1
|
Magliocca S, Romano D, Joiner TE, Madeddu F, Calati R, Zeppegno P, Gramaglia C. The Interpersonal Psychological Theory of Suicide in Italian University Students: Validation of the INQ-15 and the ACSS-FAD. Assessment 2024; 31:1070-1088. [PMID: 37876149 DOI: 10.1177/10731911231203971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
In the frame of the interpersonal psychological theory of suicide (IPTS), Interpersonal Needs Questionnaire (INQ-15) assesses thwarted belongingness (TB) and perceived burdensomeness (PB), related to suicidal ideation (SI); Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD) measures this component which contributes to lethal self-harm. The objective was to evaluate the psychometric properties of INQ-15 and ACSS-FAD in a population of Italian university students. Since the Italian INQ-15 was already validated, we translated ACSS-FAD through a multistage procedure and administered both to 1,665 Italian university students. Factor analysis confirmed a two-factor-related model of INQ-15, one factor of ACSS-FAD, and good reliability for both. We proved the association between INQ-15 and current SI and between ACSS-FAD and lifetime suicidal planning and/or suicide attempt. The convergent and discriminant validities were in line with those of previous studies. Both tools are valid and reliable to assess the constructs associated with suicide outcomes according to IPTS.
Collapse
Affiliation(s)
| | - Daniele Romano
- University of Milano-Bicocca, Italy
- University of Salento, Lecce, Italy
| | | | | | - Raffaella Calati
- University of Milano-Bicocca, Italy
- Nîmes University Hospital, France
| | - Patrizia Zeppegno
- Università del Piemonte Orientale, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Carla Gramaglia
- Università del Piemonte Orientale, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| |
Collapse
|
2
|
Fiorindi C, Giudici F, Testa GD, Foti L, Romanazzo S, Tognozzi C, Mansueto G, Scaringi S, Cuffaro F, Nannoni A, Soop M, Baldini G. Multimodal Prehabilitation for Patients with Crohn's Disease Scheduled for Major Surgery: A Narrative Review. Nutrients 2024; 16:1783. [PMID: 38892714 PMCID: PMC11174506 DOI: 10.3390/nu16111783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/25/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
Approximately 15-50% of patients with Crohn's disease (CD) will require surgery within ten years following the diagnosis. The management of modifiable risk factors before surgery is essential to reduce postoperative complications and to promote a better postoperative recovery. Preoperative malnutrition reduced functional capacity, sarcopenia, immunosuppressive medications, anemia, and psychological distress are frequently present in CD patients. Multimodal prehabilitation consists of nutritional, functional, medical, and psychological interventions implemented before surgery, aiming at optimizing preoperative status and improve postoperative recovery. Currently, studies evaluating the effect of multimodal prehabilitation on postoperative outcomes specifically in CD are lacking. Some studies have investigated the effect of a single prehabilitation intervention, of which nutritional optimization is the most investigated. The aim of this narrative review is to present the physiologic rationale supporting multimodal surgical prehabilitation in CD patients waiting for surgery, and to describe its main components to facilitate their adoption in the preoperative standard of care.
Collapse
Affiliation(s)
- Camilla Fiorindi
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
| | - Francesco Giudici
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 6, 50135 Florence, Italy; (F.G.); (S.S.)
| | - Giuseppe Dario Testa
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
- Division of Geriatric and Intensive Care Medicine, University of Florence, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy
| | - Lorenzo Foti
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
- Section of Anesthesiology and Intensive Care, University of Florence, Largo Brambilla 3, 50139 Florence, Italy
| | - Sara Romanazzo
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
| | - Cristina Tognozzi
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
| | - Giovanni Mansueto
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
| | - Stefano Scaringi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 6, 50135 Florence, Italy; (F.G.); (S.S.)
| | - Francesca Cuffaro
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
| | - Anita Nannoni
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
| | - Mattias Soop
- Department for IBD and Intestinal Failure Surgery, Karolinska University Hospital, SE 177 76 Stockholm, Sweden;
| | - Gabriele Baldini
- Department of Health Science, University of Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy; (S.R.); (C.T.); (G.M.); (F.C.); (A.N.); (G.B.)
- Multimodal Prehabilitation Center, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 6, 50135 Florence, Italy; (G.D.T.); (L.F.)
- Section of Anesthesiology and Intensive Care, University of Florence, Largo Brambilla 3, 50139 Florence, Italy
| |
Collapse
|
3
|
Pifarre J, Esquerda M, Torralba F, Bátiz J, Bofarull M. Persons with mental disorders and assisted dying practices in Spain: In response to Ramos et al. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 94:101980. [PMID: 38493732 DOI: 10.1016/j.ijlp.2024.101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
Ramos et al. paper offers a narrative review of Spanish Organic Law 3/2021, which regulates euthanasia, focusing on its application to individuals with mental disorders. Ramos et al. examine the application of legal prerequisites from an ethical-legal perspective to ascertain the conditions under which psychiatric euthanasia might be considered legitimate and compliant with legal stipulations. Nevertheless, it is apparent that the core ethical inquiries linked to this matter have not been exhaustively investigated. The criteria laid out are, in our assessment, still open to further debate and broader deliberation. Our article emphasizes the need for a comprehensive ethical and legal debate in Spain regarding psychiatric euthanasia. Competency assessment is central to the legislation, but there are concerns about the validity of assessment tools and the subjective nature of interviews. Furthermore, defining irreversible suffering in mental health contexts poses challenges. The article advocates for a deeper understanding of the needs of individuals with mental disorders before considering euthanasia and emphasizes the importance of comprehensive care and psychosocial interventions in reducing the desire for euthanasia. Ultimately, it underscores the ethical complexities of euthanasia in mental health and the necessity of prioritizing comprehensive care in addressing these complexities.
Collapse
Affiliation(s)
- Josep Pifarre
- Institut Borja de Bioética, Universitat Ramon Llull, Barcelona, Spain; San Juan de Dios Provincia de España, Madrid, Spain
| | - Montse Esquerda
- Institut Borja de Bioética, Universitat Ramon Llull, Barcelona, Spain; Hospital Sant Joan de Déu Terres de Lleida, Spain.
| | - Francesc Torralba
- Institut Borja de Bioética, Universitat Ramon Llull, Barcelona, Spain
| | - Jacinto Bátiz
- Institut Borja de Bioética, Universitat Ramon Llull, Barcelona, Spain; San Juan de Dios Provincia de España, Madrid, Spain
| | | |
Collapse
|
4
|
Pompili M. On mental pain and suicide risk in modern psychiatry. Ann Gen Psychiatry 2024; 23:6. [PMID: 38229110 PMCID: PMC10790486 DOI: 10.1186/s12991-024-00490-5] [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: 12/05/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024] Open
Abstract
Facing suicide risk is probably the most difficult task for clinicians when dealing with patients in crisis. It requires professional, intellectual, and emotional efforts. Suicide risk assessment can sometimes be distressing for clinicians, and such a state may favour the avoidance of an in-depth exploration of suicidal thoughts and behaviour. Patients often feel subjected to interpersonal assessments with little opportunity to explore their perspectives. The "One size fits all" approach tends to create distance and paradoxically contributes to an increase in the risk of suicide. Traditional clinical factors may be of limited value if a shared understanding of the patient's suicide risk is missed. To understand the suicidal mind, it is necessary to take the point of view of the subject in crisis. In this essay, the "operational model of mental pain as a main ingredient of suicide" provided by Edwin Shneidman' is overviewed with the aim of a better empathic understanding of patients' sufferance. With a phenomenological approach, the suicidal crisis appears as a complex, pervasive state rather than as a symptom of a mental disorder, as the new paradigm also suggests. In this regard, the "mentalistic" aspects of suicide propose a broader insight into the suicidal scenario far beyond the diagnosis of psychiatric disorders. In this article, the perspective of individuals who deem their mental pain to be intolerable is described to make sense of their ambivalence between the wish to die and the wish to live that can prevail if relief is provided.
