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Broos HC, Dev AS, Llabre MM, Saab PG, Timpano KR. Trait and situation-specific intolerance of uncertainty predict affective symptoms during the COVID-19 pandemic. J Affect Disord 2024; 352:115-124. [PMID: 38350541 DOI: 10.1016/j.jad.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The COVID-19 pandemic, a high-uncertainty situation, presents an ideal opportunity to examine how trait intolerance of uncertainty (IU) and situation-specific IU relate to each other and to mental health outcomes. The current longitudinal study examined the unique associations of trait and COVID-specific IU with general distress (anxiety and depression) and pandemic-specific concerns (pandemic stress and vaccine worry). METHODS A community sample of Florida adults (N = 2152) was surveyed online at three timepoints. They completed measures of trait IU at Wave 1 (April-May 2020) and COVID-specific IU at Wave 2 (May-June 2020). At Wave 3 (December-February 2021), they reported symptoms of depression, anxiety, pandemic stress, and vaccine worry. RESULTS We used structural equation modeling to test our overall model. Trait IU significantly predicted later COVID-specific IU, however there was no significant effect of trait IU on any outcome measure after accounting for COVID-specific IU. Notably, COVID-specific IU fully mediated the relationship between trait IU and all four symptom measures. LIMITATIONS There were several limitations of the current study, including the use of a community sample and high participant attrition. CONCLUSIONS Results suggest that COVID-specific IU predicts mental health outcomes over and above trait IU, extending the existing literature. These findings indicate that uncertainty may be more aversive when it is related to specific distressing situations, providing guidance for developing more specific and individualized interventions. Idiographic treatments which target situation-specific IU may be more efficacious in reducing affective symptoms and related stress during the COVID-19 pandemic or other similar events.
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Affiliation(s)
- Hannah C Broos
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America.
| | - Amelia S Dev
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Maria M Llabre
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Patrice G Saab
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Kiara R Timpano
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
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Scheible K, Beblavy R, Sohn MB, Qui X, Gill AL, Narvaez-Miranda J, Brunner J, Miller RK, Barrett ES, O’Connor TG, Gill SR. Affective Symptoms in Pregnancy are Associated with the Vaginal Microbiome. bioRxiv 2024:2024.04.12.589254. [PMID: 38645042 PMCID: PMC11030453 DOI: 10.1101/2024.04.12.589254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Composition of the vaginal microbiome in pregnancy is associated with adverse maternal, obstetric, and child health outcomes. Identifying the sources of individual differences in the vaginal microbiome is therefore of considerable clinical and public health interest. The current study tested the hypothesis that vaginal microbiome composition during pregnancy is associated with an individual's experience of affective symptoms and stress exposure. Data were based on a prospective longitudinal study of a diverse and medically healthy community sample of 275 mother-infant pairs. Affective symptoms and stress exposure and select measures of associated biomarkers (diurnal salivary cortisol, serum measures of sex hormones) were collected at each trimester; self-report, clinical, and medical records were used to collect detailed data on socio-demographic factors and health behavior, including diet and sleep. Vaginal microbiome samples were collected in the third trimester (34-40 weeks) and characterized by 16S rRNA sequencing. Identified taxa were clustered into three community state types (CST1-3) based on dissimilarity of vaginal microbiota composition. Results indicate that depressive symptoms during pregnancy were reliably associated with individual taxa and CST3 in the third trimester. Prediction of functional potential from 16S taxonomy revealed a differential abundance of metabolic pathways in CST1-3 and individual taxa, including biosynthetic pathways for the neuroactive metabolites, serotonin and dopamine. With the exception of bioavailable testosterone, no significant associations were found between symptoms- and stress-related biomarkers and CSTs. Our results provide further evidence of how prenatal psychological distress during pregnancy alters the maternal-fetal microbiome ecosystem that may be important for understanding maternal and child health outcomes.
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Affiliation(s)
- Kristin Scheible
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Robert Beblavy
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Michael B. Sohn
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Xing Qui
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Ann L. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Janiret Narvaez-Miranda
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Jessica Brunner
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Richard K. Miller
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Emily S. Barrett
- Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey, USA
| | - Tom G. O’Connor
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Wynne Center for Family Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Steven R. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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Jiang J, Wang A, Shi H, Jiang S, Li W, Jiang T, Wang L, Zhang X, Sun M, Zhao M, Zou X, Xu J. Clinical and neuroimaging association between neuropsychiatric symptoms and nutritional status across the Alzheimer's disease continuum: a longitudinal cohort study. J Nutr Health Aging 2024; 28:100182. [PMID: 38336502 DOI: 10.1016/j.jnha.2024.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To investigate the association between neuropsychiatric symptoms (NPS) and nutritional status, and explore their shared regulatory brain regions on the Alzheimer's disease (AD) continuum. DESIGN A longitudinal, observational cohort study. SETTING Data were collected from the Chinese Imaging, Biomarkers, and Lifestyle study between June 1, 2021 and December 31, 2022. PARTICIPANTS Overall, 432 patients on the AD continuum, including amnestic mild cognitive impairment and AD dementia, were assessed at baseline, and only 165 patients completed the (10.37 ± 6.08) months' follow-up. MEASUREMENTS The Mini-Nutritional Assessment (MNA) and Neuropsychiatric Inventory (NPI) were used to evaluate nutritional status and NPS, respectively. The corrected cerebral blood flow (cCBF) measured by pseudo-continuous arterial spin labeling of the dietary nutrition-related brain regions was analyzed. The association between the NPS at baseline and subsequent change in nutritional status and the association between the changes in the severity of NPS and nutritional status were examined using generalized linear mixed models. RESULTS Increased cCBF in the left putamen was associated with malnutrition, general NPS, affective symptoms, and hyperactivity (P < 0.05). The presence of general NPS (β = -1.317, P = 0.003), affective symptoms (β = -1.887, P < 0.001), and appetite/eating disorders (β = -1.714, P < 0.001) at baseline were associated with a decline in the MNA scores during follow-up. The higher scores of general NPI (β = -0.048), affective symptoms (β = -0.181), and appetite/eating disorders (β = -0.416; all P < 0.001) were longitudinally associated with lower MNA scores after adjusting for confounding factors. CONCLUSIONS We found that baseline NPS were predictors of a decline in nutritional status on the AD continuum. The worse the severity of affective symptoms and appetite/eating disorders, the poorer the nutritional status. Furthermore, abnormal perfusion of the putamen may regulate the association between malnutrition and NPS, which suggests their potentially common neural regulatory basis.
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Affiliation(s)
- Jiwei Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China; Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China; Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Shirui Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Wenyi Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Tianlin Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Linlin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Mengfan Sun
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Min Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Xinying Zou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
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Feng G, Posa S, Sureshkumar A, Simpson S, Bruno T, Morrow SA, Donkers S, Knox K, Feinstein A, Bayley M, Munce S, Simpson R. Experiences of people with multiple sclerosis and clinicians in using cognitive behavioural therapies for hidden symptoms: a systematic review and meta-aggregation. J Neurol 2024; 271:1084-1107. [PMID: 38219252 DOI: 10.1007/s00415-023-12116-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/31/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE Cognitive behavioural therapies (CBTs) are a standard of care for treatment of many 'hidden symptoms' in people with MS (PwMS), such as stress, depression, and fatigue. However, these interventions can vary widely in formatting and may not be tailored for PwMS. To optimize CBTs for MS, understanding the experiences of PwMS and clinicians is essential. This systematic review and meta-aggregation synthesizes existing qualitative data on stakeholder perspectives of CBTs for PwMS. METHODS Systematic searches across five major electronic databases were conducted. Studies reporting qualitative data were identified. Two reviewers performed screening, quality assessment, data extraction, and certainty of evidence assessments. Meta-aggregation was performed as per the Joanna Briggs Institute approach, entailing qualitative data extraction, developing categories, and synthesizing overall findings. RESULTS Twenty-eight studies were included in this review, comprising data from 653 PwMS and 47 clinicians. In the meta-aggregation, 122 qualitative results were extracted and grouped into nine categories. Categories were then combined into six synthesized findings: (1) setting the context-life with MS, (2) reasons for participating in CBTs, (3) acceptability of and experiences with participating in CBTs, (4) perceived benefits of CBTs, (5) perceived challenges with CBTs, and (6) suggestions to improve CBTs for PwMS. CONCLUSIONS A range of benefits including psychological, social, and lifestyle improvements were reported, but varied based on the design of the CBT intervention. Future CBT interventions should be tailored to participant needs, delivered in group settings, offer online options, and be delivered by a trained facilitator familiar with MS. Further exploration of the ideal CBT design for PwMS, as well as engagement with caregivers and clinicians treating MS, is warranted.
