Dataset Information

Multimorbidity of overweight and obesity alongside anxiety and depressive disorders in individuals with spinal cord injury.

ABSTRACT:

Objective

To compare the prevalence of anxiety/depression and overweight/obesity (Aim 1) and the multimorbidity of these conditions (Aim 2) in a sample of adults with and without spinal cord injury (SCI). Aim 3 was to examine whether overweight/obese individuals with SCI differ on the prevalence of anxiety/depressive disorders compared to non-overweight/obese individuals with SCI.

Design

Retrospective cohort study.

Participants

Individuals ≥16 years old who had patient encounters between January 1, 2011, and February 28, 2018. In total, 761 598 individuals were included, of which 3136 had SCI.

Main outcome measures

Individuals were identified as diagnosed with SCI, anxiety and/or depressive disorders, and overweight/obesity using the International Classification of Diseases.

Results

Age-adjusted odds ratios (ORs) were calculated using logistic regression. In contrast to non-SCI individuals, those with SCI had increased odds of anxiety disorders (OR: 3.58, 95% CI [3.29-3.90]), depressive disorders (OR: 4.33, 95% CI [3.95-4.74]), and overweight/obesity (OR: 3.08, 95% CI [2.80-3.38]). Pertaining to multimorbidity, individuals with SCI had increased odds of having overweight/obesity alongside anxiety disorders (OR: 4.30, 95% CI [3.71-4.98]) and overweight/obesity alongside depressive disorders (OR: 4.69, 95% CI [4.01-5.47]) compared to those without SCI. Individuals with SCI who were diagnosed as overweight/obese had increased odds of having anxiety disorders (OR: 2.54, 95% CI [2.06-3.13]), and depressive disorders (OR: 2.70, 95% CI [2.18-3.36]), relative to non-overweight/obese individuals with SCI.

Conclusions

This work is among the first to find evidence that individuals with SCI are at heightened odds of overweight/obesity alongside anxiety and/or depressive disorders. This early work holds clinical implications for treating these interrelated comorbidities in SCI.

SUBMITTER: Graupensperger S

PROVIDER: S-EPMC8725715 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Several studies point to a correlation between obesity and the severity of depressive and anxiety symptoms in children and adults, but there are still some controversial points about this association. The aim of this study is to investigate the relationship between body composition and the severity of anxiety/depressive symptoms in overweight and obese individuals with Metabolic Syndrome (MS). METHODS:Fifty patients, 18-50 years old, overweight or obese and with the diagnosis of MS based on the International Diabetes Federation (IDF) criteria were selected for this study. Body composition was evaluated using Dual Energy X-ray Absorptiometry (DXA). Depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS-Depression) and the Beck Depression Inventory (BDI). Anxiety symptoms were evaluated using HADS-Anxiety. RESULTS:No correlation was found between depressive symptoms (HADS-Depression or BDI) and Body Mass Index (BMI) (r?=?0.01; p?=?0.94 and r?=?-0.12, p?=?0.38; respectively), Waist Circumference (WC) (r?=?-0.06, p?=?0.67 and r?=?-0.22, p?=?0.12; respectively), and Waist-to-Hip Ratio (WHR) (r?=?-0.12, p?=?0.40 and r?=?-0.17, p?=?0.23; respectively). Additionally, no correlation was found among anxiety symptoms (HADS-Anxiety) and BMI (r?=?-0.15, p?=?0.27), and WHR (r?=?-0.17, p?=?0.24). In contrast, a significant correlation was found between percentage of total fat (DXA) and HADS-Depression (r?=?0.34, p?=?0.019) and HADS-Anxiety (r?=?0.30, p?=?0.039). Additionally, an inverse and strong correlation was found between lean mass (in grams) and HADS-Depression (r?=?-0.42, p?=?0.004), HADS anxiety (r?=?-0.57, p?<?0.0001), and BDI (r?=?-0.44, p?=?0.026). CONCLUSIONS:In individuals with MS, the percentage of body fat, and not central fat, BMI, WC, or WHR, was associated with an increased severity of anxiety and depressive symptoms. In contrast, total lean mass was strongly associated with fewer anxiety/depressive symptoms, suggesting that body composition might be related to psychiatric comorbidity in overweight individuals with MS.

Project description:BackgroundTranscutaneous spinal cord stimulation (tSCS) is a non-invasive modality in which electrodes can stimulate spinal circuitries and facilitate a motor response. This review aimed to evaluate the methodology of studies using tSCS to generate motor activity in persons with spinal cord injury (SCI) and to appraise the quality of included trials.MethodsA systematic search for studies published until May 2021 was made of the following databases: EMBASE, Medline (Ovid) and Web of Science. Two reviewers independently screened the studies, extracted the data, and evaluated the quality of included trials. The electrical characteristics of stimulation were summarised to allow for comparison across studies. In addition, the surface electromyography (EMG) recording methods were evaluated.ResultsA total of 3753 articles were initially screened, of which 25 met the criteria for inclusion. Studies were divided into those using tSCS for neurophysiological investigations of reflex responses (n = 9) and therapeutic investigations of motor recovery (n = 16). The overall quality of evidence was deemed to be poor-to-fair (10.5 ± 4.9) based on the Downs and Black Quality Checklist criteria. The electrical characteristics were collated to establish the dosage range across stimulation trials. The methods employed by included studies relating to stimulation parameters and outcome measurement varied extensively, although some trends are beginning to appear in relation to electrode configuration and EMG outcomes.ConclusionThis review outlines the parameters currently employed for tSCS of the cervicothoracic and thoracolumbar regions to produce motor responses. However, to establish standardised procedures for neurophysiological assessments and therapeutic investigations of tSCS, further high-quality investigations are required, ideally utilizing consistent electrophysiological recording methods, and reporting common characteristics of the electrical stimulation administered.

Project description:BACKGROUND: Even though weight management is essential for the health of individuals with spinal cord injuries and disorders (SCI/D), little is known about current practices, barriers, and facilitators. OBJECTIVE: To describe weight management delivery in the Veterans Affairs (VA) SCI/D System of Care, including barriers and facilitators experienced by health care providers. METHODS: Qualitative focus groups were conducted in person at 4 geographically dispersed VA medical facilities delivering care to Veterans with SCI/D. Thirty-two employees involved in weight management efforts participated. Audio-recordings were transcribed and analyzed using qualitative content analysis techniques. RESULTS: Participants at SCI centers reported that weight management treatment was delivered through the center by a multidisciplinary team using education (eg, written materials) and counseling/consults. Participants at SCI spoke facilities generally depended on facility-level programs (eg, MOVE!) to deliver treatment. Spoke facilities discussed barriers to delivering treatment through their SCI team, including staff shortages and resource and structural issues. MOVE! staff discussed barriers, including limited wheelchair space in classrooms. Staff participants across facilities noted that Veterans with SCI/D were hesitant to use facility-level programs, because of nonspecific SCI-relevant information and discomfort attending sessions with general Veterans. Other barriers, for both centers and spoke facilities, included necessary medications that increase weight, lack of evidence-based guidelines for weight management, safety concerns, and facility layout/accessibility. Facilitators included facility leadership support, provider involvement/prioritization, and community resources. CONCLUSIONS: Weight management programs delivered through the SCI team, with peers and SCI-relevant content, are likely more acceptable and beneficial to individuals with SCI/D. Program classrooms should provide ample space for individuals with SCI/D.