Opioids and fibromyalgia: frequency of use and factors associated with increased consumption in patients remitted to a tertiary care center.

BACKGROUND: Opioids are not recommended for fibromyalgia. OBJECTIVE: To investigate the frequency of opioid use in a large cohort of fibromyalgia patients and to identify factors associated with opioid consumption. METHODS: A retrospective, observational study of a large fibromyalgia cohort in a tertiary care center. We assessed fibromyalgia severity, functional capacity, anxiety, depression, drugs consumption and the patient's impression of change. We compared strong opioid consumers (SOC) and non-SOC. Inferential statistical and logistic regression analysis were used to identify factors associated with opioid consumption, and ANOVA for repeated measurements. RESULTS: We found a prevalence of 9.2% of SOC (100 patients) among 1087 patients in the cohort. During the last four years there was a significant increase on the incidence of SOC up to 12.8% (p = 0.004). There were no differences in demographic variables between SOC and non-SOC. Clinical variables were significantly more severe in SOC, and they consumed more non-opioid drugs (p < 0.0001). Opioid consumption was independently associated with other non-opioid drugs (Odds ratio 1.25, CI: 1.13-1.38), but not with the fibromyalgia severity. At three months, 62% of the patients had opioid withdrawal. There were no statistical differences in the fibromyalgia severity at the initial evaluation, or the patient's impression of change compared with those patients who continued opioids. Coping strategies were better in those patients who withdrew opioids (p = 0.044). CONCLUSIONS: We observed an increase in opioid prescriptions during the last four years. Opioid consumption was associated with concomitant use of non-opioid drugs, but it was not associated with fibromyalgia severity.

Prevalence of post-COVID-19 in patients with fibromyalgia: a comparative study with other inflammatory and autoimmune rheumatic diseases.

OBJECTIVES: To determine the prevalence and characteristics of post-COVID-19 (PC) in fibromyalgia (FM) patients. METHODS: Retrospective, multi-centric, observational study, comparing a group of FM patients (FM group) with another group of patients with other rheumatic diseases (RD group). COVID-19 diagnosis was established by positive polymerase chain reaction or antigen during acute infection or by positive antibodies thereafter. We considered PC diagnosis when symptoms remain after COVID-19. We collected the principal characteristics of COVID-19, the severity of fatigue, waking unrefreshed and cognitive impairment, and persistent symptoms. The American College of Rheumatology (ACR) criteria and the Combined Index of Severity in Fibromyalgia (ICAF) were collected in the FM group. RESULTS: RD group (n = 56) had more pneumonia (p = 0.001) and hospital admissions (p = 0.002), but the FM group (n = 78) had a higher number of symptoms (p = 0.002). The percentage of patients with PC was similar between groups (FM group 79.5%; RD group 66.1%, p = 0.081). FM group had more PC symptoms (p = 0.001), more impairment after COVID-19 (p = 0.002) and higher severity of fatigue, waking unrefreshed and cognitive impairment (p <  0.0001). Only loss of smell was more frequent in the FM group (p = 0.005). The FM group with PC (n = 29) showed more severity of the Combined Index of Severity in Fibromyalgia (ICAF) total score and physical factor after COVID-19, while emotional, coping factors and the ACR criteria did not change. CONCLUSIONS: The prevalence of PC in FM patients is similar to RD patients. In FM patients, the presence of PC does not appear to impact the severity of FM.

Clinical impact of confinement due to the COVID-19 pandemic on patients with fibromyalgia: a cohort study.

