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Hirschbeck A, Kossmann D, Schwegler H, Greiner SK, Hasan A, Roeh A. Implementing exercise recommendations into clinical practice-new findings from mental health professionals' and patients' perspectives in a university psychiatric setting. Front Sports Act Living 2024; 6:1336356. [PMID: 38832308 PMCID: PMC11144853 DOI: 10.3389/fspor.2024.1336356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/19/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction To date, concrete recommendations for physical activity in psychiatric treatments are limited. Thus, we evaluated knowledge, barriers and beliefs associated with exercise prescription of mental health professionals (MHP) to people with mental illnesses. We aimed to identify patients' barriers to exercise participation and to work out options addressing these barriers. Methods In our cross-sectional and questionnaire-based investigation, we recruited medical, nursing and therapeutic staff and patients of a psychiatric clinic by email and personal contact. Questionnaires contained the German versions of The Exercise in Mental Illness Questionnaire (EMIQ-G) and the International Physical Activity Questionnaires (IPAQ). Results We included 100 MHP and 100 patients. MHP had significantly more knowledge regarding positive effects of exercise on general health than patients. Exercise was prescribed mostly (48.4%) or always (37.9%) by MHP. The data showed missing education in exercise prescriptions and different recommendation behavior. Male patients seemed to experience exercise more often as a positive distraction and had lower physical health barriers than females. Discussion Physical activity needs to be more integrated in psychiatric treatments. Some strategies as educating MHP and patients regarding potential benefits of exercise via psychoeducative brochures and adapting recommendations to individual symptoms could improve exercise behavior in psychiatric patients.
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Affiliation(s)
- Anna Hirschbeck
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
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Petzold MB, Betzler F, Plag J, Ströhle A, Bendau A. Advising activity-knowledge, attitudes, beliefs, and behaviors regarding the recommendation of physical activity in clinical psychologists. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01819-7. [PMID: 38714563 DOI: 10.1007/s00406-024-01819-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/19/2024] [Indexed: 05/10/2024]
Abstract
BACKGROUND Regular physical activity comes with multiple benefits for physical but also mental health and can be a pivotal element in the prevention and treatment of mental disorders. Clinical psychologists play an important role in supporting their patients in increasing physical activity levels. Up to date, there is only little research on recommendation of physical activity in psychologists worldwide and no such research for psychologists in Germany. Aim of this study was to assess knowledge, attitudes, beliefs and behaviors regarding physical activity in psychologists in Germany. METHODS We assessed knowledge, attitudes, beliefs and behaviors regarding physical activity among a sample of clinical psychologists in Germany using the "Exercise in Mental Illness Questionnaire-German" (EMIQ-G) in a cross-sectional online survey. RESULTS 454 participants were included in the analysis. Participants reported moderate levels of knowledge and self-confidence in recommending physical activity. Only 14% of the participants received formal training regarding physical activity recommendation. Most participants recommended physical activity to their patients, primarily through personal discussions and referrals to exercise professionals. About one third did not give any recommendations regarding intensity. Strength training was only recommended by a minority. CONCLUSION There is a need for greater integration of information and instructions regarding the recommendation of physical activity in the treatment of people with mental disorders in the training and further education of psychologists.
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Affiliation(s)
- Moritz Bruno Petzold
- Department of Psychology, Medical School Berlin, Mecklenburgische Str. 57, 14197, Berlin, Germany.
| | - Felix Betzler
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany
| | - Jens Plag
- Department of Medicine, Health and Medical University, Potsdam, Germany
- Oberberg Fachklinik Potsdam, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany
| | - Antonia Bendau
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
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Gori A, Topino E, Griffiths MD. Family Functioning Styles and Exercise Addiction: Disengaged, Enmeshed, and Rigid Family Patterns Are Associated with Exercise Addiction. Eur J Investig Health Psychol Educ 2024; 14:148-163. [PMID: 38248130 PMCID: PMC10814248 DOI: 10.3390/ejihpe14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/20/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024] Open
Abstract
Physical exercise is a widely recommended practice for promoting health, but for some individuals, this activity can result in pathological and morbid behaviour. Therefore, the study of the factors contributing to the onset, development, and progression of exercise addiction is particularly relevant. Within this framework, the present study assessed the effect of family functioning, body image concerns, age, and gender on exercise addiction. A sample of 300 regular exercisers (Mage = 30.3 years, SD = 11.6; 69.7% females, 30.3% males) participated in the study and completed the Family Adaptability and Cohesion Evaluation Scales-IV, Body Image Concern Inventory, and Exercise Addiction Inventory. Data were analysed by implementing a series of moderated moderated-mediations. Results showed that three significant models were relevant. First, positive associations of disengaged (p < 0.05), enmeshed (p < 0.05), and rigid (p < 0.01) family functioning with exercise addiction were found. Furthermore, body image concerns mediated all these relationships, and the interaction between gender and age significantly moderated the effects of body image concerns on exercise addiction (p < 0.05). Such data may be useful for a deeper understanding of the variables associated with the development of exercise addiction, suggesting key elements on which it might be useful to focus in clinical and/or preventive activity.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Florence, Italy
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina 21, 00193 Rome, Italy;
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, UK;
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Gaş S, Ekşi Özsoy H, Cesur Aydın K. The association between sleep quality, depression, anxiety and stress levels, and temporomandibular joint disorders among Turkish dental students during the COVID-19 pandemic. Cranio 2023; 41:550-555. [PMID: 33543679 DOI: 10.1080/08869634.2021.1883364] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to examine the association between sleep quality, depression, anxiety and stress levels, and the frequency of temporomandibular disorders in a sample of Turkish dental students during the COVID-19 pandemic. METHODS The current cross-sectional study was conducted with 699 dental university students during the COVID-19 pandemic. Fonseca Anamnestic Index (FAI), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scale-21 (DASS-21) were used in the present study. RESULTS The incidence of temporomandibular joint disorders in the present study was found to be 77.5%. Female students' FAI scores were found to be statistically significantly higher than males (p < 0.05). Additionally, higher depression and anxiety and stress levels caused increased PSQI and FAI scores. CONCLUSION During the COVID-19 pandemic, increased temporomandibular joint disorders were observed with increased impaired sleep quality and higher depression, anxiety and stress levels among dental university students.
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Affiliation(s)
- Selin Gaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Beykent University, Istanbul, Turkey
| | - Hilal Ekşi Özsoy
- Department of Prosthodontics, Faculty of Dentistry, Beykent University, Istanbul, Turkey
| | - Kader Cesur Aydın
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
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Curran E, Palmer VJ, Ellis KA, Chong TWH, Rego T, Cox KL, Anstey KJ, Westphal A, Moorhead R, Southam J, Lai R, You E, Lautenschlager NT. Physical Activity for Cognitive Health: A Model for Intervention Design for People Experiencing Cognitive Concerns and Symptoms of Depression or Anxiety. J Alzheimers Dis 2023:JAD221216. [PMID: 37334591 PMCID: PMC10357152 DOI: 10.3233/jad-221216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND People experiencing cognitive concerns and symptoms of depression or anxiety are at risk for Alzheimer's disease and dementia. We know physical activity can benefit cognition but understanding how to best support engagement is an ongoing challenge. Evidence-based conceptual models of factors underpinning physical activity engagement in target populations can inform intervention tailoring to address this challenge. OBJECTIVE This study (part of a pragmatic physical activity implementation trial) aimed to develop a specified model of physical activity engagement in people experiencing depressive or anxiety symptoms and cognitive concerns, to enable optimized dementia risk reduction intervention tailoring. METHODS We employed a qualitative design, triangulating data from three sources: semi-structured individual interviews with people experiencing cognitive concerns and mild to moderate depressive or anxiety symptoms; review of published evidence; and the Capability, Opportunity and Motivation system of behavior, an existing behavioral science model. Findings were integrated to develop a contextualized model of mechanisms of action for optimizing engagement. RESULTS Twenty-one participants were interviewed, and 24 relevant papers included. Convergent and complementary themes extended understanding of intervention needs. Findings highlighted emotional regulation, capacities to enact intentions despite barriers, and confidence in existing skills as areas of population-specific need that have not previously been emphasized. The final model provides specificity, directionality, and linked approaches for intervention tailoring. CONCLUSION This study demonstrated that people experiencing cognitive concerns and symptoms of depression or anxiety require different interventions to improve physical activity engagement. The novel model can enable more precise intervention tailoring, and, ultimately, benefits for a key at-risk population.
