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Razmjou H, Robarts S, Denis S, Wainwright A, Dickson P, Murnaghan J. Discordance between self-report and performance-based outcomes: Contribution of psychosocial factors. J Health Psychol 2025; 30:1017-1027. [PMID: 38801110 PMCID: PMC11982583 DOI: 10.1177/13591053241253895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
The purpose of this study was to examine the role of psychosocial factors in the discordance between perceived and observed physical disability in patients with osteoarthritis of the hip or knee joint. This was a cross-sectional study of patients seen for consideration of joint arthroplasty surgery. Patients completed a psychosocial outcome measure, a patient self-reported functional scale, and two performance-based tests. Data of 121 patients, mean age, 67 (8), 81 (67%) females were used for analysis. The fear avoidance and positive affect domains had the strongest association with the discordance between the self-report and both performance outcome measures. Age, gender, and severity of osteoarthritis were associated with discordance in relation to walking. Fear avoidance beliefs and positive affect play important roles in perception of pain and function. Age, gender, and severity of arthritis should be taken into consideration for a more holistic approach to arthritis care.
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Affiliation(s)
- Helen Razmjou
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Susan Robarts
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Suzanne Denis
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Amy Wainwright
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - Patricia Dickson
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
| | - John Murnaghan
- Sunnybrook Health Sciences Centre, Canada
- University of Toronto, Canada
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Li X, Zhang Y, Mao Z, Chen Q, Lan X, Chen H, Sun YN, Yu CH, Wang XY. "Doctor-Led, Patient-Centered": A Mixed-Method Research Comparing Patients' and Doctors' Treatment Outcome Choices for Chronic Low Back Pain. Patient Prefer Adherence 2025; 19:433-450. [PMID: 40040868 PMCID: PMC11878113 DOI: 10.2147/ppa.s501409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2024] [Accepted: 02/12/2025] [Indexed: 03/06/2025] Open
Abstract
Background Chronic low back pain (CLBP) significantly impacts quality of life. Treatment outcomes are influenced by the perspectives and expectations of both patients and doctors, making it crucial to understand these views to optimize care and satisfaction. Purpose This study aims to analyze the alignment and differences in doctors' and patients' perceptions of treatment outcomes and explore the implications of these differences. Methods An explanatory sequential mixed-methods design was used, involving a questionnaire survey and two focus groups. The study was conducted at Dongzhimen Hospital from August 2020 to January 2021. Participants, including patients with any type of CLBP (age≥18) and doctors with at least one year of experience, were selected via purposive sampling. Quantitative data, analyzed with SPSS, were summarized as percentages for categorical variables and as means with standard deviations or medians for continuous variables. Differences between variables were assessed using the Chi-square and nonparametric rank sum tests. Focus group discussions were analyzed thematically to explore differing perspectives on treatment outcomes. Results A questionnaire gathered perspectives from 30 patients (mean age 45±11.74 years) and 26 doctors (mean age 41.7±6.7 years). The results informed the development of specific questions for focus group interviews with 8 patients and 8 doctors. Quantitative results revealed that pain/discomfort and activities of daily living were equally important to both groups. However, many outcomes were valued differently. Five themes emerged: 1) Doctors' focus on treating the whole person; 2) Patients' emphasis on cost-effectiveness/satisfaction; 3) Patients' prioritization of body image and physical function; 4) Shared priority beyond pain; 5) Shared concerns on adverse events. Conclusion This study highlights the importance of aligning treatment expectations between patients and doctors to improve satisfaction and outcomes in CLBP management. Enhanced communication strategies and shared decision-making are recommended to bridge these gaps.
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Affiliation(s)
- Xia Li
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Ying Zhang
- Yungang Community Health Service Center of 731 Hospital of Beijing Aerospace Science & Industry Group, Beijing, People’s Republic of China
| | - Zhuxin Mao
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), University of Antwerp, Antwerp, Belgium
| | - Qianji Chen
- Luohu Hospital of Traditional Chinese Medicine, Shenzhen, People’s Republic of China
| | - Xiaoxue Lan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Hong Chen
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Ya-Nan Sun
- Traditional Chinese Medicine Department, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China
| | - Chang-He Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Xi-You Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
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Ortega MA, Fraile-Martinez O, García-Montero C, Diaz-Pedrero R, Lopez-Gonzalez L, Monserrat J, Barrena-Blázquez S, Alvarez-Mon MA, Lahera G, Alvarez-Mon M. Understanding immune system dysfunction and its context in mood disorders: psychoneuroimmunoendocrinology and clinical interventions. Mil Med Res 2024; 11:80. [PMID: 39681901 DOI: 10.1186/s40779-024-00577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/01/2024] [Indexed: 12/18/2024] Open
Abstract
Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society, being mainly represented by major depressive disorder (MDD) and bipolar disorder (BD). The etiopathogenesis of mood disorders is extremely complex, with a wide spectrum of biological, psychological, and sociocultural factors being responsible for their appearance and development. In this sense, immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders, worsening mainly the central nervous system (neuroinflammation) and the periphery of the body (systemic inflammation). However, these alterations cannot be understood separately, but as part of a complex picture in which different factors and systems interact with each other. Psychoneuroimmunoendocrinology (PNIE) is the area responsible for studying the relationship between these elements and the impact of mind-body integration, placing the immune system as part of a whole. Thus, the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche, damage to the nervous system, alterations to the endocrine and metabolic systems, and disruption of the microbiota and intestinal ecosystem, as well as of other organs and, in turn, all these mechanisms are responsible for inducing and enhancing the immune dysfunction. Similarly, the clinical approach to these patients is usually multidisciplinary, and the therapeutic arsenal includes different pharmacological (for example, antidepressants, antipsychotics, and lithium) and non-pharmacological (i.e., psychotherapy, lifestyle, and electroconvulsive therapy) treatments. These interventions also modulate the immune system and other elements of the PNIE in these patients, which may be interesting to understand the therapeutic success or failure of these approaches. In this sense, this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE. Likewise, an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients, in order to identify the mechanisms described and their possible uses as biomarkers.
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Affiliation(s)
- Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain.
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain.
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain.
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain.
| | - Raul Diaz-Pedrero
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcala de Henares, Spain
| | - Laura Lopez-Gonzalez
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcala de Henares, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
| | - Silvestra Barrena-Blázquez
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
- Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031, Madrid, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806, Alcalá de Henares, Spain
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034, Madrid, Spain
- Immune System Diseases-Rheumatology and Internal Medicine Service, University Hospital Príncipe de Asturias, CIBEREHD, 28806, Alcalá de Henares, Spain
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Rao SR, Sherigar MN, Normen M, Joshi U. Teaching empathy and compassion to healthcare providers in palliative care: a scoping review. Ecancermedicalscience 2024; 18:1817. [PMID: 40171454 PMCID: PMC11959133 DOI: 10.3332/ecancer.2024.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Indexed: 04/03/2025] Open
Abstract
Empathy and compassion are core competencies that healthcare providers (HCPs) require when caring for patients and families with life-threatening illnesses like cancer. These constructs are often challenging to define and generalise and are often used interchangeably. Medical education has evolved from the traditional curriculum-based approach to a more eclectic competency-based approach. The purpose of this review is to explore the current evidence on teaching compassionate care for palliative care issues in cancer settings in lower-middle-income countries. A preliminary search of the Scopus database from 2,000 until now identified 1,502 records, of which 54 peer-reviewed articles were included in this review. Training in compassion and empathy was delivered in three formats: online, face-to-face and blended learning or hybrid. The training modalities were didactic, experiential and reflective, with many educational interventions using a multimodal approach. The educational interventions reported a positive outcome and improvement in empathetic and compassionate behaviours. However, they were limited due to inadequately defined constructs, use of self-reported outcome measures and difficulty in ascertaining if these skills were retained long-term and were translated into the clinical settings. Given that compassion and empathy are multidimensional constructs, it is imperative that educational interventions be multimodal and learner-centred, focusing on developing the knowledge, attitudes, skills and behaviours of the HCP in providing compassionate care while aiming for conceptual clarity regarding definition and more robust validated outcome measures.
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Affiliation(s)
- Seema Rajesh Rao
- BHT-Karunashraya Institute for Palliative Care Educ ation and Research, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
- School of Medicine, Cardiff University, Cardiff’dCF14 4YS, UK
- https://orcid.org/0000-0001-8278-3640
| | - Mithili Narayan Sherigar
- BHT-Karunashraya Institute for Palliative Care Educ ation and Research, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
| | - Michelle Normen
- BHT-Karunashraya, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
- https://orcid.org/0000-0001-9148-890X
| | - Udita Joshi
- BHT-Karunashraya Institute for Palliative Care Educ ation and Research, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
- https://orcid.org/0000-0002-9039-7894
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Singal AK, Vatsalya V, Agrawal R. Integrated Multidisciplinary Care Model to Manage the Dual Pathology of Alcohol Use Disorder and of Liver Disease. Clin Liver Dis 2024; 28:793-807. [PMID: 39362722 DOI: 10.1016/j.cld.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
Alcohol-associated liver disease (ALD) is the most common cause of liver disease and an indication for liver transplantation. Identification of ALD at an earlier stage and treatment of concomitant alcohol use disorder (AUD) could potentially prevent or delay the progression to advanced stages of ALD like alcohol-associated cirrhosis and alcohol-associated hepatitis. However, screening for alcohol use is often not performed and treatment of AUD is rarely administered in ALD patients, due to several barriers at the level of patients, clinicians, and administrative levels.
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Affiliation(s)
- Ashwani K Singal
- University of Louisville, 505 South Hancock Street, Louisville, KY 40202, USA.
| | - Vatsalya Vatsalya
- University of Louisville, 505 South Hancock Street, Louisville, KY 40202, USA
| | - Ruchita Agrawal
- Department of Psychiatry and Behavioral Sciences, Seven Counties Services, Inc, 530 South Jackson Street, Louisville, KY 40202, USA
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Chiang IH, Huang CH, Hsieh YW, Lin YF, Huang RY, Lin CW. Evaluation of an Innovative Postgraduate Medical Education Model Incorporating Social Determinants of Health. MEDICAL TEACHER 2024:1-7. [PMID: 39382279 DOI: 10.1080/0142159x.2024.2413022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 10/02/2024] [Indexed: 10/10/2024]
Abstract
PURPOSE Incorporating social determinants of health (SDH) into medical education is crucial. However, there are limited data on standard education models and comprehensive SDH curricula in Taiwan are insufficient. This study presents a systematic SDH curriculum instructed primarily by social workers for postgraduate doctors and aims to examine the training outcomes of the innovative curriculum. METHOD This study assessed training outcomes using Kirkpatrick model levels 1 and 2 regarding trainees' satisfaction and improvement of their knowledge and skills in written and standardized patient (SP) pre- and posttests conducted between 1 August 2021 and 31 July 2022. RESULTS A total of 28 trainees completed the training. The trainees' overall satisfaction score regarding the curriculum was high (4.6 out of 5). The median pretest scores for the written and SP tests were 66.25 ± 14.38 and 14.50 ± 5.13, respectively, whereas the median posttest scores were 80.00 ± 7.50 and 20.50 ± 6.13, respectively. Both written and SP posttest scores were significantly improved compared to the pretest scores (p < .001). CONCLUSIONS The presented education model significantly improved postgraduate doctors' SDH knowledge and biopsychosocial assessment skills, and received high satisfaction scores from the trainees. Adopting social workers as primary teachers may enhance interdisciplinary collaboration between social workers and trainee doctors.
