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Zhang C, Liu Y, Zeng L, Luo X, Fan G, Shi H, Shen J. Combined associations of cognitive impairment and psychological resilience with all-cause mortality in community-dwelling older adults. J Affect Disord 2024; 351:962-970. [PMID: 38346647 DOI: 10.1016/j.jad.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Cognitive impairment and psychological resilience are closely related in older adults, but their combined effect on mortality has not been reported. Using a nationally representative sample from the Chinese Longitudinal Healthy Longevity Study, this study examined the interactions between cognitive impairment and psychological resilience and their associations with overall survival. METHODS A total of 32,349 community-dwelling older adults (86.85 ± 11.16 years, 56.06 % female) were enrolled in 1998, 2000, 2002, 2005, 2008, 2011, and 2014; all participants were followed until 2018. Cognitive function and psychological resilience were assessed using the Mini-Mental State Examination (MMSE) and the 7-item psychological resilience questionnaire (PRQ), respectively. Illiterate subjects with an MMSE score <18, or literate subjects with an MMSE score <24 were defined as having cognitive impairment. Cox proportional risk regressions were used to analyze the association of cognitive impairment and psychological resilience with all-cause mortality. RESULTS After 146,993.52 person-years of follow-up, 23,349 older adults died. Both MMSE and PRQ scores (as continuous variables) were negatively associated with mortality risk after adjusting for all covariates. The hazard ratio (HR) of all-cause mortality for cognitive impairment was not significantly moderated by levels of psychological resilience (P-interaction = 0.094). In joint analyses, participants with combined cognitive impairment and low resilience (by the median of PRQ: < 25 points) had the highest risk of mortality (adjusted-HR: 1.56, 95%CI: 1.48-1.61), which was higher than that of patients with either condition alone. There was a significant additive interaction effect of cognitive impairment and low resilience on all-cause mortality (relative excess risk due to interaction: 0.11, 95 % CI: 0.09-0.13), and 7 % of the overall mortality risk was attributable to their synergistic effect. CONCLUSIONS Cognitive impairment and low resilience are synergistically associated with increased risk of all-cause mortality in community-dwelling older adults. The potential mechanisms underlying this combined effect warrant further exploration.
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Affiliation(s)
- Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Ye Liu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Lvtao Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Xuanmei Luo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Guoqing Fan
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| | - Ji Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
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Tian Z, Kuang K, Wilson SR, Buzzanell PM, Ye J, Mao X, Wei H. Measuring resilience for Chinese-speaking populations: a systematic review of Chinese resilience scales. Front Psychol 2024; 15:1293857. [PMID: 38605848 PMCID: PMC11007233 DOI: 10.3389/fpsyg.2024.1293857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Despite the rapid growth of interdisciplinary resilience research in Chinese contexts, no study has systematically reviewed individual-level measurement scales for Chinese-speaking populations. We report a systematic review of scales developed for or translated/adapted to Chinese-speaking contexts, where we assessed how widely used scales fare in terms of their psychometric qualities. Methods Studies included in this review must have been published in peer-reviewed English or Chinese journals between 2015-2020 and included self-reported resilience scales in Chinese-speaking populations. Searches were conducted in PsycINFO, CNKI (completed in May 2021), and PubMed (completed in January 2024). We developed coding schemes for extracting relevant data and adapted and applied an existing evaluation framework to assess the most frequently used resilience scales by seven methodological criteria. Results Analyses of 963 qualified studies suggested that Chinese resilience scales were used in a diverse range of study contexts. Among 85 unique kinds of resilience measures, we highlighted and evaluated the three most frequently used translated scales and three locally developed scales (nine scales in total including variations such as short forms). In short, resilience studies in Chinese contexts relied heavily on the translated 25-item Connor-Davidson Resilience Scale, which scored moderately on the overall quality. The locally developed Resilience Scale for Chinese Adolescents and Essential Resilience Scale received the best ratings but could use further development. Discussion We discussed how future work may advance widely used scales, and specified seven methodological recommendations for future resilience scale development with existing and new scales in and beyond the Chinese study contexts. We further addressed issues and challenges in measuring resilience as a process and called on researchers to further develop/evaluate process measures for Chinese-speaking populations.
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Affiliation(s)
- Zhenyu Tian
- Department of Communication Studies, College of Wooster, Wooster, OH, United States
| | - Kai Kuang
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Steven R. Wilson
- Department of Communication, University of South Florida, Tampa, FL, United States
| | - Patrice M. Buzzanell
- Department of Communication, University of South Florida, Tampa, FL, United States
| | - Jinyi Ye
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Xinyue Mao
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Hai Wei
- School of Journalism and Communication, Tsinghua University, Beijing, China
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Schmit A, Schurr T, Frajo-Apor B, Pardeller S, Plattner B, Tutzer F, Conca A, Fronthaler M, Haring C, Holzner B, Huber M, Marksteiner J, Miller C, Perwanger V, Pycha R, Schmidt M, Sperner-Unterweger B, Hofer A. Long-term impact of resilience and extraversion on psychological distress during the COVID-19 pandemic: a longitudinal investigation among individuals with and without mental health disorders. Front Psychiatry 2024; 15:1304491. [PMID: 38426004 PMCID: PMC10902045 DOI: 10.3389/fpsyt.2024.1304491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
Background Over the past years, the COVID-19 pandemic has caused significant disruptions in daily routines. Although the pandemic has affected almost everyone, it has been particularly challenging for people with pre-existing mental health conditions. Therefore, this study investigated the long-term impact of resilience and extraversion on psychological distress in individuals diagnosed with mental health disorders (MHD) compared to the general population. In addition, possible gender-specific differences were investigated. Methods 123 patients with pre-existing MHD and 343 control subjects from Austria and Italy participated in three online surveys that had been conducted after the initial wave of the COVID-19 pandemic (t0), during the second lockdown in both countries (t1), and one year thereafter (t2). Participants completed standardized questionnaires on psychological distress (Brief-Symptom-Checklist), resilience (Resilience Scale), and extraversion (Big Five Inventory). A mediation model was employed to test the primary hypothesis. Possible gender-specific differences were analyzed using a moderated mediation model. Results The prevalence of psychological distress was consistently higher in patients compared to controls (t0: 37.3% vs. 13.2%, t1: 38.2% vs 11.7%, t2: 37.4% vs. 13.1%). This between-group difference in psychological distress at the first follow-up was fully mediated by baseline resilience scores (65.4% of the total effect). During the second-follow up, extraversion accounted for 18% of the total effect, whereas resilience slightly decreased to 56% of the total effect. Gender was not a significant moderator in the model. Conclusion Next to showing that people with MHD were particularly affected by the pandemic, these findings indicate that higher degrees of resilience and extraversion are related to less long-term psychological distress. Our findings stress the relevance of strengthening resilience and extraversion and to provide mental health support in times of crises, both to patients with MHD and the general population.
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Affiliation(s)
- Anna Schmit
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Timo Schurr
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Beatrice Frajo-Apor
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Silvia Pardeller
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Plattner
- Sanitary Agency of South Tyrol, Department of Psychiatry, General Hospital of Bolzano, Bolzano, Italy
| | - Franziska Tutzer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Conca
- Sanitary Agency of South Tyrol, Department of Psychiatry, General Hospital of Bolzano, Bolzano, Italy
| | - Martin Fronthaler
- Sanitary Agency of South Tyrol, Therapy Center Bad Bachgart, Rodengo, Italy
| | - Christian Haring
- Department of Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Markus Huber
- Sanitary Agency of South Tyrol, Department of Psychiatry, General Hospital of Brunico, Brunico, Italy
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Carl Miller
- Department of Psychiatry, County Hospital Kufstein, Kufstein, Austria
| | - Verena Perwanger
- Sanitary Agency of South Tyrol, Department of Psychiatry, General Hospital of Merano, Merano, Italy
| | - Roger Pycha
- Sanitary Agency of South Tyrol, Department of Psychiatry, General Hospital of Bressanone, Bressanone, Italy
| | - Martin Schmidt
- Department of Psychiatry, County Hospital Lienz, Lienz, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
| | - Alex Hofer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
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Fernández-Rocha ML, García-Izquierdo M, Ríos-Rísquez MI. Psychological Resilience and Suicide Attempt in Patients With Bipolar Disorder: An Exploratory Study. J Am Psychiatr Nurses Assoc 2024; 30:44-51. [PMID: 34715743 DOI: 10.1177/10783903211050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk. AIM The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD. METHODS Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson's 10-item Resilience Scale. RESULTS Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide (T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores (r = -.28; p < .01). CONCLUSIONS Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.
