the COVID-19 pandemic in women. CONCLUSION: Determining the variables that can affect the mental health of remote workers is highly important for timely psychological intervention.

Social Media Addiction in Young Adult Patients with Anxiety Disorders and Depression.

Objective: Although the relationship between social media addiction (SMA) and mental health is bidirectional, there have been very few attempts to investigate patients with depression or anxiety disorders in terms of SMA. The first aim of this study is to determine whether young adult patients diagnosed with depression or anxiety disorders have a tendency to become addicted to social media. The second aim of the study is to examine the effects of 6 DSM-based personality traits (dependent, histrionic, narcissistic, obsessive-compulsive, borderline, and paranoid) that commonly coexist with these disorders on SMA. Methods: This study was carried out with 276 participants between the ages of 18 and 35 in the Psychiatry Outpatient Clinic in Gazi University Hospital, Turkey. Seventy-three patients diagnosed with depression, 80 patients diagnosed with anxiety disorders, and 123 healthy controls were recruited for the study. The SMA Scale, Hospital Anxiety and Depression Scale, and the Personality Belief Questionnaire-Short Form were administered to the participants. Results: Patients with anxiety disorders (PAD) and patients with depression (PD) were more addicted to social media than healthy controls (HC) despite similar frequencies of social media use. Dependent, histrionic, narcissistic, obsessive-compulsive, borderline, and paranoid personality features in HC increased the susceptibility to SMA. Borderline and dependent personality features comorbid with PAD increased the susceptibility to SMA. None of the personality traits comorbid with PD had an effect on SMA. Conclusion: The present study will serve as a base for future studies which explore factors that can make PAD or PD more vulnerable to SMA.