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Lanza G, Fisicaro F, Cantone M, Pennisi M, Cosentino FII, Lanuzza B, Tripodi M, Bella R, Paulus W, Ferri R. Repetitive transcranial magnetic stimulation in primary sleep disorders. Sleep Med Rev 2023; 67:101735. [PMID: 36563570 DOI: 10.1016/j.smrv.2022.101735] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a widely used non-invasive neuromodulatory technique. When applied in sleep medicine, the main hypothesis explaining its effects concerns the modulation of synaptic plasticity and the strength of connections between the brain areas involved in sleep disorders. Recently, there has been a significant increase in the publication of rTMS studies in primary sleep disorders. A multi-database-based search converges on the evidence that rTMS is safe and feasible in chronic insomnia, obstructive sleep apnea syndrome (OSAS), restless legs syndrome (RLS), and sleep deprivation-related cognitive deficits, whereas limited or no data are available for narcolepsy, sleep bruxism, and REM sleep behavior disorder. Regarding efficacy, the stimulation of the dorsolateral prefrontal cortex bilaterally, right parietal cortex, and dominant primary motor cortex (M1) in insomnia, as well as the stimulation of M1 leg area bilaterally, left primary somatosensory cortex, and left M1 in RLS reduced subjective symptoms and severity scale scores, with effects lasting for up to weeks; conversely, no relevant effect was observed in OSAS and narcolepsy. Nevertheless, several limitations especially regarding the stimulation protocols need to be considered. This review should be viewed as a step towards the further contribution of individually tailored neuromodulatory techniques for sleep disorders.
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Affiliation(s)
- Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy; Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy.
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Mariagiovanna Cantone
- Neurology Unit, University Hospital Policlinico "G. Rodolico-San Marco", Catania, Italy; Department of Neurology, Sant'Elia Hospital, ASP Caltanissetta, Caltanissetta, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | - Bartolo Lanuzza
- Department of Neurology IC and Sleep Research Centre, Oasi Research Institute-IRCCS, Troina, Italy
| | - Mariangela Tripodi
- Department of Neurology IC and Sleep Research Centre, Oasi Research Institute-IRCCS, Troina, Italy
| | - Rita Bella
- Department of Medical and Surgical Science and Advanced Technologies, University of Catania, Catania, Italy
| | - Walter Paulus
- Department of Neurology, Ludwig Maximilians University, Munich, Germany
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
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Concerto C, Rodolico A, La Rosa VL, Aiello B, Martinez M, Stuto S, Infortuna C, Fusar-Poli L, Signorelli MS, Commodari E, Battaglia F, Aguglia E. Flourishing or Languishing? Predictors of Positive Mental Health in Medical Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15814. [PMID: 36497895 PMCID: PMC9736882 DOI: 10.3390/ijerph192315814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
During the COVID-19 pandemic, medical students were burdened with high levels of stress, anxiety, and depression. The objective of the present study was to investigate predictors of positive mental health among medical students during the COVID-19 pandemic. We conducted an online survey from September 2021 to March 2022. We applied the snowball recruitment technique involving medical students from the University of Catania, Italy. We administered, anonymously, a questionnaire about demographic characteristics, the Depression Anxiety Stress Scale (DASS-21), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A), and the short form of the Mental Health Continuum (MHC-SF). Participants showed moderate anxiety, depression, and stress levels, and more than half had positive mental health status overall. This finding was inversely related to age, depression severity, cyclothymic, and depressive temperaments. Our results showed that medical students with depressive and cyclothymic temperaments were more at risk of worsening mental health status during the pandemic. Our findings may allow for further developments about the impact of personological characteristics on students' mental health to enable more efficient support for the most vulnerable.