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Affiliation(s)
- Gregory Feng
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Stephanie Posa
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | | | - Sharon Simpson
- Forest Hill Centre for Cognitive Behavioural Therapy, Toronto, Canada
| | - Tania Bruno
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Sarah A Morrow
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- London Health Sciences Centre, University of Western Ontario, London, Canada
| | - Sarah Donkers
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Katherine Knox
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Anthony Feinstein
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Sarah Munce
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Robert Simpson
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
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Yang Y, Ye Z, Li W, Sun Y, Dai L. Efficacy of psychosocial interventions to reduce affective symptoms in sexual and gender minorities: a systematic review and meta-analysis of randomized controlled trials. BMC Psychiatry 2024; 24:4. [PMID: 38166855 PMCID: PMC10762931 DOI: 10.1186/s12888-023-05451-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are more likely than cisgender heterosexuals to experience mental, physical, and sexual health issues. A promising contemporary strategy to address the issue of affective symptoms in sexual and gender minorities (SGM) is psychosocial intervention. OBJECTIVE To systematically evaluate the effect of psychosocial interventions on the improvement of affective symptoms in SGM, and to provide a reference for the implementation of effective psychological interventions for SGM with affective symptoms. METHODS Between the date of database construction until December 10, 2022, a computerized search of the English-language literature published both nationally and worldwide was done. 8 literature databases and 3 additional gray databases were searched. We gathered randomized controlled trials that used psychological interventions for SGM. To evaluate risk bias in included papers in accordance with Cochrane cooperation criteria, we used Review Manager 5.4 software. In conjunction with post-test and follow-up data, mean differences were standardized using Stata 12.0 software. Subgroup analysis was used to investigate the cause of heterogeneity. The study was conducted strictly in accordance with PRISMA guidelines, and it was registered on the PROSPERO platform (CRD42023408610). RESULTS This review covered 18 research, and 14 studies were included in the meta-analysis. A total of 1194 study cases, including 706 cases from the control group and 488 cases from the experimental group, were included in these investigations. Compared to the control group, the psychosocial intervention group had significantly lower levels of depression (standardized mean difference (SMD) = -0.17;95% CI = [-0.30, -0.04]; p = 0.012) and anxiety (SMD = -0.22; 95% CI = [-0.41, -0.04]; p = 0.01), but no significant differences were found for distress (SMD = -0.19; 95% CI = [-0.45,0.07]; p = 0.021). CONCLUSION According to this study, psychosocial interventions helped lessen the symptoms of depression and anxiety in SGM but had no significant effect on their psychological distress. To assess the impact of psychological intervention on SGM, more randomized controlled trials with larger sample sizes and numerous follow-up times should be done.
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Affiliation(s)
- Yawen Yang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Wuhan, Hubei Province, 430074, China
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China
- Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Zhiyu Ye
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Wuhan, Hubei Province, 430074, China
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China
- Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Wentian Li
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Wuhan, Hubei Province, 430074, China
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China
- Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Ye Sun
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China
- Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lisha Dai
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Wuhan, Hubei Province, 430074, China.
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China.
- Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China.
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Klusmann H, Eisenlohr-Moul T, Baresich K, Schmalenberger KM, Girdler S, Andersen E. Analyzing the atypical - Methods for studying the menstrual cycle in adolescents. Psychoneuroendocrinology 2023; 158:106389. [PMID: 37769538 PMCID: PMC10843271 DOI: 10.1016/j.psyneuen.2023.106389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 08/08/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND The female pubertal transition is characterized by a rapidly changing hormone milieu, which is heavily influenced by the first menstrual cycle - menarche. The first year following menarche is associated with menstrual cycles that are irregular and anovulatory. Peripuberty also marks the beginning of a female-biased risk for suicidality and depression, suggesting some influence by the menstrual cycle and ovarian hormone fluctuations. However, there are limited methods and guidelines for studying the menstrual cycle and related affective symptoms in this developmental window. Thus, this study's objective was to identify the most accurate methods for detecting ovulation in irregular cycles (Part 1) and develop guidelines based on these methods for determining menstrual cycle phases. These methods were applied to investigate hormones and affective symptoms based on cycle phase and ovulation status in a sample of peripubertal females (Part 2). METHODS Thirty-two peripubertal females (ages 11-14) provided daily urine samples of estrogen (E1G) and progesterone (PdG) metabolites and luteinizing hormone (LH), and ratings of affective symptoms for one menstrual cycle. Ten literature-derived methods for determining the presence of an LH-peak or PdG rise were compared, focusing on their feasibility for psychological research. RESULTS Methods by Sun et al. (2019) and Park et al. (2007) most accurately detected PdG rises and LH peaks in this sample, identifying 40.6% of cycles as ovulatory. As expected, ovulatory participants showed greater LH in the periovulatory phase (p = .001), greater PdG in the mid-luteal phase (p < .0001), and greater E1G in the periovulatory phase (p = .001) compared with anovulatory participants. Exemplary methods to compare psychological symptoms between both groups are provided. CONCLUSIONS Recommendations and guidelines for studying the menstrual cycle in irregular cycling adolescents are offered. Novel methods for ovulation detection identified phase-specific hormonal patterns in anovulatory and ovulatory adolescent cycles.
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Affiliation(s)
- Hannah Klusmann
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, 14195 Berlin, Germany.
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago College of Medicine, Department of Psychiatry (MC 913), 60612 Chicago, USA.
| | - Kayla Baresich
- School of Medicine, Department of Psychiatry, University of North Carolina at Chapel Hill, Carolina Crossings Building B, 2218 Nelson Highway, 27517 Chapel Hill, USA.
| | - Katja M Schmalenberger
- Department of Psychiatry, University of Illinois at Chicago College of Medicine, Department of Psychiatry (MC 913), 60612 Chicago, USA.
| | - Susan Girdler
- School of Medicine, Department of Psychiatry, University of North Carolina at Chapel Hill, Carolina Crossings Building B, 2218 Nelson Highway, 27517 Chapel Hill, USA.
| | - Elizabeth Andersen
- School of Medicine, Department of Psychiatry, University of North Carolina at Chapel Hill, Carolina Crossings Building B, 2218 Nelson Highway, 27517 Chapel Hill, USA.
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Moffa G, Kuipers J, Kuipers E, McManus S, Bebbington P. Sexual abuse and psychotic phenomena: a directed acyclic graph analysis of affective symptoms using English national psychiatric survey data. Psychol Med 2023; 53:7817-7826. [PMID: 37485689 PMCID: PMC10755243 DOI: 10.1017/s003329172300185x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Sexual abuse and bullying are associated with poor mental health in adulthood. We previously established a clear relationship between bullying and symptoms of psychosis. Similarly, we would expect sexual abuse to be linked to the emergence of psychotic symptoms, through effects on negative affect. METHOD We analysed English data from the Adult Psychiatric Morbidity Surveys, carried out in 2007 (N = 5954) and 2014 (N = 5946), based on representative national samples living in private households. We used probabilistic graphical models represented by directed acyclic graphs (DAGs). We obtained measures of persecutory ideation and auditory hallucinosis from the Psychosis Screening Questionnaire, and identified affective symptoms using the Clinical Interview Schedule. We included cannabis consumption and sex as they may determine the relationship between symptoms. We constrained incoming edges to sexual abuse and bullying to respect temporality. RESULTS In the DAG analyses, contrary to our expectations, paranoia appeared early in the cascade of relationships, close to the abuse variables, and generally lying upstream of affective symptoms. Paranoia was consistently directly antecedent to hallucinations, but also indirectly so, via non-psychotic symptoms. Hallucinosis was also the endpoint of pathways involving non-psychotic symptoms. CONCLUSIONS Via worry, sexual abuse and bullying appear to drive a range of affective symptoms, and in some people, these may encourage the emergence of hallucinations. The link between adverse experiences and paranoia is much more direct. These findings have implications for managing distressing outcomes. In particular, worry may be a salient target for intervention in psychosis.
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Affiliation(s)
- Giusi Moffa
- University of Basel, Basel, Switzerland
- University College London, London, UK
| | - Jack Kuipers
- Department of Biosystems Science and Engineering, Eidgenossische Technische Hochschule Zurich, Basel, Switzerland
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Crawford CA, Williams MK, Shell AL, MacDonald KL, Considine RV, Wu W, Rand KL, Stewart JC. Effect of modernized collaborative care for depression on brain-derived neurotrophic factor (BDNF) and depressive symptom clusters: Data from the eIMPACT trial. Psychiatry Res 2023; 330:115581. [PMID: 37931480 PMCID: PMC10842310 DOI: 10.1016/j.psychres.2023.115581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) levels are lower in people with depression and are normalized following pharmacological treatment. However, it is unknown if psychological treatments for depression improve BDNF and if change in BDNF is a mediator of intervention effects on depressive symptoms. Therefore, using data from the eIMPACT trial, we sought to determine the effect of modernized collaborative care for depression on 12-month changes in BDNF and cognitive/affective and somatic depressive symptom clusters and to examine whether BDNF changes mediate intervention effects on depressive symptoms. 216 primary care patients with depression from a safety net healthcare system were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. Plasma BDNF was measured with commercially available kits, and depressive symptom clusters were assessed by the Patient Health Questionnaire-9. The intervention did not influence BDNF but did improve both the cognitive/affective and somatic clusters over 12 months. Changes in BDNF did not mediate the intervention effect on either cluster. Our findings suggest that modernized collaborative care is an effective treatment for both the cognitive/affective and somatic symptoms of depression and that the mechanism of action is not improvements in BDNF. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02458690.
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Affiliation(s)
- Christopher A Crawford
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Michelle K Williams
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Aubrey L Shell
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Krysha L MacDonald
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA; Sandra Eskenazi Mental Health Center, Eskenazi Health, Indianapolis, IN, USA
| | - Robert V Considine
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA.
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Marek A. [Psychosomatic aspects in otorhinolaryngology-historical milestones]. HNO 2023; 71:622-631. [PMID: 37626261 DOI: 10.1007/s00106-023-01349-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND This investigation examined the development of psychosomatics in the field of otolaryngology in Germany using the examples of psychogenic deafness and chronic tinnitus by means of literature research. The focus of the study was on the period 1948-2022. METHODS A literature search was carried out in the PubMed database from 1948 and antiquarian ENT textbooks were evaluated. The search terms used were "ENT and psychosomatics," "tinnitus," "retraining therapy," "analytical psychology," "behavioral therapy," and "sensory systems." RESULTS Psychosomatic phenomena were mentioned in the treatment of nasal diseases and ear ailments in writings of Byzantine and medieval medicine. Even older are references to tinnitus in ancient Egyptian and Indian scripts. From the nineteenth to the mid-twentieth century, psychological abnormalities in ENT symptoms were assigned to the term hysteria. From the middle of the twentieth century, a paradigm shift in the assessment of psychosomatic disorders in otolaryngology became apparent. In the 1950s, a broad psychosomatic discussion was opened in individual lectures and book contributions on mental abnormalities in ENT diseases. With the implementation of the Psychosomatics Working Group of the German Society of Otorhinolaryngology, Head and Neck Surgery, psychosomatics in the field of ENT received the framework for scientific and clinical activity at the turn of the millennium. Psychosomatics is scientifically represented and part of the continuing education regulations for otolaryngology in Germany and at European level. It shows high standards in research, qualification of otolaryngologists, and patient care. CONCLUSION As of 2022, psychosomatics in otolaryngology has been steadily developing for over 70 years. The standards achieved are to be further expanded and research on cognition, affectivity, and sensory analogies intensified.