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Affiliation(s)
- Eleanor Curran
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Victoria J Palmer
- ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Terence W H Chong
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
- St Vincent's Hospital Melbourne, St George's Campus, Melbourne, Australia
| | - Thomas Rego
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Kay L Cox
- Medical School, The University of Western Australia, Perth, Australia
| | - Kaarin J Anstey
- University of New South Wales Ageing Futures Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Alissa Westphal
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Rebecca Moorhead
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Jenny Southam
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Rhoda Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Emily You
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
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Serrao Hill MMY, Hauck N, Yorgason JB, Bown C, Tankersley K. An exploration of happiness, anxiety symptoms, and depressive symptoms among older adults during the coronavirus pandemic. Front Psychol 2023; 14:1117177. [PMID: 37063588 PMCID: PMC10097967 DOI: 10.3389/fpsyg.2023.1117177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
The COVID-19 pandemic has affected millions of people worldwide. Because of the challenges associated with the pandemic, universal levels of happiness have likely depleted. We know little about how those with prior existing mental health concerns have responded to the pandemic. Using cross-sectional (study 1; N = 1,366) and longitudinal (study 2; N = 262) data, we utilized a stress and resilience perspective to explore mental health symptoms and happiness among older adults before and after the declaration of the pandemic. Results for both studies indicated higher levels of depression and anxiety symptoms predicted lower levels of happiness; however, for those who indicated higher levels of mental health symptoms, post-pandemic declaration happiness levels were higher than pre-pandemic happiness levels. Findings suggest that resilience may be learned throughout a lifetime, and that experiences from prior stressors may show benefits in responding to future ones, even among vulnerable populations.
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Affiliation(s)
- Melanie M. Y. Serrao Hill
- Optum Inc., Eden Prairie, MN, United States
- Department of School of Family Life, Brigham Young University, Provo, UT, United States
- *Correspondence: Melanie M. Y. Serrao Hill,
| | - Nancy Hauck
- Department of Community and Global Engagement, Dixie State University, St. George, UT, United States
| | - Jeremy B. Yorgason
- Department of School of Family Life, Brigham Young University, Provo, UT, United States
| | - Caroline Bown
- Department of School of Family Life, Brigham Young University, Provo, UT, United States
| | - Kortney Tankersley
- Department of School of Family Life, Brigham Young University, Provo, UT, United States
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Tracking changes in physical activity during inpatient treatment in a psychiatric clinic in Germany by asking two simple questions. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01565-2. [PMID: 36773081 PMCID: PMC9918842 DOI: 10.1007/s00406-023-01565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/23/2023] [Indexed: 02/12/2023]
Abstract
Increasing physical activity is essential to improve psychiatric patients' physical and mental health. This study aimed to characterise the physical activity levels of inpatients in a general psychiatric clinic and to determine the feasibility of using a simple tool in everyday practice to assess physical activity levels in standard patient documentation. We assessed the level of physical activity undertaken by patients treated on an inpatient basis in a psychiatric hospital over 20 months. A total of 328 patients were included in the analysis. Physical activity was measured using a slightly altered version of the Exercise as a vital sign (EVS) questionnaire. All information was extracted from letters of discharge. During inpatient treatment, moderate to vigorous activity levels increased, and more patients engaged in physical activity. Patients with mood or anxiety disorders displayed the most considerable increase in physical activity. Patients with other diagnoses, such as schizophrenia, benefitted less or not at all. Factors associated with physical activity included-among others-history of substance use, education and month of admission. Investigating the feasibility of standardised documentation of physical activity showed fluctuation in documentation rates throughout the study. The level of physical activity performed by psychiatric patients can be increased during inpatient treatment. Implementing physical activity level as part of standard patient documentation is a first step in gathering data to assess the need for interventions to achieve an optimal physical activity in psychiatric patients throughout inpatient treatment.
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Wu K, Wang S, Ding T, Li Y. The direct effect of exercise on the mental health of scientific and technological professionals and the mediating effects of stress, resilience, and social support. Front Public Health 2023; 11:1074418. [PMID: 37033085 PMCID: PMC10076757 DOI: 10.3389/fpubh.2023.1074418] [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: 10/19/2022] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Background High working pressure is one of the main causes of occupational sub-health problems in scientific and technological professionals. With the development of exercise psychology, an increasing number of scholars have begun to focus on the influence of exercise on mental health. However, a limited number of scholars have investigated the effects of exercise on mental health and related mechanisms among scientific and technological professionals. Thus, this study aimed to investigate the relationship between exercise and the mental health of scientific and technological professionals and the mediating roles of stress, resilience, and social support. Methods The respondents in this study were recruited using snowball sampling techniques and finally collected a total of 1,248 valid responses. Questionnaires were distributed through "www.wjx.cn (An online questionnaire website in China, which provides similar functions with Amazon MTurk)" in Henan province from November to December 2021. Participants were asked to complete the Positive Mental Health Scale, the stress subscale of the Depression Anxiety and Stress Scale (21 items), the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale. A total of 1,248 valid responses were obtained. Results The mean exercise time of males was longer than that of females (t = 3.65, p < 0.01). Exercise and mental health were significantly associated with differences in age (F = -8.57, F = -4.66, p < 0.01) and educational background (F = 12.86, F = 7.14, p < 0.01). There were significant correlations among exercise, mental health, stress, resilience, and social support (p < 0.01). The direct effects of exercise on mental health were significant (β = 0.271, t = 9.577, p < 0.001), and the mediating effects of stress, resilience, and social support were also significant (χ2/df = 4.72, CFI = 0.940, TLI = 0.935, SRMR = 0.048, RMSEA = 0.055). Conclusion This study explored the effects of exercise on mental health and related mechanisms among scientific and technological professionals, which is beneficial to providing effective suggestions for managing and preventing the mental health of scientific and technological professionals. Future research should include a wider range of participants and adopt a longitudinal follow-up design to more deeply investigate the relationship between exercise and the mental health of scientific and technological professionals.
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Affiliation(s)
- Kai Wu
- Institute of Psychology and Behavior, Henan University, Kaifeng, China
| | - Shengnan Wang
- Institute of Psychology and Behavior, Henan University, Kaifeng, China
- Institute of International Education, Henan University of Animal Husbandry and Economy, Zhengzhou, China
| | - Tengyun Ding
- Institute of Psychology and Behavior, Henan University, Kaifeng, China
| | - Yongxin Li
- Institute of Psychology and Behavior, Henan University, Kaifeng, China
- *Correspondence: Yongxin Li
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Mastrogiovanni C, Rosenbaum S, Delbaere K, Tiedemann A, Teasdale S, McGavin A, Briggs N, McKeon G. A mental health-informed, online health promotion programme targeting physical activity and healthy eating for adults aged 60+ years: study protocol for the MovingTogether randomised controlled trial. Trials 2022; 23:1052. [PMID: 36575463 PMCID: PMC9793388 DOI: 10.1186/s13063-022-06978-3] [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: 04/29/2022] [Accepted: 12/02/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes). METHODS A randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress. DISCUSSION COVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021.
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Affiliation(s)
- Chiara Mastrogiovanni
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Simon Rosenbaum
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia ,grid.1005.40000 0004 4902 0432School of Health Sciences, University of New South Wales, Sydney, NSW 2052 Australia
| | - Kim Delbaere
- grid.1005.40000 0004 4902 0432Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW 2031 Australia ,grid.1005.40000 0004 4902 0432School of Population Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Anne Tiedemann
- grid.511617.5Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW 2050 Australia
| | - Scott Teasdale
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia ,Mindgardens Neuroscience Network, Sydney, NSW 2052 Australia
| | - Annaliese McGavin
- grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Nancy Briggs
- grid.1005.40000 0004 4902 0432Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW 2052 Australia
| | - Grace McKeon
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia ,grid.1005.40000 0004 4902 0432School of Population Health, University of New South Wales, Sydney, NSW 2052 Australia
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Ghadirian H, Khami MR, Tabatabaei SN, mirhashemi AH, Bahrami R. COVID-19 vaccination and psychological status of Iranian dental students. Front Public Health 2022; 10:946408. [PMID: 36187676 PMCID: PMC9524372 DOI: 10.3389/fpubh.2022.946408] [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: 05/18/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
Objective The purpose of the present study was to investigate the association of COVID-19 vaccination with the quality and quantity of sleep, the level of stress, and temporomandibular joint (TMJ) disorders (TMDs) in Iranian dental students. Materials and methods In this cross-sectional research, we applied a questionnaire including 30 questions on the Perceived Stress Scale (PSS), sleep quality and quantity, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and vaccination status. All vaccinated students of the dental schools located in the city of Tehran were invited to participate in the study. Participants were divided into three groups: those vaccinated for less than a month, those vaccinated for 1-3 months, and those vaccinated for more than 3 months. A paired t-test served for statistical analysis. Results Overall, 171 out of 235 students (72.77%) completed the questionnaire, among which 90 individuals were fully vaccinated, and were included in the data analysis. Stress levels decreased (mean difference = -1.23, p-value = 0.002) and sleep quality and quantity improved mostly 1-3 months after the vaccination (mean difference = -0.5, p-value = 0.016). However, TMD symptoms were mostly alleviated in people vaccinated for more than 3 months (mean difference = -2.86, p-value <0.05). In this respect, no significant difference was observed between the two genders. Conclusion According to the results of the study, vaccination was associated with the improvement of psychological consequences of the COVID-19 pandemic. It is recommended that further longitudinal studies be conducted on larger sample sizes and different age groups by using various data collection methods (especially regarding the assessment of TMD).