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Affiliation(s)
- Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | | | - Barbara Aiello
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Miriam Martinez
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Sebastiano Stuto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Carmenrita Infortuna
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy
| | - Laura Fusar-Poli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Fortunato Battaglia
- Department of Medical Sciences, Neurology, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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Infortuna C, Battaglia F, Freedberg D, Mento C, Iannuzzo F, De Stefano R, Lombardo C, Muscatello MRA, Bruno A. Emotional Temperament and Character Dimensions and State Anger as Predictors of Preference for Rap Music in Italian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13650. [PMID: 36294230 PMCID: PMC9602764 DOI: 10.3390/ijerph192013650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The objective of the current work was to examine the relationships between affective temperaments dimensions, trait anger, and the preference for rap music in a sample of Italian adults. An online survey was administered to 662 subjects. We assessed preference for rap music using a Likert scale. Ina addition, we investigated the sample' affective temperament traits using the Memphis, Pisa, Paris, and San Diego (TEMPS-A) short scale and the trait anger by using the Trait Anger component of the State Trait Anger Expression Inventory 2 (STAXI-2). Multiple linear regression indicated that cyclothymic temperament score, hyperthymic temperament score, and trait anger scores were positive predictors while older age, and depressive temperament and higher education score were negative predictors of preference for rap music. The results expand previous literature on personality and music preference indicating the association of high energy/high activity temperaments and trait anger to preference for rap music.
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Affiliation(s)
- Carmenrita Infortuna
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
| | - Fortunato Battaglia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - David Freedberg
- Department of Art History and Archaeology and Italian Academy for Advanced Studies in America, Columbia University, New York, NY 10027, USA
| | - Carmela Mento
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy
| | - Fiammetta Iannuzzo
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
| | - Rosa De Stefano
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
| | - Clara Lombardo
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
| | - Maria Rosaria Anna Muscatello
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy
| | - Antonio Bruno
- Psychiatric Unit, University Hospital “G. Martino” of Messina, 98125 Messina, Italy
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy
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Kent N, Alhowaymel F, Kalmakis K, Troy L, Chiodo L. Development of the College Student Acute Stress Scale (CSASS). Perspect Psychiatr Care 2022; 58:2998-3008. [PMID: 35191032 PMCID: PMC9392815 DOI: 10.1111/ppc.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/14/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study is to develop and validate the College Student Acute Stress Scale, a measure of acute stress specific to college students. DESIGN AND METHODS A total sample of 440 young adults from a university in the northeast United States were surveyed across three separate research studies. Exploratory principal component analysis, internal consistency reliability, convergent and divergent validity, and test-retest reliability analyses were performed. FINDINGS Evidence of convergent and divergent validity were obtained, and adequate internal consistency and test-retest reliability were identified. PRACTICE IMPLICATIONS This study provides evidence for the validity and reliability of a self-report measure of college students' acute stress experiences.
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Affiliation(s)
- Nicole Kent
- College of Nursing, University of Massachusetts Amherst, USA
| | - Fahad Alhowaymel
- College of Nursing, University of Massachusetts Amherst, USA
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Karen Kalmakis
- College of Nursing, University of Massachusetts Amherst, USA
| | - Lisa Troy
- School of Public Health & Health Sciences and Commonwealth Honors College, University of Massachusetts Amherst, USA
| | - Lisa Chiodo
- College of Nursing, University of Massachusetts Amherst, USA
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Kwan JM, Noch E, Qiu Y, Toubat O, Christophers B, Azzopardi S, Gilmer G, Wiedmeier JE, Daye D. The Impact of COVID-19 on Physician-Scientist Trainees and Faculty in the United States: A National Survey. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1536-1545. [PMID: 35921163 PMCID: PMC9547818 DOI: 10.1097/acm.0000000000004802] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Physician-scientists have long been considered an endangered species, and their extended training pathway is vulnerable to disruptions. This study investigated the effects of COVID-19-related challenges on the personal lives, career activities, stress levels, and research productivity of physician-scientist trainees and faculty. METHOD The authors surveyed medical students (MS), graduate students (GS), residents/fellows (R/F), and faculty (F) using a tool distributed to 120 U.S. institutions with MD-PhD programs in April-June 2020. Chi-square and Fisher's exact tests were used to compare differences between groups. Machine learning was employed to select variables for multivariate logistic regression analyses aimed at identifying factors associated with stress and impaired productivity. RESULTS The analyses included 1,929 respondents (MS: n = 679, 35%; GS: n = 676, 35%; R/F: n = 274, 14%; F: n = 300, 16%). All cohorts reported high levels of social isolation, stress from effects of the pandemic, and negative impacts on productivity. R/F and F respondents were more likely than MS and GS respondents to report financial difficulties due to COVID-19. R/F and F respondents with a dual degree expressed more impaired productivity compared with those without a dual degree. Multivariate regression analyses identified impacted research/scholarly activities, financial difficulties, and social isolation as predictors of stress and impaired productivity for both MS and GS cohorts. For both R/F and F cohorts, impacted personal life and research productivity were associated with stress, while dual-degree status, impacted research/scholarly activities, and impacted personal life were predictors of impaired productivity. More female than male respondents reported increased demands at home. CONCLUSIONS This national survey of physician-scientist trainees and faculty found a high incidence of stress and impaired productivity related to the COVID-19 pandemic. Understanding the challenges faced and their consequences may improve efforts to support the physician-scientist workforce in the postpandemic period.