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Affiliation(s)
- Astrid Marek
- Abteilung für Psychosomatik in der HNO-Heilkunde, Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie, Ruhr-Universität Bochum, St. Elisabeth-Hospital Bochum, Bleichstr. 15, 44787, Bochum, Deutschland.
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10
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Alvarado-Bolaños A, Cervantes-Arriaga A, Zuazua-Vidal L, Esquivel-Zapata Ó, Alcocer-Salas Á, Rodríguez-Violante M. Determinants and impact of alexithymia on quality of life in Parkinson's disease. Neurologia 2023; 38:334-341. [PMID: 37263728 DOI: 10.1016/j.nrleng.2020.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/20/2020] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.
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Affiliation(s)
- A Alvarado-Bolaños
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - A Cervantes-Arriaga
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - L Zuazua-Vidal
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Ó Esquivel-Zapata
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Á Alcocer-Salas
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - M Rodríguez-Violante
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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11
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Eikelboom WS, Singleton EH, van den Berg E, de Boer C, Coesmans M, Goudzwaard JA, Vijverberg EGB, Pan M, Gouw C, Mol MO, Gillissen F, Fieldhouse JLP, Pijnenburg YAL, van der Flier WM, van Swieten JC, Ossenkoppele R, Kors JA, Papma JM. The reporting of neuropsychiatric symptoms in electronic health records of individuals with Alzheimer's disease: a natural language processing study. Alzheimers Res Ther 2023; 15:94. [PMID: 37173801 PMCID: PMC10176879 DOI: 10.1186/s13195-023-01240-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are prevalent in the early clinical stages of Alzheimer's disease (AD) according to proxy-based instruments. Little is known about which NPS clinicians report and whether their judgment aligns with proxy-based instruments. We used natural language processing (NLP) to classify NPS in electronic health records (EHRs) to estimate the reporting of NPS in symptomatic AD at the memory clinic according to clinicians. Next, we compared NPS as reported in EHRs and NPS reported by caregivers on the Neuropsychiatric Inventory (NPI). METHODS Two academic memory clinic cohorts were used: the Amsterdam UMC (n = 3001) and the Erasmus MC (n = 646). Patients included in these cohorts had MCI, AD dementia, or mixed AD/VaD dementia. Ten trained clinicians annotated 13 types of NPS in a randomly selected training set of n = 500 EHRs from the Amsterdam UMC cohort and in a test set of n = 250 EHRs from the Erasmus MC cohort. For each NPS, a generalized linear classifier was trained and internally and externally validated. Prevalence estimates of NPS were adjusted for the imperfect sensitivity and specificity of each classifier. Intra-individual comparison of the NPS classified in EHRs and NPS reported on the NPI were conducted in a subsample (59%). RESULTS Internal validation performance of the classifiers was excellent (AUC range: 0.81-0.91), but external validation performance decreased (AUC range: 0.51-0.93). NPS were prevalent in EHRs from the Amsterdam UMC, especially apathy (adjusted prevalence = 69.4%), anxiety (adjusted prevalence = 53.7%), aberrant motor behavior (adjusted prevalence = 47.5%), irritability (adjusted prevalence = 42.6%), and depression (adjusted prevalence = 38.5%). The ranking of NPS was similar for EHRs from the Erasmus MC, although not all classifiers obtained valid prevalence estimates due to low specificity. In both cohorts, there was minimal agreement between NPS classified in the EHRs and NPS reported on the NPI (all kappa coefficients < 0.28), with substantially more reports of NPS in EHRs than on NPI assessments. CONCLUSIONS NLP classifiers performed well in detecting a wide range of NPS in EHRs of patients with symptomatic AD visiting the memory clinic and showed that clinicians frequently reported NPS in these EHRs. Clinicians generally reported more NPS in EHRs than caregivers reported on the NPI.
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Affiliation(s)
- Willem S Eikelboom
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Ellen H Singleton
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Casper de Boer
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Michiel Coesmans
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jeannette A Goudzwaard
- Department of Internal Medicine, Section of Geriatrics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Everard G B Vijverberg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Michel Pan
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Cornalijn Gouw
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Merel O Mol
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Freek Gillissen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Jay L P Fieldhouse
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - John C van Swieten
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Jan A Kors
- Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Janne M Papma
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
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Glastad SH, Aminoff SR, Hagen R, Høegh MC, Büchmann CB, Barrett EA, Melle I, Etain B, Lagerberg TV. Nicotine use and non-pathological alcohol use and their relationship to affective symptoms and sleep disturbances in bipolar disorder. J Affect Disord 2023; 327:236-243. [PMID: 36746243 DOI: 10.1016/j.jad.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND The use of alcohol and nicotine can negatively impact the course of bipolar disorder (BD), but there is limited knowledge about how symptoms and sleep disturbances are related to concurrent nicotine use and non-pathological use of alcohol. METHODS We investigated how nicotine use and non-pathological use of alcohol relates to affective symptoms and sleep disturbances in 453 participants with BD without substance use disorders. Manic symptoms were assessed with the Young Mania Rating Scale, and depressive symptoms with The Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C). Sleep-related questions from IDS-C were used to create proxy variables for sleep disturbances, including Insomnia and Hypersomnia. Multinomial regression analysis was conducted to investigate the associations between nicotine use and sleep disturbances, controlling for possible confounders such as current use of illicit drugs and psychopharmacological treatment. RESULTS Depressive and manic symptoms were not associated with the concurrent level of alcohol or nicotine use. Individuals with medium and high levels of daily nicotine use had higher risk of insomnia than those without. Non-pathological alcohol use was not associated with sleep disturbances. LIMITATIONS Sleep disturbances were based on items from the IDS-C questionnaire. CONCLUSION We found an elevated risk for insomnia in individuals with BD and medium or high levels of daily nicotine use. We found no association between the level of affective symptoms and the level of use of alcohol or nicotine. The direction of the relationship between nicotine use and insomnia needs clarification, as it is highly relevant for treatment planning.
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Affiliation(s)
- Stine Holmstul Glastad
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
| | - Sofie Ragnhild Aminoff
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Roger Hagen
- Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Research institute, Modum Bad, Vikersund, Norway
| | - Margrethe Collier Høegh
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Camilla Bakkalia Büchmann
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Elizabeth Ann Barrett
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Bruno Etain
- INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France; Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France; Université Paris Cité, Paris, France; Fondation FondaMental, Créteil, France
| | - Trine Vik Lagerberg
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
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Karande S, Gogtay NJ, Shaikh N, Sholapurwala R, More T, Meshram P. Self-perceived anxiety symptoms in school students with borderline intellectual functioning: A cross-sectional questionnaire-based study in Mumbai, Maharashtra, India. J Postgrad Med 2023; 69:89-96. [PMID: 36930546 DOI: 10.4103/jpgm.jpgm_956_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background and Objectives Students with borderline intellectual functioning ("slow learners") underperform in all school subjects. The primary objective of this study was to evaluate the self-perceived anxiety symptoms of slow learners. Its secondary objective was to analyze impact of sociodemographic variables on their symptoms. Settings and Design Cross-sectional single-arm questionnaire-based study was conducted in the learning disability clinic of a public medical college in Mumbai. Subjects and Methods One hundred slow learners aged ≥8 to <18 years were recruited by non-probability sampling. Their anxiety symptoms scores were measured using the Screen for Child Anxiety Related Disorders-Child version (SCARED-C) instrument. Statistical Analysis Multivariate regression analysis was performed for determining the "independent" impact that variables had on the SCARED-C ("individual subscales" and "overall") scores. Results Symptoms of "separation anxiety" were present in 40%, followed by "social anxiety" in 32%, "generalized anxiety" in 31%, "panic" in 26%, "significant school avoidance" in 24%; and "overall anxiety" in 38% of slow learners. Multivariate analysis revealed that: (i) co-occurring attention-deficit/hyperactivity disorder was significantly associated with having panic symptoms (P = 0.040), and, (ii) studying in a Secondary School Certificate or Higher Secondary Certificate educational board-affiliated school was significantly associated with having symptoms of "generalized anxiety," "social anxiety," and "overall anxiety" (P = 0.009, P = 0.026, and P = 0.046, respectively). Conclusions Many slow learners in our city have symptoms of anxiety disorders and overall anxiety. There is an urgent need to screen them for anxiety disorders to facilitate their optimum rehabilitation.
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Affiliation(s)
- S Karande
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - N J Gogtay
- Department of Clinical Pharmacology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - N Shaikh
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - R Sholapurwala
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - T More
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - P Meshram
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
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Yang XH, Zhang JW, Li Y, Zhou L, Sun M. Psychotic-like experiences as a co-occurring psychopathological indicator of multi-dimensional affective symptoms: Findings from a cross-sectional survey among college students. J Affect Disord 2023; 323:33-9. [PMID: 36435396 DOI: 10.1016/j.jad.2022.11.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/05/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although connections between psychotic-like experiences (PLEs) and a series of non-psychotic disorders have been widely explored in previous research, it is unclear whether PLEs could act as a co-occurring psychopathological indicator of multi-dimensional affective symptoms. METHODS A total of 4761 students took part in an online survey which assessed the frequency of PLEs and three types of affective symptoms over lifetime. Binary logistic regression models were used to examine associations between PLEs and each type of affective symptom. Network analysis was conducted to explore the relationship among three subtypes of PLEs - persecutory ideation (PI), bizarre experiences (BEs) and perceptual abnormalities (PAs), and different types of affective symptoms. RESULTS The results showed that compared with the non-PLEs group, the PLEs group suffered significantly higher risk of experiencing three types of affective symptoms, including manic symptoms [adjusted odds ratio (aOR) 11.50, 95 % confidence interval (CI) (4.59-28.81)], depressive symptoms [aOR 7.28, 95 % CI (4.98-10.66)] and anxiety symptoms [aOR 4.47, 95 % CI (3.10-6.43)]. In the network model, bizarre experiences were the most critical central symptom. Both depressive and anxiety symptoms were most strongly associated with persecutory ideation while manic symptoms were most closely related to bizarre experiences. LIMITATIONS Cross-sectional data and self-reported symptoms. CONCLUSIONS These findings suggest that PLEs are a vital co-occurring indicator of multi-dimensional affective symptoms and show its enormous potential as a target for a host of mental health problems. Further investigation may shed light on the aetiology of the relationship between different subtypes of PLEs and affective symptoms.