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Affiliation(s)
- Hannaneh Ghadirian
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Khami
- Research Center for Caries Prevention, Dentistry Research Institute, Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Hossein mirhashemi
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rashin Bahrami
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,*Correspondence: Rashin Bahrami
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Lifestyle, Physical Activity and Dietary Habits of Medical Students of Wroclaw Medical University during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127507. [PMID: 35742755 PMCID: PMC9223718 DOI: 10.3390/ijerph19127507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
The new disease COVID-19, induced by SARS-CoV-2, causes acute respiratory infection. Many countries, including Poland, began to set a variety of different restrictions to reduce the spread of the virus. Most students had problems with online lessons. The study was conducted among second year medicine students of the Medical University of Wroclaw, and after the entire process of verification 200 respondents were accepted. The research consisted of completing the same anonymous online questionnaires twice in March and October 2020. This finally allowed for a critical assessment of the impact of the pandemic and its restrictions on the students’ daily lives. During the online classes, low levels of physical activity persisted (p = 0.718), whereas time spent sitting increased (p < 0.001). Despite positive changes in declared snacking (p = 0.061), we observed significant drops in the index of healthy diet (p = 0.001) and nutritional knowledge (p < 0.001) as well as an increase in the consumption of fast-food (p < 0.001) and energy drinks (p = 0.019). Reduced nutritional knowledge can cause a decrease in attention to healthy food preparation and much more frequent consumption of fast-food.
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ŞENEL A, BİRİNCİ T, İPEKÇİOĞLU D, YEŞİLKAYA H, KAYA MUTLU E. THE CULTURAL ADAPTATION, RELIABILITY AND VALIDITY OF THE TURKISH VERSION OF THE SIMPLE PHYSICAL ACTIVITY QUESTIONNAIRE IN COMMON MENTAL DISORDERS. TÜRK FIZYOTERAPI VE REHABILITASYON DERGISI 2022. [DOI: 10.21653/tjpr.1028157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: The aim of this study is to evaluate the validity and reliability of the Turkish version of the Simple Physical Activity Questionnaire (SIMPAQ) in patients with common mental disorders.
Methods: A total of eighty-one patients (mean age: 40.14 ± 13.05 years) were included in this study. The Turkish version of the SIMPAQ was used to evaluate the physical activity levels and sedentary behaviors of the participants. To be used as descriptive data, DSM-5 Level 1 Cross-Cutting Symptom Measure-Adult was used to evaluate mental health symptomatology. International Physical Activity Questionnaire-Short Form (UFAA-SF) and Brief Psychiatric Rating Scale (BPRS) were used to test validity of the questionnaire.
Results: The items of Turkish version of the SIMPAQ exhibited excellent intercorrelation coefficient (ICC) values (time spent in bed (0.93 (95% CI: 0.90-0.96)), sedentary time 0.87 (95% CI: 0.80-0.92), walking time 0.98 (95% CI: 0.98-0.99), exercise time 0.99 (95% CI: 0.99-0.99), and incidental activity time 0.95 (95% CI: 0.92-0.97)). However, the BPRS had a significant correlation with only the sedentary time of the SIMPAQ (rho=0.25, p=0.02), indicating convergent validity was poor.
Conclusion: The Turkish version of the SIMPAQ is semantically and linguistically adequate to quickly assess physical activity level and sedentary behavior in patients with common mental disorders.
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Affiliation(s)
| | | | - Derya İPEKÇİOĞLU
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY PROF. DR. MAZHAR OSMAN APPLICATION AND RESEARCH CENTER FOR PSYCHIATRIC AND NERVE DISEASES
| | - Haluk YEŞİLKAYA
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY PROF. DR. MAZHAR OSMAN APPLICATION AND RESEARCH CENTER FOR PSYCHIATRIC AND NERVE DISEASES
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13
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The Effectiveness and Cost of an Intervention to Increase the Provision of Preventive Care in Community Mental Health Services: Protocol for a Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053119. [PMID: 35270810 PMCID: PMC8910711 DOI: 10.3390/ijerph19053119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023]
Abstract
Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention group (implementing a new model of providing preventive care) or a control group (usual care). The model of care comprises three components: (1) a dedicated ‘healthy choices’ consultation offered by a ‘healthy choices’ clinician; (2) embedding information regarding risk factors into clients’ care plans; and (3) the continuation of preventive care by mental health clinicians in ongoing consultations. Evidence-based implementation strategies will support the model implementation, which will be tailored by being co-developed with service managers and clinicians. The primary outcomes are client-reported receipt of: (1) an assessment of chronic disease risks (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity); (2) brief advice regarding relevant risk behaviours; and (3) referral to at least one behaviour change support. Resources to develop and implement the intervention will be captured to enable an assessment of cost effectiveness and affordability. The findings will inform the development of future service delivery initiatives to achieve guideline- and policy-concordant preventive care delivery.
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Het vaststellen van fysieke activiteit van volwassenen uit 11 landen tijdens de COVID-19 pandemische lockdown. PODOSOPHIA 2022. [PMCID: PMC8831682 DOI: 10.1007/s12481-022-00343-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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Abd El-Fatah NK, Alshehri AA, Alsulami FH, Alasmari N, Osman NA. Association Between Mental Health Outcomes and Changes in Lifestyle Behavior Index Among Saudi Adults 16 Weeks After COVID-19 Pandemic Lockdown Release. Front Public Health 2022; 9:728117. [PMID: 35186859 PMCID: PMC8854758 DOI: 10.3389/fpubh.2021.728117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 12/27/2021] [Indexed: 12/30/2022] Open
Abstract
Background The current (coronavirus disease 2019 [COVID-19]) pandemic is still uncontrolled with associated dramatic changes in daily lifestyle activities. Evidence for studying the impact of these health behavior changes on our mental health is limited. Therefore, this study aimed to estimate the prevalence of psychological distresses and assess their influence by the change in the composite lifestyle behaviors before the COVID-19 pandemic till 16 weeks after the lockdown release in Saudi Arabia. Methods This cross-sectional study was conducted between October 10 and 31, 2020 by posting an online survey on social media platforms (WhatsApp and Twitter) to collect data on participants' sociodemographic, lifestyle behaviors, and mental health aspects using a validated Arabic version of the short-form version of the Depression Anxiety Stress Scales-21 (DASS-21). Results A total of 363 responded to the questionnaire. The mean age was 36.26 ± 8.54 years, and 238 (65.6%) were men. Depression, stress, and anxiety were reported in 37.5, 26.7, and 16.5% of the participants, respectively. Negative lifestyle behavioral changes were significantly associated with stress and anxiety (p < 0.05). Logistic regression revealed that financial distress and history of psychiatric illnesses were common significant factors for developing the psychological distresses. Conclusion Throughout the post-lockdown stage of the COVID-19 outbreak in Saudi Arabia, there was an evidence of psychological distresses among the adults. Negative health-related changes are directly linked with increased psychological distress. Effective health promotion strategies directed toward adopting and maintaining positive change in the composite health behaviors are crucial.
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Affiliation(s)
- Nesrin Kamal Abd El-Fatah
- Department of Nutrition, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- Joint Postgraduate Training Program for Preventive Medicine, Ministry of Health, Taif, Saudi Arabia
- *Correspondence: Nesrin Kamal Abd El-Fatah
| | | | - Fatma H. Alsulami
- Preventive Medicine and Public Health, Ministry of Health, Taif, Saudi Arabia
| | - Norah Alasmari
- Preventive Medicine and Public Health, Ministry of Health, Taif, Saudi Arabia
| | - Nermin A. Osman
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
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16
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Kosendiak A, Król M, Ściskalska M, Kepinska M. The Changes in Stress Coping, Alcohol Use, Cigarette Smoking and Physical Activity during COVID-19 Related Lockdown in Medical Students in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:302. [PMID: 35010559 PMCID: PMC8744869 DOI: 10.3390/ijerph19010302] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 12/24/2022]
Abstract
The ongoing COVID-19 pandemic has significantly limited social contacts, thus contributing to deepening isolation. Therefore, SARS-CoV-2 exerted on humanity not only a physical impact but also a psychological one, often increasing the feeling of stress. The long-term effects of such a state could include the management of depression, so our study aimed to analyze groups of medical students in different periods of the pandemic (at the beginning of the pandemic, after half a year of the pandemic, after one year of the pandemic) in order to assess the impact of this situation on coping with stress. The impact of the pandemic on the development of stress factors such as alcohol consumption and smoking was also studied. The level of physical activity in the context of coping with an uncertain situation was also assessed. The impact of the above-mentioned factors on the behavior of students, including the Mini-COPE questionnaire, AUDIT test, the Fagerström test and the IPAQ questionnaire was analyzed. It has been shown that as the pandemic and the lockdown progressed, patients consumed more often or larger amounts of alcohol, smoked more cigarettes, and levels of physical activity decreased. All these factors may have had some impact on the deterioration of coping with stress among the respondents, which would indicate that the COVID-19 pandemic significantly contributed to an increase in the sense of stress among the students.