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Affiliation(s)
| | | | - María Isabel Ríos-Rísquez
- María Isabel Ríos-Rísquez, PhD, University Hospital José María Morales Meseguer, Murcia, Spain; University of Murcia, Murcia, Spain
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Franks KH, Bransby L, Cribb L, Buckley R, Yassi N, Chong TTJ, Saling MM, Lim YY, Pase MP. Associations of Perceived Stress and Psychological Resilience With Cognition and a Modifiable Dementia Risk Score in Middle-Aged Adults. J Gerontol B Psychol Sci Soc Sci 2023; 78:1992-2000. [PMID: 37718618 PMCID: PMC10699744 DOI: 10.1093/geronb/gbad131] [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: 05/09/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES Psychological stress has been proposed as a risk factor for cognitive impairment and dementia. However, it remains unclear how an individual's stress-coping ability (i.e., psychological resilience) is related to cognition. This cross-sectional study investigated whether perceived stress and psychological resilience were associated with cognition and a modifiable dementia risk score in a large community-based sample of cognitively normal adults. The moderating effect of psychological resilience was also examined. METHODS Participants (mean age = 57 ± 7 years) enrolled in the web-based Healthy Brain Project completed the Perceived Stress Scale and the Connor-Davidson Resilience Scale. Domains of attention and working memory were assessed using the Cogstate Brief Battery (n = 1,709), and associative memory was assessed using the Cambridge Neuropsychological Test Automated Battery (n = 1,522). Dementia risk was estimated for 1,913 participants using a modified version of the Cardiovascular Risk Factors, Aging, and Incidence of Dementia dementia risk score, calculated using only readily modifiable dementia risk factors. RESULTS In separate linear regression analyses adjusted for age, sex, education, and race, greater levels of perceived stress and lower levels of psychological resilience were associated with poorer performance across all cognitive domains, as well as a higher modifiable dementia risk score. Psychological resilience did not moderate the effect of perceived stress on cognition or the dementia risk score. DISCUSSION Higher perceived stress and lower resilience were associated with poorer cognition and a greater burden of modifiable dementia risk factors. Intervention studies are required to determine if lowering stress and building resilience can mitigate cognitive deficits and reduce dementia risk.
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Affiliation(s)
- Katherine H Franks
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Lisa Bransby
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Lachlan Cribb
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Rachel Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Trevor T -J Chong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Michael M Saling
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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Sato K, Matsui M, Ono Y, Miyagishi Y, Tsubomoto M, Naito N, Kikuchi M. The relationship between cognitive reserve focused on leisure experiences and cognitive functions in bipolar patients. Heliyon 2023; 9:e21661. [PMID: 38027814 PMCID: PMC10661430 DOI: 10.1016/j.heliyon.2023.e21661] [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: 06/13/2023] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Bipolar disorder (BP) is characterized by cognitive decline. Individual differences exist in maintaining cognitive function due to daily physical activity and sleep. We examined the relationship between leisure experiences as proxies for cognitive reserve (CR) and cognitive function in patients with bipolar disorder after adjusting for daily physical activity and sleep. The CR of patients with BP (n = 24) and healthy study controls (HC) (n = 24) was assessed using premorbid IQ, years of education, and leisure activity history. Performance-based neuropsychological tests were performed to evaluate cognitive function. A self-reported scale was used to assess resilience. Physical activity and sleep were measured using an activity meter. Verbal fluency, story memory, and verbal memory were significantly positively correlated with the kinds of leisure experiences in patients with BP. A hierarchical regression analysis accounting for confounding factors showed that verbal fluency and memory were associated with the kinds of leisure experiences. Neither years of education nor resilience were significantly associated with neuropsychological scores. Various leisure experiences in patients with BP are associated with higher language-related cognitive functioning. Engaging in various leisure experiences may affect higher cognitive functions related to language.
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Affiliation(s)
- Kuniko Sato
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
| | - Mie Matsui
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
- Laboratory of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
| | - Yasuki Ono
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, 1 Bunkyocyo, Hirosaki, Aomori 036-8224, Japan
| | - Yoshiaki Miyagishi
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Makoto Tsubomoto
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Nobushige Naito
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
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Chen M, Weng Y, Zhang J, Gu L, Chen W, Qiao M, Wang M, Huang X, Chen L, Zhang L. Factors associated with nurses' attitudes for providing oral care in geriatric care facilities: a cross-sectional study. BMC Oral Health 2023; 23:801. [PMID: 37884891 PMCID: PMC10605944 DOI: 10.1186/s12903-023-03517-7] [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: 07/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The world's population is getting older. This issue is accompanied by a rise in the number of older people suffering from dementia and disability, for whom oral hygiene care is challenging. Nurses' attitudes toward providing oral care (POC) are critical for the elderly, while few studies have investigated the determinant factors of nurses' attitudes by identifying the current work pressure, resilience and self-efficacy in geriatric care facilities (GCFs). It is of great significance to explore the nurses' attitudes toward POC and associated influencing factors related to psychological aspects including resilience, self-efficacy, and stress from the workplace. METHODS Attitudes for Providing Mouth Care (A-PMC) in Chinese version were used in this cross-sectional study with 160 nurses in 2 GCFs. Data were collected using online questionnaires and analyzed by multiple linear regression analysis. Statistically significant values were considered at p < 0.05. RESULTS A total of 160 nurses participated in this study, with an average age of 32.86 ± 7.43. The mean score for the A-PMC was 2.81 ± 0.47. The score of A-PMC was negatively correlated with work pressure (r=-0.332, p < 0.01), and positively correlated with resilience (r = 0.735, p < 0.01) and self-efficacy (r = 0.425, p < 0.01) respectively. Multiple linear regression analyses identified that the potential influencing factors of A-PMC were education background, work hours every shift, self-efficacy, work pressure and resilience. CONCLUSIONS The study results indicate nurses' attitudes regarding PMC were at a low level, which is influenced by many factors. To improve nurses' attitudes toward PMC and the oral hygiene (OH) of the elderly in GCFs, it is necessary to increase nurses' education and training, establish a reasonable and effective incentive mechanism to improve nurses' work motivation and other intervention measures to reduce work pressure.
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Affiliation(s)
- Mengxia Chen
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yanqiu Weng
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Jingwen Zhang
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Liyan Gu
- Department of Neurology, No. 905 Hospital of PLA Navy, Shanghai, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Mengting Qiao
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Mengdi Wang
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xiaorong Huang
- Department of Nursing, Huzhou University, Huzhou, Zhejiang, China
| | - Lan Chen
- Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lingjuan Zhang
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China.
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Hirai S, Sakuma A, Kunii Y, Shimbo H, Hino M, Izumi R, Nagaoka A, Yabe H, Kojima R, Seki E, Arai N, Komori T, Okado H. Disease specific brain capillary angiopathy in schizophrenia, bipolar disorder, and Alzheimer's disease. J Psychiatr Res 2023; 163:74-79. [PMID: 37207434 DOI: 10.1016/j.jpsychires.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/26/2023] [Accepted: 04/08/2023] [Indexed: 05/21/2023]
Abstract
Schizophrenia (SZ) and bipolar disorder (BD), which are both psychiatric disorders, share some common clinical evidence. We recently discovered that brain capillary angiopathy is another common feature of these psychiatric disorders using fibrin accumulation in vascular endothelial cells as an indicator. This study aimed to characterize the similarities and differences in cerebral capillary injuries in various brain diseases to provide new diagnostic methods for SZ and BD and to develop new therapeutic strategies. We evaluated whether discrepancies exist in the degree of vascular damage among SZ and BD and other brain disorders (amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), and Alzheimer's disease (AD)) using postmortem brains. Our results demonstrate that fibrin was strongly accumulated in the capillaries of the grey matter (GM) of brains of patients with SZ and AD and in the capillaries of the white matter (WM) in those of patients with SZ, BD, and AD when compared with control subjects without any psychiatric or neurological disease history. However, ALS and PD brains did not present a significant increase in the amount of accumulated fibrin, either in the capillaries of WM or GM. Furthermore, significant leakage of fibrin into the brain parenchyma, indicating a vascular physical disruption, was observed in the brains of patients with AD but not in the brains of other patients compared with control subjects. In conclusion, our work reveals that Fibrin-accumulation in the brain capillaries are observed in psychiatric disorders, such as SZ, BD, and AD. Furthermore, fibrin-accumulating, nonbreaking type angiopathy is characteristic of SZ and BD, even though there are regional differences between these diseases.