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Affiliation(s)
- Jennifer M Kwan
- J.M. Kwan is a cardiologist, Yale School of Medicine, New Haven, Connecticut, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4715-1848
| | - Evan Noch
- E. Noch is a neurologist, Weill Cornell School of Medicine, New York, New York, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4561-1169
| | - Yuqing Qiu
- Y. Qiu is a biostatistician, Weill Cornell School of Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-4561-1169
| | - Omar Toubat
- O. Toubat is an MD-PhD student, University of Southern California, Los Angeles, California; ORCID: https://orcid.org/0000-0002-3377-1384
| | - Briana Christophers
- B. Christophers is an MD-PhD student, Weill Cornell Medicine, New York, New York; ORCID: https://orcid.org/0000-0001-5248-069X
| | - Stephanie Azzopardi
- S. Azzopardi is an MD-PhD student, Weill Cornell Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-9585-9234
| | - Gabrielle Gilmer
- G. Gilmer is an MD-PhD student, University of Pittsburgh, Pittsburgh, Pennsylvania; ORCID: https://orcid.org/0000-0002-9039-4183
| | - Julia Erin Wiedmeier
- J.E. Wiedmeier is a hematology/oncology fellow, Mayo Clinic Arizona, Phoenix, Arizona; ORCID: https://orcid.org/0000-0001-9434-5269
| | - Dania Daye
- D. Daye is an interventional radiologist, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-2230-7199
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Infortuna C, Gualano F, Freedberg D, Patel SP, Sheikh AM, Muscatello MRA, Bruno A, Mento C, Chusid E, Han Z, Thomas FP, Battaglia F. Motor Cortex Response to Pleasant Odor Perception and Imagery: The Differential Role of Personality Dimensions and Imagery Ability. Front Hum Neurosci 2022; 16:943469. [PMID: 35903786 PMCID: PMC9314567 DOI: 10.3389/fnhum.2022.943469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background Neuroimaging studies have shown a complex pattern of brain activation during perception of a pleasant odor and during its olfactory imagery. To date, little is known regarding changes in motor cortex excitability during these tasks. Bergamot essential oil (BEO) is extensively used in perfumes and cosmetics for its pleasantness. Therefore, to further our understanding of the human sense of smell, this study aimed to investigate the effect of perception and imagery of a pleasant odor (BEO) on motor cortex using Transcranial magnetic stimulation (TMS). Materials and Methods We examined the primary motor cortex (M1) excitability during perception of a pleasant odor (BEO) or perception of odorless saline (experiment 1). Furthermore, we tested the effect of olfactory imagery (OI) of BEO on corticospinal excitability (experiment 2). The increase in motor evoked potential (MEP) amplitude was correlated with personality dimensions scores, pleasantness, vividness, and general imagery ability. Results The results indicate that the corticospinal excitability changed after both perception and imagery of a pleasant odor (BEO). The correlation analysis shows an association with neuroticism personality trait (experiment 1) and with general olfactory imagery ability (experiment 2). Conclusion Both perception of a pleasant odor and its olfactory imagery modulate motor cortex excitability. The enhanced brain activation is affected by specific individual characteristics. Overall, our findings provide physiological evidence for a complex interaction between the olfactory and motor systems.