Collapse
Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| |
Collapse
|
5
|
Rodolico A, Cutrufelli P, Brondino N, Caponnetto P, Catania G, Concerto C, Fusar-Poli L, Mineo L, Sturiale S, Signorelli MS, Petralia A. Mental Pain Correlates with Mind Wandering, Self-Reflection, and Insight in Individuals with Psychotic Disorders: A Cross-Sectional Study. Brain Sci 2023; 13:1557. [PMID: 38002517 PMCID: PMC10670292 DOI: 10.3390/brainsci13111557] [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: 10/03/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
Understanding the cognitive processes that contribute to mental pain in individuals with psychotic disorders is important for refining therapeutic strategies and improving patient outcomes. This study investigated the potential relationship between mental pain, mind wandering, and self-reflection and insight in individuals diagnosed with psychotic disorders. We included individuals diagnosed with a 'schizophrenia spectrum disorder' according to DSM-5 criteria. Patients in the study were between 18 and 65 years old, clinically stable, and able to provide informed consent. A total of 34 participants, comprising 25 males and 9 females with an average age of 41.5 years (SD 11.5) were evaluated. The Psychache Scale (PAS), the Mind Wandering Deliberate and Spontaneous Scale (MWDS), and the Self-Reflection and Insight Scale (SRIS) were administered. Statistical analyses involved Spearman's rho correlations, controlled for potential confounders with partial correlations, and mediation and moderation analyses to understand the indirect effects of MWDS and SRIS on PAS and their potential interplay. Key findings revealed direct correlations between PAS and MWDS and inverse correlations between PAS and SRIS. The mediation effects on the relationship between the predictors and PAS ranged from 9.22% to 49.8%. The largest statistically significant mediation effect was observed with the SRIS-I subscale, suggesting that the self-reflection and insight component may play a role in the impact of mind wandering on mental pain. No evidence was found to suggest that any of the variables could function as relationship moderators for PAS. The results underscore the likely benefits of interventions aimed at reducing mind wandering and enhancing self-reflection in psychotic patients (e.g., metacognitive therapy, mindfulness). Further research will be essential to elucidate the underlying mechanisms.
Collapse
Affiliation(s)
- Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| | - Pierfelice Cutrufelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy;
| | - Pasquale Caponnetto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
- Department of Educational Sciences, Section of Psychology, University of Catania, Via Teatro Greco 84, 95124 Catania, Italy
| | | | - Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| | - Laura Fusar-Poli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
- Department of Brain and Behavioral Sciences, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy;
| | - Ludovico Mineo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| | - Serena Sturiale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| | - Antonino Petralia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (A.R.); (P.C.); (P.C.); (L.F.-P.); (L.M.); (M.S.S.); (A.P.)
| |
Collapse
|
6
|
Sharif A, Amjad F, Arslan SA, Ahmad A. Translation and validation of urdu version short form-mcgill pain questionnaire-2. BMC Sports Sci Med Rehabil 2023; 15:102. [PMID: 37580806 PMCID: PMC10424347 DOI: 10.1186/s13102-023-00715-2] [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: 06/20/2022] [Accepted: 08/04/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Low back pain is one of the most common complaints affecting many individuals. The McGill Pain Questionnaire is used in various clinical settings to assess different types of pain and one of the most extensively used outcomes measures for pain in the world. The purpose of this study was to translate and validate the original English version of the SF-MPQ-2 into Urdu (SF-MPQ-2-U). METHODS For this study, Mapi Research Trust protocols were followed for the forward and backward translation. Test-retest reliability was used to assess the reliability. Cronbach's alpha and Omega was used to determine internal consistency. Pearson's correlation was used to evaluate convergent validity. Confirmatory factor analysis was also conducted. RESULTS The Cronbach's alpha for SF-MPQ-2-U was 0.73 to 0.79, indicating acceptable internal consistency. Omega score for the SF-MPQ-U were 0.918. The ICC varied from 0.799 to 0.878 for domains of SF-MPQ-2-U. The CFA of the SF-MPQ-2-U met model fit indices with GFI and NFI > 0.90. The inter-scale correlation between baseline and re-test data was from 0.63 to 0.71, indicating a positive and strong correlation. The SF-MPQ-2-U and ODI-U had a baseline correlation of 0.547. The correlation of SF-MPQ-2-U & VAS at baseline data was 0.558. Pearson's correlation between subscales was r = 0.253 with p 0.01, which was statistically significant. CONCLUSION The SF-MPQ-2-U is considered to have good convergent validity at inter scale and between two scale levels. Reliability was checked by test-retest reliability, Internal consistency was checked using Cronbach's alpha and Omega that showed good internal consistency for measuring different types of pain in patients with low back pain who speak Urdu. To make the questionnaire more valid and reliable, it is recommended for the researchers to do in-depth research on larger sample size.
Collapse
Affiliation(s)
- Amna Sharif
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | | | | | - Ashfaq Ahmad
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| |
Collapse
|
7
|
Chen S, Cheng Y, Zhao W, Zhang Y. Psychological pain in depressive disorder: A concept analysis. J Clin Nurs 2023; 32:4128-4143. [PMID: 36128944 DOI: 10.1111/jocn.16543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVES The purpose of this paper is to identify a precise definition of the concept of psychological pain in the field of depressive disorder. BACKGROUND Psychological pain is widespread in patients with depressive disorder and plays a central role in the suicide process. However, psychological pain is currently complex and broadly defined and does not reflect the unique nature of psychological pain in depressed patients. DESIGN A concept analysis. METHODS Rodgers' evolutionary approach was used to analyse the concept of psychological pain in depressive disorders. PubMed, CINAHL, Embase, PsycINFO, Sinomed, CNKI, and Wanfang were searched and 49 articles met the inclusion criteria. RESULTS The key attributes of psychological pain were identified as negative affective perception, passive cognition and ineffective response, extreme behavioural tendency, and both state and trait characteristics. Antecedents included stressful life events, frustrated psychological needs, disease factors, physical factors, and negative cognitive biases. Consequences were the promotion of personal growth, enhanced meaning in life, low quality of life, barriers to treatment, high rates of psychiatric morbidity, self-harm, and suicide. CONCLUSION Psychological pain is a subjectively widespread, intense, and complex affective experience centered on feelings of suffering resulting from negative self-perceptions and ineffective coping based on personality traits. In addition, psychological pain has two traits: an immediate affective reflection arising from experiencing stressful life events and a persistent and stable emotional trait, respectively. RELEVANCE TO CLINICAL PRACTICE This study provides a conceptual framework to help clinical staff expand their knowledge of psychological pain and distinguish it from related terms. Interventions should address both the antecedents and the consequences and so this study suggests that future interventions could be developed in terms of positive emotions. NO PATIENT OR PUBLIC CONTRIBUTION This study did not recruit participants, therefore details of participants will not be involved.