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Affiliation(s)
- Shinobu Hirai
- Brain Metabolic Regulation Group, Frontier Laboratory, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan.
| | - Atsuhiro Sakuma
- Brain Metabolic Regulation Group, Frontier Laboratory, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan
| | - Yasuto Kunii
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan; Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Miyagi, 980-8573, Japan
| | - Hiroko Shimbo
- Brain Metabolic Regulation Group, Frontier Laboratory, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan; Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan
| | - Mizuki Hino
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan; Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Miyagi, 980-8573, Japan
| | - Ryuta Izumi
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Atsuko Nagaoka
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Rika Kojima
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Sciences, Tokyo, 156-8506, Japan
| | - Erika Seki
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Sciences, Tokyo, 156-8506, Japan
| | - Nobutaka Arai
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Sciences, Tokyo, 156-8506, Japan
| | - Takashi Komori
- Department of Pathology and Laboratory Medicine, Tokyo Metropolitan Neurological Hospital, Tokyo, 183-0042, Japan
| | - Haruo Okado
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan.
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Montalto A, Park HRP, Williams LM, Korgaonkar MS, Chilver MR, Jamshidi J, Schofield PR, Gatt JM. Negative association between anterior insula activation and resilience during sustained attention: an fMRI twin study. Psychol Med 2023; 53:3187-3199. [PMID: 37449488 DOI: 10.1017/s0033291721005262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND While previous studies have suggested that higher levels of cognitive performance may be related to greater wellbeing and resilience, little is known about the associations between neural circuits engaged by cognitive tasks and wellbeing and resilience, and whether genetics or environment contribute to these associations. METHODS The current study consisted of 253 monozygotic and dizygotic adult twins, including a subsample of 187 early-life trauma-exposed twins, with functional Magnetic Resonance Imaging data from the TWIN-E study. Wellbeing was measured using the COMPAS-W Wellbeing Scale while resilience was defined as a higher level of positive adaptation (higher levels of wellbeing) in the presence of trauma exposure. We probed both sustained attention and working memory processes using a Continuous Performance Task in the scanner. RESULTS We found significant negative associations between resilience and activation in the bilateral anterior insula engaged during sustained attention. Multivariate twin modelling showed that the association between resilience and the left and right insula activation was mostly driven by common genetic factors, accounting for 71% and 87% of the total phenotypic correlation between these variables, respectively. There were no significant associations between wellbeing/resilience and neural activity engaged during working memory updating. CONCLUSIONS The findings suggest that greater resilience to trauma is associated with less activation of the anterior insula during a condition requiring sustained attention but not working memory updating. This possibly suggests a pattern of 'neural efficiency' (i.e. more efficient and/or attenuated activity) in people who may be more resilient to trauma.
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Affiliation(s)
- Arthur Montalto
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Haeme R P Park
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Leanne M Williams
- Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Mental Illness Research Education and Clinical Centers VISN21, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, 94304-151-Y, USA
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Miranda R Chilver
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Javad Jamshidi
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Science, University of New South Wales, Sydney, NSW, Australia
| | - Justine M Gatt
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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10
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Datta A, Chetia D. Resilience and its relationship with disability in persons with bipolar disorder and schizophrenia: A comparative study. Indian J Psychiatry 2023; 65:361-367. [PMID: 37204971 PMCID: PMC10187866 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_238_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/01/2022] [Accepted: 12/17/2022] [Indexed: 05/21/2023] Open
Abstract
Background Resilience is the capacity to bounce back from adversity. Severe mental illnesses are associated with poor and heterogeneous functional outcomes. Symptom remission is inadequate to achieve patient-oriented outcome, and positive psychopathology constructs like resilience have emerged as possible mediators. An exploration of resilience and its association with functional outcomes can drive therapeutic endeavors. Aim To assess and compare the influence of resilience on disability among patients diagnosed and treated for bipolar disorder and schizophrenia in a tertiary care facility. Methods Study design - Hospital-based, cross-sectional, comparative design; study population - patients of bipolar disorder and schizophrenia with 2-5 years illness and Clinical Global Impression - Severity (CGI-S) <4; sampling procedure - consecutive sampling; sample size - 30 patients each; scales used - Connor-Davidson Resilience Scale (CD-RISC), Indian Disability Evaluation and Assessment Scale (IDEAS), and CGI-S; patients were evaluated with IDEAS, and 15 persons with and without a significant disability were recruited in each group of schizophrenia and bipolar disorder. Results The mean CD-RISC 25 score for persons with schizophrenia was 73.60 ± 13.87, whereas that for persons with bipolar disorder was 78.10 ± 15.26. For schizophrenia, only CDRISC-25 scores are statistically significant (t = -2.582, P = 0.018) for predicting IDEAS global disability. For bipolar disorder, CDRISC-25 scores (t = -2.977, P = 0.008) and CGI-severity scores (t = 3.135, P = 0.005) are statistically significant for predicting IDEAS global disability. Conclusion When disability is factored in, resilience is comparable in persons with schizophrenia and bipolar disorder. Resilience independently predicts disability in both groups. However, the type of disorder does not significantly affect the relationship between resilience and disability. Irrespective of diagnosis, higher resilience is associated with lower disability.
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Affiliation(s)
- Arnab Datta
- Department of Psychiatry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India
| | - Dhrubajyoti Chetia
- Department of Psychiatry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India
- Address for correspondence: Dr. Dhrubajyoti Chetia, Associate Professor, Department of Psychiatry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India. E-mail:
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Liang J, Huang W, Guo H, Wu W, Li X, Xu C, Xie G, Chen W. Differences of resting fMRI and cognitive function between drug-naïve bipolar disorder and schizophrenia. BMC Psychiatry 2022; 22:654. [PMID: 36271368 PMCID: PMC9587563 DOI: 10.1186/s12888-022-04301-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 09/13/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) and schizophrenia (SC) have many similarities in clinical manifestations. The acute phase of BD has psychotic symptoms, while SC also has emotional symptoms during the onset, which suggests that there is some uncertainty in distinguishing BD and SC through clinical symptoms. AIM To explore the characteristics of brain functional activities and cognitive impairment between BD and SC. METHODS Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test was performed on patients in drug-naïve BD and SC (50 subjects in each group), and resting-state functional magnetic resonance imaging (rs-fMRI) scanning was performed meanwhile. Rs-fMRI data were routinely preprocessed, and the value of the fractional amplitude of low-frequency fluctuation (fALFF) was calculated. Then each part of the scores of the RBANS and the characteristics of brain function activities were compared between the two groups. Finally used Pearson correlation to analyze the correlation between cognition and brain function. RESULTS (1) Compared with BD group, all parts of RBANS scores in SC group decreased; (2) The left inferior occipital gyrus (IOG, peak coordinates - 30, -87, -15; t = 4.78, voxel size = 31, Alphasim correction) and the right superior temporal gyrus (STG, peak coordinates 51, -12, 0; t = 5.08, voxel size = 17, AlphaSim correction) were the brain areas with significant difference in fALFF values between BD and SC. Compared with SC group, the fALFF values of the left IOG and the right STG in BD group were increased (p < 0.05); (3) Pearson correlation analysis showed that the visuospatial construction score was positively correlated with the fALFF values of the left IOG and the right STG (rleft IOG = 0.304, p = 0.003; rright STG = 0.340, p = 0.001); The delayed memory (figure recall) score was positively correlated with the fALFF value of the left IOG (rleft IOG = 0.207, p = 0.044). DISCUSSION The cognitive impairment of SC was more serious than BD. The abnormal activities of the left IOG and the right STG may be the core brain region to distinguish BD and SC, and are closely related to cognitive impairment, which provide neuroimaging basis for clinical differential diagnosis and explore the pathological mechanism of cognitive impairment.