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15
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Krebbers I, Pilz W, Vanbelle S, Verdonschot RJCG, Baijens LWJ. Affective Symptoms and Oropharyngeal Dysphagia in Head-and-Neck Cancer Patients: A Systematic Review. Dysphagia 2023; 38:127-144. [PMID: 35796877 PMCID: PMC9873770 DOI: 10.1007/s00455-022-10484-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/10/2022] [Indexed: 01/28/2023]
Abstract
Oropharyngeal dysphagia (OD) is a high impact morbidity in head-and-neck cancer (HNC) patients. A wide variety of instruments are developed to screen for affective symptoms and OD. The current paper aims to systematically review and appraise the literature to obtain insight into the prevalence, strength, and causal direction of the relationship between affective symptoms and OD in HNC patients. This review was conducted in accordance with the PRISMA statement. A systematic search of the literature was performed using PubMed, PsycINFO, Cochrane, and Embase. All available publications reporting on the relationship between affective conditions and swallowing function in HNC patients were included. Conference papers, tutorials, reviews, and studies with less than 5 patients were excluded. Fifteen studies met the inclusion criteria. The level of evidence and methodological quality were assessed using the ABC-rating scale and QualSyst critical appraisal tool. Eleven studies reported a positive relationship between affective symptoms and OD. The findings of this paper highlight the importance of affective symptom screening in dysphagic HNC patients as clinically relevant affective symptoms and OD seems to be prevalent and coincident in this population. Considering the impact of affective symptoms and OD on patients' daily life, early detection and an integrated interdisciplinary approach are recommended. However, due to the heterogeneity of study designs, outcomes, and outcome measures, the generalization of study results is limited.
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Affiliation(s)
- Iris Krebbers
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
- School for Oncology and Developmental Biology-GROW, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
- School for Oncology and Developmental Biology-GROW, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience-MHeNs, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sophie Vanbelle
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute-CAPHRI, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rob J C G Verdonschot
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
- Emergency Department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
- School for Oncology and Developmental Biology-GROW, Maastricht University Medical Center, Maastricht, The Netherlands
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Filser M, Buchner A, Fink GR, Gold SM, Penner IK. The manifestation of affective symptoms in multiple sclerosis and discussion of the currently available diagnostic assessment tools. J Neurol 2023; 270:171-207. [PMID: 36129540 PMCID: PMC9813146 DOI: 10.1007/s00415-022-11359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION In addition to physical and cognitive symptoms, patients with multiple sclerosis (MS) have an increased risk of experiencing mental health problems. METHODS This narrative review provides an overview of the appearance and epidemiology of affective symptoms in MS such as depression, anxiety, bipolar disorder, euphoria, and pseudobulbar affect. Furthermore, the association between affective symptoms and quality of life and the currently used diagnostic instruments for assessing these symptoms are considered whereby relevant studies published between 2009 and 2021 were included in the review. RESULTS Patients with mild and moderate disability more frequently reported severe problems with depression and anxiety than severe mobility problems. Apart from the occurrence of depression, little is known about the association of other affective symptoms such as anxiety, bipolar disorder, euphoria, and pseudobulbar affect and subsyndromal symptoms, which fail to meet the diagnostic criteria but are nevertheless a significant source of distress. Although there are a few recommendations in the research to perform routine screenings for diagnosable affective disorders, a standardized diagnostic procedure to assess subsyndromal symptoms is still lacking. As the applied measurements are diverse and show low accuracy to detect these symptoms, patients who experience affective symptoms are less likely to be identified. DISCUSSION In addition to the consideration of definite psychiatric diagnoses, there is an unmet need for a common definition and assessment of disease-related affective symptoms in MS. Future studies should focus on the improvement and standardization of a common diagnostic procedure for subsyndromal affective symptoms in MS to enable integrated and optimal care for patients.
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Affiliation(s)
- Melanie Filser
- Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany.,COGITO Centre for Applied Neurocognition and Neuropsychological Research, Life Science Centre, Düsseldorf, Germany
| | - Axel Buchner
- Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, University of Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine (INM-3), Research Centre, Cognitive Neuroscience, Jülich, Germany
| | - Stefan M Gold
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin (CBF), Charité Universitätsmedizin Berlin, Berlin, Germany.,Medical Department, Section Psychosomatics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center, Hamburg-Eppendorf, Germany
| | - Iris-Katharina Penner
- Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. .,COGITO Centre for Applied Neurocognition and Neuropsychological Research, Life Science Centre, Düsseldorf, Germany. .,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Salazar de Pablo G, Moreno D, Gonzalez-Pinto A, Paya B, Castro-Fonieles J, Baeza I, Graell M, Arango C, Rapado-Castro M, Moreno C. Affective symptom dimensions in early-onset psychosis over time: a principal component factor analysis of the Young Mania Rating Scale and the Hamilton Depression Rating Scale. Eur Child Adolesc Psychiatry 2022; 31:1715-1728. [PMID: 34052909 DOI: 10.1007/s00787-021-01815-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/23/2021] [Indexed: 12/11/2022]
Abstract
Early-onset psychosis (EOP) is a complex disorder characterized by a wide range of symptoms, including affective symptoms. Our aim was to (1) examine the dimensional structure of affective symptoms in EOP, (2) evaluate the predominance of the clinical dimensions and (3) assess the progression of the clinical dimensions over a 2-year period. STROBE-compliant prospective principal component factor analysis of Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale-21 (HDRS-21) at baseline, 6-months, 1-year and 2-year follow-up. We included 108 EOP individuals (mean age = 15.5 ± 1.8 years, 68.5% male). The factor analysis produced a four-factor model including the following dimensions: mania, depression/anxiety, sleep and psychosis. It explained 47.4% of the total variance at baseline, 60.6% of the total variance at 6-months follow-up, 54.5% of the total variance at 1-year follow-up and 49.5% of the total variance at 2-year follow-up. According to the variance explained, the mania factor was predominant at baseline (17.4%), 6-month follow-up (23.5%) and 2-year follow-up (26.1%), while the depression/anxiety factor was predominant at 1-year follow-up (23.1%). The mania factor was the most stable; 58.3% items that appeared in this factor (with a load > 0.4) at any time point appeared in the same factor at ≥ 3/4 time points. Affective symptoms are frequent and persistent in EOP. Mania seems to be the most predominant and stable affective dimension. However, depression and anxiety may gain predominance with time. A comprehensive evaluation of the dimensional structure and the progression of affective symptoms may offer clinical and therapeutic advantages.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dolores Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain
| | - Ana Gonzalez-Pinto
- Department of Psychiatry, Biomedical Research Networking Centre in Mental Health, BioAraba Research Institute, OSI Araba-University Hospital, University of the Basque Country (EHU/UPV), CIBERSAM, Vitoria, Spain
| | - Beatriz Paya
- Department of Child Psychiatry, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Josefina Castro-Fonieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, School of Medicine, Universidad Autónoma, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain
| | - Marta Rapado-Castro
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain. .,Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Victoria, Australia.
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Ibiza, 43, 28009, Madrid, Spain
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Osorio Acuña LC, Franco Zuluaga A. Behavioural and emotional symptoms of adolescents consulting a specialised eating disorders programme. Rev Colomb Psiquiatr (Engl Ed) 2022; 51:318-325. [PMID: 36446704 DOI: 10.1016/j.rcpeng.2020.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/25/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are complex conditions of multifactorial origin. Their main characteristic is excessive concern about body weight and shape, which causes great discomfort and physical problems and leads to a decrease in quality of life and alterations in the patient's functionality social environment. The objective of this study is to describe the emotional and behavioural symptoms of adolescents who consult a specialised ED programme in the city of Bogota. METHODS Observational, descriptive, cross-sectional study, for which patients between 11 and 19 years old with an ED diagnosis were recruited. RESULTS Forty patients with an ED diagnosis were included, of which 92% were female. The mean age of the patients was 16.6±1.9 years; 57% of patients live in a two-parent home and 30% in a single-parent home; 72% of the sample had excellent academic performance; 50% were moderately ill; 60% received pharmacological management with SSRIs; 65% of patients met clinical criteria for anxiety disorder, 30% for depressive disorder; 22.5% had aggression problems; 17.5% criminal behaviour; 72.5% of the sample met clinical criteria for internalising symptoms and 42.5% for externalising symptoms, the majority being patients with a diagnosis of bulimia nervosa. CONCLUSIONS Patients with bulimia nervosa obtained higher scores in the different emotional and behavioural symptoms than those with other eating disorders. This condition is associated with greater psychopathology, which must be examined rigorously at the time of clinical care, seeking to reduce the functional impact that these symptoms generate on the individual.
