The Approach of Physiotherapists in the Management of Patients with Persistent Pain and Comorbid Anxiety/Depression: Are There Any Differences between Male and Female Professionals?

Background and Objectives: Chronic pain is a prevalent condition that is frequently complicated by mood and anxiety disorders. The purpose of the present article is to identify differences in the management of patients with chronic pain and anxiety/mood disorders depending on the physiotherapists' gender. Materials and Methods: An ad hoc questionnaire was developed and sent to 327 physiotherapists by e-mail. The two groups identified by gender were compared by unpaired-sample t tests for continuous variables and χ2 tests for qualitative ones. A binary logistic regression was then performed with factors resulting as statistically significant in univariate analyses as independent variables and gender as a dependent one. Results: Female physiotherapists exhibited a higher level of confidence than male physiotherapists in administering continued physiotherapy for patients affected by Generalized Anxiety Disorder (GAD) (p = 0.01), as well as for individuals who had previously engaged with a mental health professional (p = 0.01). Furthermore, female physiotherapists believed that pharmacotherapy was less associated with motor side effects (p < 0.01) and more frequently recognized the importance of training to identify affective disorders (p = 0.01) and the need for more education in mental health (p = 0.01). The binary logistic regression model confirmed that female professionals were less likely to work = freelance (p = 0.015) and were more confident in the receival of physiotherapy by patients with GAD (p = 0.05). Conclusions: Female physiotherapists compared to male ones seem to be more comfortable with patients affected by mental conditions and to be more aware of the need for training on mental health. Further studies are needed to confirm the results of the present study.

Clinical uses of Bupropion in patients with Parkinson's disease and comorbid depressive or neuropsychiatric symptoms: a scoping review.

OBJECTIVE: Bupropion, an antidepressant inhibiting the reuptake of dopamine and noradrenaline, should be useful to treat depressive symptoms in patients with Parkinson's disease (PD). Limited and conflicting literature data questioned its effectiveness and safety in depressed PD patients and extended its use to other neuropsychiatric symptoms associated with this disorder. DESIGN: The databases PubMed, Embase, Web of Sciences, Cochrane Library, and the grey literature were searched. Following a scoping review methodology, articles focusing on Bupropion uses in PD patients who manifested depressive or other neuropsychiatric alterations were reviewed. RESULTS: Twenty-three articles were selected, including 7 original articles, 3 systematic reviews or meta-analyses, 11 case reports, 1 clinical guideline, and 1 expert opinion. Bupropion showed considerable effectiveness in reducing depressive symptoms, particularly in relation to apathy. Solitary findings showed a restorative effect on compulsive behaviour secondary to treatment with dopamine as well as on anxiety symptoms. The effect on motor symptoms remains controversial. The safety profile of this medication seems positive, but additional precautions should be used in subjects with psychotic symptoms. CONCLUSION: The available literature lacks good evidence to support the use of Bupropion in PD patients presenting depressive symptoms. Further investigations are needed to extend and confirm reported findings and to produce accurate clinical guidelines.

Mental health in patients affected by atopic dermatitis: which effects of treatment with dupilumab?

Atopic dermatitis (AD) is an inflammatory skin disease. Patients with AD are prone to develop anxiety and mood disorders. Aim of this study is to investigate if treatment with dupilumab may improve mental health status of patients affected by AD. A total of 66 patients with severe AD were included: 24 subjects were candidate or have just started (one month) treatment with dupilumab, and 42 have been in treatment for one year. 25.8%, 30.3%, and 45.5% of the total sample showed, respectively, clinically significant anxiety, depression, and symptoms of Internet addiction. Patients with anxiety symptoms resulted to have more severe AD, more sleep problems ( P  = 0.028), less quality of life ( P  = 0.001), more severe depressive symptoms ( P  < 0.001), to be more frequently women ( P  = 0.016), to be less frequently treated with dupilumab for one year ( P  = 0.025). Similarly, patients with clinically significant depressive symptoms resulted to have more severe AD, more sleep problems ( P  = 0.003), less quality of life ( P  < 0.001), more severe anxiety symptoms ( P  < 0.001), to be less frequently treated with dupilumab for one year ( P  = 0.008). Patients with AD treated for one year with dupilumab showed a better mental health profile in terms of less severe anxiety and depression with respect to their counterparts.