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Affiliation(s)
- I-Hui Chiang
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chi-Hsien Huang
- Department of Family and Community Medicine, E-Da Hospital and College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Feng Lin
- Social Work Section, Department of Family and Community Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Ru-Yi Huang
- Department of Family Medicine, Taipei Tzu Chi Hospital, Taipei, Taiwan
- Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan
- Data Science Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Chi-Wei Lin
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Shahali S, Tavousi M, Sadighi J, Kermani RM, Rostami R. Health challenges faced by parents of children with disabilities: a scoping review. BMC Pediatr 2024; 24:619. [PMID: 39343886 PMCID: PMC11440903 DOI: 10.1186/s12887-024-05104-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 09/24/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Parenting a child with disabilities can feel isolating and overwhelming. Understanding the health challenges of parents with disabled children is essential for providing effective healthcare. This study aims to offer a comprehensive view of the health challenges faced by these parents by synthesizing existing literature from various perspectives. METHOD This scoping review conducted using the JBI scoping review method. Searches were performed on PubMed, Web of Science, Scopus, and Google Scholar databases spanning from 2014 to 2024. The initial search yielded 388 articles, with 24 articles undergoing qualitative assessment and data analysis via narrative synthesis. RESULTS From the 24 selected articles, three health challenges were identified: physical, emotional, and social health challenges. CONCLUSION Parents of children with disabilities face intricate health challenges, including physical challenges like fatigue, musculoskeletal pain, and sleep issues. Additionally, they experience significant emotional strain, with symptoms of depression, anxiety, and hopelessness. Social isolation and stigma further compound these challenges. A collaborative approach involving healthcare professionals, policymakers, and support organizations can empower parents to thrive in their caregiving roles.
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Affiliation(s)
- Shadab Shahali
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Mahmoud Tavousi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Jila Sadighi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ramin Mozafari Kermani
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Rahele Rostami
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Veltro F, Latte G, Pontarelli C, Barcella M, Silveri L, Cardone G, Nicchiniello I, Pontarelli I, Zappone L, Luso S, Leggero P. Functioning Management and Recovery, a psychoeducational intervention for psychiatric residential facilities: a multicenter follow-up study. BMC Psychiatry 2024; 24:601. [PMID: 39237923 PMCID: PMC11375939 DOI: 10.1186/s12888-024-06033-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024] Open
Abstract
AIM Functional Management and Recovery is a standardized Psychoeducational Intervention, derived from "Integro", an effective salutogenic-psychoeducational intervention for people in recovery journey, designed to improve recovery and functioning of individuals with psychotic disorders in Psychiatric Residential Facilities (PRFs). The aim of this study is to evaluate the primary and secondary outcomes of this intervention elaborated specifically for PRFs where evidence based structured interventions seem rare and desirable. METHODS 66 individuals with psychotic disorders were recruited in 9 PRFs dislocated in the North, Center and South Italy and 63 underwent a multicenter follow-up study with a two time-point evaluation (t0, pre-treatment and t1, 6 months; ). At each time point, social functioning was assessed as primary outcome by the Personal and Social Performance scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), Recovery by Recovery Assessment Scale (RAS), Cognitive Functioning by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Stress management by Stress-Scale, Cognitive Flexibility by Modified Five-Point Test (M-FPT), Emotional Intelligence by Emotional Intelligence Index (EI-I), the PRF Atmosphere and the Opinion of users about the PFR by an ad hoc questionnaire. The Abilities Knowledge, the Utility and Pleasantness of sessions were measured by an ad hoc list of items. RESULTS 63 individuals out of 66, 52 (82,5%) affected by schizophrenia and 11 (17,5%) by bipolar I disorder with psychotic symptoms according to DSM-5-TR completed the study. At the end of the study, 43 (68,3%) were male, 57 (90.5%) were single, 5 (7.9%) engaged, 1 (1.6%) married; 45 (71.4%) unemployed. The total scores of PSP, RAS, BPRS, BANS, Stress management, Abilities Knowledge, Utility and Pleasantness of sessions showed a statistically significant improvement at t1 vs. t0. Two sub-scales out of 5 of M-FPT showed a statistically significant improvement. The Emotional Intelligence, the Unit Atmosphere and the Opinion of Users about PFR improved without statistical significance. Six months after the end of the follow-up study 22 individuals of the sample were dismissed with a very high turnover. CONCLUSIONS After a six-month follow-up (a short period of time), these results showed improvement in functioning, the primary outcome, as well as in the following secondary outcome variables: RAS, BPRS, BANS, Stress management, Abilities Knowledge, two sub-scales out of 5 of M-FPT, Utility and Pleasantness of sessions. Overall, a remarkable impact of psychoeducational structured intervention on the key Recovery variables is observed. Further studies are needed to address extent and duration of these improvements.
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Affiliation(s)
- Franco Veltro
- Associazione Italiana per la Diffusione Interventi Psicoeducativi in Salute Mentale - Associazione di Promozione Sociale (AIDIPSaM - APS), Campobasso, Italy.
| | - Gianmarco Latte
- Associazione Italiana per la Diffusione Interventi Psicoeducativi in Salute Mentale - Associazione di Promozione Sociale (AIDIPSaM - APS), Campobasso, Italy
- Dipartimento di Salute Mentale ASL Napoli 1 Centro, Napoli, Italy
| | - Cristina Pontarelli
- Dipartimento di Salute Mentale Regione Molise, Centro di Salute Mentale di Campobasso, Campobasso, Italy
- Nuove Prospettive Cooperativa, Busso, CB, Italy
| | | | | | | | - Ilenia Nicchiniello
- Dipartimento di Salute Mentale Regione Molise, Centro di Salute Mentale di Campobasso, Campobasso, Italy
- Nuove Prospettive Cooperativa, Busso, CB, Italy
| | - Irene Pontarelli
- Associazione Italiana per la Diffusione Interventi Psicoeducativi in Salute Mentale - Associazione di Promozione Sociale (AIDIPSaM - APS), Campobasso, Italy
- Dipartimento di Salute Mentale Regione Molise, Centro di Salute Mentale di Campobasso, Campobasso, Italy
| | - Lilia Zappone
- Dipartimento di Salute Mentale Regione Molise, Centro di Salute Mentale di Campobasso, Campobasso, Italy
- Nuove Prospettive Cooperativa, Busso, CB, Italy
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Xie M, Liu X, Wang A, Hao Y. Symptom network connectivity and interaction among people with HIV in China: secondary analysis based on a cross-sectional survey. BMC Public Health 2024; 24:2331. [PMID: 39198725 PMCID: PMC11351592 DOI: 10.1186/s12889-024-19728-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/08/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND The symptom burden in people with HIV (PWH) is considerable. Nonetheless, the identification of a central symptom, or bridge symptom, among the myriad symptoms experienced by PWH remains unclear. This study seeks to establish networks of symptom experiences within different clusters and investigate the relationships and interconnectedness between these symptoms in PWH. METHODS A multicenter, cross-sectional descriptive design was carried out in China over two periods: November 2021 to January 2022 and April 2022 to May 2022. A total of 711 PWH completed online questionnaires, providing information on demographics and the 27-item Self-Report Symptom Scale. The symptom network was analyzed using Network/Graph theory, allowing for the exploration of connections between physical, cognitive, and psychological symptoms. This analysis was based on data from a subset of 493 individuals out of the total 711 PWH. RESULTS A total of 493 PWH who exhibited symptoms out of a total of 711 PWH were analyzed. The average number of symptoms reported was 5.367. The most prevalent symptom was sleep disturbance (37.98%). In the node centrality analysis, a cognitive symptom, 'becoming confusing', emerged as the most central symptom with significant values for node centrality (strength = 1.437, betweenness = 140.000, closeness = 0.003). Fever was identified as the bridge symptom with the highest bridge strength (0.547), bridge closeness (0.053), lower bridge betweenness (23.000), and bridge expectedinfluence (0.285). Overall, our network displayed good accuracy and stability. CONCLUSION Early identification and assessment of the central or bridge symptoms should be emphasized in clinical practice. According to the findings from network analysis, healthcare providers should proactively explore intervention strategies or bundle care to alleviate the burden of symptoms and enable anticipatory care.
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Affiliation(s)
- Meilian Xie
- Nursing Management Department, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Xiaoyu Liu
- School of Statistics, Capital University of Economics and Business, Beijing, China.
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yiwei Hao
- Department of Medical Records and Statistics, Beijing Ditan Hospital Capital Medical University, Beijing, China
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Zierke K, Boettcher M, Behrendt P, Najem S, Zapf H, Reinshagen K, Wößmann W, Boettcher J. Health-Related Quality of Life and Mental Health of Parents of Children with Pediatric Abdominal Tumors. CHILDREN (BASEL, SWITZERLAND) 2024; 11:998. [PMID: 39201933 PMCID: PMC11352779 DOI: 10.3390/children11080998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 08/11/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Abdominal tumors rarely occur in childhood but are associated with great psychological stress for patients and their families. Parents playing a central role in their children's treatment may experience adverse effects on their Health-Related Quality of Life (HRQoL) and mental health due to the children's illness and required treatment. Given the limited knowledge of the psychosocial burden of parents with children suffering from solid abdominal tumors, this study aims to assess their HRQoL and mental health along with the impact of various psychosocial factors. METHODS A cross-sectional cohort study was carried out involving 54 parents of children with solid abdominal tumors who had surgery at the University Medical Center Hamburg-Eppendorf in Germany. The results were compared with 46 parents of children undergoing routine surgeries without a prior tumor diagnosis, and with normative values. Data were obtained using standardized questionnaires. RESULTS Parents of the index group showed significantly worse HRQoL and limited mental health. Furthermore, they showed significantly higher parental burden in several subscales and less social support in comparison with the control group. CONCLUSIONS Considering the lower parental HRQoL and the central role parents play in their children's lives, it is crucial to include prevention and intervention measures for parents as part of a multimodal treatment regime for children with solid pediatric abdominal tumors.