Collapse
Affiliation(s)
- Shuyan Chen
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yin Cheng
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Weiwei Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yanhong Zhang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| |
Collapse
|
8
|
Woźniewicz A, Cosci F. Clinical utility of demoralization: A systematic review of the literature. Clin Psychol Rev 2023; 99:102227. [PMID: 36462221 DOI: 10.1016/j.cpr.2022.102227] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/28/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
Demoralization is a complex clinical phenomenon which has raised a growing interest in clinical and research realms. The present systematic review of the literature aimed at (1) updating on demoralization prevalence in different populations, (2) identifying the instruments more largely used to assess demoralization, and (3) verifying whether new tools of assessment have been proposed. PubMed and Web of Science were searched from inception to April 2022. Search terms were: demoralization/demoralized/demoralizing/demoralised/demoralising. PRISMA guidelines were followed. GRADE rating system was used. A total of 188 papers were included. Demoralization appeared to be a distinctive psychological state common in medical, psychiatric, and non-clinical settings, thus not limited to life-threatening diseases. Diagnostic Criteria for Psychosomatic Research (DCPR) and Demoralization Scale (DS) are the most commonly used tools to assess it. DCPR allow to diagnose demoralization as a manifestation of dealing with chronic stress. DS captures dimensionally a psychological distress related to end of life. Demoralization is associated with clinical features encompassing allostatic overload, quality of life, wellbeing/euthymia. Implications on health outcomes and treatment are discussed. Demoralization warrants careful consideration in clinical contexts through valid assessment procedures. DCPR are recommended to diagnose it, DS can be helpful to capture clinical details.
Collapse
Affiliation(s)
- Agnieszka Woźniewicz
- Department of Geriatrics, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Jurija Gagarina 11, 87-100 Toruń, Poland
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, via di San salvi n. 12, Florence, Italy; Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616 6200, MD, Maastricht, The Netherlands.
| |
Collapse
|
9
|
Buckman JEJ, Cohen ZD, O'Driscoll C, Fried EI, Saunders R, Ambler G, DeRubeis RJ, Gilbody S, Hollon SD, Kendrick T, Watkins E, Eley T, Peel AJ, Rayner C, Kessler D, Wiles N, Lewis G, Pilling S. Predicting prognosis for adults with depression using individual symptom data: a comparison of modelling approaches. Psychol Med 2023; 53:408-418. [PMID: 33952358 PMCID: PMC9899563 DOI: 10.1017/s0033291721001616] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND This study aimed to develop, validate and compare the performance of models predicting post-treatment outcomes for depressed adults based on pre-treatment data. METHODS Individual patient data from all six eligible randomised controlled trials were used to develop (k = 3, n = 1722) and test (k = 3, n = 918) nine models. Predictors included depressive and anxiety symptoms, social support, life events and alcohol use. Weighted sum scores were developed using coefficient weights derived from network centrality statistics (models 1-3) and factor loadings from a confirmatory factor analysis (model 4). Unweighted sum score models were tested using elastic net regularised (ENR) and ordinary least squares (OLS) regression (models 5 and 6). Individual items were then included in ENR and OLS (models 7 and 8). All models were compared to one another and to a null model (mean post-baseline Beck Depression Inventory Second Edition (BDI-II) score in the training data: model 9). Primary outcome: BDI-II scores at 3-4 months. RESULTS Models 1-7 all outperformed the null model and model 8. Model performance was very similar across models 1-6, meaning that differential weights applied to the baseline sum scores had little impact. CONCLUSIONS Any of the modelling techniques (models 1-7) could be used to inform prognostic predictions for depressed adults with differences in the proportions of patients reaching remission based on the predicted severity of depressive symptoms post-treatment. However, the majority of variance in prognosis remained unexplained. It may be necessary to include a broader range of biopsychosocial variables to better adjudicate between competing models, and to derive models with greater clinical utility for treatment-seeking adults with depression.
Collapse
Affiliation(s)
- J. E. J. Buckman
- Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
- iCope – Camden & Islington Psychological Therapies Services – Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Z. D. Cohen
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - C. O'Driscoll
- Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
| | - E. I. Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - R. Saunders
- Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
| | - G. Ambler
- Statistical Science, University College London, 1-19 Torrington Place, London, UK
| | - R. J. DeRubeis
- Department of Psychology, School of Arts and Sciences, 425 S. University Avenue, Philadelphia PA, USA
| | - S. Gilbody
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, UK
| | - S. D. Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - T. Kendrick
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton, UK
| | - E. Watkins
- Department of Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Perry Road, Exeter, UK
| | - T.C. Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - A. J. Peel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - C. Rayner
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - D. Kessler
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK
| | - N. Wiles
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
| | - G. Lewis
- Division of Psychiatry, University College London, Maple House, London, UK
| | - S. Pilling
- Research Department of Clinical, Educational & Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, UK
- Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| |
Collapse
|
10
|
Liu Y, Zhao W, Lu Y, Zhao Y, Zhang Y, Dai M, Hai S, Ge N, Zhang S, Huang M, Liu X, Li S, Yue J, Lei P, Dong B, Dai L, Dong B. Systematic metabolic characterization of mental disorders reveals age‐related metabolic disturbances as potential risk factors for depression in older adults. MedComm (Beijing) 2022; 3:e165. [PMID: 36204590 PMCID: PMC9523679 DOI: 10.1002/mco2.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Mental disorders are associated with dysregulated metabolism, but comprehensive investigations of their metabolic similarities and differences and their clinical relevance are few. Here, based on the plasma metabolome and lipidome of subcohort1, comprising 100 healthy participants, 55 cases with anxiety, 52 persons with depression, and 41 individuals with comorbidity, which are from WCHAT, a perspective cohort study of community‐dwelling older adults aged over 50, multiple metabolites as potential risk factors of mental disorders were identified. Furthermore, participants with mental illnesses were classified into three subtypes (S1, S2, and S3) by unsupervised classification with lipidomic data. Among them, S1 showed higher triacylglycerol and lower sphingomyelin, while S2 displayed opposite features. The metabolic profile of S3 was like that of the normal group. Compared with S3, individuals in S1 and S2 had worse quality of life, and suffered more from sleep and cognitive disorders. Notably, an assessment of 6,467 individuals from the WCHAT showed an age‐related increase in the incidence of depression. Seventeen depression‐related metabolites were significantly correlated with age, which were validated in an independent subcohort2. Collectively, this work highlights the clinical relevance of metabolic perturbation in mental disorders, and age‐related metabolic disturbances may be a bridge‐linking aging and depressive.