OBJECTIVES: To our knowledge, the impact of the COVID-19 pandemic on fibromyalgia (FM) patients has not been studied before. FM patients often experience clinical impairment with stress. The aim of this study was to determine whether severity of FM increases because of confinement by the COVID-19 pandemic. METHODS: This prospective study includes patients from the Combined Index of Severity of Fibromyalgia (ICAF) cohort who met the 2010 ACR FM criteria. In this cohort, all patients have a periodical evaluation of their quality of life through two questionnaires, the ICAF, which assesses the ability to perform daily living activities, anxiety and depression, and through the Patient Global Impression of Change (PGIC), which assesses overall change after a therapeutical intervention. Pre- and post-confinement measurements were analysed. Inferential statistical analysis and ANOVA for repeated measurements were used. RESULTS: A total of 93 patients received a phone consultation, (95.5% females), mean (SD) age of 48.23 (8.38) years. Four patients were excluded as presenting COVID-19 and 51 (57%) completed the post-confinement ICAF. Following confinement, 25 (49%) patients got worse (group-worse) and 26 (51%) patients experienced no change or improved (group-stable). Comparisons between pre- and post-confinement ICAF did not show significant differences in both groups. Passive coping was significantly different in group-worse in pre-confinement evaluation. In the 80% of patients with passive coping predominance there were no changes in coping strategy. CONCLUSIONS: No clinical impairment due to COVID-19 confinement occurred. The perceived worsening among FM patients relies primarily on how patients cope with their disease, without a real impact on clinical manifestations.

Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective "real world" data analysis of fibromyalgia patients.

OBJECTIVE: To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM). METHODS: In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses. RESULTS: The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate. CONCLUSIONS: More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

Self-forgiveness in fibromyalgia patients and its relationship with acceptance, catastrophising and coping.

OBJECTIVES: Forgiveness influences health through numerous mechanisms, but commonly it is thought to reduce stress, increase healthy behaviour, and promote social support, thereby positively impacting health and wellbeing. Self-forgiveness has been given considerable attention in relation to health and wellbeing. Fibromyalgia (FM) patients had lower forgiveness of others and self-forgiveness as compared to controls. The aim of this study is to explore the relationship of self-forgiveness (FS) with the impact and severity of FM, acceptance, catastrophising, and coping. METHODS: We evaluated 228 FM female patients who completed the Mauger Forgiveness Scale, the Combined Index of Severity in Fibromyalgia (ICAF) survey, the Chronic Pain Acceptance Questionnaire (CPAQ), and the Pain Catastrophising Scale (PCS). RESULTS: High self-forgiveness is related to high levels of active coping (r=.41) and acceptation (r=.38), and low self-forgiveness is related to emotional negative factors and catastrophising (r=-.56). Two factors (physical and emotional) were obtained. Lower FS is an emotional factor with negative emotion, catastrophising and a deficit in active coping. A decision-tree analysis showed a first node with ICAF Emotional scores and a second level with CPAQ and PCS scores as predictors. CONCLUSIONS: A notable lack of FS indicates a problem (distress and catastrophising) with the health aspects related to this syndrome. Acceptance could require a low negative emotional status. People with high FS were likely to increase acceptation as the positive component of acceptance in FS. This finding does not indicate an interest in maintaining problematic behaviours.

Structural Properties and Luminescence Characteristics of Eu3+ Doped Lithium Triborate (LiB3O5) Phosphors.

Lithium triborate LiB3O5:Eu has been prepared by precipitation assisted high-temperature solid state (PAS) reaction method using lithium hydroxide (LiOH), boric acid (H3BO3) and europium chloride (EuCl3). The as prepared powders were calcined at various temperatures. As prepared and calcined powders were characterized by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectrometry (EDS), UV-Vis spectrometry and Photoluminescence (PL). The XRD profiles of the powder products revealed the presence of crystalline phase at 650 °C. Increasing bandgap with increasing dopant concentration was studied by UV-Vis spectra. The effect of dopant concentration on photoluminescence properties of LiB3O5 was also studied. The optimized Eu3+ dopant concentration for potential luminescent LiB3O5 phosphor was 0.25 mol%.

Thermoluminescence from Cu Doped Lithium Tetraborate Irradiated with X-ray and γ Using 137Cs Radioactive Source.