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Affiliation(s)
- Kira Zierke
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Michael Boettcher
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
- Department of Pediatric Surgery, University Medical Center Mannheim, University Heidelberg, Theodor-Kutzner-Ufer 1-3, 68167 Mannheim, Germany
| | - Paulina Behrendt
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Safiullah Najem
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
- Department of Pediatric and Adolescent Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Holger Zapf
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Konrad Reinshagen
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Wilhelm Wößmann
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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11
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Paton MW, Kalemtzaki E, Stoewen D, Hameedunisha T, Yang H, Donlin J, Endenburg N. WSAVA professional wellness guidelines. J Small Anim Pract 2024; 65:153-175. [PMID: 38179606 DOI: 10.1111/jsap.13689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 01/06/2024]
Affiliation(s)
- M W Paton
- 31 Clipson Crescent, Mundaring, WA, 6073, Australia
| | | | - D Stoewen
- Independent Wellness Consultant, Ayr, ON, N0B 1E0, Canada
| | - T Hameedunisha
- Caspers Healing Paws, Neuro Rehabilitation Service, 3rd cross, HBR layout, Bangalore, Karnataka, 560054, India
| | - H Yang
- Unusual Pet Vets, Osborne Park, WA, 6017, Australia
| | - J Donlin
- 1931 N. Meacham Road, Schaumburg, IL, 60173, USA
| | - N Endenburg
- One Welfare Group, Section Animals in Science and Society, and Animal Behaviour Clinic, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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12
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Supasitthumrong T, Maes M, Tunvirachaisakul C, Rungnirundorn T, Zhou B, Li J, Wainipitapong S, Ratanajaruraks A, Nimnuan C, Kanchanatawan B, Thompson T, Solmi M, Correll C. Predictors of increased affective symptoms and suicidal ideation during the COVID-19 pandemic: results from a large-scale study of 14 271 Thai adults. BMJ MENTAL HEALTH 2024; 27:e300982. [PMID: 38379238 PMCID: PMC10882356 DOI: 10.1136/bmjment-2023-300982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Increasing data suggest emergent affective symptoms during the COVID-19 pandemic. OBJECTIVES To study the impact of the COVID-19 pandemic on affective symptoms and suicidal ideation in Thai adults. METHODS The Collaborative Outcomes Study on Health and Functioning during Infection Times uses non-probability sampling (chain referring and voluntary response sampling) and stratified probability sampling to identify risk factors of mental health problems and potential treatment targets to improve mental health outcomes during pandemics. FINDINGS Analysing 14 271 adult survey participants across all four waves of the COVID-19 pandemic in Thailand, covering all 77 provinces from 1 June 2020 to 30 April 2022, affective symptoms and suicidality increased during COVID-19 pandemic. Affective symptoms were strongly predicted by pandemic (feelings of isolation, fear of COVID-19, loss of social support, financial loss, lack of protective devices) and non-pandemic (female sex, non-binary individuals, adverse childhood experiences (ACEs), negative life events, student status, multiple mental health and medical conditions, physical pain) risk factors. ACEs, prior mental health conditions and physical pain were the top three risk factors associated with both increased affective symptoms and suicidal ideation during the COVID-19 pandemic. Partial least squares analysis showed that ACEs were the most important risk factor as they impacted most pandemic and non-pandemic risk factors. CLINICAL IMPLICATIONS Rational policymaking during a pandemic should aim to identify the groups at highest risk (those with ACEs, psychiatric and medical disease, women, non-binary individuals) and implement both immediate and long-term strategies to mitigate the impact of ACEs, while effectively addressing associated psychiatric and medical conditions.
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Affiliation(s)
- Thitiporn Supasitthumrong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosoamatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
- Kyung Hee University, Seoul, South Korea
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Teerayuth Rungnirundorn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosoamatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jing Li
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosoamatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Sorawit Wainipitapong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Anchalita Ratanajaruraks
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Chaichana Nimnuan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Buranee Kanchanatawan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Trevor Thompson
- Cente for Chronic Illness and Ageing, University of Greenwich, London, UK
| | - Marco Solmi
- Department of Child and adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Christoph Correll
- Department of Child and adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, New York, New York, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine, New York, New York, USA
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
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13
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Stanghellini G, Ikkos G. Images of depression in Charles Baudelaire: clinical understanding in the context of poetry and social history. BJPsych Bull 2024; 48:33-37. [PMID: 36539257 PMCID: PMC10801405 DOI: 10.1192/bjb.2022.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/21/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
There is increasing recognition of the importance of the humanities and arts in medical and psychiatric training. We explore the poetry of Charles Baudelaire (1821-1867) and its evocations of depression through themes of mood, time and self-consciousness and discuss their relation to images of 'spleen', the 'snuffling clock' and the 'sinister mirror'. Following the literary critical commentaries of Walter Benjamin (1892-1940) and Jean Starobinski (1920-2019) we identify some of their roots in the poet's experience of the rapid and alienating urbanisation of 19th-century Paris. Appreciation of the rich vocabulary of poetry and the images it generates adds depth to clinical practice by painting vivid pictures of subjective experience, including subjective experience of the 'social' as part of the biopsychosocial constellation.
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Affiliation(s)
| | - George Ikkos
- Royal National Orthopaedic Hospital, Stanmore, UK
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14
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Holbeck M, DeVries HS, Singal AK. Integrated Multidisciplinary Management of Alcohol-associated Liver Disease. J Clin Transl Hepatol 2023; 11:1404-1412. [PMID: 37719958 PMCID: PMC10500286 DOI: 10.14218/jcth.2023.00002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 07/03/2023] Open
Abstract
Alcohol-associated liver disease (ALD) is one of the most common liver diseases and indications for liver transplantation (LT). Alcohol use disorder (AUD), a frequent accompaniment in ALD patients, may also be associated with psychiatric comorbidities such as depression and anxiety. Identification of ALD at an earlier stage, and treatment of AUD may help prevent progression to advanced stage of ALD such as cirrhosis and alcoholic hepatitis. Screening for alcohol use and AUD treatment in ALD patients is often not performed due to several barriers at the level of patients, clinicians, and administrative levels. This review details the integrated multidisciplinary care model especially on the specific role of the hepatologist, psychiatrist, addiction counselor, and social worker in providing complete management for the dual pathology of liver disease and of AUD. Laboratory assessment, pharmacological and behavioral therapies, and recommended assessments for follow-up care by the respective specialists is outlined. We provide perspective along with the literature support, with the goal of providing team based comprehensive care of patients with ALD.
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Affiliation(s)
- Malia Holbeck
- Addiction Medicine, Avera McKennan University Hospital, University of South Dakota, Sioux Falls, SD, USA
| | - Hannah Statz DeVries
- Psychiatry, Avera McKennan University Hospital, University of South Dakota, Sioux Falls, SD, USA
| | - Ashwani K. Singal
- Transplant Hepatology, Avera McKennan University Hospital, University of South Dakota, Sioux Falls, SD, USA
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15
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Sierpińska LE. Assessment of the Level of Life Satisfaction and Health Behaviors Among Patients with Chronic Hepatitis C. Am J Health Behav 2023; 47:595-604. [PMID: 37596750 DOI: 10.5993/ajhb.47.3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Objectives: An important aspect of complex care of patients with chronic hepatitis C is improvement of their quality of life. In Poland, a low level of life satisfaction is observed among patients with hepatitis C. Some patients experience concerns and anxiety that they will be identified by their employers, family, acquaintances. They are afraid of losing their job or breaking up with their loved ones. This study provides an analysis of the level of life satisfaction among patients with chronic hepatitis C. Methods: Overall, 220 patients with hepatitis C completed the Satisfaction With Life Scale (SWLS) along with an author-constructed questionnaire. Results: The mean level of satisfaction with life score was 16.3±4.9. More than a half of the patients presented a low level of satisfaction (1-4 stens)-62,7%, approximately one-third of the respondents showed a mediocre level (5-6 stens), and 8,7% indicated a high level (7-10 stens). Patients who evaluated their state of health as "poor" had the lowest life satisfaction scores-mean=13.9. Conclusions: Patients with hepatitis C assessed their satisfaction with life negatively and those aged 51-60 expressed significantly lower evaluations. Women showed a slightly lower level of life satisfaction than men, which was associated with low health self-esteem.
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Affiliation(s)
- Lidia Elbieta Sierpińska
- Military Clinical Hospital No. 1 with Polyclinic, Independent Public Health Care Unit, Lublin, Poland
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16
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Breton É, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Childhood Overeating and Disordered Eating From Early Adolescence to Young Adulthood: A Longitudinal Study on the Mediating Role of BMI, Victimization and Desire for Thinness. J Youth Adolesc 2023:10.1007/s10964-023-01796-5. [PMID: 37270466 DOI: 10.1007/s10964-023-01796-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
Eating disorders have early origins, and there could be a continuum between childhood eating behaviors, such as overeating, and long-term disordered eating, but this remains to be shown. BMI, desire for thinness and peer victimization could influence this continuum, but their interactions are unknown. To fill this gap, the study used data from the Quebec Longitudinal Study of Child Development (N = 1511; 52% girls), in which 30.9% of youth presented a trajectory associated with high disordered eating from 12 to 20 years. The results support an indirect association between overeating at age 5 and disordered eating trajectories, with different mediation processes observed between boys and girls. The findings underscore the importance of promoting healthy body images and eating behaviors among youths.
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Affiliation(s)
- Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Public Health, University of Montreal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, University Laval, Quebec, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology and Pediatrics, University of Montreal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada.
- Department of Psychology, Concordia University, Montreal, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research centre, Douglas Mental Health University Institute, Montreal, Canada.
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal, Canada.