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Affiliation(s)
- Jiaquan Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China. .,Center on Translational Neuroscience, Minzu University of China, Beijing, People's Republic of China.
| | - Wei Huang
- Department of Psychiatry, The Third People’s Hospital of Foshan, Guangdong, People’s Republic of China
| | - Huagui Guo
- Department of Psychiatry, The Third People’s Hospital of Foshan, Guangdong, People’s Republic of China
| | - Weibin Wu
- Department of Psychiatry, The Third People’s Hospital of Foshan, Guangdong, People’s Republic of China
| | - Xiaoling Li
- Department of Psychiatry, The Third People’s Hospital of Foshan, Guangdong, People’s Republic of China
| | - Caixia Xu
- Department of Psychiatry, The Third People’s Hospital of Foshan, Guangdong, People’s Republic of China
| | - Guojun Xie
- Department of Psychiatry, The Third People’s Hospital of Foshan, Guangdong, People’s Republic of China
| | - Wensheng Chen
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China.
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Yeo JJ, Chew QH, Sim K. Resilience and its inter-relationship with symptomatology, illness course, psychosocial functioning, and mediational roles in schizophrenia: A systematic review. Asia Pac Psychiatry 2022; 14:e12486. [PMID: 34431616 DOI: 10.1111/appy.12486] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/26/2021] [Accepted: 08/14/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors. METHODS A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020. RESULTS Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions. DISCUSSION Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.
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Affiliation(s)
- Jerry Jay Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qian Hui Chew
- Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore
| | - Kang Sim
- Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore
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13
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Palagini L, Miniati M, Marazziti D, Massa L, Grassi L, Geoffroy PA. Circadian Rhythm Alterations May be Related to Impaired Resilience, Emotional Dysregulation and to the Severity of Mood Features in Bipolar I and II Disorders. CLINICAL NEUROPSYCHIATRY 2022; 19:174-186. [PMID: 35821870 PMCID: PMC9263680 DOI: 10.36131/cnfioritieditore20220306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The study aimed to investigate the possible impact of resilience and emotion dysregulation on the clinical manifestations of bipolar disorders (BDs) focusing on the possible role of circadian rhythm alterations. Method A sample of 197 inpatients suffering from BD of type I (BDI) or II (BDII) were assessed during a major depressive episode using the Structural Clinical Interview for DSM-5 (SCID-5), the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS), Resilience Scale for Adults (RSA), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Difficulties in Emotion Regulation Scale (DERS) and the Scale for Suicide Ideation (SSI). Participants with or without circadian rhythm disturbances as measured with Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), were compared; regression and mediation analyses were computed. Results Participants with circadian rhythms disturbances showed a greater severity of depressive symptoms, of suicidal risk, lower resilience and more disturbances in emotion regulation including impulsivity and regulatory strategies. The logistic regression revealed that circadian rhythm disturbances was related to depressive symptoms (O.R. 4.0), suicidal risk (OR 2.51), emotion dysregulation (OR 2.28) and low resilience (OR 2.72). At the mediation analyses, circadian rhythm alterations showed an indirect effect on depressive symptoms by impairing resilience (Z= 3.17, p=0.0014)/ emotional regulation (Z= 4.36, p<0.001) and on suicidal risk by affecting resilience (Z= 2.00, p=0.045) and favoring impulsivity (Z= 2.14, p=0.032). Conclusions The present findings may show that circadian rhythm alterations might play a key role in BD manifestations, as being correlated with more severe clinical presentations of depressive symptoms, suicidal risk, impaired resilience and emotional regulation. Addressing circadian rhythm alterations might potentially promote resilience and emotion regulation hence improving mood symptoms and suicidal risk in BDs.
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Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa; Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy,Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy,Corresponding author Laura Palagini, M.D. Via Roma 67, 56100, Pisa, Italy Phone: +39-050-993165 Fax: +39-050-992656 E-mail: ,
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa; Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa; Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa; Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Pierre A. Geoffroy
- Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France,GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France,Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France
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14
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Insomnia symptoms are associated with impaired resilience in bipolar disorder: Potential links with early life stressors may affect mood features and suicidal risk. J Affect Disord 2022; 299:596-603. [PMID: 34952125 DOI: 10.1016/j.jad.2021.12.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/01/2021] [Accepted: 12/18/2021] [Indexed: 11/23/2022]
Abstract
AIM The study aimed to investigate resilience and its association with early exposure to stressful events on the clinical manifestations of bipolar disorders (BDs), such as severity of mood symptoms, suicidal ideation and behaviors focusing on the possible role of insomnia symptoms. METHOD A sample of 188 adult participants with BD of type I or II were assessed during depressed phase using the Structural Clinical Interview for DSM-5 (SCID-5), the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS), the Early Trauma Inventory Self Report-Short Form (ETISR-SF), Resilience Scale for Adults (RSA), the Insomnia Severity Index (ISI) and the Scale for Suicide Ideation (SSI). Participants with or without clinically significant insomnia were compared and we carried out correlations, regression and mediation analyses. RESULTS Participants with insomnia showed a greater severity of depressive symptoms as well as of suicidal risk, early life stressors and lower level of resilience. Insomnia symptoms mediated the association between early life stress and low resilience, between low resilience in planning future and depressive symptoms (Z = 2.17, p = 0.029) and low resilience and suicidal risk (Z = 3.05, p = 0.0002) CONCLUSION: Insomnia may be related to the severity of BDs, to higher early life stressors and lower level of resilience. Assessing and targeting insomnia symptoms may potentially promote resilience in BDs in response to early life stressful events. These results should be interpreted in light of several limitations including the cross-sectional design affecting causal interpretations.
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15
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Hilland E, Johannessen C, Jonassen R, Alnæs D, Jørgensen KN, Barth C, Andreou D, Nerland S, Wortinger LA, Smelror RE, Wedervang-Resell K, Bohman H, Lundberg M, Westlye LT, Andreassen OA, Jönsson EG, Agartz I. Aberrant default mode connectivity in adolescents with early-onset psychosis: A resting state fMRI study. Neuroimage Clin 2021; 33:102881. [PMID: 34883402 PMCID: PMC8662331 DOI: 10.1016/j.nicl.2021.102881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/14/2022]
Abstract
Abnormal default mode network (DMN) connectivity has been found in schizophrenia and other psychotic disorders. However, there are limited studies on early onset psychosis (EOP), and their results show lack of agreement. Here, we investigated within-network DMN connectivity in EOP compared to healthy controls (HC), and its relationship to clinical characteristics. A sample of 68 adolescent patients with EOP (mean age 16.53 ± 1.12 [SD] years, females 66%) and 95 HC (mean age 16.24 ± 1.50 [SD], females 60%) from two Scandinavian cohorts underwent resting state functional magnetic resonance imaging (rsfMRI). A group independent component analysis (ICA) was performed to identify the DMN across all participants. Dual regression was used to estimate spatial maps reflecting each participant's DMN network, which were compared between EOP and HC using voxel-wise general linear models and permutation-based analyses. Subgroup analyses were performed within the patient group, to explore associations between diagnostic subcategories and current use of psychotropic medication in relation to connectivity strength. The analysis revealed significantly reduced DMN connectivity in EOP compared to HC in the posterior cingulate cortex, precuneus, fusiform cortex, putamen, pallidum, amygdala, and insula. The subgroup analysis in the EOP group showed strongest deviations for affective psychosis, followed by other psychotic disorders and schizophrenia. There was no association between DMN connectivity strength and the current use of psychotropic medication. In conclusion, the findings demonstrate weaker DMN connectivity in adolescent patients with EOP compared to healthy peers, and differential effects across diagnostic subcategories, which may inform our understanding of underlying disease mechanisms in EOP.