Lithium tetraborate (Li2B4O7) pellets prepared by using water/solution assisted method were synthesized and characterized. Copper was used as doping material in order to enhance the Li2B4O7 thermoluminescent properties. For synthesis heating temperature parameters were defined at 750 °C for 2 hr, followed by 150 °C for another 2 hr. The materials were produced at five different Cu concentrations: 0.02, 0.04, 0.06, 0.08, and 0.1 wt%. The luminescent and morphological characterizations were performed by X-ray diffraction (XRD), Scanning electron microscope (SEM), Photoluminescence (PL), and Ultraviolet-visible spectroscopy (UV-Vis). XRD and SEM analysis of intrinsic and doped materials confirmed the obtained Li2B4O7 structure and show its morphology. XRD patterns of the Li2B4O7 matched a tetragonal crystal structure. Crystals of Li2B4O7 of an average size of 50 nm were obtained. The presence of the copper dopant was confirmed in crystals of Li2B4O7:Cu by SEM-EDS (energy dispersive spectroscopy X-ray). The emission spectrum of Cu doped Li2B4O7 showed a prominent peak at 367 nm, while the main UV-Vis absorption was observed from 240 nm to 300 nm due to Cu+ ion 3d10 → 3d9 4s transitions. The thermoluminescent (TL) response was studied for both γ radiation and X-ray. A 661.7 keV γ radiation using a 137Cs source at doses of 50, 100, 200, 300, 400 and 500 mGy was applied to Li2B4O7:Cu (0.1 wt%) pellets. An X-ray source was used at doses of 600, 800 and 1000 mGy to irradiate pellets of Li2B4O7:Cu (0.02, 0.04, 0.06, 0.08 and 0.1 wt%). A linear TL response was observed for both X-ray and γ radiation. The kinetic parameters were calculated using the peak shape method for the Li2B4O7:Cu (0.1 wt%).

Fibromyalgia is associated to receiving chronic medications beyond appropriateness: a cross-sectional study.

The objectives of this study are to describe appropriateness and drug treatment of comorbidities in fibromyalgia (FM). Cross-sectional study of a group of patients. Number of drugs, indication, duration and appropriateness of prescriptions were evaluated. Patients were classified as: group 1, (FM/FM) previous FM diagnosis and fulfilling criteria; group 2, (noFM/noFM) other diagnosis and not fulfilling criteria; and group 3, (noFM/FM) other diagnosis but fulfilling criteria. Drugs were classified into drugs for nervous system, analgesics/NSAID and drugs for other comorbidities. Appropriateness was evaluated following clinical therapeutic guidelines. A total of 159 patients were included in the study and classified into group 1, with 59 patients; group 2, with 67 patients; and group 3, with 33 patients. Group 1 received a greater number of different drugs and for a longer period of time, there were less severe comorbidities and more unjustified treatments. No difference was found between the other two groups. Major opioids were only consumed in group 1. Also, in group 1, 45.8 % of patients were attended in psychiatry versus 15.6 % in group 3 and 3 % in group 2. The number of somatic symptoms correlated significantly with the number of drugs. Nervous system treatments were of shorter duration than other drug treatments. There was no difference in severe comorbidities. Comorbidities in FM are similar to those of other patients, but they receive more drugs and for a longer period of time. Drugs for nervous system comorbidities are introduced later, when other somatic symptoms are already treated. In patients with FM the treatments for mild comorbidities are not well justified.

Chronic pain care.

Objective Experiencing pain not only affects patients' biopsychosocial functioning but also the existential domain. Attention to the existential, in addition to the biopsychosocial domains, might thus be important in chronic pain care. Therefore, we investigated: (a) how satisfied patients were with the attention of their practitioners to the impact of pain on biological, psychological, social, and existential life domains, and (b) how satisfaction with each domain was related to patient functioning. Method Pain patients ( N = 163) were questioned on their satisfaction with the attention of their practitioners to biological, psychological, social, and existential life domains, and on pain intensity, pain disability, life satisfaction, and depressive symptoms. Results Patients reported low satisfaction with the attention of their practitioners to the social and existential domains. Satisfaction with each domain was negatively related with pain intensity, pain disability, and depressive symptoms and positively related with life satisfaction. Only satisfaction with the existential domain was able to predict all functional outcomes above and beyond all other satisfaction variables modeled simultaneously. Conclusions Patients reported not feeling satisfied with the attention to the social and existential life domains. Furthermore, practitioners' attention to the existential domain seems highly important for patient functioning. Openness to existential concerns of pain patients might thus be an important aspect of chronic pain care.

