The prevalence of suicidal ideation and suicide attempt in patients with rheumatic diseases: a systematic review and meta-analysis

A number of studies have reported the suicidal ideation (SI) or suicide attempts (SA) of patients with rheumatic diseases. However, the estimated prevalence of those disorders varies substantially between studies. This systematic review aimed to describe the prevalence of SI and SA in rheumatic diseases. Literature search was done using Web of Science, Embase, the Cochrane database library, PubMed and CNKI database through June 2017. Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using STATA version 12.0. A random-effect meta-analysis was conducted on all eligible data. A total of 17 identified studies matched the inclusion criteria, involving 5174 participants with systemic lupus erythematosus (SLE), osteoarthritis (OA), rheumatoid arthritis (RA) and fibromyalgia (FM). Meta-analysis showed that rheumatic diseases patients have high prevalence of SI (26%, 95% CI: 19%-32%, I²=96.2%) and SA (12%, 95% CI: 3%-21%, I²=96.6%). We also found the prevalence of SI and SA in females may be higher than in males. All of these indicated that rheumatologists should screen for SI and SA in their patients. Early appropriate intervention is therefore essential to promote the patients’ good mental health.     

The effect of social network intervention for women with rheumatoid arthritis

A partially-controlled intervention study was performed. Female patients with rheumatoid arthritis (RA) were allocated to three groups: the network intervention group (n = 104), the attention control group (n = 85), and the no-treatment control group (n = 75). The network intervention consisted of an assessment session and a network meeting. Patients were assessed at baseline and approximately 10 and 18 months after the intervention. The network intervention group reported an increase in network size. Daily emotional support increased for the intervention patients compared with patients in the attention control group. The degree of social dysfunction was reduced for patients in the intervention group compared to patients in the no-treatment control group. Furthermore, for single patients, the intervention significantly increased the social network size and improved both social functioning, and perceived overall health, compared to both control groups. The results suggest that the social needs of single patients should be given special attention in clinical settings.     

Living with the unexplained: coping,distress, and depression among women with chronic fatigue syndrome and/or fibromyalgia compared to an autoimmune disorder

Chronic fatigue syndrome (CFS) and fibromyalgia are disabling conditions without objective diagnostic tests, clear-cut treatments, or established etiologies. Those with the disorders are viewed suspiciously, and claims of malingering are common, thus promoting further distress. It was hypothesized in the current study that levels of unsupportive social interactions and the coping styles used among those with CFS/fibromyalgia would be associated with perceived distress and depressive symptoms. Women with CFS/fibromyalgia (n = 39), in fact, reported higher depression scores, greater perceived distress and more frequent unsupportive relationships than healthy women (n = 55), whereas those with a chronic, but medically accepted illness comprising an autoimmune disorder (lupus erythematosus, multiple sclerosis, rheumatoid arthritis; n = 28), displayed intermediate scores. High problem-focused coping was associated with low levels of depression and perceived distress in those with an autoimmune condition. In contrast, although CFS/fibromyalgia was also accompanied by higher depression scores and higher perceived distress, this occurred irrespective of problem-focused coping. It is suggested that because the veracity of ambiguous illnesses is often questioned, this might represent a potent stressor in women with such illnesses, and even coping methods typically thought to be useful in other conditions, are not associated with diminished distress among those with CFS/fibromyalgia.     

社会支持与成年早期孤独感：有调节的中介模型

为探讨社会支持与成年早期孤独的关系,调查了556名大学生,运用SEM法、Bootstrap法、多组分析法考察社交自我效能与负性情绪在其中的影响机制及留守经历的调节。结果表明：社交自我效能、负性情绪在社会支持和孤独感之间的中介效应显著;社交自我效能和负性情绪在社会支持对孤独感的影响中起链式中介作用;留守经历对社会支持和孤独感关系存在调节作用。研究结果证实了社会支持影响孤独感及社交自我效能和负性情绪在其中的内在机制。     

The Dissociative Factor in Symptom Reports of Rheumatic Patients with and Without Fibromyalgia

The main objective of this study was to investigate the prevalence of dissociation and its relationships to symptom reporting in fibromyalgia (FM) and other rheumatic disorders (non-FM). The participants were 73 women with FM and 85 relatively matched women with other rheumatic disorders. The participants were administered the Dissociative Experiences Scale (DES), the Profile Of Mood States (POMS), and a 50-item medical checklist. The prevalence of dissociation (DES q 25) was significantly higher in FM patients(30.1%) compared to other rheumatic disorders (7.0%). Symptom reporting correlated with measures of dissociation in both patient groups (FM:R = 0.42, p < .001; non-FM:R = 0.44, p < .001), when controlled for age, depression, and anxiety. A regression analysis confirmed the strong linkage between somatic variation and dissociation. The results suggest that dissociation is a problem for a substantial segment of patients with fibromyalgia and that dissociation is related to certain physical symptoms of fibromyalgia. Dissociation offers a different perspective on medically unexplained symptoms and may need to be addressed in future research.     