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Affiliation(s)
- Carmenrita Infortuna
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Francesca Gualano
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - David Freedberg
- Department of Art History and Archeology, Italian Academy for Advanced Studies, Columbia University, New York, NY, United States
| | - Sapan P. Patel
- Department of Art History and Archeology, Italian Academy for Advanced Studies, Columbia University, New York, NY, United States
| | - Asad M. Sheikh
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY, United States
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Carmela Mento
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario “G. Martino”, University of Messina, Messina, Italy
| | - Eileen Chusid
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY, United States
| | - Zhiyong Han
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Florian P. Thomas
- Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Fortunato Battaglia
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- *Correspondence: Fortunato Battaglia,
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Oláh B, Rádi BM, Kósa K. Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137662. [PMID: 35805319 PMCID: PMC9265856 DOI: 10.3390/ijerph19137662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022]
Abstract
Medical students are at increased risk for psychological morbidity but the majority of those with mental health problems do not seek professional care. We aimed to uncover the viewpoints of medical students regarding barriers and facilitators to using university mental health services and their attitudes and preferences towards online counselling. Four semi-structured focus groups were conducted (n = 26, mean age = 21.8, ±1.88, 73% males). After reaching data saturation, interviews were audio-recorded, transcribed and content-analysed by two independent coders. Intrapersonal barriers emerged to be perceived low risk, excessive self-reliance, lack of belief in the effectiveness of service, lack of openness. Interpersonal factors were the following: assumed long waiting list, insufficient provision of service information, fear of exposure, and not being familiar with the counsellor and the process. Extrapersonal barriers such as insurance problems, the number of available sessions, adverse sociocultural attitudes, fear of stigmatisation were identified. Students suggested that the university should provide psychoeducation and routine screening, apply social marketing and stigma reduction campaigns, improve information flow, and offer not only personal but also online video counselling to target removing these barriers. The results provide a reference for the redesign of mental health services to facilitate their access by students. Implications and limitations are discussed.
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Affiliation(s)
- Barnabás Oláh
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.M.R.); (K.K.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: ; Tel.: +36-52-411-600 (ext. 54360)
| | - Bence Márk Rádi
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.M.R.); (K.K.)
| | - Karolina Kósa
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.M.R.); (K.K.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
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Yin L, Song TH, Wei YY, Zhang LG, Zhou SJ, Yu JJ, Zhang LY, Li HJ, Chen JX. Relationship Between Affective Temperaments and Suicide Risk in Patients With First-Onset Major Depressive Disorder. Front Psychiatry 2022; 13:893195. [PMID: 35747102 PMCID: PMC9211372 DOI: 10.3389/fpsyt.2022.893195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background People may endorse suicidal behavior during a major depressive episode. Affective temperaments may play a role in this risk. We explored the relationship between affective temperaments and suicide and identified some traits that can predict suicide risk in depression. Materials and Methods We analyzed the results of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) in 284 participants recruited from a psychiatric clinic and the community in Beijing and compared the subscale scores (temperaments of cyclothymic, dysthymic, anxious, irritable, and hyperthymic) among major depressive disorders (MDDs) vs. the general population as well as depressive patients with vs. without suicide risk, using Student's test, chi-square test, rank-sum test, and multivariable regression modeling. Results The incidence of suicidal risk in depressive subjects was 47.62% (80/168). Being unmarried (p < 0.001), unemployed (p = 0.007), and temperaments of dysthymic, cyclothymic, anxious, and irritable scores (all p < 0.001) were significantly more prevalent in patients with depression than in the general population. Young age (p < 0.001), female sex (p = 0.037), unmarried (p = 0.001), more severe depression (p < 0.001), and dysthymic, anxious, and cyclothymic temperament (all p < 0.05) were significantly more prevalent in patients with depressive disorder than those without suicide risk. The logistic regression analysis showed that younger age (odds ratio [OR] = 0.937, 95% CI 0.905∼0.970), female sex (OR = 2.606, 95% CI 1.142∼5.948), more severe depression (OR = 1.145, 95% CI 1.063∼1.234), cyclothymic temperament (OR = 1.275, 95% CI 1.102∼1.475), and dysthymic temperament (OR = 1.265, 95% CI 1.037∼1.542) were all independently associated with high suicidal risk in patients with first-onset major depression (p < 0.05). Conclusion Temperament traits differ between the general population and people suffering from MDD. Subjects with MDD who have much more severe depressive symptoms and a cyclothymic or dysthymic temperament were at a high risk of suicide.