Usage and effectiveness of a fully automated, open-access, Spanish Web-based smoking cessation program: randomized controlled trial.

BACKGROUND: The Internet is an optimal setting to provide massive access to tobacco treatments. To evaluate open-access Web-based smoking cessation programs in a real-world setting, adherence and retention data should be taken into account as much as abstinence rate. OBJECTIVE: The objective was to analyze the usage and effectiveness of a fully automated, open-access, Web-based smoking cessation program by comparing interactive versus noninteractive versions. METHODS: Participants were randomly assigned either to the interactive or noninteractive version of the program, both with identical content divided into 4 interdependent modules. At baseline, we collected demographic, psychological, and smoking characteristics of the smokers self-enrolled in the Web-based program of Universidad Nacional de Educación a Distancia (National Distance Education University; UNED) in Madrid, Spain. The following questionnaires were administered: the anxiety and depression subscales from the Symptom Checklist-90-Revised, the 4-item Perceived Stress Scale, and the Heaviness of Smoking Index. At 3 months, we analyzed dropout rates, module completion, user satisfaction, follow-up response rate, and self-assessed smoking abstinence. RESULTS: A total of 23,213 smokers were registered, 50.06% (11,620/23,213) women and 49.94% (11,593/23,213) men, with a mean age of 39.5 years (SD 10.3). Of these, 46.10% (10,701/23,213) were married and 34.43% (7992/23,213) were single, 46.03% (10,686/23,213) had university education, and 78.73% (18,275/23,213) were employed. Participants smoked an average of 19.4 cigarettes per day (SD 10.3). Of the 11,861 smokers randomly assigned to the interactive version, 2720 (22.93%) completed the first module, 1052 (8.87%) the second, 624 (5.26%) the third, and 355 (2.99%) the fourth. Completion data was not available for the noninteractive version (no way to record it automatically). The 3-month follow-up questionnaire was completed by 1085 of 23,213 enrolled smokers (4.67%). Among them, 406 (37.42%) self-reported not smoking. No difference between groups was found. Assuming missing respondents continued to smoke, the abstinence rate was 1.74% (406/23,213), in which 22,678 were missing respondents. Among follow-up respondents, completing the 4 modules of the intervention increased the chances of smoking cessation (OR 1.95, 95% CI 1.27-2.97, P<.001), as did smoking 30 minutes (OR 1.58, 95% CI 1.04-2.39, P=.003) or 1 hour after waking (OR 1.93, 95% CI 1.27-2.93, P<.001) compared to smoking within the first 5 minutes after waking. CONCLUSIONS: The findings suggest that the UNED Web-based smoking cessation program was very accessible, but a high level of attrition was confirmed. This could be related to the ease of enrollment, its free character, and the absence of direct contact with professionals. It is concluded that, in practice, the greater the accessibility to the program, the lower the adherence and retention. Professional support from health services and the payment of a reimbursable fee could prevent high rates of attrition.

Prospective study of the use of healthcare resources and economic costs in patients with fibromyalgia after treatment in routine medical practice.