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Affiliation(s)
- Lucia Carolina Osorio Acuña
- Especialista en psiquiatría infantil y del adolescente, Docente del Departamento de Psiquiatría, Universidad ICESI, Fundación Valle del Lili, Cali, Colombia.
| | - Alvaro Franco Zuluaga
- Especialista en psiquiatría infantil y del adolescente, Docente de psiquiatría de la Universidad El Bosque, Bogotá, Colombia
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口腔颌面部恶性肿瘤患者术后正念水平调查及影响因素分析. Beijing Da Xue Xue Bao Yi Xue Ban 2022; 54. [PMID: 35950399 DOI: 10.19723/j.issn.1671-167X.2022.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To investigate the status quo of postoperative mindfulness level in patients with oral and maxillofacial malignant tumors, to analyze its influencing factors, and to provide targeted support for the patients, in order to provide evidence for clinical support. METHODS A total of 452 patients with oral and maxillofacial malignant tumor who were admitted to the Peking University School of Stomatology from January 2021 to June 2021 were followed up by convenience sampling method, the general information questionnaire, the Five Facet Mindfulness Questionnaire, the 10-item perceived stress scale, and the self-esteem scale were used. The t test and analysis of variance were used to compare the scores of mindfulness of the patients with different demographic characteristics after oral and maxillofacial malignant tumors, and the differences of mindfulness levels between the patients with oral and maxillofacial malignant tumors and the normal population were compared by the Z test, Spearman correlation analysis was used to analyze the correlation between the scores of mindfulness and perceived stress and self-esteem. Multiple linear regression was used to analyze the influencing factors of mindfulness levels. RESULTS A total of 439 valid questionnaires were collected. The average score of postoperative mindfulness of the patients with oral and maxillofacial malignant tumor was 120.28±13.86. The scores of each dimension from high to low were as follows: act with awareness, non-judging, describing, observing, and non-reacting. Compared with the normal population, the patients with oral and maxillofacial malignant tumor showed significant differences in the total scores and scores of various dimensions after surgery. The t test and ANOVA showed that different duration of disease, age, residence, education, marital status, per capita monthly income, occupation, and medical payment methods had influences on postoperative mindfulness level of the patients with oral and maxillofacial malignant tumor (P < 0.10). Spearman correlation analysis showed that the level of mindfulness was negatively correlated with the level of perceived stress, and positively correlated with the level of self-esteem. The duration of illness, marital status, stress perception and self-esteem were included in the regression equation, suggesting that postoperative mindfulness levels of the patients with oral and maxillofacial malignant tumor had an important effect. CONCLUSION Patients with oral and maxillofacial malignant tumors have low postoperative mindfulness, which is related to duration of disease, marital status, and the level of perceived stress. Medical staff should identify this group as soon as possible, provide effective psychological intervention, help to improve the level of mindfulness, and strive to improve the patients'mental health.
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20
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Medina JC, Paz C, García-Mieres H, Niño-Robles N, Herrera JE, Feixas G, Montesano A. Efficacy of psychological interventions for young adults with mild-to-moderate depressive symptoms: A meta-analysis. J Psychiatr Res 2022; 152:366-374. [PMID: 35793580 DOI: 10.1016/j.jpsychires.2022.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Psychological interventions are commonly used to treat mild-to-moderate depression, but their efficacy in young adults has not been exhaustively addressed. This meta-analysis aims to establish it in comparison to no treatment, wait-list, usual treatment, passive interventions, and other bona-fide treatments. METHODS The search was conducted in Scopus, MEDLINE, PsycINFO, ClinicalTrials.gov, the ISRCTN Registry, Cochrane CENTRAL, Clarivate BIOSIS Previews and the METAPSY database, retrieving studies from the start of records to April 2020. Eligibility criteria included samples of 16-30 years experiencing mild-to-moderate depressive symptoms and participating in randomized controlled trials (RCTs), non-RCTs, or pre-post studies measuring depressive symptomatology and featuring psychological treatments. RESULTS Up to 45 studies met criteria, consisting of 3,947 participants, assessed using the Quality Assessment Tool for Quantitative Studies and their results meta-analyzed assuming random effects. Psychological interventions proved to be efficacious in RCTs compared to no treatment (g = -0.68; 95% CI = -0.87, -0.48) and wait-list (g = -1.04; 95% CI = -1.25, -0.82), while depressive symptoms also improved in pre-post studies (g = -0.99; 95% CI = -1.32, -0.66). However, intervention efficacy was similar to usual care, passive, and bona-fide comparators. The heterogeneity found, a likely reporting bias and the low quality of most studies must be considered when interpreting these results. CONCLUSIONS Psychological treatments are efficacious to reduce depressive symptoms in young adults, but comparable to other interventions in the mild-to-moderate range. Moderators like depression severity or therapist involvement significantly influenced their efficacy, with results encouraging clinicians to adopt flexible and personalized approaches.
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Affiliation(s)
- J C Medina
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.
| | - C Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - H García-Mieres
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - N Niño-Robles
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - J E Herrera
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - G Feixas
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - A Montesano
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
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Singham T, Saunders R, Brooker H, Creese B, Aarsland D, Hampshire A, Ballard C, Corbett A, Desai R, Stott J. Are subtypes of affective symptoms differentially associated with change in cognition over time: A latent class analysis. J Affect Disord 2022; 309:437-445. [PMID: 35490883 DOI: 10.1016/j.jad.2022.04.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/14/2022] [Accepted: 04/24/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the absence of disease-modifying treatments, identifying potential psychosocial risk factors for dementia is paramount. Depression and anxiety have been identified as potential risk factors. Studies however have yielded mixed findings, lending possibility to the fact that potential constellations of co-occurring depression and anxiety symptoms may better explain the link between affective symptoms and cognitive decline. METHODS Data from participants (aged 50 and above) of the PROTECT study was used. Latent Class Analysis (LCA) was conducted on 21,684 participants with baseline anxiety and depression measures. Multiple linear regressions models, using a subset of these participants (N = 6136) who had complete cognition data at baseline and at 2-year follow-up, were conducted to assess for associations between class membership and longitudinal changes in cognition. RESULTS The LCA identified a 5-class solution: "No Symptoms", "Sleep", "Sleep and Worry", "Sleep and Anhedonia", and "Co-morbid Depression and Anxiety". Class membership was significantly associated with longitudinal change in cognition. Furthermore, this association differed across different cognitive measures. LIMITATIONS Limitations included significant attrition and a generally healthy sample which may impact generalisability. CONCLUSIONS Substantial heterogeneity in affective symptoms could explain previous inconsistent findings concerning the association between affective symptoms and cognition. Clinicians should not focus solely on total symptom scores on a single affective domain, but instead on the presence and patterns of symptoms (even if sub-clinical) on measures across multiple affective domains. Identifying particular subgroups that are at greater risk of poor cognitive outcomes may support targeted prevention work.
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Affiliation(s)
- Timothy Singham
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rob Saunders
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Helen Brooker
- College of Medicine and Health, University of Exeter, UK
| | - Byron Creese
- College of Medicine and Health, University of Exeter, UK
| | - Dag Aarsland
- Department of Old age Psychiatry, IoPPN, Kings College London, UK; Centre for Age-related research, Stavanger University Hospital, Stavanger, Norway
| | - Adam Hampshire
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, UK
| | - Clive Ballard
- College of Medicine and Health, University of Exeter, UK
| | - Anne Corbett
- College of Medicine and Health, University of Exeter, UK
| | - Roopal Desai
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joshua Stott
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
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Minuti A, Brufani F, Menculini G, Moretti P, Tortorella A. The complex relationship between gut microbiota dysregulation and mood disorders: A narrative review. Curr Res Neurobiol 2022; 3:100044. [PMID: 36685764 PMCID: PMC9846469 DOI: 10.1016/j.crneur.2022.100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/09/2022] [Accepted: 06/01/2022] [Indexed: 01/25/2023] Open
Abstract
Gut microbiota regulates neurotransmission, neurogenesis, neuroinflammation, and neuroendocrine signaling. The aim of the present review is to analyze the literature concerning gut microbiota dysregulation and mood symptoms, with the specific hypothesis that such alterations play a role in the onset of mood disorders. Here, in fact, we review recent research focusing on how gut microbiota dysregulation influences the onset of mood disorders and on possible pathophysiological mechanisms involved in this interaction. We pay specific attention to the relationship between gut microbiota dysregulation and inflammatory state, Th17 differentiation, neuroactive factors, and TRP metabolism. The association between gut microbiota dysregulation and mood disorders is critically analyzed under a clinical point of view, also focusing on the emergence of mood symptoms in the context of medical conditions. These latter correlations may enable an interdisciplinary perspective in the clinical approach to such symptoms, as well as new treatment strategies, such as nutritional interventions, psychobiotics, antibiotics, as well as fecal microbiota transplantation.
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Affiliation(s)
| | | | | | | | - Alfonso Tortorella
- Corresponding author. Department of Psychiatry University of Perugia, Piazza Severi 1, Perugia, Italy.
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Jordán-Quintero MI, Agudelo Hernández F, De la Rosa AJ, Cardona Porras LF, Uribe-Restrepo JM. Implementation of a multi-family intervention for children with behavioural and emotional problems in a semi-rural population. Rev Colomb Psiquiatr (Engl Ed) 2022; 51:113-122. [PMID: 35753982 DOI: 10.1016/j.rcpeng.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/05/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the feasibility of implementing a community-based, multi-family group intervention in a semi-rural population in Aranzazu, northern Caldas, Colombia. METHODS Qualitative study. A convenience sample was taken of 10 families with children with affective and behavioural disorders, previously identified by the Child Behaviour Checklist (CBCL). The Multifamily Psychoeducational Psychotherapy (MF-PEP) model was adapted to the culture and needs of the families. RESULTS The contents of the sessions and the topics and experiences that were most significant for the children and their families are described. CONCLUSIONS The adaptation to the cultural context of the multi-family intervention had a very good acceptability by all participants: caregivers, children and therapists.