Collapse
Affiliation(s)
- Yu Liu
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Wanyu Zhao
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Ying Lu
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Yunli Zhao
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada
| | - Yan Zhang
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Miao Dai
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Shan Hai
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Ning Ge
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Shuting Zhang
- Department of Neurology, West China Hospital Sichuan University Chengdu China
| | - Mingjin Huang
- The Third Hospital of Mianyang Sichuan Mental Health Center Mianyang China
| | - Xiaohui Liu
- School of Life Sciences Tsinghua University Beijing China
| | - Shuangqing Li
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Peng Lei
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Biao Dong
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Lunzhi Dai
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| | - Birong Dong
- National Clinical Research Center for Geriatrics and Department of General Practice State Key Laboratory of Biotherapy West China Hospital Sichuan University Chengdu China
| |
Collapse
|
11
|
Charvet C, Boutron I, Morvan Y, Le Berre C, Touboul S, Gaillard R, Fried E, Chevance A. How to measure mental pain: a systematic review assessing measures of mental pain. EVIDENCE-BASED MENTAL HEALTH 2022; 25:e4. [PMID: 35902215 PMCID: PMC10231614 DOI: 10.1136/ebmental-2021-300350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 06/21/2022] [Indexed: 11/04/2022]
Abstract
QUESTION Although mental pain is present in many mental disorders and is a predictor of suicide, it is rarely investigated in research or treated in care. A valid tool to measure it is a necessary first step towards better understanding, predicting and ultimately relieving this pain. STUDY SELECTION AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a systematic review to identify all published standardised measures of mental pain. We used qualitative content analysis to evaluate the similarity of each measure, quantified via Jaccard Index scores ranging from no similarity (0) to full similarity (1). Finally, using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology, we evaluated each measure's development (assessing 35 features), its content validity (31 features) and if the latter was rated at least adequate, its other psychometric properties. FINDINGS We identified 10 self-reported scales of mental pain in 2658 screened studies relying on diverse definitions of this construct. The highest average similarity coefficient for any given measure was 0.24, indicative of weak similarity (individual pairwise coefficients from 0 to 0.5). Little to no information was provided regarding the development and the content validity of all 10 scales. Therefore, their development and content validity were rated 'inadequate' or 'doubtful'. CONCLUSIONS AND CLINICAL IMPLICATIONS There is not enough evidence of validity to recommend using one measure over others in research or clinical practice. Heterogeneous use of disparate measures across studies limits comparison and combination of their results in meta-analyses. Development by all stakeholders (especially patients) of a consensual patient-reported measure for mental pain is needed. PROSPERO REGISTRATION NUMBER CRD42021242679.
Collapse
Affiliation(s)
- Camille Charvet
- Medical School, Sorbonne Université, FR-75006, Paris, France
| | - Isabelle Boutron
- CRESS U1153, Université Paris-Cité, Inserm, FR-75006, Paris, France
- Service d'épidémologie clinique, APHP, GHU Cochin-Hôtel Dieu, FR-75005, Paris, France
| | - Yannick Morvan
- CESP, Inserm, Maison de Solenn, FR-75005, Paris, France
- Laboratoire CLIPSYD, EA4430, Université Paris-Nanterre, FR-92000, Nanterre, France
| | - Catherine Le Berre
- CRESS U1153, Université Paris-Cité, Inserm, FR-75006, Paris, France
- Service d'épidémologie clinique, APHP, GHU Cochin-Hôtel Dieu, FR-75005, Paris, France
| | | | - Raphaël Gaillard
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatry &Neurosciences, FR-75014, Paris, France
| | - Eiko Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Astrid Chevance
- CRESS U1153, Université Paris-Cité, Inserm, FR-75006, Paris, France
- Service d'épidémologie clinique, APHP, GHU Cochin-Hôtel Dieu, FR-75005, Paris, France
| |
Collapse
|
12
|
Abstract
BACKGROUND Mental pain has been proposed as a global person-centered outcome measure. The aim of this cross-sectional study was to test an essential requisite of such a measure, namely that mental pain incorporates independent contributions from a range of discrete but disparate outcome measures. METHODS Two hundred migraine patients were assessed concerning migraine disability, psychosomatic syndromes, mental pain, depression, anxiety, and psychosocial dimensions. General linear models were tested to verify which measures would individually make unique contributions to overall mental pain. RESULTS The final model, accounting for 44% of variance, identified that higher mental pain was associated with more severe depressive symptoms, higher migraine disability, lower well-being, and poorer quality of life. CONCLUSION In this sample, mental pain was shown to behave as expected of a global outcome measure, since multiple measures of symptomatology and quality of life showed modest but significant bivariate correlations with mental pain and some of these measures individually made unique contributions to overall mental pain.
Collapse
|
13
|
Pompili M, Innamorati M, Erbuto D, Luciano M, Sampogna G, Abbate-Daga G, Barlati S, Carmassi C, Castellini G, De Fazio P, Di Lorenzo G, Di Nicola M, Ferrari S, Goracci A, Gramaglia C, Martinotti G, Nanni MG, Pasquini M, Pinna F, Poloni N, Serafini G, Signorelli M, Tortorella A, Ventriglio A, Volpe U, Fiorillo A. High depression symptomatology and mental pain characterize suicidal psychiatric patients. Eur Psychiatry 2022; 65:e54. [PMID: 36041998 PMCID: PMC9491079 DOI: 10.1192/j.eurpsy.2022.2312] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered. METHODS 2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk. RESULTS More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments. CONCLUSIONS Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.
Collapse
Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Carmassi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Arianna Goracci
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.,Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Nicola Poloni
- Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | | | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| |
Collapse
|
14
|
Wagner J, Bermúdez-Millán A, Berthold SM, Buckley T, Buxton OM, Feinn R, Kong S, Kuoch T, Master L, Scully M, Seng K. Psychological distress and health behaviours among Cambodian Americans at risk for developing diabetes. Stress Health 2022; 39:372-383. [PMID: 35986929 DOI: 10.1002/smi.3189] [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: 11/26/2021] [Revised: 06/25/2022] [Accepted: 08/10/2022] [Indexed: 11/07/2022]
Abstract
This paper reports secondary data analysis of associations between psychological distress and health behaviours among Cambodian Americans. Data are from baseline assessments from a diabetes prevention trial. All participants met stucriteria for depression and were free of diabetes. Participants (n = 191) completed surveys, a food frequency assessment, and wore sleep and physical activity actigraphy devices for 7 days. A factor analysis of symptoms of post-traumatic stress, baksbat (a Cambodian culture-bound syndrome), depression, and anxiety yielded a single factor named 'psychological distress'. Multivariate models controlling for psychotropic medications were run for the following outcomes: sleep actigraphy, self-reported sleep, physical activity actigraphy, self-reported physical activity, nutrition, and substance use. For actigraphy, higher distress was associated with lower moderate/vigorous physical activity and higher mean variability of 24 h total sleep time. Higher distress was also associated with worse self-reported sleep quality as indicated by standard, and culturally-specific, sleep indicators. Higher distress was also associated with lower use of food labels, lower carbohydrate consumption, and higher alcohol consumption as a coping mechanism. Interventions to mitigate diabetes risk in high-distress populations may benefit from strategies to decrease psychological distress. The sequelae of complex trauma may transcend discrete psychiatric diagnoses.