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Affiliation(s)
- Eva Hilland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Norway.
| | - Cecilie Johannessen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rune Jonassen
- Faculty of Health Sciences, Oslo Metropolitan University, Norway
| | - Dag Alnæs
- Bjørknes College, Oslo, Norway; Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kjetil N Jørgensen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Claudia Barth
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Stener Nerland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Laura A Wortinger
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Runar E Smelror
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Kirsten Wedervang-Resell
- Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Hannes Bohman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Mathias Lundberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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Sánchez J, Estrada-Hernández N, Booth J, Pan D. Factor structure, internal reliability, and construct validity of the Brief Resilience Scale (BRS): A study on persons with serious mental illness living in the community. Psychol Psychother 2021; 94:620-645. [PMID: 33749967 DOI: 10.1111/papt.12336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 02/22/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Resilience, the ability to bounce back from a stressful situation, is a valuable asset for aiding adults with serious mental illness (SMI) in navigating the recovery process. People with SMI experience stress, including traumatic experiences at disproportionate rates. The purposes of this study were to examine the factor structure, internal reliability, and construct validity of the Brief Resilience Scale (BRS) among adults with SMI living in the community. DESIGN A cross-sectional survey design was used. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and correlational analyses were employed. METHODS Three hundred fifteen adults with SMI were recruited for two studies (Sample 1, n = 122; Sample 2, n = 193) from three states. All participants completed the BRS along with nearly identical positive psychology- and psychopathology-related measures. RESULTS EFA revealed the BRS was unidimensional and explained 61.20% of the variance. Results from seven CFA models suggested a bifactor structure for the BRS, which fit the data best. Internal reliability of the BRS was computed to be within acceptable ranges (α = .87, ω = .90). The BRS was positively correlated with measures of positive coping and life satisfaction, providing convergent validity. Divergent validity was supported by negative correlations between the BRS and measures of psychiatric symptoms, succumbing, and self-stigma. CONCLUSIONS The BRS is a valid measure that can be used by clinical and research professionals to assess levels of resilience in adults with SMI at baseline and across time. PRACTITIONER POINTS The Brief Resilience Scale (BRS) was developed to measure a person's ability to bounce back from stressful situations. The BRS was examined in adults with serious mental illness living in the community. The BRS presented a bifactor structure measuring resilience (an outcome) and correlated with positive psychology- and psychopathology-related measures. The BRS can be used by practitioners to assess levels of resilience in their clients at baseline and over time to evaluate the effectiveness of therapeutic interventions.
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Affiliation(s)
- Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA
| | - Noel Estrada-Hernández
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA
| | - Jamar Booth
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA.,Department of Clinical Counseling and Mental Health, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Deyu Pan
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA
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Huang D, Liu Z, Cao H, Yang J, Wu Z, Long Y. Childhood trauma is linked to decreased temporal stability of functional brain networks in young adults. J Affect Disord 2021; 290:23-30. [PMID: 33991943 DOI: 10.1016/j.jad.2021.04.061] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/13/2021] [Accepted: 04/25/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Both childhood trauma and disruptions in brain functional networks are implicated in the development of psychiatric disorders in early adulthood. However, the relationships between these two factors remain unclear. This study aimed to investigate whether and how childhood trauma would relate to changes of functional network dynamics in young adults. METHODS Resting-state functional magnetic resonance imaging data were collected from 53 young healthy adults, whose childhood trauma histories were assessed by the Childhood Trauma Questionnaire (CTQ). Network switching rate, a measure of stability of dynamic brain networks over time, was calculated at both global and local levels for each participant. Switching rates at both levels were compared between participants with and without childhood trauma, and further correlated with CTQ total score. RESULTS In the current sample, 19 (35.8%) participants reported a history of childhood trauma. At the global level, participants with childhood trauma showed significantly higher network switching rates than those without trauma (F = 10.021, p = 0.003). A significant positive correlation was found between network switching rates and CTQ scores in the entire sample (r = 0.378, p = 0.007). At the local level, these effects were mainly observed in the default-mode, fronto-parietal, cingulo-opercular, and occipital subnetworks. CONCLUSIONS Our study provides preliminary evidence for a possible long-term effect of childhood trauma on brain functional dynamism. These findings may have potential contributions to psychiatric disorders during adulthood.
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Affiliation(s)
- Danqing Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, New York, United States; Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York, United States.
| | - Jie Yang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Zhipeng Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Yicheng Long
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China.
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Şenormancı G, Korkmaz N, Şenormancı Ö, Uğur S, Topsaç M, Gültekin O. Effects of Exercise on Resilience, Insight and Functionality in Patients with Chronic Schizophrenia in a Psychiatric Nursing Home Setting: A Randomized Controlled Trial. Issues Ment Health Nurs 2021; 42:690-698. [PMID: 33275467 DOI: 10.1080/01612840.2020.1847221] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To our knowledge, there are no studies on the effects of exercise in patients with severe schizophrenia-related disability or in nursing home settings. Again, the literature search on the influence of exercise on insight and resilience gives no results except mind-body exercises. The aim of this study was to investigate the effects of exercise on psychotic symptoms, depression, functionality, insight and resilience in patients with severe schizophrenia-related disability living in nursing home setting. Thirty-nine patients with schizophrenia were recruited. Exercise group with 20 patients who continued resistance exercise for 60 min, 2 days a week, for 3 months; and treatment as usual (TAU) group with 19 patients. All patients were administered Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms (SANS), Calgary Depression Scale for Schizophrenia (CDSS), Schedule for Assessment of Insight (SAI), Functional Remission of General Schizophrenia Scale (FROGS), Resilience Scale for Adults (RSA) at baseline and 3 months after. There were no significant differences between the groups for baseline and third month scores. In both groups significant decrease in SANS scores, significant increase in scores of FROGS total and social functioning, daily life skills subscale and RSA perception of the self were observed. In exercise group, significant decrease in CDSS scores, and significant increase in SAI awareness of illness, FROGS health and treatment, occupational functioning scores were found. Exercise combined with TAU may be effective in increasing awareness of illness and alleviating depression in chronic schizophrenia.
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Affiliation(s)
- Güliz Şenormancı
- Department of Psychiatry, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Nimet Korkmaz
- Faculty of Sport Sciences Physical Education and Sports Teaching Department, Uludağ University , Bursa , Turkey
| | - Ömer Şenormancı
- Department of Psychiatry, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Selen Uğur
- Faculty of Sport Sciences Physical Education and Sports Teaching Department, Uludağ University , Bursa , Turkey
| | - Mine Topsaç
- Faculty of Sport Sciences Physical Education and Sports Teaching Department, Uludağ University , Bursa , Turkey
| | - Okan Gültekin
- Faculty of Sport Sciences Physical Education and Sports Teaching Department, Uludağ University , Bursa , Turkey
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19
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Jung SJ, Lee GB, Nishimi K, Chibnik L, Koenen KC, Kim HC. Association between psychological resilience and cognitive function in older adults: effect modification by inflammatory status. GeroScience 2021; 43:2749-2760. [PMID: 34184172 PMCID: PMC8238632 DOI: 10.1007/s11357-021-00406-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
To examine the association between psychological resilience and cognitive function and investigate the role of acute inflammation as an effect modifier. Total 7535 people from the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC), aged ≥ 50 years and residing in areas near Seoul, South Korea, were included in this cross-sectional analysis. Stressful life events in the past 6 months were gauged by the Life Experience Survey, and current depression symptoms were analyzed with the Beck Depression Inventory-II. Participants were categorized into the following four groups according to their past experience and depression status: reference, resilient, reactive depression, and vulnerable depression. Cognitive function was evaluated using the mini-mental state examination (MMSE). The level of high-sensitivity C-reactive protein (hsCRP) was measured from blood samples. A generalized linear model was used. Upon adjusting for socio-demographic factors, comorbidity, and lifestyle factors, the final model was stratified with the highest quartile of the hsCRP level by sex. Compared to the reference group, the resilient group showed higher MMSE, which was also significant in women (adj-β = 0.280, p-value < 0.001). Vulnerable depression group showed a significantly lower MMSE (adj-β = − -0.997, p-value 0.002), especially in men. This pattern seemed to be limited to the low hsCRP subgroup. We provided evidence from the largest Korean population used to evaluate the association between psychological resilience and cognition, which was more prominent in low inflammatory status. Psychological resilience was associated with a lower likelihood of cognitive deficit in women. This pattern was modulated by inflammatory status.