OBJECTIVES: To estimate the burden and to prospectively analyse resources utilisation and costs in a cohort of treated patients with fibromyalgia (FM) in daily practice. METHODS: Prospective, observational, multicentre, 3-month study in 232 patients with FM according to the ACR criteria (98% women, 47 years), with no concomitant systemic diseases, followed in rheumatology units. The control group consisted of 110 subjects without FM or any other systemic condition, paired by age and gender. Clinical assessment, use of healthcare resources and treatments, out-of-pocket expenses, occupational status, days off work, and calculation of lost workdays equivalents were recorded. RESULTS: Patients had worse clinical status, four times the control group's healthcare costs, twelve times its indirect costs and six times its total costs. After the treatment, there was significant clinical improvement in the patient group, the healthcare costs were significantly reduced in all components except for drugs costs, which increased (p<0.001), and out-of-pocket expenses, which remained unaltered. Indirect costs were reduced (p<0.05) in the FM group only, mainly due to fewer days off work. The patient group presented a significantly greater variation in montly total costs than the controls; -€193.75 ± 781.9 vs. -€26.22 ± 402.7, p=0.006. The patients who most reduced their healthcare costs were actively employed. CONCLUSIONS: Treated patients with FM in daily practice improved their clinical status and were accompanied by a significant reduction in the cost of the illness. The extra cost of drugs is substantially compensated for by less use of other healthcare resources and fewer days off work.

Mental Health, Quality of Life and Coping Strategies in Vulnerable Children During the COVID-19 Pandemic.

BACKGROUND: The coronavirus pandemic has led to a situation without precedent in modern history. The aim of this study is to analyse the consequences after one year of the pandemic on a group of children and adolescents assessed at the beginning of the pandemic in 2020 and to determine the most effective ways of psychologically coping with this pandemic. METHOD: Two different, but equivalent, groups with a total of 604 (study I, 2020) and 743 (study II, 2021) children and adolescents in residential care, foster families, kinship families or family strengthening programs in Spain were evaluated using the SDQ (mental health measure), KIDSCREEN-10 index (quality of life measure) and Kidcope (coping behaviour measure). An independent sample t-test and a decision tree analysis were used. RESULTS: The mental health of children and adolescents decreased by 9.7%, and Self-Perceived quality of life did not change after one year of the COVID-19 pandemic. Nonactive coping strategies predicted worse mental health and worse quality of life. Problem solving served as a protective factor. CONCLUSION: One year after, the COVID-19 pandemic has an effect on the psychological wellbeing of children and adolescents, and the consequences can be reduced if proper coping strategies are used.

Fluorescent organic particle doped polymer-based gel dosimeter for neutron detection.

The purpose of this work is to develop a material capable of detecting neutrons produced by photodisintegration in a linear accelerator for its medical use. In this study, we have developed a gel-like material doped with fluorescent organic particles. PPO at 1 wt% is used as primary dopant and POPOP as secondary one at 0.03 wt%. A set of four samples is produced, with boric acid concentrations of 0, 400, 800 and 1200 ppm. The viscoelastic properties of the material are characterized with rheological measurements, finding a gel-like behavior, i.e., a material that can keep its original shape if no stresses are applied, but can also be deformed by applying a moderate shear rate. Furthermore, the material was irradiated with gamma, electron, and neutron emission sources from 137Cs, 22Na, 60Co, 210Po, 90Sr and 241AmBe, and its response was measured in two different experimental settings, in two different institutions, for comparative purposes. From these measurements, one can clearly establish that the new material detects neutrons, electrons, and gammas within the MeV regions and below. Thus, our findings show that the developed material and its properties make it a promising technology for its use in a neutron detector.

A confirmatory study of the Combined Index of Severity of Fibromyalgia (ICAF*): factorial structure, reliability and sensitivity to change.

BACKGROUND: Fibromyalgia (FM) is a complex syndrome that affects many aspects of the patient's life and it is very difficult to evaluate in clinical practice. A recent study has developed the Combined Index of Severity of Fibromyalgia (ICAF), an instrument that evaluates diverse aspects of FM and offers five indices: emotional, physical, active coping, passive coping and total. The objective of this study is to confirm the structure of the ICAF, check its test-retest reliability, assess its sensitivity to change, and compare the results obtained in a sample of patients with fibromyalgia with another sample of healthy controls. METHODS: A total of 232 patients took part in the study, 228 women and 4 men, with a mean age of 47.73 years of age (SD = 8.61) and a time of disease evolution since diagnosis of 4.28 years (SD = 4.03). The patients from the FM group completed the ICAF. Between one and two weeks later, they again attended the clinic and complete the 59 items on the ICAF (retest) and immediately afterwards they began treatment (according to daily clinical practice criteria). A sample of healthy subjects was also studied as a control group: 110 people were included (106 women and 4 men) with a mean age of 46.01 years of age (SD = 9.35). The study was conducted in Spain. RESULTS: The results obtained suggest that the four-factor model obtained in the previous study adequately fits the data obtained in this study. The test-retest reliability and internal consistency were all significant and show a high degree of correlation for all the factors as well as in overall score. With the exception of the passive coping factor, all the other scores, including the overall score, were sensitive to change after the therapeutic intervention. The ICAF scores of the patients with fibromyalgia compared with those of the control group were markedly different. CONCLUSIONS: The findings suggest that the ICAF is a valid, reliable, sensitive to change instrument with the added advantage that it offers some additional domains (factors) that provide very valuable information regarding the most delicate aspects of the patient, which must be addressed at the time of treatment in daily clinical practice.