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Affiliation(s)
- Lu Yin
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Tian-He Song
- Department of Psychology, Chengde Medical University, Hebei, China
| | - Yan-Yan Wei
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Li-Gang Zhang
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Shuang-Jiang Zhou
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Jian-Jin Yu
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Li-Ye Zhang
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Hong-Juan Li
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
| | - Jing-Xu Chen
- Beijing Hui-Long-Guan Hospital, Peking University Hui-Long-Guan Clinical Medical School, Beijing, China
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Relationship between Depressive Symptoms and Weather Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095069. [PMID: 35564464 PMCID: PMC9101342 DOI: 10.3390/ijerph19095069] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/31/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022]
Abstract
Background: Weather is a well-known factor worldwide in psychiatric problems such as depression, with the elderly and females being particularly susceptible. The aim of this study was to detect associations between the risk of depressive symptoms (DS) and weather variables. Methods: 6937 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study during 2006−2008. To assess the risk of DS, a multivariate logistic model was created with predictors such as socio-demographic factors, health behaviors, and weather variables. Results: DS were found in 23.4% of the respondents, in 15.6% of males and in 29.9% in females. A higher risk of DS (by 25%) was associated with November−December, a rising wind speed, and relative humidity (RH) < 94% and snowfall during the cold period occurring 2 days before the survey. A higher air temperature (>14.2 °C) predominant during May−September had a protective impact. A higher risk of DS in males was associated with lower atmospheric pressure (<1009 hPa) 2 days before. Females were more sensitive to the monthly variation, snowfall, and RH. Conclusions: The findings of our study suggest that some levels of weather variables have a statistically significant effect on DS.
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Lanza G, Cosentino FII, Lanuzza B, Tripodi M, Aricò D, Figorilli M, Puligheddu M, Fisicaro F, Bella R, Ferri R, Pennisi M. Reduced Intracortical Facilitation to TMS in Both Isolated REM Sleep Behavior Disorder (RBD) and Early Parkinson's Disease with RBD. J Clin Med 2022; 11:jcm11092291. [PMID: 35566417 PMCID: PMC9104430 DOI: 10.3390/jcm11092291] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/06/2022] [Accepted: 04/18/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND a reduced intracortical facilitation (ICF), a transcranial magnetic stimulation (TMS) measure largely mediated by glutamatergic neurotransmission, was observed in subjects affected by isolated REM sleep behavior disorder (iRBD). However, direct comparison between iRBD and Parkinson's disease (PD) with RBD is currently lacking. METHODS resting motor threshold, contralateral cortical silent period, amplitude and latency of motor evoked potentials, short-interval intracortical inhibition, and intracortical facilitation (ICF) were recorded from 15 drug-naïve iRBD patients, 15 drug-naïve PD with RBD patients, and 15 healthy participants from the right First Dorsal Interosseous muscle. REM sleep atonia index (RAI), Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Epworth Sleepiness Scale (ESS) were assessed. RESULTS Groups were similar for sex, age, education, and patients for RBD duration and RAI. Neurological examination, MMSE, ESS, and GDS were normal in iRBD patients and controls; ESS scored worse in PD patients, but with no difference between groups at post hoc analysis. Compared to controls, both patient groups exhibited a significantly decreased ICF, without difference between them. CONCLUSIONS iRBD and PD with RBD shared a reduced ICF, thus suggesting the involvement of glutamatergic transmission both in subjects at risk for degeneration and in those with an overt α-synucleinopathy.