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17
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Claudia C, Eleonora R, Laura P, Romina L, Campanino C, Valdo R, Edoardo M, Ilaria D, Rotella F. Orthorexia nervosa and type 1 diabetes: results of a cross-sectional study. Acta Diabetol 2023; 60:681-686. [PMID: 36806923 DOI: 10.1007/s00592-023-02044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023]
Abstract
AIM Orthorexia nervosa (ON) is a condition characterized by an excessive importance attributed to the intake of healthy foods. This study was aimed at investigating the prevalence of ON in subjects with type 1 diabetes (T1D) compared to control subjects. METHODS Patient with T1D using either flash glucose monitoring or continuous glucose monitoring were enrolled. For the selection of control group, each patient was asked to indicate one non-diabetic subject of their same sex and approximate age among colleagues at work and school. Patients and controls completed the following questionnaires: ORTO-15, Dusseldorf Orthorexie Scale (DOS), Eating Disorder Examination Questionnaire (EDE-Q) and Brief Symptom Inventory (BSI). The principal outcome was the prevalence of ON among T1D and control subjects. RESULTS We enrolled 44 patients with T1D aged 39.7 ± 15.7 years, with BMI 24.3 ± 4.3 kg/m2, and mean HbA1c 53.5 [49-57] mmol/mol. Control subjects were similar to T1D with respect to sex, age and BMI. Thirty-two [72%] and 29 [65%] subjects among patients and controls, respectively, had ORTO15 < 40 (between-group p = 0.48). Two (4.5%) and zero subjects among patients and controls, respectively, had DOS ≥ 30 (p = 0.29). Median scores of DOS, but not of ORTO-15, were significantly higher in patients than in controls. None of the metabolic variables showed a correlation with psychometric tests in T1D. CONCLUSION Although the prevalence of ON was not significantly higher in T1D than in controls, patients with T1D showed higher scores of some, but not all, tests assessing orthorexia, without any significant correlation with metabolic parameters.
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Affiliation(s)
| | - Rossi Eleonora
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pala Laura
- Department of Diabetology, Careggi Hospital, Florence, Italy
| | - Lelmi Romina
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Chiara Campanino
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Ricca Valdo
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Mannucci Edoardo
- Department of Diabetology, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Dicembrini Ilaria
- Department of Diabetology, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
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18
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Badreldin N, Ditosto JD, Grobman WA, Yee LM. Maternal psychosocial factors associated with postpartum pain. Am J Obstet Gynecol MFM 2023; 5:100908. [PMID: 36809840 PMCID: PMC10121962 DOI: 10.1016/j.ajogmf.2023.100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The experience of pain is shaped by a host of psychological, cultural, and social factors. Although pain is the most common postpartum complaint, data on its relationship with psychosocial factors and postpartum pain are limited. OBJECTIVE This study aimed to examine the relationship between self-reported postpartum pain scores and patient-level psychosocial factors, including relationship status, pregnancy intendedness, employment, education, and psychiatric diagnosis. STUDY DESIGN This was a secondary analysis of data from a prospective observational study of postpartum patients at 1 institution (May 2017 to July 2019) who used an oral opioid at least once during their postpartum hospitalization. Enrolled participants completed a survey, which included questions regarding their social situation (including relationship status), psychiatric diagnoses, and perceptions of their pain control during their postpartum hospitalization. The primary outcome was self-reported overall pain during the postpartum hospitalization (score of 0-100). Multivariable analyses accounted for age, body mass index, nulliparity, and mode of delivery. RESULTS In this cohort of 494 postpartum patients, most patients (84.0%) underwent cesarean delivery, and 41.3% of patients were nulliparous. In a pain score of 0 to 100, participants reported a median pain score of 47. On bivariable analyses, there was no significant difference in pain score between patients with and without an unplanned pregnancy or a psychiatric diagnosis. Patients who were unpartnered, those without a college education, and those who were unemployed reported significantly higher pain scores (57.5 vs 44.8 [P<.01], 52.6 vs 44.6 [P<.01], and 53.6 vs 44.6 [P<.01], respectively). In multivariable analyses, patients who were unpartnered and unemployed reported significantly higher adjusted pain scores than patients who were partnered and employed (adjusted beta coefficients: 7.93 [95% confidence interval, 2.29-13.57] vs 6.67 [95% confidence interval, 2.28-11.05]). CONCLUSION Psychosocial factors, such as relationship and employment statuses, which are indicators of social support, are associated with the experience of pain postpartum. These findings suggest that addressing social support, such as via enhanced support from the health care team, warrants exploration as a nonpharmacologic means of improving the postpartum pain experience.
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Affiliation(s)
- Nevert Badreldin
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee).
| | - Julia D Ditosto
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee)
| | - William A Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH (Dr Grobman)
| | - Lynn M Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee)
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19
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Thurner C, Stengel A. Long-COVID syndrome: physical-mental interplay in the spotlight. Inflammopharmacology 2023; 31:559-564. [PMID: 36892678 PMCID: PMC9996557 DOI: 10.1007/s10787-023-01174-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/10/2023]
Abstract
Patients suffering from Long-COVID syndrome experience a variety of different symptoms on a physical, but also on a psychological and social level. Previous psychiatric conditions such as depression and anxiety have been identified as separate risk factors for developing Long-COVID syndrome. This suggests a complex interplay of different physical and mental factors rather than a simple cause-effect relationship of a specific biological pathogenic process. The biopsychosocial model provides a foundation for understanding these interactions and integrating them into a broader perspective of the patient suffering from the disease instead of the individual symptoms, pointing towards the need of treatment options on a psychological as well as social level besides biological targets. This leads to our conclusion, that the biopsychosocial model should be the underlying philosophy of understanding, diagnosing and treating patients suffering from Long-COVID syndrome, moving away from the strictly biomedical understanding suspected by many patients, treaters and the media while also reducing the stigma still associated with the suggestion of a physical-mental interplay.
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Affiliation(s)
- Carolin Thurner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
- Charité Center for Internal Medicine and Dermatology, Medical Clinic for Psychosomatic Medicine, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Berlin, Germany.
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20
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von Rüden EL, Janssen-Peters H, Reiber M, van Dijk RM, Xiao K, Seiffert I, Koska I, Hubl C, Thum T, Potschka H. An exploratory approach to identify microRNAs as circulatory biomarker candidates for epilepsy-associated psychiatric comorbidities in an electrical post-status epilepticus model. Sci Rep 2023; 13:4552. [PMID: 36941269 PMCID: PMC10027890 DOI: 10.1038/s41598-023-31017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
Patients with epilepsy have a high risk of developing psychiatric comorbidities, and there is a particular need for early detection of these comorbidities. Here, in an exploratory, hypothesis-generating approach, we aimed to identify microRNAs as potential circulatory biomarkers for epilepsy-associated psychiatric comorbidities across different rat models of epilepsy. The identification of distress-associated biomarkers can also contribute to animal welfare assessment. MicroRNA expression profiles were analyzed in blood samples from the electrical post-status epilepticus (SE) model. Preselected microRNAs were correlated with behavioral and biochemical parameters in the electrical post-SE model, followed by quantitative real-time PCR validation in three additional well-described rat models of epilepsy. Six microRNAs (miR-376a, miR-429, miR-494, miR-697, miR-763, miR-1903) were identified showing a positive correlation with weight gain in the early post-insult phase as well as a negative correlation with social interaction, saccharin preference, and plasma BDNF. Real-time PCR validation confirmed miR-203, miR-429, and miR-712 as differentially expressed with miR-429 being upregulated across epilepsy models. While readouts from the electrical post-SE model suggest different microRNA candidates for psychiatric comorbidities, cross-model analysis argues against generalizability across models. Thus, further research is necessary to compare the predictive validity of rodent epilepsy models for detection and management of psychiatric comorbidities.
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Affiliation(s)
- Eva-Lotta von Rüden
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany
| | - Heike Janssen-Peters
- Hannover Medical School (MHH), Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover, Germany
| | - Maria Reiber
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany
| | - Roelof Maarten van Dijk
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany
| | - Ke Xiao
- Hannover Medical School (MHH), Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover, Germany
| | - Isabel Seiffert
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany
| | - Ines Koska
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany
| | - Christina Hubl
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany
| | - Thomas Thum
- Hannover Medical School (MHH), Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover, Germany
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Koeniginstr. 16, 80539, Munich, Germany.
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21
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Solomou S, Logue J, Reilly S, Perez-Algorta G. A systematic review of the association of diet quality with the mental health of university students: implications in health education practice. HEALTH EDUCATION RESEARCH 2023; 38:28-68. [PMID: 36441584 PMCID: PMC9853940 DOI: 10.1093/her/cyac035] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
University students are at risk of experiencing mental health problems during the transition from home to university. This transition can also adversely affect their diet quality. This review aims to examine bidirectional associations from observational studies regarding the influence of diet quality on the mental health of university students, and vice versa. The databases PubMed, CINAHL, EMBASE, PsycINFO, The Cochrane Library and Web of Science were searched using relevant search terms. The searches were last updated on 15 July 2022. Majority of studies (36 out of 45) found that good diet quality of students was associated with better mental health in terms of depression, anxiety, stress and overall general mental well-being. Moreover, majority of studies (19 out of 23) found that stress and anxiety of students were associated with poorer diet quality. The effect sizes observed were generally small-moderate. Healthy diets of students have been associated with better mental health in terms of depression, anxiety, stress or other mental health issues. Stress experienced by university students has been associated with unhealthy diets. There are implications for health education research, as interventions to improve diet quality at the university level could reduce mental health issues; additionally, interventions to support students under stress may lead to healthier dietary habits when living on campuses. Randomized controlled trials and intervention studies are needed to further investigate these implications.
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Affiliation(s)
| | - Jennifer Logue
- Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - Siobhan Reilly
- Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK
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22
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Korupolu R, Malik A, Ratcliff C, Robinson-Whelen S, Taylor HB. Feasibility, Acceptability, and Efficacy of Mindfulness Training in People With Upper Motor Neuron Disorders: A Systematic Review. Arch Phys Med Rehabil 2022; 103:2410-2428. [PMID: 35760105 DOI: 10.1016/j.apmr.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 05/03/2022] [Accepted: 05/12/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This systematic review aims to gain a comprehensive understanding of the feasibility, acceptability, and efficacy of mindfulness-based interventions (MBIs) on depression, anxiety, fatigue, and health-related quality of life among individuals with upper motor neuron disorders (UMNDs). DATA SOURCES PubMed, PsycINFO, Excerpta Medica Database, and Cumulative Index to Nursing and Allied Health Literature were searched for relevant studies published between January 2001 and June 2021. STUDY SELECTION Clinical trials published in English evaluating MBIs in adults with the 4 most common UMNDs (multiple sclerosis, brain injury including stroke, spinal cord injury, amyotrophic lateral sclerosis) were included. DATA EXTRACTION Two reviewers independently performed the risk of bias assessment using standardized tools and extracted desired data electronically. DATA SYNTHESIS A total of 44 studies were included: 26 randomized controlled trials, 10 nonrandomized controlled trials, and 8 pre-post intervention studies. The average ± SD duration of MBIs was 8±2 weeks. On average, 85%±14% of participants completed the MBI, and the retention rate at follow-up was 80%±16%. Only 14% of the studies delivered MBIs virtually, and feasibility metrics were similar to in-person studies. Among studies reporting acceptability data, most participants reported satisfaction with the MBI. Randomized controlled trials that evaluated the effects of MBI on depression, anxiety, fatigue, and quality of life revealed greater relative improvement in these outcomes among MBI participants compared with controls, with differences greater when compared with passive control than active control participants. None of the studies included in this review studied dose response. CONCLUSIONS Based on current data, MBIs are feasible and offer a promising approach to address the biopsychosocial needs of individuals with UMNDs. MBIs are associated with a high acceptance rate among participants, with notable improvements in depression, anxiety, fatigue, and quality of life post intervention. Future studies are needed to evaluate alternate models of delivery of MBIs and the dose-response relationship.