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Affiliation(s)
- Martha Isabel Jordán-Quintero
- Grupo de Investigación: Perspectivas en ciclo Vital, Salud Mental y Psiquiatría, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Unidad de Salud Mental, Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.
| | | | | | | | - José Miguel Uribe-Restrepo
- Grupo de Investigación: Perspectivas en ciclo Vital, Salud Mental y Psiquiatría, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Viana RT, de Freitas Araújo É, Lima LAO, Teixeira-Salmela LF, de Morais Faria CDC. General and comparative self-rated health in chronic stroke: an important outcome measure for health professionals. BMC Neurol 2022; 22:78. [PMID: 35255837 PMCID: PMC8900340 DOI: 10.1186/s12883-022-02592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND After a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors. METHODS Sixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%). RESULTS General SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function. CONCLUSION SRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains.
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Affiliation(s)
- Ramon Távora Viana
- Department of Physical Therapy, Faculty of Medicine, Universidade Federal Do Ceará, Fortaleza, Brazil
| | - Érika de Freitas Araújo
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 1270-901, MG, Belo Horizonte, Brazil
| | | | - Luci Fuscaldi Teixeira-Salmela
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 1270-901, MG, Belo Horizonte, Brazil
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Jiang Y, Wong NH, Chan YC, Poon KT. Lay awake with a racing mind: The associations between sexual objectification, insomnia, and affective symptoms. J Affect Disord 2022; 299:359-66. [PMID: 34915082 DOI: 10.1016/j.jad.2021.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/09/2021] [Accepted: 12/12/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sexual objectification is a form of interpersonal maltreatment that women may experience in daily life. Research has focused on testing how it leads to various psychological distresses. However, little research has examined its influences on women's sleep quality, the underlying psychological mechanisms, and the potential implications for affective symptoms. We addressed this research gap by testing whether sexual objectification predicted perceived stress and insomnia, thereby predicting affective symptoms (i.e., depression and anxiety). We further examined whether sex-is-power beliefs moderated these associations. METHODS Participants completed validated measures of sex-is-power beliefs, sexual objectification, perceived stress, insomnia, depression, and anxiety. We conducted regression analyses, structural equation modeling, and bootstrapping analyses to test the associations between these psychological constructs. RESULTS As predicted, the results showed that sexual objectification was positively associated with perceived stress, insomnia, and affective symptoms. Moreover, perceived stress and insomnia serially mediated the association between sexual objectification and affective symptoms. Furthermore, sex-is-power beliefs moderated the serial mediation effect, such that the effect was only observed among participants with weak sex-is-power beliefs. CONCLUSIONS These findings advanced current theories and knowledge of sexual objectification by demonstrating that sexual objectification is associated with perceived stress and insomnia, thereby predicting affective symptoms. The findings also highlighted the role of beliefs in weakening the negative consequences of sexual objectification.
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Logan M, Kapoor S, Peterson L, Oliveira M, Han DY. Mechanism of olfactory deficit in neurotrauma and its related affective distress: A narrative review. World J Psychiatry 2021; 11:1259-1266. [PMID: 35070775 PMCID: PMC8717038 DOI: 10.5498/wjp.v11.i12.1259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/29/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
Traumatic brain injury (TBI) is among the leading causes of death and disability all over the globe. TBI is also commonly associated with clinical sequelae of posttraumatic depression, and reports of other subsequent affective distress are common. Similarly, posttraumatic changes in chemoreceptive sensory functions, primarily due to coup-contrecoup injury induced shearing of the olfactory nerve fibers, leading to anosmia and ageusia are also well documented in the literature. However, the current literature is limited in addressing the intersections between said variables. The aim of this study was to provide a focused narrative review of the literature, to address these intersections found in clinical sequelae of TBI. As chemoreceptive sensory deficits are also linked to significant affective distress of their own, this review addresses the bidirectionality between sensory deficit and affective distress. Prevalence, demographics, mechanisms, and clinical implications are presented. Previous research is presented and discussed, in an effort to highlight the importance of consideration for all factors in TBI patient care and future research.
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Affiliation(s)
- Mark Logan
- Department of Neurology, UK HealthCare, Lexington, KY 40536, United States
| | - Siddharth Kapoor
- Department of Neurology, University of Kentucky, Lexington, KY 40536, United States
| | - Luke Peterson
- Department of Psychology, University of Connecticut, Storrs, CT 06269, United States
| | - Martin Oliveira
- Department of Neuropsychology, Neuro Health of Connecticut, West Hartford, CT 06107, United States
| | - Dong Y Han
- Department of Neurology, University of Kentucky, Lexington, KY 40536, United States
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Thomas BP, Tarumi T, Wang C, Zhu DC, Tomoto T, Munro Cullum C, Dieppa M, Diaz-Arrastia R, Bell K, Madden C, Zhang R, Ding K. Hippocampal and rostral anterior cingulate blood flow is associated with affective symptoms in chronic traumatic brain injury. Brain Res 2021; 1771:147631. [PMID: 34464600 DOI: 10.1016/j.brainres.2021.147631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/02/2021] [Accepted: 08/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to assess cerebral blood flow (CBF) and its association with self-reported symptoms in chronic traumatic brain injury (TBI). PARTICIPANTS Sixteen participants with mild to severe TBI and persistent self-reported neurological symptoms, 6 to 72 months post-injury were included. For comparison, 16 age- and gender-matched healthy normal control participants were also included. MAIN MEASURES Regional CBF and brain volume were assessed using pseudo-continuous Arterial Spin Labeling (PCASL) and T1-weighted data respectively. Cognitive function and self-reported symptoms were assessed in TBI participants using the national institutes of health (NIH) Toolbox Cognition Battery and Patient-Reported Outcome Measurement Information System respectively. Associations between CBF and cognitive function, symptoms were assessed. RESULTS Global CBF and regional brain volumes were similar between groups, but region of interest (ROI) analysis revealed lower CBF bilaterally in the thalamus, hippocampus, left caudate, and left amygdala in the TBI group. Voxel-wise analysis revealed that CBF in the hippocampus, parahippocampus, rostral anterior cingulate, inferior frontal gyrus, and other temporal regions were negatively associated with self-reported anger, anxiety, and depression symptoms. Furthermore, region of interest (ROI) analysis revealed that hippocampal and rostral anterior cingulate CBF were negatively associated with symptoms of fatigue, anxiety, depression, and sleep issues. CONCLUSION Regional CBF deficit was observed in the group with chronic TBI compared to the normal control (NC) group despite similar volume of cerebral structures. The observed negative correlation between regional CBF and affective symptoms suggests that CBF-targeted intervention may potentially improve affective symptoms and quality of life after TBI, which needs to be assessed in future studies.
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Affiliation(s)
- Binu P Thomas
- Advanced Imaging Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA.
| | - Takashi Tarumi
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA.
| | - Ciwen Wang
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - David C Zhu
- Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA
| | - Tsubasa Tomoto
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - C Munro Cullum
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Neurological Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - Marisara Dieppa
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 51 North 39(th) St, Philadelphia, PA 19104, USA
| | - Kathleen Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
| | - Christopher Madden
- Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA
| | - Rong Zhang
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - Kan Ding
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA
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Treffers E, Duijndam S, Schiffer AS, Scherders MJ, Habibović M, Denollet J. Validity of the 15-item social inhibition questionnaire in outpatients receiving psychological or psychiatric treatment: The association between social inhibition and affective symptoms. Gen Hosp Psychiatry 2021; 73:1-8. [PMID: 34482278 DOI: 10.1016/j.genhosppsych.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Social inhibition may promote symptoms of depression and anxiety in adults from an outpatient hospital population. The current work builds on a previously corroborated construct of social inhibition and examines the psychometric properties of this assessment tool and its predictive validity in the adult outpatient hospital population. METHODS A total of 350 adult outpatients receiving treatment at the department of Medical Psychology or Psychiatry completed measures of social inhibition and symptoms of anxiety (7-item Generalized Anxiety Disorder scale) and depression (9-item Patient Health Questionnaire). Factor analyses, reliability estimates, and regression analyses were used to replicate the robustness of the model of social inhibition, and the 15-item Social Inhibition Questionnaire (SIQ15). RESULTS In the current sample (N = 350; Mage = 45 years; 67.4% women), factor analyses confirmed the previously suggested three-factor model of social inhibition as measured by the SIQ15. The subscales of behavioral inhibition, interpersonal sensitivity and social withdrawal proved to be internally consistent (Cronbach's α between 0.87/0.95) and stable over time (test-retest reliability between r = 0.76/0.83). At baseline, interpersonal sensitivity and social withdrawal were associated with anxiety and depressive symptoms. At three months follow-up, only interpersonal sensitivity was related to depressive symptoms. CONCLUSIONS Social inhibition is associated with anxiety and depression at baseline and can be reliably assessed with the SIQ15 in an outpatient hospital population. The association of interpersonal sensitivity with depressive symptoms at three-month follow-up suggests an important aim for future research on the development of preventive methods for affective symptoms in socially inhibited outpatients.