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Affiliation(s)
- Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. .,Department of Public Health, Graduate School of Yonsei University, Seoul, Korea. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Ga Bin Lee
- Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
| | - Kristen Nishimi
- Department of Social Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Lori Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.,Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
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20
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Zhao L, Sznajder K, Cheng D, Wang S, Cui C, Yang X. Coping Styles for Mediating the Effect of Resilience on Depression Among Medical Students in Web-Based Classes During the COVID-19 Pandemic: Cross-sectional Questionnaire Study. J Med Internet Res 2021; 23:e25259. [PMID: 34033579 PMCID: PMC8189284 DOI: 10.2196/25259] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/09/2020] [Accepted: 05/19/2021] [Indexed: 01/20/2023] Open
Abstract
Background Due to strict, nationwide, comprehensive COVID-19 protective measures, including home quarantine, all Chinese medical students began taking web-based classes beginning in the spring semester of 2020. Home quarantine, web-based classes, and the stress surrounding the COVID-19 pandemic may have triggered an increased incidence of mental health problems among medical students. Although there have been increasing amounts of literature on depression among medical students, studies focusing on positive psychological resources, such as resilience during the COVID-19 pandemic, still need to be expanded. Objective This study aims to assess depression among medical students who are taking web-based classes during the COVID-19 pandemic and to investigate the role of coping styles as mediators between resilience and depression. Methods A cross-sectional study of 666 medical students involving stratified sampling in Shenyang, Liaoning Province, China, was completed between March 20 and April 10, 2020. The participants responded to a self-administered, smartphone-based questionnaire, which included the Patient Health Questionnaire-9, Simplified Coping Style Questionnaire, and Ego Resilience 89 Scale. Hierarchical linear regression and structural equation modeling were used in this study. Results The prevalence of depression among the participants was 9.6% (64/666) in this study. The regression analysis revealed that grade (the year in which the medical student was in training) (P=.013), how well students adapted to web-based classes (P<.001), their levels of resilience (P=.04), and their coping styles were independent predictors for depression (P<.001). Resilience and positive coping styles were negatively related to depression (resilience: P=.04; positive coping styles: P<.001), and negative coping styles were positively related to depression (P<.001). The structural equation modeling analysis showed that the effect of resilience on depression was partially mediated by coping styles (P=.007). Conclusions In this study, it was found that the prevalence of depression was slightly low and coping styles mediated the association between resilience and depression among medical students during the COVID-19 pandemic. These findings have significant implications for future studies. Future studies and interventions should aim to improve resilience and promote positive coping styles.
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Affiliation(s)
- Lina Zhao
- Institute of Foreign Languages, China Medical University, Shenyang, China
| | - Kristin Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Philadelphia, PA, United States
| | - Dan Cheng
- Hospital of Stomatology, China Medical University, Shenyang, China
| | - Shimeng Wang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Can Cui
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning Province, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning Province, China
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21
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Poumeaud F, Mircher C, Smith PJ, Faye PA, Sturtz FG. Deciphering the links between psychological stress, depression, and neurocognitive decline in patients with Down syndrome. Neurobiol Stress 2021; 14:100305. [PMID: 33614867 PMCID: PMC7879042 DOI: 10.1016/j.ynstr.2021.100305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 12/27/2022] Open
Abstract
The relationships between psychological stress and cognitive functions are still to be defined despite some recent progress. Clinically, we noticed that patients with Down syndrome (DS) may develop rapid neurocognitive decline and Alzheimer's disease (AD) earlier than expected, often shortly after a traumatic life event (bereavement over the leave of a primary caregiver, an assault, modification of lifestyle, or the loss of parents). Of course, individuals with DS are naturally prone to develop AD, given the triplication of chromosome 21. However, the relatively weak intensity of the stressful event and the rapid pace of cognitive decline after stress in these patients have to be noticed. It seems DS patients react to stress in a similar manner normal persons react to a very intense stress, and thereafter develop a state very much alike post-traumatic stress disorders. Unfortunately, only a few studies have studied stress-induced regression in patients with DS. Thus, we reviewed the biochemical events involved in psychological stress and found some possible links with cognitive impairment and AD. Interestingly, these links could probably be also applied to non-DS persons submitted to an intense stress. We believe these links should be further explored as a better understanding of the relationships between stress and cognition could help in many situations including individuals of the general population.
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Affiliation(s)
- François Poumeaud
- Univ. Limoges, Peripheral Neuropathies, EA6309, F-87000, Limoges, France
| | - Clotilde Mircher
- Institut Jérôme Lejeune, 37 Rue des Volontaires, F-75015, Paris, France
| | - Peter J. Smith
- University of Chicago, 950 E. 61st Street, SSC Suite 207, Chicago, IL, 60637, USA
| | - Pierre-Antoine Faye
- Univ. Limoges, Peripheral Neuropathies, EA6309, F-87000, Limoges, France
- CHU Limoges, Department of Biochemistry and Molecular Biology, F-87000, Limoges, France
| | - Franck G. Sturtz
- Univ. Limoges, Peripheral Neuropathies, EA6309, F-87000, Limoges, France
- CHU Limoges, Department of Biochemistry and Molecular Biology, F-87000, Limoges, France
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22
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Testing Kumpfer’s Resilience Model Among Adults With Serious Mental Illness. REHABILITATION COUNSELING BULLETIN 2021. [DOI: 10.1177/00343552211006770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Having a serious mental illness (SMI) is often associated with significant adversities, and people respond differently to adversities. The existing research supports that people with SMI can achieve and maintain positive life outcomes despite experiencing adversities. Resilience, the ability to cope with (or bounce back quickly from) crisis, can help buffer the negative effects of various types of adversities, including chronic illness and disability, and facilitate the psychosocial adaptation process to SMI. Kumpfer’s resilience model, a person-process-context framework, has been widely used to conceptualize, and assess for, resilience in various populations, including people with chronic illnesses and disabilities. However, the research in resilience among people with SMI is very limited. The purpose of this study was to empirically assess the utility of Kumpfer’s resilience model and its proposed predictive components for conceptualizing the adaptation process to SMI. One hundred forty-four participants completed a Qualtrics survey containing demographic questions and a series of validated instruments representing the major components of Kumpfer’s resilience model. Hierarchical regression analysis was used to analyze the data, and the final model explained 71% of the variance of the dependent variable—adaptation to disability. Avoidance coping, internalized stigma, and optimism were significant independent predictors of adaptation to disability. This study supports the utilization of Kumpfer’s resilience model to conceptualize the adaptation to disability process among people with SMI. Implications for rehabilitation counseling practices are discussed.
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23
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Vargas T, Damme KSF, Ered A, Capizzi R, Frosch I, Ellman LM, Mittal VA. Neuroimaging Markers of Resiliency in Youth at Clinical High Risk for Psychosis: A Qualitative Review. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:166-177. [PMID: 32788085 PMCID: PMC7725930 DOI: 10.1016/j.bpsc.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/26/2022]
Abstract
Psychotic disorders are highly debilitating and constitute a major public health burden. Identifying markers of psychosis risk and resilience is a necessary step toward understanding etiology and informing prevention and treatment efforts in individuals at clinical high risk (CHR) for psychosis. In this context, it is important to consider that neural risk markers have been particularly useful in identifying mechanistic determinants along with predicting clinical outcomes. Notably, despite a growing body of supportive literature and the promise of recent findings identifying potential neural markers, the current work on CHR resilience markers has received little attention. The present review provides a brief overview of brain-based risk markers with a focus on predicting symptom course. Next, the review turns to protective markers, examining research from nonpsychiatric and schizophrenia fields to build an understanding of framing, priorities, and potential, applying these ideas to contextualizing a small but informative body of resiliency-relevant CHR research. Four domains (neurocognition, emotion regulation, allostatic load, and sensory and sensorimotor function) were identified and are discussed in terms of behavioral and neural markers. Taken together, the literature suggests significant predictive value for brain-based markers for individuals at CHR for psychosis, and the limited but compelling resiliency work highlights the critical importance of expanding this promising area of inquiry.
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Affiliation(s)
- Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, Illinois.
| | | | - Arielle Ered
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Riley Capizzi
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Isabelle Frosch
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, Illinois; Department of Psychiatry, Northwestern University, Evanston, Illinois; Department of Medical Social Sciences, Northwestern University, Evanston, Illinois; Institute for Policy Research, Northwestern University, Evanston, Illinois; Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, Illinois
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24
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Abstract
Chronic stress exposure is associated with impaired cognitive function; however, the underlying mechanism is not yet clear. This study investigated the association between perceived chronic stress and anticipatory processing, measured by event-related potentials, and the moderating role of resilience on this relationship in healthy adults. Fifty-nine healthy volunteers (22.52 ± 1.75 years) underwent a continuous performance test, and anticipatory processing was indexed with the contingent negative variation (CNV) of event-related potentials, the Cohen Perceived Stress Scale, and the Connor-Davidson Resilience Scale. The results showed that greater reports of perceived chronic stress were associated with more negative early CNVs; however, there was no significant relationship between perceived chronic stress and behavioral performance on the continuous performance test. More importantly, the relationship between perceived chronic stress and early CNV was moderated by resilience as the association between the Cohen Perceived Stress Scale score and early CNV amplitude was significant for low and average levels of resilience. These results not only suggest that chronic stress may lead to decreased cognitive efficiency in cortical anticipatory activity, but also underscore the role of resilience as a key protective factor in decreased cognitive efficiency.