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Affiliation(s)
- Radha Korupolu
- Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, Texas; TIRR Memorial Hermann, Houston, Texas.
| | - Aila Malik
- Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, Texas
| | - Chelsea Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, Texas
| | - Susan Robinson-Whelen
- TIRR Memorial Hermann, Houston, Texas; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Heather B Taylor
- Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, Texas; TIRR Memorial Hermann, Houston, Texas
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23
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Mazur A, Bartoń E. The Structure of the Relationship between Physical Activity and Psychosocial Functioning of Women and Men during the COVID-19 Epidemic in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11860. [PMID: 36231158 PMCID: PMC9565899 DOI: 10.3390/ijerph191911860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Since the coronavirus disease (COVID-19) pandemic is a serious crisis in many countries around the world, it is important to conduct empirical research aimed at identifying risks and factors protecting the functioning of people affected by it. For this reason, the goals of the present research were to determine the level of physical activity and the severity of symptoms characteristic of mental disorders, cognitive disorders and the quality of social functioning, as well as the structure of the relationship between physical activity and psychosocial functioning of 226 women and 226 men during the COVID-19 epidemic in Eastern Poland. The research was conducted using the IPAQ-SF Questionnaire, GHQ-28 Questionnaires, TUS Test-6/9 version, the original SFS Scale and a self-developed sociodemographic survey. The collected data indicate that women as compared to men show lower levels of weekly physical activity, walking, moderate activity, vigorous activity and quality of functioning in family relationships, but higher severity of mental health disorders, somatic symptoms, functional disorders, depressive symptoms, cognitive disorders, perceptual work disorders, attention deficits and higher quality of functioning in work relationships. On the other hand, the structural model indicates that physical activity, interacting with mental health disorders and cognitive disorders, is positively associated with the social functioning of the respondents, and gender is the moderator of the occurring dependencies. This suggests that physical activity adapted to the condition of health may be an important component of gender-individualized psychopreventive interventions.
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Affiliation(s)
- Anna Mazur
- Laboratory of Psychoprophylaxis and Psychological Support, Faculty of Human Science, University of Economics and Innovation, 20-209 Lublin, Poland
| | - Elżbieta Bartoń
- Department of Neurology, Neurological and Psychiatric Nursing, Chair of Conservative Nursing, Medical University, 20-059 Lublin, Poland
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24
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Kubon J, Romagnano V, Sokolov AN, Fallgatter AJ, Braun C, Pavlova MA. Neural circuits underpinning face tuning in male depression. Cereb Cortex 2022; 33:3827-3839. [PMID: 35989312 DOI: 10.1093/cercor/bhac310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Reading bodies and faces is essential for efficient social interactions, though it may be thought-provoking for individuals with depression. Yet aberrations in the face sensitivity and underwriting neural circuits are not well understood, in particular, in male depression. Here, we use cutting-edge analyses of time course and dynamic topography of gamma oscillatory neuromagnetic cortical activity during administration of a task with Arcimboldo-like images. No difference in face tuning was found between individuals with depression and their neurotypical peers. Furthermore, this behavioral outcome nicely dovetails with magnetoencephalographic data: at early processing stages, the gamma oscillatory response to images resembling a face was rather similar in patients and controls. These bursts originated primarily from the right medioventral occipital cortex and lateral occipital cortex. At later processing stages, however, its topography altered remarkably in depression with profound engagement of the frontal circuits. Yet the primary difference in depressive individuals as compared with their neurotypical peers occurred over the left middle temporal cortices, a part of the social brain, engaged in feature integration and meaning retrieval. The outcome suggests compensatory recruitment of neural resources in male depression.
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Affiliation(s)
- Julian Kubon
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Valentina Romagnano
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Alexander N Sokolov
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Christoph Braun
- MEG Center, Medical School and University Hospital, Eberhard Karls University of Tübingen, Otfried Müller Str. 47, 72076 Tübingen, Germany
| | - Marina A Pavlova
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
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25
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Using a Clinical Formulation to Understand Psychological Distress in People Affected by Huntington’s Disease: A Descriptive, Evidence-Based Model. J Pers Med 2022; 12:jpm12081222. [PMID: 35893316 PMCID: PMC9332789 DOI: 10.3390/jpm12081222] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
Huntington’s disease (HD) is an inherited, life-limiting neurodegenerative condition. People with HD experience changes in cognitive, motor and emotional functioning, and can also, mainly at later stages, exhibit behaviours that professionals and carers might find distressing such as hitting others, throwing objects, swearing or making inappropriate comments. While clinical formulation (an individualised approach used by mental health professionals to describe an individual’s difficulties) is a helpful tool to conceptualise patients’ wellbeing, a specific formulation framework has not yet been developed for HD. However, evidence has shown that formulation can help guide clinical interventions and increase consistency of approach across multi-disciplinary teams, refine risk management, and improve staff or carers’ empathic skills and understanding of complex presentations. As a consequence, this paper proposes a new clinical formulation model for understanding distress among people with HD, based on a biopsychosocial framework. More specifically, this includes key elements centring on an individual’s past experience and personal narratives, as well as anticipatory cognitions and emotions about the future. In-depth discussions regarding the components of the model and their importance in HD formulations are included, and a fictional yet representative case example is presented to illustrate their application within the context of personalised care.
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26
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Chadwick E, Billings J. Barriers to delivering trauma-focused interventions for people with psychosis and post-traumatic stress disorder: A qualitative study of health care professionals' views. Psychol Psychother 2022; 95:541-560. [PMID: 35124894 PMCID: PMC9304310 DOI: 10.1111/papt.12387] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 01/19/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Trauma-focused interventions have been shown to be effective treatments for post-traumatic stress disorder (PTSD), and clinical guidelines support their use with people with psychosis. Despite this, they are used relatively infrequently in this population. We sought to explore UK health care professionals' perceptions of what impedes or facilitates the use of trauma-focused interventions among people with psychosis and PTSD. DESIGN A qualitative study using constructivist grounded theory methodology. METHODS We conducted semi-structured interviews with 18 health care professionals working within the commissioning and delivery of clinical services for people with psychosis. RESULTS Three inter-related barriers to the use of trauma-focused interventions were conceptualized: coherent understanding; structural support; and safe space. CONCLUSIONS Delivery of trauma-focused interventions within routine clinical practice may be supported by attention to the coherent integration of discussion of trauma into the clinical discourse of services; the processes, pathways, and organizational culture that facilitate access to treatment; and training that targets clinician confidence and skills.
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Affiliation(s)
- Eleanor Chadwick
- Department of Clinical, Educational and Health PsychologyUCLLondonUK
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27
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Nürnberger P, von Lewinski D, Rothenhäusler HB, Braun C, Reinbacher P, Kolesnik E, Baranyi A. A biopsychosocial model of severe fear of COVID-19. PLoS One 2022; 17:e0264357. [PMID: 35226661 PMCID: PMC8884481 DOI: 10.1371/journal.pone.0264357] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction COVID-19 is a respiratory infection that causes not only somatic health issues, but also frequently psychosocial burdens. The aims of this study were to investigate biopsychosocial factors that might further aggravate fear of COVID-19, and to establish a biopsychosocial model of severe fear of COVID-19. Methods 368 participants were included in this study. Biopsychosocial factors observed comprised biological factors (somatic risk), psychological factors (state/trait anxiety, physical symptoms of anxiety, severe health anxiety, specific phobias, depression), and psychosocial factors (social support, financial losses, social media consumption, social contacts with COVID-19 infected people). Psychometric questionnaires included State-Trait Anxiety Inventory, Beck’s Anxiety Inventory, Whiteley-Index / Illness Attitude Scales, Specific Phobia Questionnaire, WHO-5 and Social Support Survey. Results 162/368 (44.0%) participants had almost no fear, 170/368 (46.2%) participants had moderate fear, and 45/368 (12.2%) participants had severe fear of COVID-19. Female participants showed higher levels of fear of COVID-19 than male participants (gender: χ2 = 18.47, p<0.001). However, the level of fear of COVID-19 increased in male participants when they had contact with people who were infected with COVID-19, while in contrast the level of fear of COVID-19 decreased in female participants when they had such contacts [ANCOVA: fear of COVID-19 (contact x gender): F(1,363) = 5.596, p = .019]. Moreover, participants without relationships showed higher levels of fear of COVID-19 (marital status: χ2 = 14.582, p = 0.024). Furthermore, financial losses due to the COVID-19 were associated with higher levels of fear of COVID-19 [ANCOVA: fear of COVID-19(financial loss x gender): F(1, 363) = 22.853, p< .001]. Multiple regression analysis revealed female gender, severe health anxiety (WI-IAS) and state /trait anxiety (STAI) as significant predictors of severe fear of COVID-19. Conclusion In this study significant predictors of severe fear of COVID-19 were female gender, pre-existing state and trait anxiety, as well as severe health anxiety. The finding of significant predictors of fear of COVID-19 might contribute to detect people who might suffer most from severe, overwhelming fear of COVID-19 at an early stage.
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Affiliation(s)
- Patrick Nürnberger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Dirk von Lewinski
- Department of Internal Medicine Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Hans-Bernd Rothenhäusler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Celine Braun
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Patrick Reinbacher
- Department of Orthopaedics and Traumatology, Medical University of Graz, Graz, Austria
| | - Ewald Kolesnik
- Department of Internal Medicine Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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28
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Gottlieb A, Bakos-Block C, Langabeer JR, Champagne-Langabeer T. Sociodemographic and Clinical Characteristics Associated with Improvements in Quality of Life for Participants with Opioid Use Disorder. Healthcare (Basel) 2022; 10:healthcare10010167. [PMID: 35052330 PMCID: PMC8775674 DOI: 10.3390/healthcare10010167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The Houston Emergency Opioid Engagement System was established to create an access pathway into long-term recovery for individuals with opioid use disorder. The program determines effectiveness across multiple dimensions, one of which is by measuring the participant’s reported quality of life (QoL) at the beginning of the program and at successive intervals. Methods: A visual analog scale was used to measure the change in QoL among participants after joining the program. We then identified sociodemographic and clinical characteristics associated with changes in QoL. Results: 71% of the participants (n = 494) experienced an increase in their QoL scores, with an average improvement of 15.8 ± 29 points out of a hundred. We identified 10 factors associated with a significant change in QoL. Participants who relapsed during treatment experienced minor increases in QoL, and participants who attended professional counseling experienced the largest increases in QoL compared with those who did not. Conclusions: Insight into significant factors associated with increases in QoL may inform programs on areas of focus. The inclusion of counseling and other services that address factors such as psychological distress were found to increase participants’ QoL and success in recovery.
