Christine Potkul

The results of a recent study show that persistent postnatal depression (PND) lasting 6 months or longer can have severe implications on child development.

, included 9848 women whose average age was 28.5 years at delivery, and 8287 children comprising 4227 boys and 4060 girls. Data were collected throughout different periods of the childrens’ development, from preschool to late adolescence, using the self-rated Edinburg Postnatal Depression Scale (EPDS). PND was identified as persistent when the EPDS score was higher than the 3 threshold levels—moderate, marked, or severe&mdash;at both 2 and 8 months after childbirth.

The findings concluded that PND lasting 6 months or greater, compared with episodes that did not persist, may have negative effects on a child’s development. Persistent and severe depression increase the risk for behavioral problems at 3.5 years of age, achieving lower mathematics grades at 16 years of age, and developing depression at 18 years of age. Patients at risk of maternal depression require treatment to protect their mental health and their children’s development.

“We know postnatal depression is commonly affecting approximately 1 in 10 women,” said study authors Elena Netsi BSc, MSc, DPhil, and Alan Stein, FRCPsych, in a statement. “Our study highlights that screening both early and late in the postnatal year can help identify women whose depression persists. This should alert health care professionals to women whose depression may become chronic, and such women should be prioritized for treatment.”

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The results of a recent study show that persistent postnatal depression lasting 6 months or longer can have severe implications on child development.

Persistent and Severe Postnatal Depression Increase Children's Risk of Development Issues

The results of a recent UK study reveal that psychological distress, whether considered low or moderate, can increase a patient’s risk for chronic obstructive pulmonary disease (COPD), arthritis, and cardiovascular disease (CVD).

The study, published in the Journal of Psychosomatic Research, examined the association between psychological distress and socioeconomic position for diabetes, arthritis, COPD, and CVD. The research team gathered data from 16,485 adults and considered each patient’s health habits that would affect risk and their variations based on socioeconomic status.

The study controlled for age, sex, body mass index, baseline disease, and social support. Using the General Health Questionnaire (GHQ), at baseline, patients self-reported their experience with the 4 disorders over the past 3 years. The patients were then divided by socioeconomic position, based on occupation, using the Registrar General’s Social Class.

Psychological Distress Increases Risk for Chronic Diseases

, examined the association between psychological distress and socioeconomic position for diabetes, arthritis, COPD, and CVD. The research team gathered data from 16,485 adults and considered each patient’s health habits that would affect risk and their variations based on socioeconomic status.

The researchers found that there was a dose-response pattern of psychological distress linked with significantly increased risk for COPD, CVD, and arthritis. Patients who scored 7 or higher on the GHQ were said to be at greater risk for COPD (odds ratio [OR], 3.25; 95% CI, 1.47-7.18), CVD (OR, 3.06; 95% CI, 1.89-4.98), and arthritis (OR, 2.22; 95% CI, 1.58-2.13). Additionally, smoking status, exercise, and eating habits also affected this association. 

The results of a recent UK study reveal that psychological distress, whether considered low or moderate, can increase a patient’s risk for chronic obstructive pulmonary disease, arthritis, and cardiovascular disease.

Psychological Distress and Socioeconomic Status Increase Risk for Chronic Diseases

Patients with HIV have a high likelihood of developing depression related to their diagnosis, according to the results of a recent study. Uncertain what actions to take, many of these patients do not seek medical care and go without proper therapy.

, examined the association between the length of time a patient remains depressed and care outcomes among 5927 HIV-positive adult patients. Participants took multiple depressive severity assessments that were translated into a measurement of percent of days with depression. The results showed that patients spend a median of 14% of their days with depression.

According to the study, each 25% increase in the amount of days spent with depression resulted in an 8% increase in the risk of missed appointments, a 5% increase in the risk of treatment failure, and a 19% increase in mortality. Patients experiencing depression for the duration of the follow-up period had a 37% greater risk of missing appointments, a 23% increased risk of treatment failure, and a mortality rate 2 times higher than patients who never spent time depressed.

These study findings show that patients with HIV who develop depression are more susceptible to worse health outcomes than their counterparts without depression. Health care providers need to accurately identify depression in these patients through regular screenings and provide them with an individualized treatment that works for them.

Patients with HIV have a high likelihood of developing depression related to their diagnosis, according to a recent study., and many of them do not seek medical care.

Patients With HIV Who Develop Depression Are Unlikely to Seek Treatment

Routine HIV screening tests are preventive measures recommended by the CDC for all patients aged 13 to 64 years. Provider-initiated 

 test offers are an important strategy for increasing HIV screening among heterosexual populations, but improvement is needed, according to a study published in the CDC’s 

By offering this service, health care providers remind patients of the importance of HIV testing, especially among heterosexual populations at an increased risk for acquiring the infection. To obtain more information about the prevalence and predictors of provider-initiated HIV test offers in this patient population, the National HIV Behavioral Surveillance (NHBS) used data from Virginia.

The NHBS recruited heterosexual, cis-gendered individuals aged 18 to 60 years, who have an increased risk for acquiring HIV attributed to heterosexual activity and are of low-income status. Patients must not have used injection drugs or had male-to-male sexual contact in the previous 12 months before interviews.