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Affiliation(s)
- Xia Shi
- Department of Psychology, Tianjin university of technology and education, Tianjin, China
| | - Jianhui Wu
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
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25
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Liu M, Mejia-Lancheros C, Lachaud J, Nisenbaum R, Stergiopoulos V, Hwang SW. Resilience and Adverse Childhood Experiences: Associations With Poor Mental Health Among Homeless Adults. Am J Prev Med 2020; 58:807-816. [PMID: 32147372 DOI: 10.1016/j.amepre.2019.12.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Adverse childhood experiences are known risk factors for a range of social, economic, and health-related outcomes over the life course. Resilience is a known protective factor. This study examines the associations of adverse childhood experiences and resilience with poor mental health outcomes among homeless adults with mental illness. METHODS This study utilized data from 565 homeless adults with mental illness participating in a Housing First intervention in Toronto (2009-2013) to evaluate their sociodemographic characteristics, adverse childhood experience exposure, resilience, and mental health outcomes. Descriptive statistics were generated, and logistic regression models were used to examine the association of total adverse childhood experience score and resilience with poor mental health outcomes. Analyses were conducted in 2019. RESULTS The average total adverse childhood experience score was 4.1 (SD=2.8) among all study participants. Individuals with a lifetime duration of homelessness exceeding 36 months (p=0.011) had higher mean scores. Total score was positively associated with several mental illness diagnoses and psychopathology severity, indicated by co-occurring mental illness diagnoses (AOR=1.23, 95% CI=1.13, 1.33) and high Colorado Symptom Index scores (AOR=1.26, 95% CI=1.14, 1.38). Resilience served as a protective factor against several individual mental illness diagnoses, co-occurring mental illness diagnoses (AOR=0.85, 95% CI=0.76, 0.95), and high Colorado Symptom Index scores (AOR=0.69, 95% CI=0.61, 0.79). CONCLUSIONS Findings highlight the high prevalence of adverse childhood experiences and their negative impact on homeless adults with mental illness. Resilience protects against adverse childhood experience-associated poor mental health outcomes, thereby serving as a potential interventional target in homeless populations.
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Affiliation(s)
- Michael Liu
- Harvard Medical School, Boston, Massachusetts; MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Cilia Mejia-Lancheros
- MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - James Lachaud
- MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Rosane Nisenbaum
- MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephen W Hwang
- MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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26
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Long Y, Liu Z, Chan CKY, Wu G, Xue Z, Pan Y, Chen X, Huang X, Li D, Pu W. Altered Temporal Variability of Local and Large-Scale Resting-State Brain Functional Connectivity Patterns in Schizophrenia and Bipolar Disorder. Front Psychiatry 2020; 11:422. [PMID: 32477194 PMCID: PMC7235354 DOI: 10.3389/fpsyt.2020.00422] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/24/2020] [Indexed: 11/13/2022] Open
Abstract
Schizophrenia and bipolar disorder share some common clinical features and are both characterized by aberrant resting-state functional connectivity (FC). However, little is known about the common and specific aberrant features of the dynamic FC patterns in these two disorders. In this study, we explored the differences in dynamic FC among schizophrenia patients (n = 66), type I bipolar disorder patients (n = 53), and healthy controls (n = 66), by comparing temporal variabilities of FC patterns involved in specific brain regions and large-scale brain networks. Compared with healthy controls, both patient groups showed significantly increased regional FC variabilities in subcortical areas including the thalamus and basal ganglia, as well as increased inter-network FC variability between the thalamus and sensorimotor areas. Specifically, more widespread changes were found in the schizophrenia group, involving increased FC variabilities in sensorimotor, visual, attention, limbic and subcortical areas at both regional and network levels, as well as decreased regional FC variabilities in the default-mode areas. The observed alterations shared by schizophrenia and bipolar disorder may help to explain their overlapped clinical features; meanwhile, the schizophrenia-specific abnormalities in a wider range may support that schizophrenia is associated with more severe functional brain deficits than bipolar disorder. Together, these findings highlight the potentials of using dynamic FC as an objective biomarker for the monitoring and diagnosis of either schizophrenia or bipolar disorder.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute of Central South University, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute of Central South University, Changsha, China
| | | | - Guowei Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute of Central South University, Changsha, China
| | - Zhimin Xue
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute of Central South University, Changsha, China
| | - Yunzhi Pan
- Mental Health Institute of Central South University, Changsha, China
| | - Xudong Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute of Central South University, Changsha, China
| | - Xiaojun Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute of Central South University, Changsha, China
| | - Dan Li
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Weidan Pu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
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27
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Gonzalez R, Gonzalez SD, McCarthy MJ. Using Chronobiological Phenotypes to Address Heterogeneity in Bipolar Disorder. MOLECULAR NEUROPSYCHIATRY 2020; 5:72-84. [PMID: 32399471 DOI: 10.1159/000506636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/18/2020] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a neuropsychiatric mood disorder characterized by recurrent episodes of mania and depression in addition to disruptions in sleep, energy, appetite, and cognitive functions-rhythmic behaviors that typically change on daily cycles. BD symptoms can also be provoked by seasonal changes, sleep, and/or circadian disruption, indicating that chronobiological factors linked to the circadian clock may be a common feature in the disorder. Research indicates that BD exists on a clinical spectrum, with distinct subtypes often intersecting with other psychiatric disorders. This heterogeneity has been a major challenge to BD research and contributes to problems in diagnostic stability and treatment outcomes. To address this heterogeneity, we propose that chronobiologically related biomarkers could be useful in classifying BD into objectively measurable phenotypes to establish better diagnoses, inform treatments, and perhaps lead to better clinical outcomes. Presently, we review the biological basis of circadian time keeping in humans, discuss the links of BD to the circadian clock, and pre-sent recent studies that evaluated chronobiological measures as a basis for establishing BD phenotypes. We conclude that chronobiology may inform future research using other novel techniques such as genomics, cell biology, and advanced behavioral analyses to establish new and more biologically based BD phenotypes.