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Affiliation(s)
- Assaf Gottlieb
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA; (A.G.); (C.B.-B.); (J.R.L.)
| | - Christine Bakos-Block
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA; (A.G.); (C.B.-B.); (J.R.L.)
| | - James R. Langabeer
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA; (A.G.); (C.B.-B.); (J.R.L.)
- McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin St., Houston, TX 77030, USA
| | - Tiffany Champagne-Langabeer
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA; (A.G.); (C.B.-B.); (J.R.L.)
- Correspondence:
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Zucco GM, Doty RL. Multiple Chemical Sensitivity. Brain Sci 2021; 12:46. [PMID: 35053790 PMCID: PMC8773480 DOI: 10.3390/brainsci12010046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 01/09/2023] Open
Abstract
Multiple Chemical Sensitivity (MCS), a condition also known as Chemical Sensitivity (CS), Chemical Intolerance (CI), Idiopathic Environmental Illness (IEI) and Toxicant Induced Loss of Tolerance (TILT), is an acquired multifactorial syndrome characterized by a recurrent set of debilitating symptoms. The symptoms of this controversial disorder are reported to be induced by environmental chemicals at doses far below those usually harmful to most persons. They involve a large spectrum of organ systems and typically disappear when the environmental chemicals are removed. However, no clear link has emerged among self-reported MCS symptoms and widely accepted objective measures of physiological dysfunction, and no clear dose-response relationship between exposure and symptom reactions has been observed. In addition, the underlying etiology and pathogenic processes of the disorder remain unknown and disputed, although biologic and psychologic hypotheses abound. It is currently debated whether MCS should be considered a clinical entity at all. Nevertheless, in the last few decades MCS has received considerable scientific and governmental attention in light of the many persons reporting this illness. In this review, we provide a general overview of the history, definition, demographics, prevalence, and etiologic challenges in defining and understanding MCS.
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Affiliation(s)
- Gesualdo M Zucco
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35100 Padova, Italy
| | - Richard L Doty
- Smell and Taste Center, Department of Otorhinolaryngology, Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Gonzalez-Domenech P, Romero-Béjar JL, Gutierrez-Rojas L, Jimenez-Fernandez S, Diaz-Atienza F. Behavioural Difficulties in Children and Adolescents with Mental Disorders under Extreme Situations. J Clin Med 2021; 10:jcm10214876. [PMID: 34768396 PMCID: PMC8584948 DOI: 10.3390/jcm10214876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/22/2022] Open
Abstract
In 2020, the Governments of many countries maintained different levels of confinement of the population due to the pandemic that produced the COVID-19. There are few studies published on the psychological impact in the child and adolescent population diagnosed with mental disorders, especially during the home confinement stage. Explanatory models based on socio-demographic and clinical variables provide an approximation to level changes in different dimensions of behavioural difficulties. A categorical-response logistic ordinal regression model, based on a cross-sectional study with 139 children and adolescents diagnosed with mental disorders is performed for each dimension under analysis. Most of the socio-demographic and clinical explanatory variables considered (24 of 26) were significant at population level for at least one of the four dimensions of behavioural difficulties (15 response variables) under analysis. Odds-ratios were interpreted to identify risk or protective factors increasing or decreasing severity in the response variable. This analysis provides useful information, making it possible to more readily anticipate critical situations due to extreme events, such as a confinement, in this population.
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Affiliation(s)
- Pablo Gonzalez-Domenech
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
| | - José Luis Romero-Béjar
- Department of Statistics and Operational Research, University of Granada, Avda Fuentenueva, 18071 Granada, Spain
- Correspondence:
| | - Luis Gutierrez-Rojas
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
| | - Sara Jimenez-Fernandez
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
| | - Francisco Diaz-Atienza
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
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Banaei M, Kariman N, Ozgoli G, Nasiri M. Bio-psychosocial factor of vaginismus in Iranian women. Reprod Health 2021; 18:210. [PMID: 34663378 PMCID: PMC8524876 DOI: 10.1186/s12978-021-01260-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/07/2021] [Indexed: 11/26/2022] Open
Abstract
Background and aim Various physical, psychological, social and cultural factors contribute to vaginismus. Therefore, given the multidimensionality of this disorder and the need to pay more attention to all biological, psychological and social dimensions in its treatment, the present study was conducted to investigate the bio-psychological factors contributing to vaginismus. Methods This descriptive cross-sectional study was conducted on 180 Iranian women with vaginismus who had been referred to sexual health clinics of Tehran province in 2020. Multistage random sampling method was used in this study, and vaginismus was diagnosed in women by a specialist through using a questionnaire. Data collection tools included demographic and obstetric information form, valid and reliable Sexual Function Questionnaire, Depression Anxiety Stress Scales (DASS), Sex Fear Questionnaire, Vaginal Penetration Cognition Questionnaire, Sexual Self-Efficacy Scale, Sexual Knowledge and Attitude Scale, Sexual Quality of Life-Female, Inventory of Sexual Satisfaction, ENRICH Marital Satisfaction Scale, Sexual Intimacy Scale and Questionnaire for Diagnosis of Vaginismus. In order to determine the factors related to vaginismus, multiple linear regression model was used through SPSS software version 25 (SPSS Inc., Chicago, IL). Results Based on the results of the present study, the mean age of women and the mean duration of their marriage were 27.77 ± 5.36 and 4.07 ± 3.87 years respectively. As the results of multiple linear regression revealed, the variables of fear of sex (B = 0.141, P = 0.036), positive cognition (B = 0.197, P = 0.046), self-image (B = 0.651, P = 0.001), sexual intimacy (B = -0.116, P = 0.021), quality of sexual life (B = 0.115, P = 0.002) and education (B = 2.129, P = 0.024) from the bio-psychosocial model were the final predictors of vaginismus diagnosis score in women with this disorder. According to the results of multiple linear regression, 45.5% of the variance of vaginismus diagnosis total score was explained by these variables (R = 0.706, R2 = 0.498 and ADJ.R2 = 0.455). Conclusion The results of the present study showed that the variables of fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education were the final predictors of vaginismus diagnosis score. This disorder is, thus, considered to be multidimensional. As a sexual dysfunction, Vaginismus prevents sexual penetration through involuntary and frequent spasms of the muscles in the one-third of vagina's outer part. Factors such as negative beliefs about sex, cultural factors, fear of pain, injury, bleeding and so forth play significant roles in the prediction of vaginismus. Therefore, given the multidimensionality of vaginismus and the need to pay attention to all biological, psychological and social dimensions in treating it, and since the bio-psychosocial model is a strong framework for the factors contributing to sexual problems whose recognition will lead to the design of multidimensional treatments, the present study was conducted on 180 Iranian women with vaginismus to investigate the bio-psychological factors associated with vaginismus. The present study showed that the fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education from the bio-psychosocial model were the final predictors of vaginismus diagnosis score. Therefore, this model can be used in designing interventions for the treatment of vaginismus, especially in the psychological and interpersonal domains.
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Affiliation(s)
- Mojdeh Banaei
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Nasiri
- Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wu CL, Chen CL, Wen SH. Profile of the Change in Depression during Proton-Pump Inhibitor Therapy in Patients with Gastroesophageal Reflux Disease: Influence of the Mucosal Break. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115964. [PMID: 34199477 PMCID: PMC8199631 DOI: 10.3390/ijerph18115964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/18/2022]
Abstract
Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, p < 0.01, Cohen’s d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), p < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), p = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.
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Affiliation(s)
- Chia-Liang Wu
- Department of Psychiatry, Taipei Veterans General Hospital, Yuli Branch, Hualien 981002, Taiwan;
- Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan
| | - Chien-Lin Chen
- Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien 970473, Taiwan;
| | - Shu-Hui Wen
- Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Correspondence:
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Gabel CP, Guy B, Mokhtarinia HR, Melloh M. Slacklining: An explanatory multi-dimensional model considering classical mechanics, biopsychosocial health and time. World J Orthop 2021; 12:102-118. [PMID: 33816138 PMCID: PMC7995339 DOI: 10.5312/wjo.v12.i3.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/13/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
This paper aims to overcome slacklining's limited formulated explanatory models. Slacklining is an activity with increasing recreational use, but also has progressive adoption into prehabilitation and rehabilitation. Slacklining is achieved through self-learned strategies that optimize energy expenditure without conceding dynamic stability, during the neuromechanical action of balance retention on a tightened band. Evolved from rope-walking or 'Funambulus', slacklining has an extensive history, yet limited and only recent published research, particularly for clinical interventions and in-depth hypothesized multi-dimensional models describing the neuromechanical control strategies. These 'knowledge-gaps' can be overcome by providing an, explanatory model, that evolves and progresses existing standards, and explains the broader circumstances of slacklining's use. This model details the individual's capacity to employ control strategies that achieve stability, functional movement and progressive technical ability. The model considers contributing entities derived from: Self-learned control of movement patterns; subjected to classical mechanical forces governed by Newton's physical laws; influenced by biopsychosocial health factors; and within time's multi-faceted perspectives, including as a quantified unit and as a spatial and cortical experience. Consequently, specific patient and situational uses may be initiated within the framework of evidence based medicine that ensures a multi-tiered context of slacklining applications in movement, balance and stability. Further research is required to investigate and mathematically define this proposed model and potentially enable an improved understanding of human functional movement. This will include its application in other diverse constructed and mechanical applications in varied environments, automation levels, robotics, mechatronics and artificial-intelligence factors, including machine learning related to movement phenotypes and applications.