Patients who completed the face-to-face NHBS interviews, but did not meet all criteria were excluded from the study, leaving 333 respondents. To examine the association between HIV test offers and demographic and behavioral characteristics, researchers used univariable log-binomial regression models. All the analysis variables were self-reported by respondents.   

According to the findings in this study, 58% of respondents reported not receiving an HIV test offer from their health care provider compared with 42% who did. Among the individuals who did report an HIV test offer, 71% of patients underwent HIV testing during the 12 months following the interview, while only 16% of patients not offered the HIV test went for screenings during that period. 

HIV test offer prevalence was lower among patients uninsured than among those with health insurance (PR = 0.78; 95% Cl = 0.59-1.03). The prevalence of HIV test offers in patients aged 31 to 40 years (PR = 1.24; 95% Cl = 0.89-1.72) was higher compared with patients aged 51 to 60 years (PR = 0.71; 95% Cl = 0.49-1.01).  

HIV test offer prevalence was lower among men than women (prevalence ratio [PR] = 0.67; 95% cl = 0.50-0.89). Researchers found the relationship between gender and HIV test offer significant (aPR = 0.72; 95% Cl = 0.53-0.97). 

When potential confounders were adjusted for in this relationship, prevalence of HIV test offers remained significantly lower in men than in women (aPR = 0.69; 95% Cl = 0.51-0.93). The likelihood of females receiving more HIV test offers could be attributed to their participation in family planning services, fewer sex partners, and more frequent seeking of health care and routine health screens than male patients.  

Health care providers who offer HIV tests will encourage patients to integrate preventive HIV screenings into their health care routines. If providers implement this strategy, heterosexual adults at increased risk for acquiring the infection, especially males, will be more inclined to undergo repeat HIV screening.  

Karen D, Tina C, Anne R, et al. Prevalence and Predictors of Provider-Initiated HIV Test Offers Among Heterosexual Persons at Increased Risk for Acquiring HIV Infection-Virginia 2016. MMWR Morb Mortal Wkly Rep. 2018; 67(25);714-717.  

HealthÂ care providers who offer HIV tests encourage patients to integrate preventive screenings into their health care routines.


Provider-Initiated HIV Test Offers:Â ImportantÂ Strategy, Yet UnderusedÂ 

Opioid therapy has been used in the United States by medical practitioners since the early 1990s to manage backaches, headaches, and other chronic, non-cancer related pains in patients. However, opioid-related overdoses have increased within the last few years, causing physicians and policymakers to reconsider using opioids as long-term treatments. 

The discontinuation of opioid therapy may address the rising death toll caused by drug overdoses while maintaining or potentially improving chronic, non-cancer pain in patients, according to a recent study.  

 evaluated pain intensity following discontinuation of long-term opioid therapy.

Sterling McPherson, PhD, associate professor and director for biostatistics and clinical trial design at the WSU Elson F. Floyd College of Medicine, and colleagues collected data from patients at the Veteran Affairs (VA) Portland Health Care System and the Oregon Health and Science University. The study surveyed 551 VA patients who had been on long-term opioid therapy for chronic, non-cancer related pain for at least 12 months before suspending their treatment. Participants were identified by a diagnosis of either musculoskeletal pain (87%), neuropathic pain (6%), or headache pain, including migraines (11%).

Over a 2-year period, patients rated their pain on a scale from 0 to 10, with 0 representing no pain and 10 representing the worst possible pain. Researchers tracked changes in pain intensity 12 months before and after patients terminated opioid therapy using biostatistical analysis and computer modeling. Patients were placed in 1 of 4 groups based on the level of pain they reported while receiving long-term opioid therapy and post therapy. 

According to the findings, patients experienced a vast spectrum of pain intensity from the time they were treated with opioids to the months after stopping the medication. The survey results showed that chronic, non-cancer pain remained the same or slightly reduced. The researchers noted that it is still unclear why some patients experience greater pain reductions than others and future research will hopefully provide an explanation. 

Careful Management Key to Fighting Opioid Epidemic

“Our hope is that this will lead to being able to target specific sub-populations with different types of treatments for their chronic pain,” Dr McPherson said in a press release. “In addition, we hope to continue to characterize potential adverse effects from being discontinued from long-term opioid therapy.” 

Results suggest using opioids to manage pain in patients with chronic, non-cancer ailments is no more effective than not using opioids, the researchers concluded. Medical practitioners can utilize the information from this study to make patients aware of the alternatives that exist. Opioid-related drug overdoses are a national issue that won’t improve if health care practices are not modified to deter addictive and dangerous behaviors, according to the study authors.  

Chronic pain remains the same or gets better after stopping opioid treatment: WSU study questions value of long-term opioid therapy for chronic, non-cancer pain [news release]. WSU’s website. 

https://news.wsu.edu/2018/07/02/chronic-pain-remains-gets-better-stopping-opioid-treatment/

The discontinuation of opioid therapy may address the rising death toll caused by drug overdoses while maintaining or potentially improving chronic, non-cancerÂ pain in patients, according to a recent study.   