The impact of social support on the acceptance process among RA patients: A qualitative study

Acceptance is an important component of pain management, being associated with improved quality of life and lower levels of pain and depression. In enabling patients with chronic diseases to accept unpleasant consequences and to establish a new way of living, the support they receive from their social environment may play a decisive role. In this article, we identify the key sources and types of social support that are relevant for rheumatoid arthritis (RA) patients, and explore when and how those sources are important across the different stages of the acceptance process. We conducted a qualitative study involving 20 semi-structured interviews with RA patients in Switzerland. Analysis of the data followed the precepts of grounded theory. We found that, amid the complexity and variety of patients’ struggles for acceptance, there were some common experiences or ‘key moments’ in which social support played an important role. While three sources of support – family, physicians and the external social context – are fundamental for RA patients, all three may inhibit as well as encourage acceptance, due to the invisible and unpredictable character of the disease. There is a pervasive risk either of underestimating patients’ suffering or of over-supporting, both of which prevent patients accepting the disease and developing a new ‘normal’ life. We conclude that sources of social support need to find a middle way between scepticism and solicitousness.     

Loneliness among school-aged children and their parents

The aim of this study was to examine the existence of the intergenerational transmission of loneliness between parents and children, including an examination of its stability and of gender differences. The study consisted of an evaluation of loneliness in mothers ( n = 834), fathers ( n = 661) and their 10-year-old children ( n = 981). Parent's self-reported loneliness was measured once, and their children's social and emotional loneliness were assessed at three time-points. The stability analysis indicated average stability in children's loneliness, especially their social loneliness. Boys were found to experience more emotional loneliness than girls. Structural equation modeling indicated no direct relationship between mothers'/fathers' loneliness and their children's loneliness. However, mothers' and fathers' loneliness reduced their daughters' peer-evaluated cooperating skills, which consequently predicted higher levels of both social and emotional loneliness.     

An examination of the physical health, health care use, and psychological well-being of spouses of people with fibromyalgia syndrome.

The present study compared the physical and mental health and the health care use of spouses of patients with fibromyalgia syndrome (FS group; n = 135) with that of spouses of healthy individuals (n = 153). FS group participants reported lower health and affective states and scored higher on depression, loneliness, and subjective stress than comparison group participants (p < .017). Husbands in the FS group who reported more illness impact and whose wives reported worse sleep quality and less self-efficacy had more psychological difficulties. No differences were found in health care costs between groups. These findings suggest that chronic illness in a partner may negatively affect an individual's physical and mental health.     

A preliminary study of an online pain management programme for patients with ankylosing spondylitis

This study was a preliminary attempt to develop and examine an online pain management programme incorporating mindfulness‐informed exercises (i.e. breathing and body scanning exercises) and CBT elements for ankylosing spondylitis patients. Thirty patients diagnosed with ankylosing spondylitis participated in a five‐week online pain management programme, which was delivered primarily through a website. The materials covered by the website included breathing and body scanning exercises, mindful walking exercise, positive thinking and management of dysfunctional thinking. Each participant received instructions and reminders from a counselling psychologist through electronic communications each week. They completed the Brief Pain Inventory, Ryff's Psychological Well‐being Scale, Pain Self‐Efficacy Questionnaire, Pain Catastrophizing Scale and Cognitive and Affective Mindfulness Scale‐Revised before and after the treatment programme. In addition, four face‐to‐face focus groups were conducted to yield supplementary qualitative findings. The overall results indicate that this online pain management programme can improve sleep quality and reduce pain interference and catastrophic responses to pain in ankylosing spondylitis patients, albeit being not very effective for mitigating the intensity of pain. Moreover, male and female patients can benefit equally from the online programme. Findings from the focus groups revealed some challenges faced by local patients when practising mindfulness‐informed exercises. Some solutions to those challenges were put forward in accordance with patients’ feedback.     