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Affiliation(s)
| | - Bernard Guy
- Ecole des Mines de Saint-Etienne, Industrial and Natural Processes Division, Saint Etienne 4200, Loire, France
| | - Hamid Reza Mokhtarinia
- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran 12345, Iran
| | - Markus Melloh
- School of Health Professions, Institute of Health Sciences, Zurich University of Applied Sciences, Winterthur 8400, Switzerland
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Yang YJ, Chen CN, Zhan JQ, Liu QS, Liu Y, Jiang SZ, Wei B. Decreased Plasma Hydrogen Sulfide Level Is Associated With the Severity of Depression in Patients With Depressive Disorder. Front Psychiatry 2021; 12:765664. [PMID: 34858235 PMCID: PMC8631961 DOI: 10.3389/fpsyt.2021.765664] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/22/2021] [Indexed: 12/28/2022] Open
Abstract
Accumulating evidence has suggested a dysfunction of synaptic plasticity in the pathophysiology of depression. Hydrogen sulfide (H2S), an endogenous gasotransmitter that regulates synaptic plasticity, has been demonstrated to contribute to depressive-like behaviors in rodents. The current study investigated the relationship between plasma H2S levels and the depressive symptoms in patients with depression. Forty-seven depressed patients and 51 healthy individuals were recruited in this study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was used to evaluate depressive symptoms for all subjects and the reversed-phase high-performance liquid chromatography (RP-HPLC) was used to measure plasmaH2S levels. We found that plasma H2S levels were significantly lower in patients with depression relative to healthy individuals (P < 0.001). Compared with healthy controls (1.02 ± 0.34 μmol/L), the plasma H2S level significantly decreased in patients with mild depression (0.84 ± 0.28 μmol/L), with moderate depression (0.62 ± 0.21μmol/L), and with severe depression (0.38 ± 0.18 μmol/L). Correlation analysis revealed that plasma H2S levels were significantly negatively correlated with the HAMD-17 scores in patients (r = -0.484, P = 0.001). Multivariate linear regression analysis showed that plasma H2S was an independent contributor to the HAMD-17 score in patients (B = -0.360, t = -2.550, P = 0.015). Collectively, these results suggest that decreased H2S is involved in the pathophysiology of depression, and plasma H2S might be a potential indicator for depression severity.
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Affiliation(s)
- Yuan-Jian Yang
- Biological Psychiatry Laboratory, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China.,Department of Psychiatry, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Clinical Research Center on Mental Disorders, Nanchang, China
| | - Chun-Nuan Chen
- Department of Neurology, The Second Clinical Medical College, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
| | - Jin-Qiong Zhan
- Biological Psychiatry Laboratory, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Clinical Research Center on Mental Disorders, Nanchang, China
| | - Qiao-Sheng Liu
- Department of Psychiatry, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Clinical Research Center on Mental Disorders, Nanchang, China
| | - Yun Liu
- Department of Psychiatry, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China
| | - Shu-Zhen Jiang
- Biological Psychiatry Laboratory, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China
| | - Bo Wei
- Biological Psychiatry Laboratory, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China.,Department of Psychiatry, Jiangxi Mental Hospital/Affiliated Mental Hospital of Nanchang University, Nanchang, China.,Jiangxi Provincial Clinical Research Center on Mental Disorders, Nanchang, China
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Cases C, Gallini A, Lafont Rapnouil S, Bougon E, Mathur A, Brismontier A, Taib S, Sporer M, Arbus C, Salles J. Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices. Front Psychiatry 2021; 12:581449. [PMID: 33868036 PMCID: PMC8044516 DOI: 10.3389/fpsyt.2021.581449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
The use of relevant guidelines is critical in psychiatric clinical practice to ensure the homogeneity of the global care provided. Consequently, it is important to identify whether they are utilized successfully and, if not, why. This would enable pragmatic solutions to be agreed to improve the organization of care and the removal of any barriers to the guidelines' implementation. The first step in this process, before any exploration of the limitations of the guidelines themselves, involves a determination of whether they are actually applied in clinical practice. We therefore evaluated discrepancies between the guidelines relating to patients with borderline personality disorder and current practices in the psychiatric Emergency Department at Toulouse University Hospital. This was achieved using a reading process involving a panel of eight local experts who analyzed relevant medical files extracted from a database. They were guided by, and instructed to answer, six standardized questions in relation to each file to determine the method's feasibility. A total of 333 files were analyzed to determine whether, in the local experts' judgment, the care provided reflected current guidance. This reading process revealed substantial agreement (0.85%; Fleiss Kappa -0.69), which is a promising outcome and suggests that such methods could be used in future protocols. Moreover, the process is practical and reliable and requires very few materials.
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Affiliation(s)
- Cécile Cases
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France
| | - Adeline Gallini
- CHU de Toulouse, Service d'épidémiologie, Unité de Soutien Méthodologique à la Recherche (USMR), Toulouse, France.,Inserm, Unité 1027 Epidémiologie et analyses en santé publique, Vieillissement et maladie d'Alzheimer: de l'observation à l'intervention, Toulouse, France
| | | | - Emmanuelle Bougon
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France
| | - Anjali Mathur
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France
| | - Ariane Brismontier
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France
| | - Simon Taib
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France
| | - Marie Sporer
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France
| | - Christophe Arbus
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France.,Institut des Handicaps Neurologiques, Psychiatriques et Sensoriels-CHU de Toulouse, Toulouse, France
| | - Juliette Salles
- CHU Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, Toulouse, France.,Institut des Handicaps Neurologiques, Psychiatriques et Sensoriels-CHU de Toulouse, Toulouse, France.,Infinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France
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Talarowska M, Chodkiewicz J, Nawrocka N, Miniszewska J, Biliński P. Mental Health and the SARS-COV-2 Epidemic-Polish Research Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7015. [PMID: 32992807 PMCID: PMC7579123 DOI: 10.3390/ijerph17197015] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/20/2022]
Abstract
Background: The aim of this study was to assess the mental state of Poles in the first weeks of the SARS-COV-2 epidemic. Methods: In the study, the General Health Questionnaire-28 (GHQ-18), The Perceived Stress Scale (PSS-10), and Mini-Cope were used. Results: The study was conducted on a group of 443 individuals, including 348 women (78.6%) and 95 men (21.4%). There were more women (χ2 = 6.42, p = 0.02) in the group of people with high results in the GHQ-28 questionnaire and the differentiating factors between those with sten scores above 7 (significantly deteriorated mental health) and those with average or low results (sten score below 7) turned out to be: treatment for mental disorders before the pandemic (χ2 = 19.57, p < 0.001) and the use of psychotherapy during the pandemic (χ2 = 4.21, p = 0.04) and psychiatric pharmacotherapy (χ2 = 8.31, p = 0.01). The presence of suicidal thoughts since the appearance of the pandemic-related restraints and limitations significantly differentiates the compared groups (χ2 = 38.48, p < 0.001). Conclusions: Every fourth person in the examined group (over 26% of the respondents) recorded results that indicate a high probability of mental functioning disorders. Approximately 10% of the respondents signalled the occurrence of suicidal thoughts since the beginning of the pandemic. The respondents complain mainly about problems in everyday life, lack of satisfaction from one's own activities, tension, trouble sleeping, and feelings of exhaustion. Individuals with significantly reduced mental well-being use non-adaptive coping strategies, such as denying problems, emotional discharge, taking substances, discontinuation of action, and blaming themselves for the situation. The risk factors for the deterioration of the mental state of the respondents during the pandemic include psychiatric treatment before the beginning of the pandemic, the presence of suicidal thoughts during forced isolation, and the use of non-adaptive coping strategies (denial of the existence of problems, emotional discharge, use of psychoactive substances, discontinuation of action, and blaming oneself for the situation).
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Affiliation(s)
- Monika Talarowska
- Institute of Psychology, University of Lodz, 91-433 Lodz, Poland; (J.C.); (N.N.); (J.M.)
| | - Jan Chodkiewicz
- Institute of Psychology, University of Lodz, 91-433 Lodz, Poland; (J.C.); (N.N.); (J.M.)
| | - Natalia Nawrocka
- Institute of Psychology, University of Lodz, 91-433 Lodz, Poland; (J.C.); (N.N.); (J.M.)
| | - Joanna Miniszewska
- Institute of Psychology, University of Lodz, 91-433 Lodz, Poland; (J.C.); (N.N.); (J.M.)
| | - Przemysław Biliński
- The President Stanisław Wojciechowski State University of Applied Sciences in Kalisz, 92-800 Kalisz, Poland;
- Copernicus Memorial Multidisciplinary Comprehensive Cancer and Traumatology Center, 93-513 Lodz, Poland
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Vieira ER, Richard L, da Silva RA. Perspectives on Research and Health Practice in Physical and Occupational Therapy in Geriatrics during and Post COVID-19. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1786906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, Florida, USA
| | - Lynne Richard
- Department of Occupational Therapy, Florida International University, Miami, Florida, USA
| | - Rubens A. da Silva
- Department of Health Sciences, University of Quebec in Chicoutimi, Saguenay, Canada
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Hung H, Kueh LL, Roan JN, Tsai JJ. Fostering 2 nd-year medical students' reflective capacity: A biopsychosocial model course. Tzu Chi Med J 2020; 32:291-297. [PMID: 32955525 PMCID: PMC7485666 DOI: 10.4103/tcmj.tcmj_65_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/17/2019] [Accepted: 07/09/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The biopsychosocial (BPS) model has been proposed to take into account the interaction of psychological and social factors in medical practice. Although some studies have explored its application in medical education, little has been evaluated about students' reflection in such courses. This study introduced a BPS model course and aimed to assess changes in students' reflective capacity resulting from this course. MATERIALS AND METHODS Eighty-seven written reflections before and after the course were segmented, coded, and rated using the Reflection Evaluation for Learners' Enhanced Competencies Tool rubric, which contains six factors of reflective capacity, namely description of disease experience, presence, attending to emotions, description of conflict or disorienting dilemma, meaning making, and action. RESULTS After the BPS model course, the overall reflective capacity, as well as the "Presence" and "Meaning making" scores, increased, while scores for "Attending to emotion" decreased significantly. "Description of disease experience," "Description of conflict or disorienting dilemma," and "Action" showed no significant change. CONCLUSION Pedagogical suggestions are discussed for a BPS model course with reflective training for young medical students.