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Affiliation(s)
- Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
- Clinical Neurophysiology Research Unit, Oasi Research Institute—IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy;
- Correspondence: ; Tel.: +39-095-3782448
| | - Filomena Irene Ilaria Cosentino
- Department of Neurology IC and Sleep Research Center, Oasi Research Institute—IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (B.L.); (M.T.); (D.A.)
| | - Bartolo Lanuzza
- Department of Neurology IC and Sleep Research Center, Oasi Research Institute—IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (B.L.); (M.T.); (D.A.)
| | - Mariangela Tripodi
- Department of Neurology IC and Sleep Research Center, Oasi Research Institute—IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (B.L.); (M.T.); (D.A.)
| | - Debora Aricò
- Department of Neurology IC and Sleep Research Center, Oasi Research Institute—IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy; (F.I.I.C.); (B.L.); (M.T.); (D.A.)
| | - Michela Figorilli
- Neurology Unit, Department of Medical Sciences and Public Health, University of Cagliari and AOU Cagliari, Asse Didattico E., SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (M.F.); (M.P.)
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E., SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy
| | - Monica Puligheddu
- Neurology Unit, Department of Medical Sciences and Public Health, University of Cagliari and AOU Cagliari, Asse Didattico E., SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (M.F.); (M.P.)
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico E., SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (F.F.); (M.P.)
| | - Rita Bella
- Department of Medical and Surgical Science and Advanced Technologies, University of Catania, Via Santa Sofia 78, 95125 Catania, Italy;
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute—IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy;
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy; (F.F.); (M.P.)
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11
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Natale A, Concerto C, Rodolico A, Birgillito A, Bonelli M, Martinez M, Signorelli MS, Petralia A, Infortuna C, Battaglia F, Aguglia E. Risk Perception among Psychiatric Patients during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052620. [PMID: 35270313 PMCID: PMC8909657 DOI: 10.3390/ijerph19052620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 01/06/2023]
Abstract
The fear of the new coronavirus infection has driven many non-COVID-19 patients away from essential healthcare. Our study aimed to investigate the perception of risk and feelings of danger for the contagion in a sample of Italian psychiatric patients. We conducted a cross-sectional observational study during the second wave of the COVID-19 pandemic and the lockdown in Italy. The risk perception and risk-related variables were assessed in a sample of 150 consecutive patients with a previous diagnosis of major depression (50), bipolar I disorder (50), and schizophrenia seeking ambulatory care using a questionnaire previously administered to the general Italian population. Our results showed that patients were more concerned about economic, psychological, and interpersonal consequences of COVID-19 pandemic, rather than about their own health. At the multiple regression analysis, the likelihood of COVID-19 resolution was positively influenced by the diagnosis of schizophrenia, the increased perceived effectiveness, and the presence of positive emotions. Indeed, positive emotions and uncertainty positively influenced interpersonal risk. Our study highlights the need to provide more support to psychiatric patients during emergency events to prevent them from engaging in risky behaviors.
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Affiliation(s)
- Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Andrea Birgillito
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Marina Bonelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Miriam Martinez
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Antonino Petralia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
| | - Carmenrita Infortuna
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98121 Messina, Italy;
| | - Fortunato Battaglia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
- Correspondence:
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.N.); (C.C.); (A.R.); (A.B.); (M.B.); (M.M.); (M.S.S.); (A.P.); (E.A.)
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12
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Concerto C, Rodolico A, Ciancio A, Messina C, Natale A, Mineo L, Battaglia F, Aguglia E. Vitamin D and Depressive Symptoms in Adults with Multiple Sclerosis: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:199. [PMID: 35010459 PMCID: PMC8750302 DOI: 10.3390/ijerph19010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Vitamin D deficiency has been correlated with Multiple Sclerosis (MS) risk and disease activity. There is some controversy as to whether vitamin D could have an impact on depressive symptoms in people with MS (pwMS). The aim of this scoping review was to evaluate the association between vitamin D status and depressive symptoms in pwMS. METHODS We searched databases to include studies published up to March 2021 to provide an overview of the available evidence on the correlation between vitamin D status and depressive symptoms in pwMS. The eligibility criteria were as follows: studies evaluating the use of vitamin D measurement on depressive symptoms in patients suffering from MS, including randomized and non-randomized studies; studies written in English; and studies exploring an adult population over the age of 18. RESULTS Eleven studies met our inclusion criteria: two of them were abstracts only; the majority were cross-sectional studies; two were prospective longitudinal studies; one was a retrospective cohort study; and one was a randomized placebo-controlled trial (RCT). Of the eleven studies selected, seven showed a potential correlation between low vitamin D levels and depressive symptoms. CONCLUSION Future RCT studies should include patients with greater severity of depressive symptoms and should consider confounding factors such as sun exposure and seasonal variation of vitamin D.