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Affiliation(s)
- Aureliusz Kosendiak
- Department of Physical Education and Sport, Wroclaw Medical University, Wojciecha z Brudzewa 12, 51-601 Wroclaw, Poland;
| | - Magdalena Król
- Department of Pharmaceutical Biochemistry, Division of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211a, 50-556 Wroclaw, Poland; (M.K.); (M.Ś.)
| | - Milena Ściskalska
- Department of Pharmaceutical Biochemistry, Division of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211a, 50-556 Wroclaw, Poland; (M.K.); (M.Ś.)
| | - Marta Kepinska
- Department of Pharmaceutical Biochemistry, Division of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211a, 50-556 Wroclaw, Poland; (M.K.); (M.Ś.)
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de Sousa GM, Tavares VDDO, de Meiroz Grilo MLP, Coelho MLG, de Lima-Araújo GL, Schuch FB, Galvão-Coelho NL. Mental Health in COVID-19 Pandemic: A Meta-Review of Prevalence Meta-Analyses. Front Psychol 2021; 12:703838. [PMID: 34621212 PMCID: PMC8490780 DOI: 10.3389/fpsyg.2021.703838] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Mental health burden has been massively reported during the COVID-19 pandemic period. Aiming to summarise these data, we present a meta-review of meta-analyses that evaluated the impact of COVID-19 pandemic on anxiety, depressive and stress symptoms, psychological distress, post-traumatic stress disorder/symptoms (PTSD), and sleep disturbance, reporting its prevalence on general public (GP) and health care workers (HCW). Methods: A search was performed in the PubMed, EMBASE, and the Web of Science. Sleep disturbances, psychological distress, stress, and burnout were grouped as "Psychophysiological stress," and anxiety, depression, and PTSD were grouped as "Psychopathology." A random-effects model, calculating the pooled prevalence together with 95% confidence interval was performed for each domain. Subgroup analyses were performed for each population type (GP and HCW) and for each mental health outcome. For anxiety and depression, subgroup analysis for population type was performed. Heterogeneity is reported as I 2. Publication bias was assessed through visual inspection of the funnel plot, and further tested by Egger's test and trim and fill analyses. Results: A total of 18 meta-analyses were included. The prevalence of psychophysiological stress was 31.99% (CI: 26.88-37.58, I 2 = 99.9%). HCW showed a higher prevalence (37.74%, CI: 33.26-42.45, I 2 = 99.7%) than the GP (20.67%, 15.07-27.66, I 2 = 99.9%). The overall prevalence of insomnia, psychological distress, and stress were, respectively, 32.34% (CI: 25.65-39.84), 28.25% (CI: 18.12-41.20), and 36% (CI: 29.31-43.54). Psychopathology was present at 26.45% (CI: 24.22-28.79, I 2 = 99.9%) of the sample, with similar estimates for population (HCW 26.14%, CI: 23.37-29.12, I 2 = 99.9%; GP: 26.99%, CI: 23.41-30.9, I 2 = 99.9%). The prevalence of anxiety, depression, and PTSD was 27.77% (CI: 24.47-31.32), 26.93% (CI: 23.92-30.17), and 20% (CI: 15.54-24.37), respectively. Similar proportions between populations were found for anxiety (HCW = 27.5%, CI: 23.78-31.55; GP = 28.33%, CI: 22.1-35.5) and depression (HCW = 27.05%, CI: 23.14-31.36; GP = 26.7%, CI: 22.32-31.59). Asymmetry in the funnel plot was found, and a slight increase in the estimate of overall psychopathology (29.08%, CI: 26.42-31.89) was found after the trim and fill analysis. Conclusions: The prevalence of mental health problems ranged from 20 to 36%. HCW presented a higher prevalence of psychophysiological stress than the general population. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=252221, identifier: CRD42021252221.
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Affiliation(s)
- Geovan Menezes de Sousa
- Laboratory of Hormone Measurement, Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
- Graduate Program in Psychobiology and Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Vagner Deuel de Oliveira Tavares
- Laboratory of Hormone Measurement, Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
- Graduate Program in Psychobiology and Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Maria Lara Porpino de Meiroz Grilo
- Laboratory of Hormone Measurement, Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
- Graduate Program in Psychobiology and Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Monique Leite Galvão Coelho
- Laboratory of Hormone Measurement, Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Geissy Lainny de Lima-Araújo
- Laboratory of Hormone Measurement, Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
- Brain Institute, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Nicole Leite Galvão-Coelho
- Laboratory of Hormone Measurement, Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
- Graduate Program in Psychobiology and Department of Physiology and Behaviour, Federal University of Rio Grande Do Norte, Natal, Brazil
- National Science and Technology Institute for Translational Medicine (INCT-TM), São Paulo, Brazil
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
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Physical Activity among Adults Residing in 11 Countries during the COVID-19 Pandemic Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137056. [PMID: 34280992 PMCID: PMC8297220 DOI: 10.3390/ijerph18137056] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/17/2022]
Abstract
During the novel coronavirus (COVID-19) pandemic, physical activity (PA) behaviors were altered worldwide due to public health measures such as “lockdown.” This study described PA among adults residing in 11 countries during COVID-19 lockdown and examined factors associated with PA engagement. We conducted a cross-sectional anonymous survey among adults (≥18 years old) in 11 countries (Brazil, Bulgaria, China, India, Ireland, Malaysia, North Macedonia, Singapore, Spain, Turkey, United States). Of 11,775 participants, 63.7% were female and 52.8% were 18–34 years old. More than 40% of participants were insufficiently active (43.9%) and reported a decrease in their PA during lockdown (44.8%). Statistically significant differences were observed in (1) proportions of participants being insufficiently active, (2) level of PA, and (3) decrease in PA across the 11 countries. More stringent governmental policy responses were associated with greater likelihood of being insufficiently active during lockdown (adjusted odds ratio = 1.22, 95% confidence interval = 1.03, 1.45). Higher depression or anxiety scores were associated with greater likelihood of decreased level of PA during lockdown.We found substantial reductions in PA levels during COVID-19 lockdown across countries. Country-specific PA promotion interventions are needed during this and similar global emergencies.
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Nesbitt AE, Collins KJ, Nalder E, Sabiston CM. Occupational outcomes of a physical activity intervention for post-secondary student mental health. The Canadian Journal of Occupational Therapy 2021; 88:254-265. [PMID: 34132119 DOI: 10.1177/00084174211021708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND. Physical activity (PA) is a therapeutic approach to address post-secondary student mental health, yet the effect of PA on occupational outcomes has been understudied among students. PURPOSE. This study (1) identified and described occupational performance issues (OPIs) among post-secondary students seeking mental health support and (2) assessed pre- and post-intervention differences in occupational performance and performance satisfaction. METHOD. Using a single group pre-test post-test pilot study design, participants (N = 20) completed a 6-week, 1-hour PA intervention. The Canadian Occupational Performance Measure was administered pre- and post-intervention. FINDINGS. The most commonly reported OPIs included academics, PA, and sleep hygiene. There were significant improvements in participants' occupational performance (mean change: 2.7, p < .001; dz = 2.28) and performance satisfaction (mean change: 3.7, p < .001; dz = 3.04). IMPLICATIONS. Results provide an initial demonstration of the benefits of PA for occupational outcomes within a post-secondary mental health context.
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20
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Lipert A, Kozłowski R, Timler D, Marczak M, Musiał K, Rasmus P, Kamecka K, Jegier A. Physical Activity as a Predictor of the Level of Stress and Quality of Sleep during COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115811. [PMID: 34071446 PMCID: PMC8198542 DOI: 10.3390/ijerph18115811] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
Background: The coronavirus pandemic and the government restrictions significantly disturbed the daily functioning of people, thereby influencing healthy behaviors, such as physical activity—the core indicator of well-being. This study evaluates the associations between physical activity (PA), the level of stress and quality of sleep during the COVID-19 pandemic lockdown. Methods: An online survey was distributed during the governmental lockdown in April 2020 and included measures for assessing physical activity, stress and sleep. The surveyed participants included all adults aged 18 years and over. The final data were collected from the 1959 respondents using: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI). Findings: Almost half of the respondents indicated a low level of PA, performing only 60 min of PA daily. Most of the participants reported a moderate or high level of stress (57% and 29%, respectively) and 64% of them reported poor quality of sleep. People with low levels of stress performed on average 85.1 min/day of walking (WPA), 40.9 min/day of moderate PA (MPA) or 52.6 min/day of vigorous PA (VPA). People with good quality of sleep performed 82.9 min/day of WPA, 43.6 min/day MPA and 40.5 min/day VPA. Interpretation: The results from the study indicate that the volume of daily PA may be a predictor of the level of stress and sleep quality in adults during the COVID-19 pandemic lockdown. To retain a low level of stress and good quality of sleep, a lifestyle that allows to achieve a moderate level of physical activity should be maintained. The optimal daily dose of PA is at least 70 min per day, involving different intensities.