Collapse
Affiliation(s)
- Julie Wagner
- UConn Schools of Medicine and Dental Medicine, Farmington, Connecticut, USA
| | | | | | | | - Orfeu M Buxton
- Pennsylvania State University, University Park, Pennsylvania, USA
| | | | - Sengly Kong
- Khmer Health Advocates, West Hartford, Connecticut, USA
| | - Theanvy Kuoch
- Khmer Health Advocates, West Hartford, Connecticut, USA
| | - Lindsay Master
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - Mary Scully
- Khmer Health Advocates, West Hartford, Connecticut, USA
| | - Kagnica Seng
- Central Connecticut State University, New Britain, Connecticut, USA
| |
Collapse
|
15
|
Baryshnikov I, Isometsä E. Psychological pain and suicidal behavior: A review. Front Psychiatry 2022; 13:981353. [PMID: 36203837 PMCID: PMC9531162 DOI: 10.3389/fpsyt.2022.981353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022] Open
Abstract
Despite accumulation of clinical research on risk factors for suicidal process, understanding of the mechanisms and pathways underlying the emergence of suicidal thoughts and their progression to acts is insufficient. The suicidal process has been conceptualized in multiple psychological theories that have aimed to shed light on the interplay of contributing factors. One of the central concepts included in both the cubic model of suicide and the three-step theory of suicide is psychological pain (mental pain or psychache). Over the two last decades, interest in psychological pain has increased considerably, particularly since the discovery of the complex link between the pain processing system and the neurobiology of suicide, and the putative antisuicidal effect of buprenorphine. Growing evidence supports the association between experiencing psychological pain and suicidal ideation and acts in both clinical and non-clinical samples. However, many questions related to the concept of psychological pain and its role in prediction of suicidal behavior remain to be answered in future research. In this narrative review, we have outlined the history of the concept, the definition of psychological pain, and the tools developed for its measurement, summarized the empirical research on psychological pain in relation to suicidal behavior, and suggested future directions for clinical research on psychological pain and suicidal behavior.
Collapse
Affiliation(s)
- Ilya Baryshnikov
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| |
Collapse
|
16
|
Romanazzo S, Mansueto G, Cosci F. Anxiety in the Medically Ill: A Systematic Review of the Literature. Front Psychiatry 2022; 13:873126. [PMID: 35722552 PMCID: PMC9203680 DOI: 10.3389/fpsyt.2022.873126] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although anxiety is highly represented in the medically ill and its occurrence has relevant clinical implications, it often remains undetected and not properly treated. This systematic review aimed to report on anxiety, either symptom or disorder, in patients who suffer from a medical illness. METHODS English-language papers reporting on anxiety in medically ill adults were evaluated. PubMed, PsycINFO, Web of Science, and Cochrane databases were systematically searched from inception to June 2021. Search term was "anxiety" combined using the Boolean "AND" operator with "medically ill/chronic illness/illness/disorder/disease." Risk of bias was assessed via the Joanna Briggs Institute (JBI) Critical Appraisal Tools-Checklist for Prevalence Studies. The PRISMA guidelines were followed. RESULTS Of 100,848 citations reviewed, 329 studies met inclusion criteria. Moderate or severe anxious symptoms were common among patients with cardiovascular, respiratory, central nervous system, gastrointestinal, genitourinary, endocrine, musculoskeletal system or connective tissue, dermatological diseases, cancer, AIDS and COVID-19 infections. The most common anxiety disorder was generalized anxiety disorder, observed among patients with cardiovascular, respiratory, central nervous system, dermatologic diseases, cancer, primary aldosteronism, amenorrhea, and COVID-19 infection. Panic disorder was described for cardiovascular, respiratory, dermatology diseases. Social anxiety was found for cardiovascular, respiratory, rheumatoid diseases. Specific phobias were relatively common in irritable bowel syndrome, gastroesophageal reflux, end-stage renal disease. CONCLUSION Anxiety is a major challenge in medical settings. Recognition and proper assessment of anxiety in patients who suffer from a medical illness is necessary for an appropriate management. Future reviews are warranted in order also to clarify the causal and temporal relationship between anxiety and organic illness.
Collapse
Affiliation(s)
- Sara Romanazzo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
17
|
Psychiatric patients are more vulnerable to the Spanish euthanasia law? REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:231-233. [PMID: 34810134 DOI: 10.1016/j.rpsmen.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 11/20/2022]
|
18
|
Gewirtz-Meydan A, Lassri D. #Me2PT: A qualitative analysis of a social media network campaign to raise awareness of the consequences of childhood sexual abuse. CHILD ABUSE & NEGLECT 2021; 121:105267. [PMID: 34418862 DOI: 10.1016/j.chiabu.2021.105267] [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] [Received: 02/10/2021] [Revised: 07/29/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is a highly prevalent and serious stressor, linked to short- and long-term psychopathology and to posttraumatic stress disorder (PTSD) specifically. The hashtag #Me2PT, which stands for "me-too-post-trauma," was created in order to raise awareness of the longitudinal consequences of sexual abuse, as specifically manifested in symptoms of PTSD or complex PTSD. It was disseminated on social media networks during 2019 and offered a platform for CSA survivors to share their own personal experience of living with CSA-related posttraumatic symptoms. OBJECTIVE The current study was designed in order to examine the way survivors conveyed their experiences and perceptions with response to the invitation of the hashtag #Me2PT. All the posts were written in the Hebrew-language, and thematic analysis was carried on all the written narratives. PARTICIPANTS AND SETTING 40 Posts that were written in the Hebrew language under the hashtag campaign of #Me2PT. METHODS Thematic analysis was carried on the 40 posts by two of the authors. Shenton four criterions for qualitative study trustworthiness were employed with peer discussion on main results were discussed with the leaders of the campaign, survivors of CSA. RESULTS The authors identified four main themes within the written narratives of the survivors: (1) why am I writing, (2) my personal PTSD, (3) between life and death, and (4) post-trauma as 'a bleeding wound'. CONCLUSIONS These findings exemplify the constant mental pain and struggle that survivors deal with, but at the same time demonstrate the importance of hope, the comfort found in being understood, and the wish to live a meaningful life despite the pain. This paper may contribute to the understanding of survivors' experiences of living with CSA-related posttraumatic symptoms, as conveyed by them spontaneously and authentically, potentially informing best practice for professionals working with this population.
Collapse
Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel.
| |
Collapse
|
19
|
Carrozzino D, Patierno C, Guidi J, Berrocal Montiel C, Cao J, Charlson ME, Christensen KS, Concato J, De Las Cuevas C, de Leon J, Eöry A, Fleck MP, Furukawa TA, Horwitz RI, Nierenberg AA, Rafanelli C, Wang H, Wise TN, Sonino N, Fava GA. Clinimetric Criteria for Patient-Reported Outcome Measures. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:222-232. [PMID: 34038901 DOI: 10.1159/000516599] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
Patient-reported outcome measures (PROMs) are self-rated scales and indices developed to improve the detection of the patients' subjective experience. Given that a considerable number of PROMs are available, it is important to evaluate their validity and usefulness in a specific research or clinical setting. Published guidelines, based on psychometric criteria, do not fit in with the complexity of clinical challenges, because of their quest for homogeneity of components and inadequate attention to sensitivity. Psychometric theory has stifled the field and led to the routine use of scales widely accepted yet with a history of poor performance. Clinimetrics, the science of clinical measurements, may provide a more suitable conceptual and methodological framework. The aims of this paper are to outline the major limitations of the psychometric model and to provide criteria for clinimetric patient-reported outcome measures (CLIPROMs). The characteristics related to reliability, sensitivity, validity, and clinical utility of instruments are critically reviewed, with particular reference to the differences between clinimetric and psychometric approaches. Of note is the fact that PROMs, rating scales, and indices developed according to psychometric criteria may display relevant clinimetric properties. The present paper underpins the importance of the clini-metric methodology in choosing the appropriate PROMs. CLIPROM criteria may also guide the development of new indices and the validation of existing PROMs to be employed in clinical settings.