Loneliness, depression, social support, and quality of life in older chronically ill Appalachians

This study's purpose was to describe loneliness and to examine the relationships between loneliness, depression, social support, and QOL in chronically ill, older Appalachians. In-person interviews were conducted with a convenience sample of 60 older, chronically ill, community-dwelling, and rural adults. Those with dementia or active grief were excluded. The UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1985), Geriatric Depression Scale (Shiekh & Yesavage, 1986), Katz ADL scale (Katz, Down, & Cash, 1970), MOS Social Support Scale (Sherbourne & Stewart, 1991), and a visual analog scale for Quality of Life (Spitzer et al., 1981) scale were used. Diagnoses were obtained through chart reviews. SPSS was used for data analyses. The majority of the 65% female sample (M age = 75 years) were married and impoverished. Participants' number of chronic illnesses averaged more than 3. Over 88% of participants reported at least 1 area of functional impairment. Loneliness was prevalent with UCLA loneliness scores indicating moderate to high loneliness, ranging from 39 to 62 (possible scores were 20-80). Higher loneliness scores correlated with depression, lower Qol, and lower social support, particularly lower emotional support. This study provides evidence that loneliness is a significant problem for older chronically ill Appalachian adults and that it may be related to low emotional support. Further, it provides evidence that this population may be significantly lonely and may not self-identify as lonely. Screening for loneliness and designing interventions that target the emotional aspects of loneliness could be important in this population.     

Social Support and Subjective Health in Fibromyalgia: Self-Compassion as a Mediator

Individuals with fibromyalgia report lower levels of health-related quality of life (HRQL) compared to other chronically ill populations and interpersonal factors (i.e., social support) may influence risk. What is less understood is how intrapersonal factors (i.e., self-compassion) may impact the social support-HRQL linkage. We examined the association between social support and HRQL in a sample of persons with fibromyalgia and tested the potential mediating role of self-compassion. Self-identified adults in the United States with fibromyalgia (N?=?508) were recruited from state, regional, and national organizations and support groups and completed an online battery of self-report questionnaires including: Multidimensional Health Profile—Psychosocial Functioning Index, Short-Form 36 Health Survey, and Self-Compassion Scale-Short Form. Individuals with greater subjective social support reported higher levels of self-compassion and, in turn, higher mental HRQL. These findings provide greater information about psychosocial constructs and HRQL and extend our understanding of self-compassion among individuals living with fibromyalgia.

     

How daydreaming relates to life satisfaction, loneliness, and social support: the importance of gender and daydream content

Daydreaming appears to have a complex relationship with life satisfaction and happiness. Here we demonstrate that the facets of daydreaming that predict life satisfaction differ between men and women (Study 1; N=421), that the content of daydreams tends to be social others (Study 2; N=17,556), and that who we daydream about influences the relation between daydreaming and happiness variables like life satisfaction, loneliness, and perceived social support (Study 3; N=361). Specifically, daydreaming about people not close to us predicts more loneliness and less perceived social support, whereas daydreaming about close others predicts greater life satisfaction. Importantly, these patterns hold even when actual social network depth and breadth are statistically controlled, although these associations tend to be small in magnitude. Individual differences and the content of daydreams are thus important to consider when examining how happiness relates to spontaneous thoughts.     

Differences on the projective hand test among chronic pain patients reporting three different pain experiences

This study examined personality differences among individuals experiencing 3 different types of pain. The projective Hand Test was administered to 90 individuals who were seeking treatment at a pain clinic in an urban area of the southeast United States. These people were seeking treatment for either arthritis (n = 31), fibromyalgia (n = 29), or migraine headaches (n = 30). A 2 (gender) x 3 (pain group) x Age Group multivariate analysis of variance was conducted using the quantitative Hand Test scoring variables as dependent measures. Results indicated that individuals who were seeking treatment for migraine headaches had a higher production rate of responses involving exhibitionistic displays (EXH) than individuals in the other 2 groups. Individuals who were seeking treatment for fibromyalgia had a higher production rate of responses indicating fear and phobic concerns (FEAR) than individuals in the other 2 groups. Individuals who were seeking treatment for arthritis had a higher production rate of Active (ACT) responses than individuals in the other 2 groups. Possible causes and consequences of these effects are discussed.     