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Affiliation(s)
- Anna Lipert
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland; (K.M.); (A.J.)
- Correspondence:
| | - Remigiusz Kozłowski
- Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland;
| | - Dariusz Timler
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Michał Marczak
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland; (M.M.); (K.K.)
| | - Kamila Musiał
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland; (K.M.); (A.J.)
| | - Paweł Rasmus
- Department of Medical Psychology, Medical University of Lodz, 90-131 Lodz, Poland;
| | - Karolina Kamecka
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland; (M.M.); (K.K.)
| | - Anna Jegier
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland; (K.M.); (A.J.)
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21
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Yirmiya K, Yakirevich-Amir N, Preis H, Lotan A, Atzil S, Reuveni I. Women's Depressive Symptoms during the COVID-19 Pandemic: The Role of Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4298. [PMID: 33919564 PMCID: PMC8072624 DOI: 10.3390/ijerph18084298] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/28/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has multiple ramifications for pregnant women. Untreated depression during pregnancy may have long-term effects on the mother and offspring. Therefore, delineating the effects of pregnancy on the mental health of reproductive-age women is crucial. This study aims to determine the risk for depressive symptoms in pregnant and non-pregnant women during COVID-19, and to identify its bio-psycho-social contributors. A total of 1114 pregnant and 256 non-pregnant women were recruited via social media in May 2020 to complete an online survey that included depression and anxiety questionnaires, as well as demographic, obstetric and COVID-19-related questionnaires. Pregnant women also completed the Pandemic-Related Pregnancy Stress Scale (PREPS). Pregnant women reported fewer depressive symptoms and were less concerned that they had COVID-19 than non-pregnant women. Among pregnant women, risk factors for depression included lower income, fewer children, unemployment, thinking that one has COVID-19, high-risk pregnancy, earlier gestational age, and increased pregnancy-related stress. Protective factors included increased partner support, healthy behaviors, and positive appraisal of the pregnancy. Thus, being pregnant is associated with reduced risk for depressive symptoms during the pandemic. Increased social support, engaging in health behaviors and positive appraisal may enhance resilience. Future studies of pregnant versus non-pregnant women could clarify the role of pregnancy during stressful events, and clarify aspects of susceptibility and resilience during pregnancy.
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Affiliation(s)
- Karen Yirmiya
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel;
- Interdisciplinary Center, Baruch Ivcher School of Psychology, Herzlia 4610101, Israel
| | - Noa Yakirevich-Amir
- Department of Psychiatry, Hadassah Medical Center, Jerusalem 9103401, Israel; (N.Y.-A.); (A.L.)
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Amit Lotan
- Department of Psychiatry, Hadassah Medical Center, Jerusalem 9103401, Israel; (N.Y.-A.); (A.L.)
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Shir Atzil
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel;
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center, Jerusalem 9103401, Israel; (N.Y.-A.); (A.L.)
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
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22
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Freyberg J, Brage S, Kessing LV, Faurholt-Jepsen M. The association between self-reported physical activity and objective measures of physical activity in participants with newly diagnosed bipolar disorder, unaffected relatives, and healthy individuals. Nord J Psychiatry 2021; 75:186-193. [PMID: 33779478 PMCID: PMC7610645 DOI: 10.1080/08039488.2020.1831063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The association between the International Physical Activity Questionnaire Short Form (IPAQ-SF) and objective measures of physical activity has never been evaluated in participants with newly diagnosed bipolar disorder (BD). Our aim was to compare IPAQ-SF to objective measures in participants with newly diagnosed BD, their unaffected first-degree relatives (UR), and healthy control individuals (HC) in groups combined and stratified by group. MATERIALS AND METHODS Physical activity measurements were collected on 20 participants with newly diagnosed BD, 20 of their UR, and 20 HC using individually calibrated combined acceleration and heart rate sensing (Actiheart) for seven days. IPAQ-SF was self-completed at baseline. Correlation between measurements from the two methods was examined with Spearman rank correlation coefficient and agreement levels examined with modified Bland-Altman plots. RESULTS Physical activity energy expenditure (PAEE) from IPAQ-SF was weakly but significantly positively correlated with physical activity estimates measured using acceleration and heart rate in groups combined (Actiheart PAEE) (ρ= 0.301, p = 0.02). Correlations for each group were positive, but only in UR were it statistically significant (BD: p = 0.18, UR: p = 0.007, HC: p = 0.84). Self-reported PAEE and moderate-intensity were markedly underestimated [PAEE in all participants combined: 62.7 (Actiheart) vs. 24.3 kJ/day/kg (IPAQ-SF), p < 0.001], while vigorous-intensity was overestimated. Bland-Altman plots indicated proportional bias. CONCLUSION These results suggest that the use of the IPAQ-SF to monitor levels of physical activity in participants with newly diagnosed BD, in a psychiatric clinical setting, should be used with caution and consideration.
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Affiliation(s)
- Josefine Freyberg
- The Copenhagen Affective Disorder research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Lars Vedel Kessing
- The Copenhagen Affective Disorder research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- The Copenhagen Affective Disorder research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Activation of the orbitofrontal cortex by both meditation and exercise: A near-infrared spectroscopy study. PLoS One 2021; 16:e0247685. [PMID: 33621250 PMCID: PMC7901739 DOI: 10.1371/journal.pone.0247685] [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: 01/17/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022] Open
Abstract
In some types of meditation, such as mindfulness and Zen, breathing is the focus of attention, whereas during an excessive, short-period of anaerobic exercise, the muscles become the focus of attention. Thus, during both efforts, one’s attention is focused on a certain feature of the body. Both meditation and exercise generally provide mental refreshment to humans. We hypothesized that the same brain regions are activated by both efforts in humans. To examine this hypothesis, we engaged participants in 3 tasks: meditation, exercise, and a control task. After each task, the participants underwent a 2-back test to concentrate their thoughts, while changes in their blood hemoglobin levels were simultaneously monitored using near-infrared spectroscopy (NIRS). Seventeen participants (20–24 years of age; 11 men, 6 women) were enrolled. We applied a fast-Fourier transform (FFT) analysis to the NIRS wave data and calculated the correlation coefficients of the FFT data between (1) meditation and control, (2) exercise and control, and (3) meditation and exercise, at the orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex (DLPFC), brain areas that are generally involved in mental refreshment. A significant difference in the correlation coefficients between the OFC and DLPFC was detected in the meditation and exercise analysis, and signal source analysis confirmed that the NIRS waves spread from the right and left OFC edges (i.e., right and left temples) toward the center. Our results suggest that both meditation and exercise activate the OFC, which is involved in emotional reactions and motivation behavior, resulting in mental refreshment.
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Malhi GS, Bell E, Bassett D, Boyce P, Bryant R, Hazell P, Hopwood M, Lyndon B, Mulder R, Porter R, Singh AB, Murray G. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry 2021; 55:7-117. [PMID: 33353391 DOI: 10.1177/0004867420979353] [Citation(s) in RCA: 236] [Impact Index Per Article: 78.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. METHODS Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. RESULTS The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. CONCLUSION The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. MOOD DISORDERS COMMITTEE Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.
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Affiliation(s)
- Gin S Malhi
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, NSW, Australia.,Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Erica Bell
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, NSW, Australia.,Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | | | - Philip Boyce
- Department of Psychiatry, Westmead Hospital and the Westmead Clinical School, Wentworthville, NSW, Australia.,Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Philip Hazell
- Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne and Professorial Psychiatry Unit, Albert Road Clinic, Melbourne, VIC, Australia
| | - Bill Lyndon
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, NSW, Australia
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Ajeet B Singh
- The Geelong Clinic Healthscope, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
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Mounir I, Menvielle L, Perlaza S, Chênevert D, Planchard JH, Fabre R, Benoit M, Benyamina A, Rolland B, Cherikh F, David R. Psychological Distress and Tobacco Use Among Hospital Workers During COVID-19. Front Psychiatry 2021; 12:701810. [PMID: 34393861 PMCID: PMC8355418 DOI: 10.3389/fpsyt.2021.701810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/09/2021] [Indexed: 01/23/2023] Open
Abstract
Background and Aims: This work aims to assess the impact of the COVID-19 pandemic on hospital workers' psychological parameters and attitudes toward substance use, before and during the French COVID-19 lockdown. Methods: An online survey was proposed to the staff of the University Hospital of Nice and Sainte-Marie psychiatric hospital in France from May 18 to June 6, 2020 assessing changes in daily habits, psychological distress and changes in substance use, including smoking. Results: A total of 702 respondents (80.3% female) filled out the survey. Overall, most of the workers reported increased stress, irritability, sadness, decreased motivation, and a worse quality of sleep after the beginning of the COVID-19 lockdown. Additionally, hospital workers who were more likely to use tobacco during the COVID-19 lockdown reported increased sadness (OR = 1.23, p < 0.001), loss of motivation (OR = 0.86, p < 0.05), alcohol consumption (OR = 3.12, p < 0.001), lower incomes (OR = 1.69, p < 0.05), living alone (OR = 1.77, p < 0.001) and doing less physical activity (OR = 0.36, p < 0.001). Conclusion: During the first lockdown, significant psychological changes (sadness, distress, irritability) associated with changes in tobacco use and physical activity were reported. Such results should encourage hospital leaders to implement dedicated policies to better accompany hospital workers' psychological distress.
