Comorbid pain experiences in young women with dysmenorrhea.

The association among dysmenorrhea, chronic pain, and conditions classified as central sensitivity syndromes (CSS) is largely unknown. We investigated the co-occurrence of dysmenorrhea with chronic pain and other CSS (e.g., fibromyalgia, migraines); and, whether severity of menstrual symptoms was associated with severity of chronic pain and of somatic symptoms. Women from a mid-sized Canadian university women (N = 248, Mage = 21.52) completed measures of menstrual pain severity, chronic pain severity, somatic symptoms severity, and the presence of comorbid CSS. Pearson's correlations assessed the relationship between severity of dysmenorrhea, chronic pain, and somatic symptoms. MANOVA procedures assessed the interaction between dysmenorrhea and chronic pain and χ2 analyses were used to test the frequency of CSS among women with dysmenorrhea. Higher ratings of menstrual symptom severity were associated with increased chronic pain severity (r =.66, p <.001), and somatic symptom severity (r =.66, p <.001). Women with dysmenorrhea were not more likely to experience chronic pain, but were more likely to report a CSS, χ2 (1) = 5.12, p <.05. Dysmenorrhea symptoms may extend beyond the menstrual phase and be associated with more severe symptoms among women with comorbid pain and somatic concerns.

Trajectories of social support in adults with type 2 diabetes: Associations with depressive symptoms and functional disability.

OBJECTIVES: Little is known about temporal trajectories of social support in adults with type 2 diabetes (T2D) and how they are associated with diabetes-related outcomes. This study identified and explored different trajectories of social support in a community sample of adults with T2D, as well as the extent to which different trajectories were prospectively associated with depressive symptoms and functional disability. METHODS: Data came from five annual waves of the Evaluation of Diabetes Treatment study (N = 1077). Social support, depressive symptoms, and functional disability were assessed via self-report. Separate analyses were conducted to examine the associations between social support trajectories, depressive symptoms, and functional disability, adjusting for demographic characteristics, diabetes-related covariates, and baseline depressive symptoms and functional disability. RESULTS: Latent class growth modeling identified four distinct social support trajectories. Trajectory Groups 1 and 2 comprised participants with persistently low and persistently moderate-low social support, respectively. Trajectory Groups 3 and 4 included participants with persistently moderate-high and persistently high social support, respectively. People with persistently low social support reported higher functional disability relative to those with persistently moderate-high and persistently high social support. CONCLUSIONS: The findings of the present study indicate that temporal patterns of social support are a predictor of future functional disability among adults with T2D.

Do mental disorders moderate the association between diabetes status and alcohol consumption?

Although heavy alcohol consumption is associated with diabetes-related complications, little is known about patterns of alcohol use among people with diabetes. Moreover, heavy drinking is more common among individuals with major depressive disorder (MDD), bipolar disorder (BD), and generalized anxiety disorder (GAD) than in the general population, and these disorders are often comorbid with diabetes. The present study tested the hypothesis that mental disorders moderate the association between diabetes status and alcohol consumption. A total of 14,302 adult participants aged 40-79 were included from the cross-sectional 2012 Canadian Community Health Survey-Mental Health (1,698 with diabetes). Data were analyzed using hierarchical linear regression models. MDD and BD, but not GAD, significantly moderated the association between diabetes status and alcohol quantity, such that the presence of diabetes was strongly and negatively associated with alcohol quantity if individuals had MDD or BD. There was no interaction between diabetes status and any of the mental disorders and alcohol frequency. This study suggests that among individuals with diabetes, those with comorbid MDD or BD drink less than those without MDD or BD. Further investigation of this association is needed and could help inform future alcohol-related interventions among individuals with diabetes.

Alcohol consumption, depressive symptoms, and the incidence of diabetes-related complications.

BACKGROUND: Heavy alcohol consumption in individuals with type 2 diabetes mellitus (T2DM) is related to increased risks of diabetes-related micro- and macrovascular complications. Depressive symptoms may be relevant to this relationship, because high depressive symptoms are associated with an increased risk of complications. This study investigated whether the interaction between depressive symptoms and alcohol frequency was positively related to the development of neuropathy, retinopathy, nephropathy, and coronary artery disease (CAD), such that those with high depressive symptoms and high alcohol frequency will be at increased risk of complications. METHODS: Data were from five waves of the Evaluation of Diabetes Treatment annual survey including 1413 adults with T2DM in Quebec. Data on alcohol frequency (number of drinking occasions), depressive symptoms, and complications were collected annually. The development of each complication was investigated using multiple logistic regression analysis with generalized estimating equations. RESULTS: After adjusting for sociodemographic, lifestyle, and diabetes-related covariates, the interaction between alcohol frequency and depressive symptoms was positively related to the incidence of neuropathy and CAD, such that those with high depressive symptoms who drank the most frequently had the highest risk of neuropathy (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.00-1.04; P = 0.04) and CAD (OR 1.02, 95% CI 1.00-1.04; P = 0.04). This interaction was not significantly related to retinopathy or nephropathy. CONCLUSION: Individuals with high depressive symptoms and high alcohol frequency may have a particularly high risk of neuropathy and CAD. Future prevention efforts should examine both alcohol frequency and depressive symptoms when evaluating the risk of complications.