Collapse
Affiliation(s)
- Danilo Carrozzino
- Department of Psychology Renzo Canestrari, University of Bologna, Bologna, Italy
| | - Chiara Patierno
- Department of Psychology Renzo Canestrari, University of Bologna, Bologna, Italy
| | - Jenny Guidi
- Department of Psychology Renzo Canestrari, University of Bologna, Bologna, Italy
| | - Carmen Berrocal Montiel
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Jianxin Cao
- Changzhou First People's Hospital and Psychosomatic Gastroenterology Institute, Soochow University, Changzhou, China
| | - Mary E Charlson
- Division of Clinical Epidemiology and Evaluative Sciences Research, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Kaj Sparle Christensen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - John Concato
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.,Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, Canary Islands, Spain
| | - Jose de Leon
- University of Kentucky Mental Health Research Center at Eastern State Hospital, Lexington, Kentucky, USA
| | - Ajandek Eöry
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Marcelo Pio Fleck
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ralph I Horwitz
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Chiara Rafanelli
- Department of Psychology Renzo Canestrari, University of Bologna, Bologna, Italy
| | - Hongxing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Thomas N Wise
- Department of Psychiatry, Inova Health Systems, Falls Church, Virginia, USA.,Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| |
Collapse
|
20
|
Brailovskaia J, Teismann T, Friedrich S, Schneider S, Margraf J. Suicide ideation during the COVID-19 outbreak in German university students: Comparison with pre-COVID 19 rates. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100228. [PMID: 34632441 PMCID: PMC8488981 DOI: 10.1016/j.jadr.2021.100228] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/19/2021] [Accepted: 09/07/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction An increase of suicidal thinking within the COVID-19 pandemic has been postulated. Yet, direct comparisons with pre-COVID-19 rates are missing. Methods The present study investigated whether levels and rates of suicidal ideation have changed between 2016 and 2020. Data of N = 664 university students (five cohorts: 2016: n = 105, 2017: n = 117, 2018: n = 108, 2019: n = 154, 2020: n = 180) were collected by online surveys. Results The rate of students suffering from suicidal ideation was twice as high in 2020 than in previous years. Furthermore, levels of suicidal thinking and of depression were higher in 2020 than in 2019 and 2016. Limitations The sample size of the current study was rather modest and suicide ideation was assessed with a single item only. Conclusions The rate of students suffering from suicidal ideation was twice as high in 2020 than in previous years. Help-lines and online counselling should be promoted to the public and the possibilities of telepsychotherapy for suicidal people should be used and expanded.
Collapse
Affiliation(s)
- Julia Brailovskaia
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - Sören Friedrich
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Department of Clinical Child and Adolescent Psychology, Ruhr-Universität Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| |
Collapse
|
21
|
Abstract
BACKGROUND Pain has been qualified under four categories: nociception, perception of pain, suffering, and pain behaviors. Most of the literature on migraine has devoted attention to the first two. The aim of the present cohort study was to investigate patients with migraine enrolled at a tertiary care unit to study suffering and mental pain and identify potential risk factors for migraine. METHODS An observational cross-sectional study was carried out on patients with chronic migraine (CM) and episodic migraine (EM), and healthy subjects (HS). The three groups were matched for age and sex. A comprehensive assessment of migraine disability, pain, psychiatric disorders, psychosomatic syndromes, depressive and anxious symptoms, euthymia, psychosocial variables, mental pain, and pain-proneness (PP) was performed. RESULTS Three hundred subjects were enrolled (100 CM, 100 EM, and 100 HS). Based on the multiple regression analyses, those presenting PP (social impairment: odds ratio [OR] = 3.59, 95% confidence interval [CI] = 1.14-11.29; depressive symptoms: OR = 3.82, 95% CI = 1.74-8.41) were more likely to be CM than HS. Those with higher levels of PP (social impairment: OR = 4.04, 95% CI = 1.60-10.22; depressive symptoms: OR = 2.02, 95% CI = 1.26-3.24) were more likely to be EM than HS. Those presenting higher levels of mental pain were more likely to be CM than EM (OR = 1.45, 95% CI = 1.02-2.07). CONCLUSION Migraine is an unpleasant sensory and emotional experience associated with psychosocial manifestations that might contribute to the level of suffering of the individuals. Mental pain resulted to be the variable that most differentiated patients with CM from EM.
Collapse
|
22
|
Cosci F. Clinimetric Perspectives in Clinical Psychology and Psychiatry. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:217-221. [PMID: 34052804 DOI: 10.1159/000517028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Lab, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
23
|
Mental Pain in Eating Disorders: An Exploratory Controlled Study. J Clin Med 2021; 10:jcm10163584. [PMID: 34441880 PMCID: PMC8397208 DOI: 10.3390/jcm10163584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Mental pain (MP) is a transdiagnostic feature characterized by depression, suicidal ideation, emotion dysregulation, and associated with worse levels of distress. The study explores the presence and the discriminating role of MP in EDs in detecting patients with higher depressive and ED-related symptoms. Seventy-one ED patients and 90 matched controls completed a Clinical Assessment Scale for MP (CASMP) and the Mental Pain Questionnaire (MPQ). ED patients also completed the Beck Depression Inventory-II (BDI-II), Clinical Interview for Depression (CID-20), and Eating Attitudes Test (EAT-40). ED patients exhibited significantly greater severity and higher number of cases of MP than controls. Moreover, MP resulted the most important cluster predictor followed by BDI-II, CID-20, and EAT-40 in discriminating between patients with different ED and depression severity in a two-step cluster analysis encompassing 87.3% (n = 62) of the total ED sample. Significant positive associations have been found between MP and bulimic symptoms, cognitive and somatic-affective depressive symptoms, suicidal tendencies, and anxiety-related symptoms. In particular, those presenting MP reported significantly higher levels of depressive and anxiety-related symptoms than those without. MP represents a clinical aspect that can help to detect more severe cases of EDs and to better understand the complex interplay between ED and mood symptomatology.