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Affiliation(s)
- E Treffers
- Department of Medical Psychology, Catharina Ziekenhuis Eindhoven, Eindhoven, the Netherlands
| | - S Duijndam
- Tilburg University, Department of Medical and Clinical Psychology, and Center of Research on Psychology and Somatic disorders (CoRPS), Tilburg, the Netherlands.
| | - A S Schiffer
- Department of Medical Psychology, Catharina Ziekenhuis Eindhoven, Eindhoven, the Netherlands
| | - M J Scherders
- Department of Medical Psychology, Catharina Ziekenhuis Eindhoven, Eindhoven, the Netherlands; Department of Psychiatry, Catharina Ziekenhuis Eindhoven, Eindhoven, the Netherlands
| | - M Habibović
- Tilburg University, Department of Medical and Clinical Psychology, and Center of Research on Psychology and Somatic disorders (CoRPS), Tilburg, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Cardiology, Tilburg, the Netherlands
| | - J Denollet
- Tilburg University, Department of Medical and Clinical Psychology, and Center of Research on Psychology and Somatic disorders (CoRPS), Tilburg, the Netherlands
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Schiewer V, Dietz T, Tavenrath S, Öztürk-Arenz H, Jäger RS, Klein A, Labouvie H, Kusch M. [Common foundation of alexithymia and expressive suppression]. Psychotherapeut (Berl) 2021; 67:166-175. [PMID: 34720437 PMCID: PMC8549590 DOI: 10.1007/s00278-021-00546-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 11/10/2022]
Abstract
Hintergrund Internationale Studien konnten bereits einen Zusammenhang zwischen Alexithymie und expressiver Suppression belegen. Im deutschsprachigen Raum wurde dieser Zusammenhang bisher nur sehr selten betrachtet. Übergeordnetes Ziel der vorliegenden Studie war die Untersuchung eines korrelativen und faktoriellen Zusammenhangs von Alexithymie und expressiver Suppression. Material und Methoden Insgesamt 317 Personen nahmen einer Onlinebefragung teil. Mithilfe der deutschsprachigen Versionen der Toronto Alexithymia Scale-26 (TAS-26) und des Emotion Regulation Questionnaire (ERQ) wurden Daten zu Alexithymie und expressiver Suppression erfasst. Ergebnisse Es bestanden signifikante Korrelationen zwischen der Subskala „Schwierigkeit bei der Identifikation von Gefühlen“ der TAS-26 und der Skala „Unterdrückung“ des ERQ (r = 0,5; p < 0,001) sowie zwischen der Subskala „Schwierigkeit bei der Beschreibung von Gefühlen“ der TAS-26 und der Skala „Unterdrückung“ des ERQ (r = 0,64; p < 0,001). Die Ergebnisse einer explorativen Faktorenanalyse ergaben eine Zwei-Faktoren-Lösung mit einem gemeinsamen Faktor für die TAS-26-Subskalen „Schwierigkeit bei der Identifikation von Gefühlen“ und „Schwierigkeit bei der Beschreibung von Gefühlen“ und der Skala „Unterdrückung“ des ERQ mit einer gemeinsamen Varianz von 38,2 % (χ2 = 363,843; p < 0,001; Kaiser-Meyer-Olkin[KMO]-Wert = 0,699). Schlussfolgerung Die Ergebnisse legen nahe, dass den Skalen der TAS-26 in den Komponenten „Schwierigkeit bei der Identifikation von Gefühlen“ und „Schwierigkeit bei der Beschreibung von Gefühlen“ sowie der Skala „Unterdrückung“ des ERQ in der Komponente der „expressiven Suppression“ ein gemeinsames Konstrukt zugrunde liegt, das mit dem Begriff der Sprachlosigkeit belegt werden kann.
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Affiliation(s)
- Vera Schiewer
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Thilo Dietz
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Sally Tavenrath
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Hülya Öztürk-Arenz
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Reinhold S Jäger
- Zentrum für Empirische Pädagogische Forschung, Universität Koblenz-Landau, Campus Landau, Landau, Deutschland
| | - Anne Klein
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Hildegard Labouvie
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
| | - Michael Kusch
- Psychoonkologische Versorgungsforschung, Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
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Abstract
COVID-19 has the potential to detrimentally impact HIV self-management in people living with HIV (PLHIV). Effective HIV-self management is critically important in managing symptoms as well as viral suppression. We examined the impact of the COVID-19 pandemic on HIV self-management, social support, social isolation, depressive symptoms, anxiety, and stress in PLHIV. 85 PLHIV were recruited from social media sites and completed an online survey. Data were collected between April 23 and 30, 2020. Participants reported increases in social isolation, depressive symptoms, anxiety, and stress and decreases in social support and overall HIV self-management from pre- to during the pandemic. Additionally, the Social Support domain and Chronic Nature of HIV domain of the HIV Self-Management Scale were also decreased from pre- to during the pandemic. The ability for PLHIV to maintain HIV self-management during this time is essential and HIV care providers should have plans in place to provide support.
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Affiliation(s)
- Rachel K Wion
- Indiana University School of Nursing, 600 Barnhill Dr., Indianapolis, IN, 46202, USA.
| | - Wendy R Miller
- Indiana University School of Nursing, 600 Barnhill Dr., Indianapolis, IN, 46202, USA
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Kolberg E, Hjetland GJ, Thun E, Pallesen S, Nordhus IH, Husebo BS, Flo-Groeneboom E. The effects of bright light treatment on affective symptoms in people with dementia: a 24-week cluster randomized controlled trial. BMC Psychiatry 2021; 21:377. [PMID: 34320937 PMCID: PMC8317398 DOI: 10.1186/s12888-021-03376-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The majority of people with dementia have behavioral and psychological symptoms of dementia (BPSD), including depression, anxiety and agitation. These may be elicited or aggravated by disrupted circadian rhythms. Bright light treatment (BLT) is a promising non-pharmacological approach to the management of BPSD, but previous research has yielded mixed results. METHODS Eight nursing home dementia units (1 unit = 1 cluster) with 78 patients were invited to participate in a cluster randomized controlled trial from September 2017 to April 2018 investigating the effects of BLT on sleep and circadian rhythms (primary outcome) and BPSD (secondary outcome). Ceiling mounted LED-panels were installed in the intervention group (four units), providing light at 1000 lx and 6000 K (vertically at 1.2 m) between 10 a.m. and 3 p.m., with lower values in the mornings and evenings. Standard indoor light was used in the control group (four units). BPSD were assessed with The Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory Nursing Home Version (NPI-NH). Data collection took place at baseline and after 8, 16 and 24 weeks. Multilevel regression models with and without false discovery rate correction were used for the analysis, with baseline values and dementia stage entered as covariates. RESULTS Sixty-nine patients were included in the study at baseline. Compared to the control group, the intervention group had a larger reduction on the composite scores of both the CSDD (95% CI = - 6.0 - - 0.3) and the NPI-NH (95% CI = - 2.2 - - 0.1), as well as on the NPI-NH Affect sub-syndrome, and the CSDD Mood related signs sub-scale at follow-up after 16 weeks. With FDR correction, the group difference was significant on the CSDD Mood related signs sub-scale (95% CI = - 2.7 - - 0.8) and the NPI-NH Affect sub-syndrome (95% CI = - 1.6 - - 0.2). No differences were found between conditions at weeks 8 or 24. CONCLUSION Compared to the control condition, affective symptoms were reduced after 16 weeks in the group receiving BLT, suggesting BLT may be beneficial for nursing home patients with dementia. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03357328 . Retrospectively registered on November 29, 2017.
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Affiliation(s)
- Eirin Kolberg
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009, Bergen, Norway.
| | - Gunnhild Johnsen Hjetland
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway ,City Department of Health and Care, City of Bergen, Norway
| | - Eirunn Thun
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
| | - Ståle Pallesen
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, Faculty of Psychology, University of Bergen (UiB) Christies gate 12, 5015 Bergen, Bergen, Norway ,grid.412008.f0000 0000 9753 1393Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway ,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Inger Hilde Nordhus
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway ,grid.5510.10000 0004 1936 8921Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, (UiO), Oslo, Norway
| | - Bettina S. Husebo
- grid.7914.b0000 0004 1936 7443Centre for Elderly and Nursing Home Medicine (SEFAS), Department of Global Public Health and Primary Care, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
| | - Elisabeth Flo-Groeneboom
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
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Teetharatkul T, Vitayanont A, Liabsuetrakul T, Aunjitsakul W. Associations between symptom severity and well-being among Thai patients with schizophrenia: a cross-sectional analytical study. BMC Psychiatry 2021; 21:348. [PMID: 34253169 PMCID: PMC8276510 DOI: 10.1186/s12888-021-03358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/30/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Severity of symptoms in patients with schizophrenia is a determinant of patient's well-being, but evidence in low- and middle-income countries is limited. We aimed to measure the symptom severity using objective measurements, the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity scale (CGI-S), and their associations with well-being in patients with schizophrenia. METHODS Patients with schizophrenia aged ≥18 years, without active psychosis including no history of hospitalization within the last 6 months, were included. Symptom severity was measured by the clinicians using BPRS and CGI-S. The patients' well-being was assessed by self-report using the Subjective Well-being under Neuroleptic treatment scale (SWN) as continuous and binary outcomes (categorized into adequate or poor well-being). Correlations between symptom severity (BPRS and CGI-S scores) and well-being (SWN score) were analyzed using Pearson's correlation. Association between well-being status and BPRS was analyzed using multivariate logistic regression. RESULTS Of 150 patients, BPRS and CGI-S were inversely correlated with SWN score (r = - 0.47; p < 0.001 and - 0.21; p < 0.01, respectively). BPRS Affect domain had the highest correlation with SWN (r = - 0.51, p < 0.001). In multivariate logistic regression, BPRS score and being unemployed were associated with poor well-being status (adjusted OR 1.08; 95%CI 1.02-1.14; p = 0.006, and 4.01; 95%CI 1.38-11.7; p = 0.011, respectively). CONCLUSION Inverse relationships between symptom severity and well-being score were found. Higher BPRS Affect domain was significantly associated with lower patients' well-being. The use of BPRS tool into routine clinical practice could serve as an adjunct to physician's clinical evaluation of patients' symptoms and may help improve patient's well-being. Further research on negative symptoms associated with well-being is required.