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Affiliation(s)
- Hsuan Hung
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Ling Kueh
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
| | - Jun-Neng Roan
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital and College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jing-Jane Tsai
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
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Desarrollo evolutivo humano y longevidad. Un análisis bio-psicosocial. REVISTA IBEROAMERICANA DE PSICOLOGÍA 2020. [DOI: 10.33881/2027-1786.rip.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
En este trabajo se hace una revisión bibliográfica sobre el desarrollo evolutivo humano y longevidad, desde un enfoque biopsicosocial (Engel, 1977; Gliedt et al., 2017; Lehman et al., 2017). Tras aplicar el método de análisis PRISMA, se obtuvieron diversos resultados relacionados con un desarrollo evolutivo más longevo; así, en el área biológica, 3 factores: los SNPs, los telómeros y la química del estrés; en el área psicológica, 5 factores: la metacognición, la resiliencia, la espiritualidad, las relaciones personales y la depresión; y en el área social, 8 factores: la pseudo-heredabilidad, las relaciones conyugales, la maternidad, el nivel educativo, estilos de vida, dieta y restricción calórica, actividad física y mental y tecnología sanitaria. Ante los datos obtenidos en las tres áreas, de este enfoque biopsicosocial, y el repetido solapamiento entre factores del área psicológica y del área social, se plantea que pudieran considerarse estas dos como una conjunta, proponiéndose un enfoque explicativo con dos áreas: bio-psicosocial que, por factores encontrados en este trabajo, quedarían un 18,7% de biológica y un 81,3% psicosocial. Actualmente, hay suficiente información sobre desarrollo evolutivo humano y longevidad, pero una ausencia de investigaciones que estudien esos factores desde una perspectiva integrada. Mucha de esa información privilegiada se podría aplicar ya, psicológica y socialmente, a la población en general, para una mejora de su salud, en cualquier fase del desarrollo evolutivo humano.
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Neff AS. Technical and Theoretic Limitations of the Experimental Evidence Supporting a Gut Bacterial Etiology in Mental Illness. Clin Ther 2020; 42:e74-e81. [PMID: 32115244 DOI: 10.1016/j.clinthera.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 02/06/2023]
Abstract
The impact of gut bacteria on the brain and behavior has become the subject of intense research. The brain is sensitive to biochemical and physiologic changes in the body, for example, changes in blood oxygenation or nutritional status. The collection of microorganisms residing within the digestive tract (the gut microbiome) is increasingly considered a major contributor to human physiology. These 2 considerations have led to the hypothesis that human psychology, including complex constructs like emotion and mental illness, could be influenced by the composition or function of gut bacteria. Five lines of evidence have been used to support the concept, including human correlational research, probiotic supplementation, antibiotic use, germ-free animal research, and fecal transplantation. Results from these experiments do not provide substantial support for the theory that complex human psychology is under the influence of gut bacteria. Placebo-controlled interventional research in humans, in particular fecal microbiota transplantation, will be required before a stronger conclusion can be reached.
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Affiliation(s)
- Andrew Steven Neff
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA; Department of Psychology and Behavioral Sciences, Rochester University, Rochester Hills, MI, USA.
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Tripathi A, Das A, Kar SK. Biopsychosocial Model in Contemporary Psychiatry: Current Validity and Future Prospects. Indian J Psychol Med 2019; 41:582-585. [PMID: 31772447 PMCID: PMC6875848 DOI: 10.4103/ijpsym.ijpsym_314_19] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anamika Das
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sujita K. Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Barreira DP, Marinho RT, Bicho M, Fialho R, Ouakinin SRS. Psychosocial and Neurocognitive Factors Associated With Hepatitis C - Implications for Future Health and Wellbeing. Front Psychol 2018; 9:2666. [PMID: 30687151 PMCID: PMC6333630 DOI: 10.3389/fpsyg.2018.02666] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Hepatitis C virus (HCV) infection involves changes not only from the point of view of physical health, but also emotional, and social that have a significant impact on the quality of life of these patients. According to the literature review, it seems that there is an important association between psychosocial factors, in particular on a cognitive level and disease progression. The aim of this mini-review is to summarize recent literature looking at the associations between psychosocial and neurocognitive factors and HCV. Methods: PubMed/Medline was systematically searched for psychosocial and neurocognitive factors associated with hepatitis C, treatment adherence, and patient wellbeing. Results: Patients present with a range of extrahepatic symptoms including fatigue, anxiety, depression, and neurocognitive dysfunction. HCV's impact on quality of life and wellbeing has serious clinical and social implications. Conclusion: Hepatitis C and its management continue to have a profound impact on health and psychologic wellbeing. Considering the serious extrahepatic implications for individuals, it is imperative that healthcare professionals pay close attention to psychosocial and neurocognitive factors. The focus on combined clinical approaches could enhance understanding about the health and social impacts of hepatitis C along the life course.
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Affiliation(s)
- David Pires Barreira
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Lisboa Norte-Hospital de Santa Maria, Lisbon, Portugal
- *Correspondence: David Pires Barreira,
| | - Rui Tato Marinho
- Faculdade de Medicina, Universidade de Lisboa, Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Lisboa Norte-Hospital de Santa Maria, Lisbon, Portugal
| | - Manuel Bicho
- Laboratório de Genética, Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
| | - Renata Fialho
- Assertive Outreach Team, Sussex Partnership NHS Foundation Trust, Brighton and Hove, United Kingdom
| | - Silvia Raquel Soares Ouakinin
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Kelly JF, Greene MC, Bergman BG. Is recovery from cannabis use problems different from alcohol and other drugs? Results from a national probability-based sample of the United States adult population. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 53:55-64. [PMID: 29287223 DOI: 10.1016/j.drugpo.2017.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The policy landscape regarding the legal status of cannabis (CAN) in the US and globally is changing rapidly. Research on CAN has lagged behind in many areas, none more so than in understanding how individuals suffering from the broad range of cannabis-related problems resolve those problems, and how their characteristics and problem resolution pathways are similar to or different from alcohol [ALC] or other drugs [OTH]. Greater knowledge could inform national policy debates as well as the nature and scope of any additional needed services as CAN population exposure increases. METHOD National, probability-based, cross-sectional sample of the US non-institutionalized adult population was conducted July-August 2016. Sample consisted of those who responded "yes" to the screening question, "Did you used to have a problem with alcohol or drugs but no longer do?" (63.4% response rate from 39,809 screened adults). Final weighted sample (N = 2002) was mostly male (60.0% [1.53%]), aged 25-49 (45.2% [1.63%]), non-Hispanic White (61.4% [1.64%]), employed (47.7% [1.61%]). Analyses compared CAN to ALC and OTH on demographic, clinical, treatment and recovery support services utilization, and quality of life (QOL) indices. RESULTS 9.1% of the US adult population reported resolving a significant substance problem, and of these, 10.97% were CAN. Compared to ALC (M = 49.79) or OTH (M = 43.80), CAN were significantly younger (M = 39.41, p < 0.01), had the earliest onset of regular use (CAN M = 16.89, ALC M = 19.02, OTH M = 23.29, p < 0.01), and resolved their problem significantly earlier (CAN M = 28.87, ALC M = 37.86, OTH M = 33.06, p < 0.01). Compared to both ALC and OTH, CAN were significantly less likely to report use of inpatient treatment and used substantially less outpatient treatment, overall (p < 0.01), although CAN resolving problems more recently were more likely to have used outpatient treatment (p < 0.01). Lifetime attendance at mutual-help meetings (e.g., AA) was similar, but CAN (M = 1.67) had substantially lower recent attendance compared to ALC (M = 7.70) and OTH (M = 7.65). QOL indices were similar across groups. CONCLUSION Approximately 2.4 million Americans have resolved a significant cannabis problem. Compared to ALC and OTH, the pattern of findings for CAN suggest similarities but also some notable differences in characteristics and problem resolution pathways particularly regarding earlier problem offset and less use of formal and informal services. Within a shifting policy landscape, research is needed to understand how increases in population exposure and potency may affect the nature and magnitude of differences observed in this preliminary study.
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Affiliation(s)
- John F Kelly
- Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, 151 Merrimac Street, 6th Floor, Boston, MA 02114, United States.
| | - M Claire Greene
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, United States
| | - Brandon G Bergman
- Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, 151 Merrimac Street, 6th Floor, Boston, MA 02114, United States
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Kelly JF, Bergman B, Hoeppner BB, Vilsaint C, White WL. Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug Alcohol Depend 2017; 181:162-169. [PMID: 29055821 PMCID: PMC6076174 DOI: 10.1016/j.drugalcdep.2017.09.028] [Citation(s) in RCA: 153] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/23/2017] [Accepted: 09/26/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Alcohol and other drug (AOD) problems confer a global, prodigious burden of disease, disability, and premature mortality. Even so, little is known regarding how, and by what means, individuals successfully resolve AOD problems. Greater knowledge would inform policy and guide service provision. METHOD Probability-based survey of US adult population estimating: 1) AOD problem resolution prevalence; 2) lifetime use of "assisted" (i.e., treatment/medication, recovery services/mutual help) vs. "unassisted" resolution pathways; 3) correlates of assisted pathway use. Participants (response=63.4% of 39,809) responding "yes" to, "Did you use to have a problem with alcohol or drugs but no longer do?" assessed on substance use, clinical histories, problem resolution. RESULTS Weighted prevalence of problem resolution was 9.1%, with 46% self-identifying as "in recovery"; 53.9% reported "assisted" pathway use. Most utilized support was mutual-help (45.1%,SE=1.6), followed by treatment (27.6%,SE=1.4), and emerging recovery support services (21.8%,SE=1.4), including recovery community centers (6.2%,SE=0.9). Strongest correlates of "assisted" pathway use were lifetime AOD diagnosis (AOR=10.8[7.42-15.74], model R2=0.13), drug court involvement (AOR=8.1[5.2-12.6], model R2=0.10), and, inversely, absence of lifetime psychiatric diagnosis (AOR=0.3[0.2-0.3], model R2=0.10). Compared to those with primary alcohol problems, those with primary cannabis problems were less likely (AOR=0.7[0.5-0.9]) and those with opioid problems were more likely (AOR=2.2[1.4-3.4]) to use assisted pathways. Indices related to severity were related to assisted pathways (R2<0.03). CONCLUSIONS Tens of millions of Americans have successfully resolved an AOD problem using a variety of traditional and non-traditional means. Findings suggest a need for a broadening of the menu of self-change and community-based options that can facilitate and support long-term AOD problem resolution.
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Affiliation(s)
- John F. Kelly
- Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac Street, and Harvard Medical School, Boston, MA, 02114, United States,Corresponding author at: Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac Street, Boston, MA, 02114, United States. (J.F. Kelly)
| | - Brandon Bergman
- Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac Street, and Harvard Medical School, Boston, MA, 02114, United States
| | - Bettina B. Hoeppner
- Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac Street, and Harvard Medical School, Boston, MA, 02114, United States
| | - Corrie Vilsaint
- Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac Street, and Harvard Medical School, Boston, MA, 02114, United States
| | - William L. White
- Chestnut Health Systems, W Chestnut St, Bloomington, IL, 61701, United States
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