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Affiliation(s)
- Izza Mounir
- Department of Addiction, University Hospital of Nice, Nice, France
| | - Loick Menvielle
- Department of Human Resources Management, Edhec Business School, Nice, France
| | - Samir Perlaza
- Centre de Recherche de Sophia Antipolis-Mediterranee, INRIA, Valbonne, France
| | - Denis Chênevert
- Department of Human Resources Management, HEC Montreal, Montreal, QC, Canada
| | | | - Roxane Fabre
- CoBTeK Lab, Department of Public Health, Côte d'Azur University, University Hospital of Nice, Nice, France
| | - Michel Benoit
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Amine Benyamina
- Department of Psychiatry and Addiction, AP-HP, Paul Brousse Hospital, Paris, France
| | - Benjamin Rolland
- Academic Department of Addiction Medicine in Lyon, Centre Hospitalier Le Vinatier, Hospices Civils de Lyon, Bron, France
| | - Faredj Cherikh
- Department of Addiction, University Hospital of Nice, Nice, France
| | - Renaud David
- Department of Geriatric Psychiatry, Cimiez Hospital, Nice, France
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26
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Werneck AO, Schuch FB, Stubbs B, Oyeyemi AL, Szwarcwald CL, Vancampfort D, Silva DR. Independent and combined associations of sugar-sweetened beverage consumption, TV viewing, and physical activity with severe depressive symptoms among 59,402 adults. ACTA ACUST UNITED AC 2020; 43:574-583. [PMID: 33331496 PMCID: PMC8639020 DOI: 10.1590/1516-4446-2020-1073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/29/2020] [Indexed: 12/13/2022]
Abstract
Objective: Our aim was to analyze the association between sugar-sweetened beverage consumption and depressive symptoms, as well as the extent to which TV viewing and physical activity moderate this association. Methods: We used cross-sectional data from the 2013 Brazilian National Survey (Pesquisa Nacional de Saúde) of 59,402 adults (33,482 women, mean age = 42.9 years, 95%CI 42.7-43.2 years). Depressive symptoms (Patient Health Questionnaire-9), physical activity, TV viewing, and sugar-sweetened beverage consumption, as well as potential confounders (chronological age, ethnicity, consumption of candy/sweets and fruit, multimorbidity, education, and employment status) were self-reported. Poisson regression models were used for association analyses. Results: The consumption of 16 or more glasses/week of sugar-sweetened beverages was associated with higher levels of severe depressive symptoms among women compared to no consumption (prevalence ratio [PR] 1.71 [95%CI 1.38-2.11]). Consistent interactions were observed between 1-5 glasses and TV viewing (PR 2.09 [95%CI 1.06-4.12]) and between 11-15 glasses and TV viewing (PR 2.90 [95%CI 1.29-6.50]) among men compared to no consumption, given that the co-occurrence of sugar-sweetened beverage consumption and elevated TV viewing was associated with higher odds of severe depressive symptoms. Sugar-sweetened beverage consumption did not interact with physical activity, only presenting an independent association. Conclusion: Sugar-sweetened beverage consumption was independently associated with severe depressive symptoms among women and interacted with TV viewing, but not with physical activity among men.
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Affiliation(s)
- André O Werneck
- Departamento de Nutrição, Escola de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Felipe B Schuch
- Departamento de Métodos e Técnicas Desportivas, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London Maudsley NHS Foundation Trust, London, UK
| | - Adewale L Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Borno State, Nigeria
| | - Célia L Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Danilo R Silva
- Departamento de Educação Física, Universidade Federal de Sergipe (UFS), São Cristóvão, SE, Brazil
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27
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Fehily C, Hodder R, Bartlem K, Wiggers J, Wolfenden L, Dray J, Bailey J, Wilczynska M, Stockings E, Clinton-McHarg T, Regan T, Bowman J. The effectiveness of interventions to increase preventive care provision for chronic disease risk behaviours in mental health settings: A systematic review and meta-analysis. Prev Med Rep 2020; 19:101108. [PMID: 32477852 PMCID: PMC7248238 DOI: 10.1016/j.pmedr.2020.101108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/01/2020] [Accepted: 04/26/2020] [Indexed: 11/25/2022] Open
Abstract
Clinical practice guidelines direct mental health services to provide preventive care to address client chronic disease risk behaviours, however, this care is not routinely provided. The aim of this systematic review was to synthesise evidence regarding the effectiveness of interventions to increase provision of preventive care by mental health services; by care element (ask, assess, advice, assist, arrange) and risk behaviour (tobacco smoking, poor nutrition, harmful alcohol consumption, physical inactivity). Electronic bibliographic databases, Google Scholar, relevant journals, and included study reference lists were searched. Eligible studies were of any design with a comparison group that reported the effectiveness of an intervention to increase the provision of at least one element of preventive care for at least one risk behaviour in a mental health setting. Twenty studies were included, most commonly examining smoking (n = 20) and 'ask' (n = 12). Meta-analysis found interventions involving task shifting were effective in increasing smoking 'advice' (n = 2 RCTs; p = 0.009) and physical activity 'advice' (n = 2 RCTs; p = 0.002). Overall, meta-analysis and narrative synthesis indicated that effective intervention strategies (categorised according to the Effective Practice and Organisation of Care taxonomy) were: task shifting, educational meetings, health information systems, local consensus processes, authority and accountability, and reminders. The most consistent findings across studies were with regard to preventive care for smoking, while conflicting or limited evidence was found regarding other risk behaviours. While further rigorous research examining key risk behaviours is recommended, the findings may inform the selection of strategies for future interventions and service delivery initiatives.
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Affiliation(s)
- Caitlin Fehily
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Rebecca Hodder
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Kate Bartlem
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Julia Dray
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - Jacqueline Bailey
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
| | - Magda Wilczynska
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, Randwick, NSW, Australia
| | - Tara Clinton-McHarg
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Timothy Regan
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Jenny Bowman
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
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28
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Trott M, Yang L, Jackson SE, Firth J, Gillvray C, Stubbs B, Smith L. Prevalence and Correlates of Exercise Addiction in the Presence vs. Absence of Indicated Eating Disorders. Front Sports Act Living 2020; 2:84. [PMID: 33345075 PMCID: PMC7739814 DOI: 10.3389/fspor.2020.00084] [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] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022] Open
Abstract
Despite the many benefits of regular, sustained exercise, there is evidence that exercise can become addictive, to the point where the exerciser experiences negative physiological and psychological symptoms, including withdrawal symptoms upon cessation, training through injury, and the detriment of social relationships. Furthermore, recent evidence suggests that the etiology of exercise addiction is different depending on the presence or absence of eating disorders. The aim of this study was to explore to what extent eating disorder status, body dysmorphic disorder, reasons for exercise, social media use, and fitness instructor status were associated with exercise addiction, and to determine differences according to eating disorder status. The key findings showed that the etiology of exercise addiction differed according to eating disorder status, with variables including social media use, exercise motivation, and ethnicity being uniquely correlated with exercise addiction only in populations with indicated eating disorders. Furthermore, body dysmorphic disorder was highly prevalent in subjects without indicated eating disorders, and could be a primary condition in which exercise addiction is a symptom. It is recommended that clinicians and practitioners working with patients who present with symptoms of exercise addiction should be screened for eating disorders and body dysmorphic disorder before treatments are considered.
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Affiliation(s)
- Mike Trott
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada.,Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.,NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Claire Gillvray
- Cognitive Sports Therapy, Cambridge, United Kingdom.,Cambridge Private Doctors, Nuffield Hospital, Cambridge, United Kingdom.,RC Psych Sports and Exercise Psychiatry Special Interest Group, London, United Kingdom
| | - Brendon Stubbs
- Positive Ageing Research Institute (PARI), Anglia Ruskin University, Cambridge, United Kingdom.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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Stanton R, To QG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, Fenning AS, Vandelanotte C. Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4065. [PMID: 32517294 PMCID: PMC7312903 DOI: 10.3390/ijerph17114065] [Citation(s) in RCA: 779] [Impact Index Per Article: 194.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022]
Abstract
The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18-45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and stress symptoms. Health-promotion strategies directed at adopting or maintaining positive health-related behaviors should be utilized to address increases in psychological distress during the pandemic. Ongoing evaluation of the impact of lifestyle changes associated with the pandemic is needed.
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Affiliation(s)
- Robert Stanton
- Cluster for Resilience and Well-being, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 5043, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
| | - Quyen G. To
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
- Physical Activity Research Group, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 504, Australia
| | - Saman Khalesi
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
- Physical Activity Research Group, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 504, Australia
| | - Susan L. Williams
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
- Physical Activity Research Group, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 504, Australia
| | - Stephanie J. Alley
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
- Physical Activity Research Group, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 504, Australia
| | - Tanya L. Thwaite
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
- Physical Activity Research Group, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 504, Australia
| | - Andrew S. Fenning
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia; (Q.G.T.); (S.K.); (S.L.W.); (S.J.A.); (T.L.T.); (A.S.F.); (C.V.)