Collapse
|
24
|
Sensky T. Mental Pain and Suffering: The "Universal Currencies" of the Illness Experience? PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:337-344. [PMID: 32781446 DOI: 10.1159/000509587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Tom Sensky
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom,
| |
Collapse
|
25
|
Alacreu-Crespo A, Cazals A, Courtet P, Olié E. Brief Assessment of Psychological Pain to Predict Suicidal Events at One Year in Depressed Patients. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:320-323. [PMID: 32268339 DOI: 10.1159/000506957] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/28/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Adrián Alacreu-Crespo
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France, .,PSNREC INSERM U1061, Université de Montpellier, INSERM, CHU de Montpellier, Montpellier, France, .,FondaMental Foundation, Créteil, France,
| | - Aurélie Cazals
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,PSNREC INSERM U1061, Université de Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,PSNREC INSERM U1061, Université de Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,PSNREC INSERM U1061, Université de Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| |
Collapse
|
26
|
Cosci F, Chouinard G. Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:283-306. [PMID: 32259826 DOI: 10.1159/000506868] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 02/27/2020] [Indexed: 11/19/2022]
Abstract
Studies on psychotropic medications decrease, discontinuation, or switch have uncovered withdrawal syndromes. The present overview aimed at analyzing the literature to illustrate withdrawal after decrease, discontinuation, or switch of psychotropic medications based on the drug class (i.e., benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonists, antidepressants, ketamine, antipsychotics, lithium, mood stabilizers) according to the diagnostic criteria of Chouinard and Chouinard [Psychother Psychosom. 2015;84(2):63-71], which encompass new withdrawal symptoms, rebound symptoms, and persistent post-withdrawal disorders. All these drugs may induce withdrawal syndromes and rebound upon discontinuation, even with slow tapering. However, only selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, and antipsychotics were consistently also associated with persistent post-withdrawal disorders and potential high severity of symptoms, including alterations of clinical course, whereas the distress associated with benzodiazepines discontinuation appears to be short-lived. As a result, the common belief that benzodiazepines should be substituted by medications that cause less dependence such as antidepressants and antipsychotics runs counter the available literature. Ketamine, and probably its derivatives, may be classified as at high risk for dependence and addiction. Because of the lag phase that has taken place between the introduction of a drug into the market and the description of withdrawal symptoms, caution is needed with the use of newer antidepressants and antipsychotics. Within medication classes, alprazolam, lorazepam, triazolam, paroxetine, venlafaxine, fluphenazine, perphenazine, clozapine, and quetiapine are more likely to induce withdrawal. The likelihood of withdrawal manifestations that may be severe and persistent should thus be taken into account in clinical practice and also in children and adolescents.
Collapse
Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy, .,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands,
| | - Guy Chouinard
- Clinical Pharmacology and Toxicology Program, McGill University and Mental Health Institute of Montreal Fernand Seguin Research Centre, University of Montreal, Montreal, Québec, Canada
| |
Collapse
|
27
|
Construct and criterion validity of patient-reported outcomes (PROs) for depression: A clinimetric comparison. J Affect Disord 2021; 283:30-35. [PMID: 33516084 DOI: 10.1016/j.jad.2021.01.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND A number of patient-reported outcomes (PROs) have been developed but insufficient attention has been devoted to the assessment of their clinimetric properties. Clinimetrics, the science of clinical measurements, has been considered an emerging approach for evaluating reliability and validity of PROs. This is the first study using clinimetric principles to compare the construct and criterion validity of the Major Depression Inventory (MDI), the Beck Depression Inventory-II (BDI-II), the World Health Organization Well-Being Index (WHO-5), three of the most widely used PROs for the assessment of depression. METHODS Construct validity was evaluated via Item Response Theory (IRT) models (i.e., combining Rasch and Mokken analyses). Using the ICD-10 diagnostic algorithm for any depression as the gold standard, Receiver Operating Characteristic (ROC) curves were performed to examine the criterion validity of PROs. RESULTS One hundred healthy subjects (73% females, 32.6 ± 10.5 years) participated in the study, giving a response rate of 90.1%. When using IRT analyses, MDI and WHO-5 were found to be reliable and unidimensional, while BDI-II showed lack of unidimensionality. ROC analyses supported the diagnostic accuracy of MDI and the screening properties of WHO-5. LIMITATIONS The main limitations of the present study are that healthy subjects were assessed only via only self-reported measures and a cross-sectional design was used. CONCLUSIONS WHO-5 and MDI outperformed BDI-II in terms of construct and criterion validity. WHO-5 should be considered when screening for depression, while MDI should be used as a valid diagnostic instrument and as a unidimensional measure to assess depression severity.
Collapse
|
28
|
Carrozzino D, Patierno C, Fava GA, Guidi J. The Hamilton Rating Scales for Depression: A Critical Review of Clinimetric Properties of Different Versions. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:133-150. [PMID: 32289809 DOI: 10.1159/000506879] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/27/2020] [Indexed: 11/19/2022]
Abstract
The format of the original Hamilton Rating Scale for Depression (HAM-D) was unstructured: only general instructions were provided for rating individual items. Over the years, a number of modified versions of the HAM-D have been proposed. They differ not only in the number of items, but also in modalities of administration. Structured versions, including item definitions, anchor points and semi-structured or structured interview questions, were developed. This comprehensive review was conducted to examine the clinimetric properties of the different versions of the HAM-D. The aim was to identify the HAM-D versions that best display the clinimetric properties of reliability, validity, and sensitivity to change. The search was conducted on MEDLINE, Scopus, Web of Science, and PubMed, and yielded a total of 35,473 citations, but only the most representative studies were included. The structured versions of the HAM-D were found to display the highest inter-rater and test-retest reliability. The Clinical Interview for Depression and the 6-item HAM-D showed the highest sensitivity in differentiating active treatment from placebo. The findings indicate that the HAM-D is a valid and sensitive clinimetric index, which should not be discarded in view of obsolete and not clinically relevant psychometric criteria. The HAM-D, however, requires an informed use: unstructured forms should be avoided and the type of HAM-D version that is selected should be specified in the registration of the study protocol and in the methods of the trial.
Collapse
Affiliation(s)
| | - Chiara Patierno
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy
| |
Collapse
|
29
|
Benasi G, Fava GA, Rafanelli C. Kellner's Symptom Questionnaire, a Highly Sensitive Patient-Reported Outcome Measure: Systematic Review of Clinimetric Properties. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:74-89. [PMID: 32050199 DOI: 10.1159/000506110] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patient-reported outcomes (PROs) are of increasing importance in clinical medicine. However, their evaluation by classic psychometric methods carries considerable limitations. The clinimetric approach provides a viable framework for their assessment. OBJECTIVE The aim of this paper was to provide a systematic review of clinimetric properties of the Symptom Questionnaire (SQ), a simple, self-rated instrument for the assessment of psychological symptoms (depression, anxiety, hostility, and somatization) and well-being (contentment, relaxation, friendliness, and physical well-being). METHODS The PRISMA guidelines were used. Electronic databases were searched from inception up to March 2019. Only original research articles, published in English, reporting data about the clinimetric properties of the SQ, were included. RESULTS A total of 284 studies was selected. The SQ has been used in populations of adults, adolescents, and older individuals. The scale significantly discriminated between subgroups of subjects in both clinical and nonclinical settings, and differentiated medical and psychiatric patients from healthy controls. In longitudinal studies and in controlled pharmacological and psychotherapy trials, it was highly sensitive to symptoms and well-being changes and discriminated between the effects of psychotropic drugs and placebo. CONCLUSIONS The SQ is a highly sensitive clinimetric index. It may yield clinical information that similar scales would fail to provide and has a unique position among the PROs that are available. Its use in clinical trials is strongly recommended.
