This systematic review aimed to synthesise multimorbidity profiling literature to identify replicable and clinically meaningful groupings of multimorbidity. We searched six electronic databases ...(Medline, EMBASE, PsycINFO, CINAHL, Scopus, and Web of Science) for articles reporting multimorbidity profiles. The identified profiles were synthesised with multidimensional scaling, stratified by type of statistical analysis used in the derivation of profiles. The 51 studies that met inclusion criteria reported results of 98 separate analyses of multimorbidity profiling, with a total of 407 multimorbidity profiles identified. The statistical techniques used to identify multimorbidity profiles were exploratory factor analysis, cluster analysis of diseases, cluster analysis of people, and latent class analysis. Reporting of methodological details of statistical methods was often incomplete. The discernible groupings of multimorbidity took the form of both discrete categories and continuous dimensions. Mental health conditions and cardio-metabolic conditions grouped along identifiable continua in the synthesised results of all four methods. Discrete groupings of chronic obstructive pulmonary disease with asthma, falls and fractures with sensory deficits and of Parkinson’s disease and cognitive decline where partially replicable (identifiable in the results of more than one method), while clustering of musculoskeletal conditions and clustering of reproductive systems were each observed only in one statistical approach. The two most replicable multimorbidity profiles were mental health conditions and cardio-metabolic conditions. Further studies are needed to understand aetiology and evolution of these multimorbidity groupings. Guidelines for strengthening the reporting of multimorbidity profiling studies are proposed.
The Association Between Anxiety and Falls: A Meta-Analysis Hallford, David John; Nicholson, Geoff; Sanders, Kerrie ...
The journals of gerontology. Series B, Psychological sciences and social sciences,
09/2017, Letnik:
72, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Falls occur frequently among older adults and can lead to a range of adverse and debilitating outcomes. Although symptoms of clinical anxiety have been implicated as risk factors for falls, there is ...no current consensus on the empirical association between anxiety and falls. The current study aimed to address this gap in the literature by conducting a quantitative, meta-analytic review of findings from previous studies.
A systematic literature search of bibliographic databases was conducted, yielding 18 studies that fit the criteria for inclusion in the meta-analysis.
A random-effects model of all 18 studies showed a significant overall odds ratio of 1.53 (95% CI 1.28-1.83, p < .001), indicating that elevated levels of anxiety were associated with a 53% increased likelihood of falls. A high amount of variance among effect sizes was observed. Only age was identified as a moderator of this relationship in a subgroup of the samples.
Clinical anxiety is associated with falls, however, further research is required to elucidate the factors that might moderate or mediate this relationship, the casual pathways through which they are related, and the associations between different types of anxiety and falls.
Definitions of sexual dysfunctions in women and men are critical in facilitating research and enabling clinicians to communicate accurately.
To present the new set of definitions of all forms of ...sexual dysfunction in women and men adopted by the Fourth International Consultation on Sexual Medicine (ICSM) held in 2015.
Classification systems, including the International Classification of Diseases, 10th Edition and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and systems that focus on only specific types of sexual dysfunctions (e.g., the International Society for Sexual Medicine definition for premature ejaculation) were reviewed.
Evidence-based definitions were retained, gaps in definitions were identified, and outdated definitions were updated or discarded. Where evidence was insufficient or absent, expert opinion was used. Some definitions were self-evident and termed clinical principles.
The evidence to support the various classification systems was carefully evaluated. A more comprehensive analysis of this evidence can be found in two other articles in this journal that consider the incidence and prevalence and the risk factors for sexual dysfunction in men and women. These data were used to shape the definitions for sexual dysfunction that have been recommended by the 2015 ICSM.
The definitions that have been adopted are those that are most strongly supported by the literature at this time or are considered clinical principles or consensus of experts' opinions. As more research and clinical studies are conducted, there likely will be modifications of at least some definitions.
The incidence and prevalence of various sexual dysfunctions in women and men are important to understand to designate priorities for epidemiologic and clinical research.
This manuscript was designed ...to conduct a review of the literature to determine the incidence and prevalence of sexual dysfunction in women and men.
Members of Committee 1 of the Fourth International Consultation on Sexual Medicine (2015) searched and reviewed epidemiologic literature on the incidence and prevalence of sexual dysfunctions. Key older studies and most studies published after 2009 were included in the text of this article.
The outcome measures were the reports in the various studies of the incidence and prevalence of sexual dysfunction among women and men.
There are more studies on incidence and prevalence for men than for women and many more studies on prevalence than incidence for women and men. The data indicate that the most frequent sexual dysfunctions for women are desire and arousal dysfunctions. In addition, there is a large proportion of women who experience multiple sexual dysfunctions. For men, premature ejaculation and erectile dysfunction are the most common sexual dysfunctions, with less comorbidity across sexual dysfunctions for men compared with women.
These data need to be treated with caution, because there is a high level of variability across studies caused by methodologic differences in the instruments used to assess presence of sexual dysfunction, ages of samples, nature of samples, methodology used to gather the data, and cultural differences. Future research needs to use well-validated tools to gather data and ensure that the data collection strategy is clearly described.
The current randomized study evaluated an online cognitive behavioral therapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, ...sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed.
The association between adult attachment and sexual functioning is an important area of research. However, there has been no previous attempt to systematically review the available literature between ...these dimensions, and how their interrelationships may vary within different populations.