- Physical Activity Research Group, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville 504, Australia
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30
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Sportliche Aktivität als mögliche Therapieoption bei ADHS. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Guerrera CS, Furneri G, Grasso M, Caruso G, Castellano S, Drago F, Di Nuovo S, Caraci F. Antidepressant Drugs and Physical Activity: A Possible Synergism in the Treatment of Major Depression? Front Psychol 2020; 11:857. [PMID: 32435223 PMCID: PMC7218094 DOI: 10.3389/fpsyg.2020.00857] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/06/2020] [Indexed: 12/18/2022] Open
Abstract
Major depressive disorder (MDD) is a severe mental illness that affects 5–20% of the general population. Current antidepressant drugs exert only a partial clinical efficacy because approximately 30% of depressed patients failed to respond to these drugs and antidepressants produce remission only in 30% of patients. This can be explained by the fact that the complex pathophysiology of depression has not been completely elucidated, and treatments have been mainly developed following the “monoaminergic hypothesis” of depression without considering the key role of other factors involved in the pathogenesis of MDD, such as the role of chronic stress and neuroinflammation. Chronic stress acts as a risk factor for the development of MDD through the impairment of neurotrophins signaling such as brain-derived neurotrophic factor (BDNF) and transforming-growth-factor-β1 (TGF-β1). Stress-induced depressive pathology contributes to altered BDNF level and function in MDD patients and, thereby, an impairment of neuroplasticity at the regional and circuit level. Recent studies demonstrate that aerobic exercise strongly increases BDNF production and it may contribute as a non-pharmacological strategy to improve the treatment of cognitive and affective symptoms in MDD. Here we will provide a general overview on the possible synergism between physical activity and antidepressants in MDD. Physical activity can synergize with antidepressant treatment by rescuing neurotrophins signaling in MDD patients, promoting neuronal health and recovery of function in MDD-related circuits, finally enhancing pharmacotherapeutic response. This synergism might be particularly relevant in elderly patients with late-life depression, a clinical subgroup with an increased risk to develop dementia.
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Affiliation(s)
- Claudia Savia Guerrera
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Department of Educational Sciences, University of Catania, Catania, Italy
| | - Giovanna Furneri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Department of Educational Sciences, University of Catania, Catania, Italy
| | - Margherita Grasso
- Department of Laboratories, Oasi Research Institute - IRCCS, Troina, Italy.,Department of Drug Sciences, University of Catania, Catania, Italy
| | - Giuseppe Caruso
- Department of Laboratories, Oasi Research Institute - IRCCS, Troina, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Caraci
- Department of Laboratories, Oasi Research Institute - IRCCS, Troina, Italy.,Department of Drug Sciences, University of Catania, Catania, Italy
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Bolognese MA, Franco CB, Ferrari A, Bennemann RM, Lopes SMA, Bertolini SMMG, Júnior NN, Branco BHM. Group Nutrition Counseling or Individualized Prescription for Women With Obesity? A Clinical Trial. Front Public Health 2020; 8:127. [PMID: 32426316 PMCID: PMC7203219 DOI: 10.3389/fpubh.2020.00127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/30/2020] [Indexed: 01/21/2023] Open
Abstract
Background: This study investigates the effects of group counseling vs. individual dietary prescription on physical, nutritional, and mental health in overweight or obese women. Methods: Seventy-four women aged 40-59 years with body mass index ≥ 25 kg/m2 were randomized into 2 intervention arms: group nutrition counseling (GNC) or individualized nutrition prescription (INP). Twenty-seven women completed the 12-week intervention protocol. The GNC received counseling once a week and the INP received an individualized prescription once a month. All participants attended physical exercise sessions 3 times a week following the same protocol. Body mass, body mass index, fat mass, body fat percentage, lean mass, lipid profile, hemoglobin A1c, insulin and liver transaminases were measured pre- and post-intervention in both arms. A 3 day food record was applied to calculate the intake of calories, carbohydrates, proteins, and lipids. Body image dissatisfaction, level of anxiety, self-esteem measure and pathological eating attitudes were measured. Results: Both dietary interventions decreased body mass, body mass index, fat mass, body fat percentage, total caloric intake, carbohydrates, proteins, lipids, body dissatisfaction, anxiety, and saturated and polyunsaturated fats (p < 0.05). Lean mass, metabolic variables, self-esteem and pathological eating attitudes remained unchanged (p > 0.05). Conclusion: Both nutritional interventions combined with concurrent exercise were effective to improve anthropometrics, body composition, food intake, and some mental health parameters. We suggest that the choice of nutritional intervention (GNC or INP) could be based on the participants preference, considering the adherence and satisfaction, to promote health and quality of life.
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Affiliation(s)
- Marciele Alves Bolognese
- Post-Graduation Program in Health Promotion, University Center of Maringa, Maringa, Brazil
- Research Group in Physical Education, Physiotherapy, Sports, Nutrition and Performance of the University Center of Maringa (GEFFEND/UniCesumar), Maringa, Brazil
| | | | - Ariana Ferrari
- Post-Graduation Program in Science, Technology and Food Safety, University Center of Maringa, Maringa, Brazil
| | - Rose Mari Bennemann
- Post-Graduation Program in Health Promotion, University Center of Maringa, Maringa, Brazil
| | | | | | - Nelson Nardo Júnior
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Braulio Henrique Magnani Branco
- Post-Graduation Program in Health Promotion, University Center of Maringa, Maringa, Brazil
- Research Group in Physical Education, Physiotherapy, Sports, Nutrition and Performance of the University Center of Maringa (GEFFEND/UniCesumar), Maringa, Brazil
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Ärztliche Vorbildfunktion bezüglich körperlicher Aktivität für Patienten mit psychischen Erkrankungen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00421-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Zusammenfassung
Hintergrund
Körperliche Aktivität spielt eine bedeutende Rolle bei der Behandlung psychischer Störungen. Psychiatern/ärztlichen Psychotherapeuten kommt eine Schlüsselrolle dabei zu, ihren Patienten körperliche Aktivität zu empfehlen. Zum Empfehlungsverhalten dieses Kollektivs liegen bisher keine Untersuchungen vor.
Ziele der Arbeit
Das Empfehlungsverhalten in Bezug auf körperliche Aktivität sowie verhaltensbezogene und motivationale Korrelate, die das Empfehlungsverhalten potenziell beeinflussen, bei deutschen Psychiatern/ärztlichen Psychotherapeuten sollte untersucht werden.
Material und Methoden
Insgesamt beantworteten 151 deutsche Psychiater/ärztliche Psychotherapeuten (Alter: M = 32,5 Jahre; Geschlecht: 47,0 % weiblich) einen Onlinefragebogen bezüglich körperlicher Aktivität. Dabei wurden das Empfehlungsverhalten körperlicher Aktivität, die Einstellung, das eigene Aktivitätsverhalten und die Selbstkonkordanz eigener Motivation, körperlich aktiv zu sein, erfasst.
Ergebnisse
Die meisten Psychiater/ärztliche Psychotherapeuten gaben an, körperliche Aktivität einigen (54,5 %, n = 82) oder all ihren Patienten zu empfehlen (33,8 %, n = 51). Das Empfehlungsverhalten korrelierte signifikant positiv mit der Selbstkonkordanz der Motivation (r = 0,19) sowie mit der Einstellung zur Bedeutsamkeit körperlicher Aktivität (r = 0,16). Hingegen bestand keine signifikante Korrelation zwischen dem eignen Aktivitätsniveau und dem Empfehlungsverhalten der Psychiater/ärztlichen Psychotherapeuten (r = 0,04).
Schlussfolgerung
Ein Großteil der Psychiater/ärztlichen Psychotherapeuten empfiehlt körperliche Aktivität. Positiv auf das Empfehlungsverhalten wirkten sich insbesondere die Einschätzung der körperlichen Aktivität als bedeutsam sowie eine hohe Selbstkonkordanz der eigenen Motivation, körperlich aktiv zu sein, aus. Interventionsprogramme, die das Empfehlungsverhalten von Psychiatern/ärztlichen Psychotherapeuten steigern wollen, sollten auf die Selbstkonkordanz der Motivation der Psychiater/ärztlichen Psychotherapeuten, körperlich aktiv zu sein, fokussieren und sich nicht nur auf die Bedeutsamkeit körperlicher Aktivität konzentrieren.