Collapse
Affiliation(s)
- Giada Benasi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Chiara Rafanelli
- Department of Psychology, University of Bologna, Bologna, Italy,
| |
Collapse
|
30
|
|
31
|
Alacreu-Crespo A, Giner L, Courtet P. Psychiatric patients are more vulnerable to the Spanish euthanasia law? REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:S1888-9891(21)00020-3. [PMID: 33497858 DOI: 10.1016/j.rpsm.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Adrián Alacreu-Crespo
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, Francia; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, Francia; Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, España.
| | - Lucas Giner
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, España; Departamento de Psiquiatría, Universidad de Sevilla, Sevilla, España
| | - Philippe Courtet
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, Francia; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, Francia
| |
Collapse
|
32
|
Morales S, Barros J. Mental Pain Surrounding Suicidal Behaviour: A Review of What Has Been Described and Clinical Recommendations for Help. Front Psychiatry 2021; 12:750651. [PMID: 35153847 PMCID: PMC8828913 DOI: 10.3389/fpsyt.2021.750651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To conduct a comprehensive review of scientific publications related to mental pain and suicide risk in order to deepen relevant aspects to guide clinical interventions. METHOD Using a text analysis tool, we collected the terms most frequently linked with that situation in published results of research using various tools to evaluate mental pain or psychache. DISCUSSION We propose clinical interventions for the clinical conditions most commonly associated with mental pain.
Collapse
Affiliation(s)
- Susana Morales
- Psychiatry Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Jorge Barros
- Psychiatry Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| |
Collapse
|
33
|
Guidi J, Fava GA. The emerging role of euthymia in psychotherapy research and practice. Clin Psychol Rev 2020; 82:101941. [DOI: 10.1016/j.cpr.2020.101941] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/26/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022]
|
34
|
Grossman-Giron A, Becker G, Kivity Y, Shalev S, Tzur Bitan D. Mental pain intensity and tolerance as predictors of psychotherapy process and outcome. J Clin Psychol 2020; 77:1296-1306. [PMID: 33156973 DOI: 10.1002/jclp.23085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/21/2020] [Accepted: 10/25/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND The extensive reliance on symptoms for the study of psychotherapy is often criticized. In this study we examined whether the subjective sense of mental pain predicts psychotherapy process and outcome, above and beyond the effect of symptomatic distress. METHODS Outpatients (n = 53) treated in a psychiatric hospital completed measures of mental pain intensity and tolerance, symptomatic distress, and session climate at pretreatment and posttreatment. Multilevel modeling was utilized to assess the predictive effect of mental pain, while controlling baseline symptomatic distress. RESULTS Patients with high mental pain at baseline showed significant reductions in distress, while patients with low mental pain showed no significant improvement. Moreover, low mental pain and high mental pain tolerance predicted decreases in session smoothness. CONCLUSIONS Mental pain can serve as a predictive marker for psychotherapy process and outcome, and complement the reliance on symptomatic distress in psychotherapy research.
Collapse
Affiliation(s)
- Ariella Grossman-Giron
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gideon Becker
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Psychology, College for Law and Business, Ramat Gan, Israel
| | - Yogev Kivity
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
- Department of Psychology, Pennsylvania State University, State College, Pennsylvania, USA
| | - Shani Shalev
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
35
|
Fava GA, Tomba E, Brakemeier EL, Carrozzino D, Cosci F, Eőry A, Leonardi T, Schamong I, Guidi J. Reply to Alacreu-Crespo et al. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:324-325. [PMID: 32272476 DOI: 10.1159/000507337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Elena Tomba
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
| | | | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Ajándék Eőry
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Tommaso Leonardi
- Clinical Trials Network and Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Isabel Schamong
- Department of Clinical Psychology and Psychotherapy and Center for Mind, Brain, and Behavior, Phillips University of Marburg, Marburg, Germany
| | - Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| |
Collapse
|
36
|
Lengvenyte A, Strumila R, Courtet P, Kim SYH, Olié E. "Nothing Hurts Less Than Being Dead": Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu'être mort »: La douleur psychologique dans les descriptions de cas d'euthanasie et de suicide assisté psychiatrique aux Pays-Bas. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:612-620. [PMID: 32501108 PMCID: PMC7485035 DOI: 10.1177/0706743720931237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Euthanasia and assisted suicide (EAS) of individuals with mental disorders is a growing practice in several countries, including the Netherlands. Here, we aimed to identify the most frequent dimensions of and associated factors to psychological pain, which has been associated with suicidality, in individuals undergoing psychiatric EAS. METHODS An exploratory retrospective content analysis of the English translation of 66 digital case records of individuals who died by EAS in the Netherlands between 2011 and 2014 was performed. Nine standard psychological pain dimensions (irreversibility, loss of control, emptiness, emotional flooding, freezing, social distancing, narcissistic wounds, confusion, and self-estrangement), illness, and sociodemographic variables were evaluated by 2 independent raters using a premade data abstraction form (Kohen κ > 0.8 in all cases). RESULTS The mean number of dimensions was 4.64 ± 1.20 (median = 5), out of 9. The most frequent dimensions were irreversibility, loss of control, emptiness, and emotional flooding, in decreasing order. Past treatment refusal and the mention of social connections in case descriptions were related to the higher number of psychological pain dimensions (4.89 ± 1.24 vs. 4.31 ± 1.07, P = 0.03 and 5.05 ± 1.17 vs. 4.43 ± 1.17, P = 0.03, respectively). Emotional flooding was the only dimension specifically associated with specific psychiatric conditions, namely posttraumatic phenomena and personality disorders. CONCLUSIONS Numerous psychological pain dimensions were detected in case descriptions of individuals who underwent EAS before the procedure. Subjective nature of the study precludes definite conclusions but suggest that future studies should explore psychological pain and the role of interventions targeting it in patients requesting EAS.
Collapse
Affiliation(s)
- Aiste Lengvenyte
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Lithuania
| | - Robertas Strumila
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Lithuania
| | - Philippe Courtet
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Lithuania.,PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| | - Scott Y H Kim
- Department of Bioethics, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Emilie Olié
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.,PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| |
Collapse
|
37
|
Guidi J, Piolanti A, Berrocal C, Gostoli S, Carrozzino D. Incremental Validity Of The Diagnostic Criteria For Psychosomatic Research - Revised (DCPR-R) To Clinical Assessment In Primary Care. Psychiatry Res 2020; 291:113233. [PMID: 32563748 DOI: 10.1016/j.psychres.2020.113233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 01/26/2023]
Abstract
Psychosocial problems are highly prevalent among primary care (PC) patients, but they often remain undetected using traditional classification systems. The aim of the present study was to test the incremental validity of the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R), in addition to standard psychiatric assessment based on DSM-5, with regard to the prediction of psychosocial functioning of PC patients. Two-hundred PC patients were consecutively recruited. A comprehensive assessment was performed using two clinical interviews and three self-rating questionnaires (the PsychoSocial Index [PSI], the Short-Form Health Survey [SF-12] and the Illness Attitude Scales [IAS]) for the assessment of psychopathology and psychosocial functioning. Adding the DCPR-R to DSM-5, the amount of explained variance significantly increased by 9% to 16% in the PSI subscales, by 13% in the SF-12 mental component summary, and by 2% to 6% in the IAS scales. The joint use of DCPR-R and DSM-5 thus significantly increased the prediction of psychosocial functioning of primary care patients. These findings further support the use of the DCPR-R in PC settings, particularly in patients who do not satisfy DSM-5 criteria and yet present with high psychological distress, maladaptive illness behavior, impaired psychological well-being and quality of life.
Collapse
Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy.
| | | | - Carmen Berrocal
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Sara Gostoli
- Department of Psychology, University of Bologna, Bologna, Italy
| | | |
Collapse
|