To provide an in‐depth critical investigation of the literature on the association between adult attachment and sexual functioning (satisfaction, dysfunction, and behaviors).
A systematic literature review of research reported in PsychINFO, Scopus, PubMed, and Psychology and Behavioral Sciences Collection from January 1, 1990 to November 8, 2011.
The results demonstrated that higher levels of anxious and avoidant attachment were related to less satisfying sexual relationships, higher levels of sexual dysfunction, and different sexual intercourse frequencies and motivations for sex.
There is a need for further research to target the sexual functioning of males and to incorporate representative samples (ethnicity, sexual orientation, and relationship status) into the analyses. Moreover, measurement of sexual behavior needs to encompass a range of sexual functioning variables. Stefanou C and McCabe MP. Adult attachment and sexual functioning: A review of past research. J Sex Med **;**:**–**.
This article presents a review of previous research concerning risk factors for sexual dysfunction in women and men.
The aim is to evaluate past research studies to determine the contribution of all ...risk factors to the development and maintenance of sexual dysfunction among women and men.
Studies were organized under a biopsychosocial framework, with the bulk of studies of women and men having investigated the role of biological factors.
The outcome measures were the data on factors for sexual dysfunction.
Many more studies investigated risk factors for sexual dysfunction in men than in women. For women and men, diabetes, heart disease, urinary tract disorders, and chronic illness were significant risk factors for sexual dysfunction. Depression and anxiety and the medications used to treat these disorders also were risk factors for sexual dysfunction in women and men. In addition, substance abuse was associated with sexual dysfunction. Many other social and cultural factors were related to sexual dysfunction in women and men.
Psychosocial factors are clearly risk factors for sexual dysfunction. Women and men with sexual dysfunction should be offered psychosocial evaluation and treatment, if available, in addition to medical evaluation and treatment. The impact of social and cultural factors on sexual function requires substantially more research. The evidence that erectile dysfunction is a harbinger of other forms of cardiovascular disease is strong enough to recommend that clinical evaluation for occult cardiovascular disease should be undertaken in men who do not have known cardiovascular disease but who develop organic erectile dysfunction, especially in men younger than 70 years.
The aim of this study was to report and analyze the published data from randomized controlled trials (RCTs) for (i) the psychosocial outcomes associated with erectile dysfunction (ED) before ...treatment with a phosphodiesterase type 5 (PDE5) inhibitor; and (ii) the change in psychosocial outcomes after the use of a PDE5 inhibitor in men with ED.
The method used was a prospectively designed systematic literature review of publications reported in MEDLINE via PubMed, EMBASE, the Cochrane Library, Science Citation Index Expanded, and PsychINFO from January 1, 1995 to May 14, 2012.
The main outcome measures were scores on psychosocial measures in men who were treated for ED with a PDE5 inhibitor before and after treatment.
A total of 1,714 publications were retrieved; 1,674 publications were excluded because they did not meet the design requirements of the review, and 40 publications (32 RCTs) were retained. Before treatment, men who participated in clinical trials reported relatively good quality of life and overall relationships, but poor sexual relationships and sexual satisfaction, diminished confidence, low self‐esteem, and symptoms of depression. After treatment, there were significant improvements from baseline in most of these measures, except for overall life satisfaction and overall relationship satisfaction.
ED and the treatment of ED are associated with substantially broader aspects of a man's life than just erectile functioning. This review demonstrates the importance of evaluating the psychosocial factors associated with ED and its treatment, and the importance of using standardized scales to conduct this evaluation. Further research is needed to better understand the mechanisms underlying the reciprocal relationships among physical and psychological functioning in men with ED. McCabe MP and Althof SE. A systematic review of the psychosocial outcomes associated with erectile dysfunction: Does the impact of erectile dysfunction extend beyond a man's inability to have sex? J Sex Med 2014;11:347–363.
The role of medical conditions, childhood experiences, and psychological and relationship factors in the development and maintenance of male sexual difficulties is not well understood. Using ...self-report questionnaires, the current study examined how these factors are associated with male sexual difficulties overall, as well as for each of four separate problems (low sexual desire, erectile difficulties, premature ejaculation, delayed ejaculation). The participants for the study were 331 Australian men from the general population, all of whom were in cohabiting heterosexual relationships and had experienced one or more of the aforementioned sexual problems. Data were collected via an online survey between January 2010 and April 2011. The results demonstrated that medical factors as well as current psychological factors (e.g., performance anxiety) were most likely associated with each male sexual difficulty. These findings are in contrast to those obtained with women, where relationship factors are strongly related to female sexual problems. They would suggest that the targets for sex therapy may be different for men and women, with medical problems and performance anxiety being the primary targets for men.
This review provides an evaluation of the correlates and/or risk factors associated with disordered eating and the pursuit of muscularity among adolescent boys. One of the main conclusions is that ...similar factors and processes are associated with both behavioral problems. Several factors found to be consistently associated with disordered eating among boys are also similar to those found with girls. These include body mass index, negative affect, self-esteem, perfectionism, drug use, perceived pressure to lose weight from parents and peers, and participation in sports that focus on leanness. However, as many of the findings have only been verified using cross-sectional designs, prospective studies are now needed.
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