Psychological Flexibility Is Key for Reducing the Severity and Impact of Fibromyalgia.

Fibromyalgia has a significant impact on the lives of patients; symptoms are influenced by psychological factors, such as psychological flexibility and catastrophizing. The objective of this study was to determine the importance of these variables in moderating the association between the severity and impact of fibromyalgia symptoms. A total of 187 patients from a general hospital population were evaluated using the Combined Index of Severity of Fibromyalgia (ICAF), the Fibromyalgia Impact Questionnaire (FIQ), the Acceptance and Action Questionnaire-II (AAQ-II), and the Pain Catastrophizing Scale (PCS). A series of multiple regression analyses were carried out using the PROCESS macro and decision tree analysis. The results show that psychological flexibility modulates the relation between severity and the impact of fibromyalgia symptoms. Catastrophism has residual importance and depends on the interaction with psychological flexibility. Interaction occurs if the severity of the disease is in transition from a mild to a moderate level and accounts for 40.1% of the variance in the sample. These aspects should be considered for evaluation and early intervention in fibromyalgia patients.

Development of a self-reporting tool to obtain a combined index of severity of fibromyalgia (ICAF).

BACKGROUND: Fibromyalgia is a syndrome with heterogeneous symptoms. The evaluation in the clinical setting usually fails to cover the complexity of the syndrome. This study aims to determine how different aspects of fibromyalgia are inter-related when measured by means of a self-reporting tool. The objective is to develop a more complete evaluation model adjusted to the complexity and multi-dimensional nature of the syndrome. METHODS: Application was made of the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Brief Pain Inventory, the Fatigue Assessment Scale, the Health Assessment Questionnaire, the General Health Questionnaire (GHQ-28), the Chronic Pain Coping Inventory, the Arthritis Self-efficacy Scale and the Sleep Quality Scale. An assessment was made, on the basis of clinical interviews, case histories and specific tests, of the patient sociodemographic data, comorbidity, physical exploration and other clinical indexes. An exploratory factor analysis was made, with comparisons of the clinical index scores in extreme groups of patients. RESULTS: The ICAF composed of 59 items was obtained, offering four factors that explain 64% of the variance, and referred to as Emotional Factor (33.7%), Physical-Activity (15%), Active Coping (9%) and Passive Coping (6.3%). A t-test between the extreme scores of these factors in the 301 patients revealed statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs. CONCLUSIONS: This study offers a tool allowing more complete and rapid evaluation of patients with fibromyalgia. The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a self-assessment questionnaire based on elements from well known tests.

Psychological Wellbeing of Vulnerable Children During the COVID-19 Pandemic.

BACKGROUND: A pandemic disaster has specific effects on mental health, however, little is known about those specific effects in children and adolescents. Thus, the aim of this study is to describe the psychological impact of the COVID-19 pandemic on a sample of children and adolescents and to compare the results with previous national data and other studies to determine variations. METHOD: A total of 459 children and adolescents in residential care, foster families, kinship families, or family strengthening programs under SOS Children's Villages Spain were evaluated using the SDQ to measure internalizing and externalizing problems and using KIDSCREEN-10 index to measure heath related quality of life. An independent sample t-test, one-way ANOVA and the chi-square test were used. RESULTS: The children and adolescents in this study had worse psychological wellbeing than those in the 2017 Spanish reference, that is, before the COVID-19 outbreak. Quality of life remained the same. No differences between care modalities were found. CONCLUSION: It is necessary to monitor the mental health status of children and adolescents to prevent possible problems. Additionally, it is necessary to use well-known assessment instruments because it is essential to have a reference to other situations and populations.