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Affiliation(s)
- Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Alessia Ciancio
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Christian Messina
- MS Center, Department “G.F. Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy;
| | - Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Ludovico Mineo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
| | - Fortunato Battaglia
- Department of Medical Sciences, Neurology and Psychiatry, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA;
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (A.R.); (A.C.); (A.N.); (L.M.); (E.A.)
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13
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Wang D, He N, Liu Y, Pang R, Dilixiati M, Wumaier A. Influencing factors of depressive symptoms in patients with malignant tumour. J Int Med Res 2021; 49:3000605211062450. [PMID: 34894827 PMCID: PMC8669887 DOI: 10.1177/03000605211062450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To assess the influencing factors of depressive symptoms in malignant tumour patients. METHODS Participants were 2079 inpatients with malignant tumour (1291: depressive symptoms; 788 no depressive symptoms). Univariable and multivariable logistic regression were used to evaluate sociodemographic and clinical factors influencing depressive symptoms. RESULTS Risk factors were family income ≤5000 yuan (odds ratio [OR]: 4.966, 95% confidence interval [CI]: 2.938-8.395) and 5001-10,000 yuan (OR: 3.111, 95% CI: 1.840-5.260); Karnofsky Performance Status of 70 (OR: 2.783, 95% CI: 1.281-6.042) and 80 (OR: 1.834, 95% CI: 1.139-2.953); disease course ≤1 year; palliative treatment (OR: 2.288, 95% CI: 1.292-4.055); progressive disease (OR: 1.876, 95% CI: 1.284-2.739); pain (OR: 1.973, 95% CI: 1.555-2.505); cancer type: lung (OR: 3.199, 95% CI: 1.938-5.279), oesophagus (OR: 3.288, 95% CI: 1.673-6.464), cervix (OR: 1.542, 95% CI: 1.056-2.253) and partial knowledge of disease condition (OR: 2.366, 95% CI: 1.653-3.385). Return to work (OR: 0.503, 95% CI: 0.348-0.727) and physical exercise (OR: 0.437, 95% CI: 0.347-0.551) were protective against depressive symptoms. CONCLUSIONS Several factors affected depressive symptoms in malignant tumour patients, including income, disease type and course, palliative treatment, return to work and physical exercise.
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Affiliation(s)
- Dongmei Wang
- Department of Pharmacology, Xinjiang Medical University, Urumqi, Xinjiang, China.,Department of Integrated Traditional Chinese and Western Medicine, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Nana He
- Department of Oncology, Affiliated Hospital of Traditional Chinese Medicine, Urumqi, Xinjiang, China
| | - Yuwu Liu
- Morphological Center, College of Basic Medicine, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Rui Pang
- Department of Integrated Traditional Chinese and Western Medicine, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Meikereayi Dilixiati
- Department of Integrated Traditional Chinese and Western Medicine, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ainiwaer Wumaier
- Department of Pharmacology, Xinjiang Medical University, Urumqi, Xinjiang, China
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14
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Infortuna C, Mineo L, Buffer S, Thomas FP, Muscatello MRA, Aguglia E, Bruno A, Zoccali RA, Sheikh A, Chusid E, Han Z, Battaglia F. Acute social and somatic stress alters cortical metaplasticity probed with non-invasive brain stimulation in humans. Int J Psychophysiol 2021; 170:1-5. [PMID: 34547303 DOI: 10.1016/j.ijpsycho.2021.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
Studying the neuronal mechanisms that govern the cortical adaptations to acute stress is critical for understanding the development of neuropsychiatric diseases. Homeostatic plasticity stabilizes the neural activity in which a previous synaptic event drives subsequent synaptic plasticity. In this study, we evaluated the effect of acute stress induced with the socially evaluated cold pressor test (SECPT) on cortical metaplasticity in humans using a non-invasive brain stimulation protocol. After being exposed to the SECPT and control stress conditions, 30 healthy participants were tested for cortical metaplasticity assessed with changes in the amplitude of the motor evoked potential (MEP) induced by a single-pulse transcranial magnetic stimulation (TMS). Cortical metaplasticity was induced by combining priming with cathodal tDCS (cTDCS) followed by a sub-threshold 1-Hz