Objective determinants of perceived social support

Objective characteristics of people's social networks were examined as determinants of the perceived availability of social support in two populations: elderly adults (n = 50) and mothers of 1-year-olds (n = 71). Number of network members and frequency of contact with network members, computed separately for kin and nonkin were examined as predictors of loneliness, overall social support, and the six components of social support proposed by Weiss (1974). Kin were found to be more effective providers than nonkin of some aspects of social support. Network characteristics were better predictors of perceived social support for the elderly than for the mothers, but a maximum of 30% of the variance in perceived social support was attributable to the objective network characteristics in either sample. It is recommended that future research on the determinants of perceived social support consider actual interpersonal behaviors, their contexts, and personality characteristics that affect the facilitation an interpretation of supportive behaviors.     

Loneliness is a unique predictor of age-related differences in systolic blood pressure

A population-based sample of Caucasians, African Americans, and Latino Americans, 50-68 years of age (M = 57.5), from Cook County, Illinois (N = 229), was tested to examine how loneliness and co-occurring psychosocial factors (depressive symptoms, perceived stress, social support, and hostility) were related to indices of cardiovascular and endocrine functioning. Extending prior research, the authors found that loneliness was associated with elevated systolic blood pressure (SBP) and age-related increases in SBP, net of demographic variables, health behavior variables, and the remaining psychosocial factors. Loneliness was not associated with differences in autonomic or endocrine functioning. Although the results are limited by the cross-sectional methods used, they are consistent with the hypothesis that cardiovascular disease contributes to increased morbidity and mortality among lonely individuals.     

Exercise, pain, perceived family support, and quality of life in Korean patients with ankylosing spondylitis

Relations of habitual exercise and pain, perceived family support, and the quality of life in patients with functional class II for ankylosing spondylitis were explored. In a cross-sectional study perceived pain, family support, and quality of life were compared for 30 patients (23 women and 7 men whose mean age was 28.3 yr.+/-8.6 yr.) practicing exercise regularly and for 38 sedentary patients (31 women and 7 men whose mean age was 27.2+/-6.7 yr.). Exercising patients reported significantly lower pain, greater perceived family support, and increased quality of life than their sedentary peers. Pain ratings were significantly negatively correlated with the quality of life in both groups (r = -.26 in exercisers and r = -.50 in sedentary patients) and control group's perceived family support was significantly correlated .44 with quality of life. These results encourage further study of the associations of habitual exercise with perceived pain, family support, and quality of life.     

Coping strategies and quality of life in women with advanced breast cancer and their family caregivers

Abstract

This study examines the effects of personal resources of both heart patients and their close social partners on patients' coping and quality of life. Generalized personal resources (self-efficacy beliefs, dispositional optimism, self-regulation competence) and outcomes were assessed by questionnaire 1–3 days before surgery (n = 122) and again six months later (n= 50). Outcome variables were coping styles, social resources (social support and social integration), emotional states, and further measures of quality of life. Patients' personal resources were dominant in the prediction of most of the outcomes. Partners' resources were uniquely related to social support, social integration, and quality of life as perceived by the patients. Further, partners' personality resources predicted changes in patients' loneliness and energy levels during the six-month interval.     

Loneliness, social support and cardiovascular reactivity to laboratory stress

Self-reported or explicit loneliness and social support have been inconsistently associated with cardiovascular reactivity (CVR) to stress. The present study aimed to adapt an implicit measure of loneliness, and use it alongside the measures of explicit loneliness and social support, to investigate their correlations with CVR to laboratory stress. Twenty-five female volunteers aged between 18 and 39 years completed self-reported measures of loneliness and social support, and an Implicit Association Test (IAT) of loneliness. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) reactivity indices were measured in response to psychosocial stress induced in the laboratory. Functional support indices of social support were significantly correlated with CVR reactivity to stress. Interestingly, implicit, but not explicit, loneliness was significantly correlated with DBP reactivity after one of the stressors. No associations were found between structural support and CVR indices. Results are discussed in terms of validity of implicit versus explicit measures and possible factors that affect physiological outcomes.     

"When it's just me at home, it hits me that I'm completely alone": an online survey of adolescents in self-care

The present study examined adolescents' experiences of loneliness and solitude in their responses to an online survey on self-care. Both quantitative (n = 272) and qualitative (n = 150) responses were coded for these feelings when home alone. Results indicate that adolescents experience the duality of aloneness, including both positive solitude and negative loneliness. Adolescents' responses range from embraced solitude and self-care to feelings of loneliness and rejection of time by themselves. Adolescents reporting loneliness were significantly less likely to enjoy being home alone during the day and at night (p < or = .001). Also, gender, age, and emotions such as fear, boredom, and separation anxiety are associated with loneliness among adolescents in self-care. Interventions to increase connectedness and combat loneliness during out-of-school hours are recommended.