History of abuse and psychological distress symptoms among female sex workers in two Mexico-U.S. border cities.

This study examined histories of past emotional, physical, and sexual abuse as correlates of current psychological distress using data from 916 female sex workers (FSWs) who were enrolled in a safer-sex behavioral intervention in Tijuana and Ciudad (Cd.) Juarez, Mexico. We hypothesized that histories of abuse would be associated with higher symptom levels of depression and somatization and that social support would moderate the relationship. Nonparametric correlations and a series of hierarchical regression analyses revealed that all forms of past abuse predicted higher levels of depressive symptoms, and physical and sexual abuse were significantly associated with higher levels of somatic symptoms. Social support was also significantly associated with fewer symptoms of distress; however, it was not shown to moderate the relationship between abuse history and distress.

Empirical Grouping of Pain Zones in Fibromyalgia: A Preliminary Study.

OBJECTIVES: Widespread pain is important for the diagnosis of fibromyalgia (FM). For this purpose, the sum of pain regions obtained from a topographical distribution has been used to compute a Widespread Pain Index (WPI), but there is no empirical basis for choosing the regions. The aim of this study was to find an empirical distribution of the pain regions. MATERIALS AND METHODS: We evaluated 228 female patients with FM. They completed the Fibromyalgia Survey Questionnaire, Fibromyalgia Impact Questionnaire (FIQ), Combined Index of Severity in Fibromyalgia (ICAF), and Short Form-36 Health Survey. The pain regions of the WPI were grouped by the topographical distribution (WPIR) and compared with a new empirical distribution (WPIE) obtained through exploratory factor analysis. A decision- tree analysis was conducted to identify the optimal algorithm for selecting pain regions related to the severity of FM. RESULTS: The WPIE has a normal distribution compared with the WPIR. It also shows higher correlations with FM severity. From the factor analysis, 4 factors explain 48.5% of the variance. Two factors (emotional and physical) can conform to the decision-tree analysis using the dependent variables FIQ and ICAF. These factors are very congruent with the cutoff points previously proposed for FIQ and ICAF. The emotional factor is the first in the decision-tree. DISCUSSION: WPIE has a normal distribution and shows better predictive qualities than WPIR. The emotional factor is conceptualized as emotional because of the relative importance of the right hemisphere in negative emotions and pain. The physical factor could be responsible for the decreased ability to coordinate left-right stepping.

Comparison between administration via Internet and paper-and-pencil administration of two clinical instruments: SCL-90-R and GHQ-28.

The objective of this study is to compare the results of the Symptom Check List (SCL)-90-R and the General Health Questionnaire (GHQ)-28 administered on paper with the results of administration via Internet. Forty university students were asked to respond to the two questionnaires, first in one format (Internet or paper), and 1 week later in the other format. For the GHQ-28, no statistically significant differences were found between the two forms of presentation, Internet or paper, except in the social dysfunction subscale. In the case of the SCL-90-R, there were differences in the Positive Symptoms Distress Index (PSDI) and in the somatization and obsession-compulsion subscales. The effect of using the two formats in combination was also analyzed. Internal consistency of the instruments is high for both types of presentation (alpha=0.91 in GHQ-28; alpha=0.97 in SCL-90-R). Correlation between the two formats is also high, with values ranging between 0.76 and 0.92, p<0.001, except in the social dysfunction subscale. Finally, correlation between the GHQ-28 and SCL-90-R is also high, for both the paper and Internet results (r=0.88, p<0.01 on paper and r=0.83, p<0.01 via Internet). The differences found should be verified in future research with other types of sample.