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Hickie IB, Scott EM, Cross SP, Iorfino F, Davenport TA, Guastella AJ, Naismith SL, Carpenter JS, Rohleder C, Crouse JJ, Hermens DF, Koethe D, Markus Leweke F, Tickell AM, Sawrikar V, Scott J. Right care, first time: a highly personalised and measurement-based care model to manage youth mental health. Med J Aust 2020; 211 Suppl 9:S3-S46. [PMID: 31679171 DOI: 10.5694/mja2.50383] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Mood and psychotic syndromes most often emerge during adolescence and young adulthood, a period characterised by major physical and social change. Consequently, the effects of adolescent-onset mood and psychotic syndromes can have long term consequences. A key clinical challenge for youth mental health is to develop and test new systems that align with current evidence for comorbid presentations and underlying neurobiology, and are useful for predicting outcomes and guiding decisions regarding the provision of appropriate and effective care. Our highly personalised and measurement-based care model includes three core concepts: ▶ A multidimensional assessment and outcomes framework that includes: social and occupational function; self-harm, suicidal thoughts and behaviour; alcohol or other substance misuse; physical health; and illness trajectory. ▶ Clinical stage. ▶ Three common illness subtypes (psychosis, anxious depression, bipolar spectrum) based on proposed pathophysiological mechanisms (neurodevelopmental, hyperarousal, circadian). The model explicitly aims to prevent progression to more complex and severe forms of illness and is better aligned to contemporary models of the patterns of emergence of psychopathology. Inherent within this highly personalised approach is the incorporation of other evidence-based processes, including real-time measurement-based care as well as utilisation of multidisciplinary teams of health professionals. Data-driven local system modelling and personalised health information technologies provide crucial infrastructure support to these processes for better access to, and higher quality, mental health care for young people. CHAPTER 1: MULTIDIMENSIONAL OUTCOMES IN YOUTH MENTAL HEALTH CARE: WHAT MATTERS AND WHY?: Mood and psychotic syndromes present one of the most serious public health challenges that we face in the 21st century. Factors including prevalence, age of onset, and chronicity contribute to substantial burden and secondary risks such as alcohol or other substance misuse. Mood and psychotic syndromes most often emerge during adolescence and young adulthood, a period characterised by major physical and social change; thus, effects can have long term consequences. We propose five key domains which make up a multidimensional outcomes framework that aims to address the specific needs of young people presenting to health services with emerging mental illness. These include social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness type, stage and trajectory. Impairment and concurrent morbidity are well established in young people by the time they present for mental health care. Despite this, services and health professionals tend to focus on only one aspect of the presentation - illness type, stage and trajectory - and are often at odds with the preferences of young people and their families. There is a need to address the disconnect between mental health, physical health and social services and interventions, to ensure that youth mental health care focuses on the outcomes that matter to young people. CHAPTER 2: COMBINING CLINICAL STAGE AND PATHOPHYSIOLOGICAL MECHANISMS TO UNDERSTAND ILLNESS TRAJECTORIES IN YOUNG PEOPLE WITH EMERGING MOOD AND PSYCHOTIC SYNDROMES: Traditional diagnostic classification systems for mental disorders map poorly onto the early stages of illness experienced by young people, and purport categorical distinctions that are not readily supported by research into genetic, environmental and neurobiological risk factors. Consequently, a key clinical challenge in youth mental health is to develop and test new classification systems that align with current evidence on comorbid presentations, are consistent with current understanding of underlying neurobiology, and provide utility for predicting outcomes and guiding decisions regarding the provision of appropriate and effective care. This chapter outlines a transdiagnostic framework for classifying common adolescent-onset mood and psychotic syndromes, combining two independent but complementary dimensions: clinical staging, and three proposed pathophysiological mechanisms. Clinical staging reflects the progression of mental disorders and is in line with the concept used in general medicine, where more advanced stages are associated with a poorer prognosis and a need for more intensive interventions with a higher risk-to-benefit ratio. The three proposed pathophysiological mechanisms are neurodevelopmental abnormalities, hyperarousal and circadian dysfunction, which, over time, have illness trajectories (or pathways) to psychosis, anxious depression and bipolar spectrum disorders, respectively. The transdiagnostic framework has been evaluated in young people presenting to youth mental health clinics of the University of Sydney's Brain and Mind Centre, alongside a range of clinical and objective measures. Our research to date provides support for this framework, and we are now exploring its application to the development of more personalised models of care. CHAPTER 3: A COMPREHENSIVE ASSESSMENT FRAMEWORK FOR YOUTH MENTAL HEALTH: GUIDING HIGHLY PERSONALISED AND MEASUREMENT-BASED CARE USING MULTIDIMENSIONAL AND OBJECTIVE MEASURES: There is an urgent need for improved care for young people with mental health problems, in particular those with subthreshold mental disorders that are not sufficiently severe to meet traditional diagnostic criteria. New comprehensive assessment frameworks are needed to capture the biopsychosocial profile of a young person to drive highly personalised and measurement-based mental health care. We present a range of multidimensional measures involving five key domains: social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness type, stage and trajectory. Objective measures include: neuropsychological function; sleep-wake behaviours and circadian rhythms; metabolic and immune markers; and brain structure and function. The recommended multidimensional measures facilitate the development of a comprehensive clinical picture. The objective measures help to further develop informative and novel insights into underlying pathophysiological mechanisms and illness trajectories to guide personalised care plans. A panel of specific multidimensional and objective measures are recommended as standard clinical practice, while others are recommended secondarily to provide deeper insights with the aim of revealing alternative clinical paths for targeted interventions and treatments matched to the clinical stage and proposed pathophysiological mechanisms of the young person. CHAPTER 4: PERSONALISING CARE OPTIONS IN YOUTH MENTAL HEALTH: USING MULTIDIMENSIONAL ASSESSMENT, CLINICAL STAGE, PATHOPHYSIOLOGICAL MECHANISMS, AND INDIVIDUAL ILLNESS TRAJECTORIES TO GUIDE TREATMENT SELECTION: New models of mental health care for young people require that interventions be matched to illness type, clinical stage, underlying pathophysiological mechanisms and individual illness trajectories. Narrow syndrome-focused classifications often direct clinical attention away from other key factors such as functional impairment, self-harm and suicidality, alcohol or other substance misuse, and poor physical health. By contrast, we outline a treatment selection guide for early intervention for adolescent-onset mood and psychotic syndromes (ie, active treatments and indicated and more specific secondary prevention strategies). This guide is based on experiences with the Brain and Mind Centre's highly personalised and measurement-based care model to manage youth mental health. The model incorporates three complementary core concepts: ▶A multidimensional assessment and outcomes framework including: social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness trajectory. ▶Clinical stage. ▶Three common illness subtypes (psychosis, anxious depression, bipolar spectrum) based on three underlying pathophysiological mechanisms (neurodevelopmental, hyperarousal, circadian). These core concepts are not mutually exclusive and together may facilitate improved outcomes through a clinical stage-appropriate and transdiagnostic framework that helps guide decisions regarding the provision of appropriate and effective care options. Given its emphasis on adolescent-onset mood and psychotic syndromes, the Brain and Mind Centre's model of care also respects a fundamental developmental perspective - categorising childhood problems (eg, anxiety and neurodevelopmental difficulties) as risk factors and respecting the fact that young people are in a period of major biological and social transition. Based on these factors, a range of social, psychological and pharmacological interventions are recommended, with an emphasis on balancing the personal benefit-to-cost ratio. CHAPTER 5: A SERVICE DELIVERY MODEL TO SUPPORT HIGHLY PERSONALISED AND MEASUREMENT-BASED CARE IN YOUTH MENTAL HEALTH: Over the past decade, we have seen a growing focus on creating mental health service delivery models that better meet the unique needs of young Australians. Recent policy directives from the Australian Government recommend the adoption of stepped-care services to improve the appropriateness of care, determined by severity of need. Here, we propose that a highly personalised approach enhances stepped-care models by incorporating clinical staging and a young person's current and multidimensional needs. It explicitly aims to prevent progression to more complex and severe forms of illness and is better aligned to contemporary models of the patterns of emergence of psychopathology. Inherent within a highly personalised approach is the incorporation of other evidence-based processes, including real-time measurement-based care and use of multidisciplinary teams of health professionals. Data-driven local system modelling and personalised health information technologies provide crucial infrastructure support to these processes for better access to, and higher quality of, mental health care for young people.
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Affiliation(s)
- Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Elizabeth M Scott
- Brain and Mind Centre, University of Sydney, Sydney, NSW.,University of Notre Dame Australia, Sydney, NSW
| | - Shane P Cross
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | | | | | | | | | | | - Jacob J Crouse
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Daniel F Hermens
- Brain and Mind Centre, University of Sydney, Sydney, NSW.,Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya, QLD
| | - Dagmar Koethe
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | | | | | - Vilas Sawrikar
- Brain and Mind Centre, University of Sydney, Sydney, NSW.,University of Edinburgh, Edinburgh, UK
| | - Jan Scott
- Brain and Mind Centre, University of Sydney, Sydney, NSW.,Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
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Editorial: What can be done to decrease early deaths in people with severe mental disorders? Curr Opin Psychiatry 2019; 32:373-374. [PMID: 31373928 DOI: 10.1097/yco.0000000000000537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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