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Affiliation(s)
- Robert Gonzalez
- Department of Psychiatry and Behavioral Health, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Suzanne D Gonzalez
- Department of Psychiatry and Behavioral Health, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.,Department of Pharmacology, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Michael J McCarthy
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry and Center for Chronobiology, University of California, San Diego, La Jolla, California, USA
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28
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Long Y, Chen C, Deng M, Huang X, Tan W, Zhang L, Fan Z, Liu Z. Psychological resilience negatively correlates with resting-state brain network flexibility in young healthy adults: a dynamic functional magnetic resonance imaging study. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:809. [PMID: 32042825 DOI: 10.21037/atm.2019.12.45] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Psychological resilience is an important personality trait whose decrease is associated with many common psychiatric disorders, but the neural mechanisms underlying it remain largely unclear. In this study, we aimed to explore the neural correlates of psychological resilience in healthy adults by investigating its relationship with functional brain network flexibility, a fundamental dynamic feature of brain network defined by switching frequency of its modular community structures. Methods Resting-state functional magnetic resonance imaging (fMRI) scans were acquired from 41 healthy adults, whose psychological resilience was quantified by the Connor-Davidson Resilience Scale (CD-RISC). Dynamic functional brain network was constructed for each subject, whose flexibility was calculated at all the global, subnetwork and region-of-interest (ROI) levels. After that, the associations between CD-RISC score and brain network flexibility were assessed at all levels by partial correlations controlling for age, sex, education and head motion. Correlation was also tested between the CD-RISC score and modularity of conventional static brain network for comparative purposes. Results The CD-RISC score was significant negatively correlated with the brain network flexibility at global level (r=-0.533, P=0.001), and with flexibility of the visual subnetwork at subnetwork level (r=-0.576, corrected P=0.002). Moreover, significant (corrected P<0.05) or trends for (corrected P<0.10) negative correlations were found between the CD-RISC score and flexibilities of a number of visual and default-mode areas at ROI level. Meanwhile, the modularity of static brain network did not reveal significant correlation with CD-RISC score (P>0.05). Conclusions Our results suggest that excessive fluctuations of the functional brain community structures during rest may be indicative of a lower psychological resilience, and the visual and default-mode systems may play crucial roles in such relationship. These findings may provide important implications for improving our understanding of the psychological resilience.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China.,Mental Health Institute of Central South University, Changsha 410011, China
| | - Chujun Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Mengjie Deng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xiaojun Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Wenjian Tan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Li Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Zebin Fan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha 410011, China.,Mental Health Institute of Central South University, Changsha 410011, China
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29
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Chen H, Xu J, Mao Y, Sun L, Sun Y, Zhou Y. Positive Coping and Resilience as Mediators Between Negative Symptoms and Disability Among Patients With Schizophrenia. Front Psychiatry 2019; 10:641. [PMID: 31551832 PMCID: PMC6748026 DOI: 10.3389/fpsyt.2019.00641] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/08/2019] [Indexed: 12/20/2022] Open
Abstract
Objective: This study proposes a schizophrenia disability model to describe the associations between negative symptoms and disability to test the possible mediating roles of positive coping and resilience and to compare the relative weights of the indirect effects of these two mediators in an integrated whole. Methods: A total of 407 hospitalized Han Chinese patients diagnosed with stable schizophrenia or schizoaffective disorder were included. Patients were evaluated using the following scales: the Simplified Coping Style Questionnaire (SCQ) for positive coping, the Connor-Davidson Resilience Scale (CD-RISC) for resilience, the Positive and Negative Syndrome Scale (PANSS) for negative symptoms, and the World Health Organization Disability Assessment Schedule, Version II (WHO-DAS II) for the severity of disability. The schizophrenia disability distal mediation model was constructed using the structural modeling (SEM) approach. Bootstrapping procedures and the PRODCLIN program were used to examine the mediating roles of positive coping and resilience. Results: The schizophrenia disability model was well-fitted to the observed data. Positive coping and resilience together with negative symptoms explained 66% of the variance in disability. Positive coping and resilience partly mediated the negative symptoms-disability relationship. The bootstrapped unstandardized indirect effect was 0.319, and the direct effect was 0.224. Positive coping also has a significant positive effect on resilience. In addition, the ratio of the specific indirect effect of positive coping to the total indirect effect (48%) is higher than that of resilience (30%). Conclusion: Positive coping and resilience are two key causal mediators of the negative symptoms-disability relationship. Positive coping and resilience are important personal resources for patients with schizophrenia. We found that the indirect effect of positive coping was relatively more important than that of resilience. This result suggests that personalized treatments aimed at resilience and positive coping can effectively buffer the impact of negative symptoms for patients with schizophrenia and promote rehabilitation.
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Affiliation(s)
- Haotian Chen
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China.,School of Nursing, Harbin Medical University, Daqing, China
| | - Jianfeng Xu
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
| | - Yue Mao
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
| | - Lili Sun
- School of Nursing, Harbin Medical University, Daqing, China.,Department of Senior Citizens Welfare, Beijing College of Social Administration, Beijing, China
| | - Yujing Sun
- School of Nursing, Harbin Medical University, Daqing, China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University, Daqing, China
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30
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Kane C, Tomotake M, Hamatani S, Chiba S, Kameoka N, Watanabe S, Nakataki M, Numata S, Ohmori T. Clinical factors influencing resilience in patients with anorexia nervosa. Neuropsychiatr Dis Treat 2019; 15:391-395. [PMID: 30787613 PMCID: PMC6365225 DOI: 10.2147/ndt.s190725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study was to elucidate clinical factors influencing resilience in anorexia nervosa (AN) patients. PATIENTS AND METHODS Twenty female patients with AN (median age =30.0 years, quartile deviation =6.8) and 40 female healthy controls (HCs) (median age =30.0 years, quartile deviation =8.6) participated in the present study. Resilience was assessed with the Connor- Davidson resilience scale (CD-RISC). Clinical symptoms were evaluated with the structured interview guide for the Hamilton depression rating scale (SIGH-D) and the eating disorder inventory-2 (EDI-2). RESULTS Scores of the CD-RISC in the AN group were lower than those in the HC group, and the SIGH-D score in the AN group was higher than that in the HC group. Scores of interoceptive confusion, interpersonal difficulty and negative self-image subscales of the EDI-2 negatively correlated with the CD-RISC score. Moreover, stepwise regression analysis showed that negative self-image score was an independent predictor of the CD-RISC score. CONCLUSION These results suggest that among these clinical factors including psychopathologies, self-dissatisfaction and feeling of being rejected by others are the most important influencing factors on an AN patients' resilience.
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Affiliation(s)
- Chikako Kane
- Department of Nursing, Tokushima University Hospital, Tokushima-shi, Tokushima, Japan Email
| | - Masahito Tomotake
- Department of Mental Health, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development Chiba University, Chuouku, Chiba, Japan
| | - Shinichi Chiba
- Department of Mental Health, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Naomi Kameoka
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Shinya Watanabe
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Masahito Nakataki
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
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31
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Kim HK, Park HY, Seo E, Bang M, Song YY, Lee SY, Kim KR, Park JY, Kang JI, Lee E, An SK. Factors Associated With Psychosocial Functioning and Outcome of Individuals With Recent-Onset Schizophrenia and at Ultra-High Risk for Psychosis. Front Psychiatry 2019; 10:459. [PMID: 31293463 PMCID: PMC6606785 DOI: 10.3389/fpsyt.2019.00459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 06/11/2019] [Indexed: 01/31/2023] Open
Abstract
Background: Patients with schizophrenia have impairments in social functioning and are readmitted to healthcare institutions frequently. Individuals at ultra-high risk (UHR) for psychosis already present poor social functioning; among those individuals, the conversion rate from the putative prodromal phase to overt psychosis is 20%-30% within 1-2 years. Here, we analyzed the factor structure of self-related variables and neuro- and socio-cognitive function, and investigated whether these factors were associated with psychosocial function and prognostic outcome in individuals with recent-onset schizophrenia (ROSPR) or at UHR for psychosis. Methods: We evaluated 60 individuals at UHR for psychosis, 47 individuals with ROSPR, and 71 healthy controls using a comprehensive neurocognitive test battery and self-reported attribution scales, self-esteem, resilience, aberrant subjective experiences of schizotypy (physical anhedonia, social anhedonia, magical ideation, and perceptual aberration), and basic symptoms. We assessed psychosocial function with the Quality of Life Scale (QLS). Results: Factor analysis of all subjects revealed a four-factor structure comprising social-cognitive bias, reflective self, neurocognition, and pre-reflective self factors. Multiple regression analysis at baseline revealed that the factor structure predicted QLS. In the UHR group, social-cognitive bias, reflective self, neurocognition, and negative symptoms were significant determinants, explaining 38.0% of total QLS score variance. In the ROSPR group, reflective self and negative symptoms were significant determinants, explaining 54.4% of total QLS score variance. During follow-up, 13 individuals at UHR for psychosis developed psychosis (cumulative prevalence: 31.2% ± 7.6% at 6 years), with neurocognition score at baseline remaining a significant predictor of conversion [χ2(1) = 4.009, p = 0.045; hazard ratio 0.56, 95% confidence interval 0.31-0.99, p = 0.048]. Five patients with schizophrenia were (re)admitted during follow-up (cumulative prevalence: 16.1% ± 7.1% at 6 years); no factor was found to predict (re)admission. Conclusion: Factor analysis revealed an intrinsic four-factor structure of social-cognitive bias, reflective self, neurocognition, and pre-reflective self. The four factors were associated with social functioning at baseline and prodrome-to-psychosis conversion during follow-up, indicating the clinical significance of the four-factor structure. These findings provide a framework for understanding schizophrenia.
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Affiliation(s)
- Hyun Kyu Kim
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Yoon Park
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunchong Seo
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Yun Young Song
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Su Young Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Kyung Ran Kim
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, South Korea
| | - Jee In Kang
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Lee
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, South Korea
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