repetitive stimulation (rTMS) test session. Our results showed that SECPT induced cardiovascular adaptations (increase in systolic, diastolic blood pressure, and heart rate), indicating that SECPT effectively induced acute stress. Also, in our experiments stimulation of subjects with 1-Hz rTMS after they had undergone the SECPT condition induced inhibition of MEP whereas 1-Hz rTMS administered after the control condition induced a facilitatory (physiologic) response pattern. Here we observed that acute stress impairs homeostatic metaplasticity. The dysfunctional regulation of cortical plastic changes after stress could play a pivotal role in the pathogenesis of neurological and psychiatric diseases.
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Affiliation(s)
- Carmenrita Infortuna
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
| | - Ludovico Mineo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy
| | - Steven Buffer
- Department of Medical Sciences and Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Florian P Thomas
- Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy
| | - Antonio Bruno
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
| | - Asad Sheikh
- Department of Pre-clinical Sciences, New York College of Podiatric Medicine, New York, USA
| | - Eileen Chusid
- Department of Pre-clinical Sciences, New York College of Podiatric Medicine, New York, USA
| | - Zhyiong Han
- Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Fortunato Battaglia
- Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA.
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15
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Wang J, Liu W, Zhang Y, Xie S, Yang B. Perceived Stress Among Chinese Medical Students Engaging in Online Learning in Light of COVID-19. Psychol Res Behav Manag 2021; 14:549-562. [PMID: 34017205 PMCID: PMC8131094 DOI: 10.2147/prbm.s308497] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/14/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose After a year of the COVID-19 pandemic, countries have repeatedly imposed strict quarantine regimes as the virus mutates and becomes more contagious. Medical undergraduate education has been disrupted and transformed into prolonged home isolation and online learning. Although studies have reported that the COVID-19 pandemic tends to increase perceived stress (PS) and affect the mental health of medical students, the influencing factors are unclear. Therefore, based on the stress process model, this study will comprehensively evaluate the distribution of stressors of medical students and explore the personal and environmental predictors of PS during the epidemic. Participants and Methods An online survey was conducted among medical students (n=369) from three medical universities in western China who engaged in online learning. A stress process conceptual framework was formed to explore the influencing factors of PS. The survey items contained four sections: (a) the potential stressors derived from academic, psychosocial and health-related demands; coping resources such as (b) online learning environment support and (c) personal resilience, including online learning behavior and individual characteristics; and (d) PS, perception of imbalanced demands and coping resources. Results The mean PS score was 17.39 (SD=4.58), and over four-fifths (82.3%) of the students had moderate to high levels of stress. The average item scores of academic, psychosocial and health-related stressors were 2.72 (SD=0.55), 2.31 (SD=0.55) and 2.07 (SD=0.50), respectively. Gender, grade, psychosocial stressors, health-related stressors, specific online learning behavior (persistence, attitude and flexibility), and the online learning environment (teaching, social and cognitive presence) were predictors of PS. Conclusion Our results specify that a reduction in psychological and health-related stressor stimulation, specific online learning behavior promotion, and well-established online learning environment support could be considered essential for alleviating the negative impacts of COVID-19 on the psychosocial health of medical undergraduates.
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Affiliation(s)
- Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Weichu Liu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yunmei Zhang
- School of Nursing, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shiqi Xie
- School of Nursing, Chongqing Medical University, Chongqing, People's Republic of China
| | - Bing Yang
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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