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Affiliation(s)
- Teerapat Teetharatkul
- grid.7130.50000 0004 0470 1162Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Arnont Vitayanont
- grid.7130.50000 0004 0470 1162Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Tippawan Liabsuetrakul
- grid.7130.50000 0004 0470 1162Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110 Thailand
| | - Warut Aunjitsakul
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
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Dotson VM, Taiwo Z, Minto LR, Bogoian HR, Gradone AM. Orbitofrontal and Cingulate Thickness Asymmetry Associated with Depressive Symptom Dimensions. Cogn Affect Behav Neurosci 2021. [PMID: 34136976 DOI: 10.3758/s13415-021-00923-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 11/08/2022]
Abstract
Both clinical depression and subthreshold depressive symptoms have been associated with alterations in cortical thickness. Studies have yielded conflicting results regarding whether cortical thinning or cortical thickening best characterize the depressive state. Also unclear is whether cortical thickness differences are lateralized. This study examined the relationship between depressive symptom dimensions and cortical thickness asymmetry in cingulate and orbitofrontal regions. Fifty-four community-dwelling adults between the ages of 18 and 81 years received a 3-Tesla magnetic resonance imaging scan and completed the Center for Epidemiologic Studies Depression Scale (CES-D). Cortical thickness values were extracted for the rostral anterior cingulate, caudal anterior cingulate, posterior cingulate, isthmus cingulate, and orbitofrontal cortex. An asymmetry index was calculated for each region. Data were analyzed using separate general linear models for each region, in which the CES-D somatic symptoms, negative affect, and anhedonia subscale scores predicted the asymmetry indices, controlling for age and sex. Higher scores on the anhedonia subscale were associated with right-sided asymmetry in orbitofrontal thickness, whereas higher somatic symptom subscale scores predicted greater left-sided asymmetry in posterior cingulate thickness. Follow-up analyses showed the orbitofrontal effect was specific to the medial, not the lateral, orbitofrontal cortex. These results suggest asymmetries in cortical thickness are apparent at even subthreshold levels of depressive symptoms, as all but five participants were below the CES-D cutoff for clinical depression, and that the relationship varies for different symptom dimensions of depression. Understanding brain asymmetries across the range of depressive symptom severity is important for informing targeted depression treatment.
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Lopez C, Sultan S, Lamore K, Dufour C, Favré E, Fasse L, Flahault C. Difficulties encountered by physicians and mental health professionals in evaluating and caring for affective and behavioral problems in pediatric brain tumor survivors. Support Care Cancer 2021. [PMID: 33990882 DOI: 10.1007/s00520-021-06250-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pediatric brain tumor survivors (PBTS) present a high risk for emotional and behavioral disorders. When addressing these difficulties, differences in study designs; variety of and disagreement about diagnoses; and intricate links of emotional, behavioral, and cognitive issues may complicate the interpretation of studies and probably also the work of clinicians. We aimed to survey the difficulties perceived by physicians and mental health professionals in their practice and their interest in developing a new evaluative tool. METHODOLOGY We surveyed 29 health professionals involved in the follow-up of this population. They completed questionnaires about their clinical practice (difficulties, needs, activities) and indicated diagnosis hypotheses and treatment plans on a clinical case developed for this study. RESULTS Emotional and behavioral disorders were reported as difficult to assess for 93% of participants. The overlap of symptoms (90%) and the lack of an adapted diagnostic framework (90%) were the main reasons mentioned. Respectively 93%, 90%, and 65% of participants would at least "often" make referrals to psychological (93%), neuropsychological (90%), and psychiatric (65%) assessments and care. Family and group therapy were less common as was drug management. All participants were in favor of creating a tool to help with diagnosis and treatment. When responding to a clinical case, the heterogeneity of participants' responses highlighted their issues in diagnosing and managing these patients. CONCLUSION This survey exemplifies the difficulties of health professionals related to the evaluation and management of affective and behavioral disorders experienced by PBTS. It underlines the need to help professionals by initiating systematic assessment strategies with this vulnerable population.
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Osorio Acuña LC, Franco Zuluaga A. Behavioural and Emotional Symptoms of Adolescents Consulting a Specialised Eating Disorders Programme. Rev Colomb Psiquiatr (Engl Ed) 2021; 51:S0034-7450(21)00044-5. [PMID: 33962787 DOI: 10.1016/j.rcp.2020.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/13/2020] [Accepted: 11/25/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are complex conditions of multifactorial origin. Their main characteristic is excessive concern about body weight and shape, which causes great discomfort and physical problems and leads to a decrease in quality of life and alterations in the patient's functionality social environment. The objective of this study is to describe the emotional and behavioural symptoms of adolescents who consult a specialised ED programme in the city of Bogota. METHODS Observational, descriptive, cross-sectional study, for which patients between 11 and 19 years old with an ED diagnosis were recruited. RESULTS Forty patients with an ED diagnosis were included, of which 92% were female. The mean age of the patients was 16.6±1.9 years; 57% of patients live in a two-parent home and 30% in a single-parent home; 72% of the sample had excellent academic performance; 50% were moderately ill; 60% received pharmacological management with SSRIs; 65% of patients met clinical criteria for anxiety disorder, 30% for depressive disorder; 22.5% had aggression problems; 17.5% criminal behaviour; 72.5% of the sample met clinical criteria for internalising symptoms and 42.5% for externalising symptoms, the majority being patients with a diagnosis of bulimia nervosa. CONCLUSIONS Patients with bulimia nervosa obtained higher scores in the different emotional and behavioural symptoms than those with other eating disorders. This condition is associated with greater psychopathology, which must be examined rigorously at the time of clinical care, seeking to reduce the functional impact that these symptoms generate on the individual.
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Affiliation(s)
- Lucia Carolina Osorio Acuña
- Especialista en psiquiatría infantil y del adolescente, Docente del Departamento de Psiquiatría, Universidad ICESI, Fundación Valle del Lili, Cali, Colombia.
| | - Alvaro Franco Zuluaga
- Especialista en psiquiatría infantil y del adolescente, Docente de psiquiatría de la Universidad El Bosque, Bogotá, Colombia
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Guerrero Moreno J, Biazoli CE, Baptista AF, Trambaiolli LR. Closed-loop neurostimulation for affective symptoms and disorders: An overview. Biol Psychol 2021; 161:108081. [PMID: 33757806 DOI: 10.1016/j.biopsycho.2021.108081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/28/2022]
Abstract
Affective and anxiety disorders are the most prevalent and incident psychiatric disorders worldwide. Therapeutic approaches to these disorders using non-invasive brain stimulation (NIBS) and analogous techniques have been extensively investigated. In this paper, we discuss the combination of NIBS and neurofeedback in closed-loop setups and its application for affective symptoms and disorders. For this, we first provide a rationale for this combination by presenting some of the main original findings of NIBS, with a primary focus on transcranial magnetic stimulation (TMS), and neurofeedback, including protocols based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Then, we provide a scope review of studies combining real-time neurofeedback with NIBS protocols in the so-called closed-loop brain state-dependent neuromodulation (BSDS). Finally, we discuss the concomitant use of TMS and real-time functional near-infrared spectroscopy (fNIRS) as a possible solution to the current limitations of BSDS-based protocols for affective and anxiety disorders.
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Affiliation(s)
- Javier Guerrero Moreno
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - Claudinei Eduardo Biazoli
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil; Department of Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, UK
| | - Abrahão Fontes Baptista
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil; Laboratory of Medical Investigations 54 (LIM-54), Universidade de São Paulo, São Paulo, Brazil; NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil; Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Lucas Remoaldo Trambaiolli
- McLean Hospital, Harvard Medical School, Boston, USA; School of Medicine and Dentistry, University of Rochester, Rochester, USA.
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Jordán-Quintero MI, Agudelo Hernández F, Julio De la Rosa A, Cardona Porras LF, Uribe-Restrepo JM. Implementation of a Multi-Family Intervention for Children With Behavioural and Emotional Problems in a Semi-Rural Population. Rev Colomb Psiquiatr (Engl Ed) 2020; 51:S0034-7450(20)30093-7. [PMID: 33735058 DOI: 10.1016/j.rcp.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/05/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To determine the feasibility of implementing a community-based, multi-family group intervention in a semi-rural population in Aranzazu, northern Caldas, Colombia. METHODS Qualitative study. A convenience sample was taken of 10 families with children with affective and behavioural disorders, previously identified by the Child Behaviour Checklist (CBCL). The Multifamily Psychoeducational Psychotherapy (MF-PEP) model was adapted to the culture and needs of the families. RESULTS The contents of the sessions and the topics and experiences that were most significant for the children and their families are described. CONCLUSIONS The adaptation to the cultural context of the multi-family intervention had a very good acceptability by all participants: caregivers, children and therapists.
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Affiliation(s)
- Martha Isabel Jordán-Quintero
- Grupo de Investigación: Perspectivas en ciclo vital, salud mental y psiquiatría, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Unidad de Salud Mental, Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.
| | | | | | | | - José Miguel Uribe-Restrepo
- Grupo de Investigación: Perspectivas en ciclo vital, salud mental y psiquiatría, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Alvarado-Bolaños A, Cervantes-Arriaga A, Zuazua-Vidal L, Esquivel-Zapata Ó, Alcocer-Salas Á, Rodríguez-Violante M. Determinants and impact of alexithymia on quality of life in Parkinson's disease. Neurologia 2020; 38:S0213-4853(20)30338-8. [PMID: 33317969 DOI: 10.1016/j.nrl.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.
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Affiliation(s)
- A Alvarado-Bolaños
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - A Cervantes-Arriaga
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - L Zuazua-Vidal
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Ó Esquivel-Zapata
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Á Alcocer-Salas
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - M Rodríguez-Violante
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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Abstract
PURPOSE OF REVIEW Anxiety disorders are the most prevalent mental disorders. Although prevalence estimates are lower in males than females, the disability associated with anxiety disorders has been increasing in males. This review focuses on recent research studying sex differences in anxiety disorders and associated symptoms in older adults. RECENT FINDINGS Females are close to three times more likely than males to report most anxiety disorders. Heterogeneity exists in sex-specific lifetime and past-year estimates. Age-appropriate instruments such as the CIDI65+ show higher estimates than previous research. The profiles of females and males with anxiety with respect to depressive and somatization symptoms are different. Age-appropriate standardized mental disorder instruments have been developed and may be useful to overcome the challenges of observed heterogeneity in anxiety disorders and allow for future cross-country comparisons and a better description of the epidemiology and biopsychosocial factors associated with different types of anxiety disorders in older adults.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Longueuil, Quebec, Canada.
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les Innovations en Santé, Longueuil, Quebec, Canada.
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Centre de recherche -CSIS, Campus Longueuil,150 Place Charles-Le Moyne, Longueuil, Quebec, J4K 0A8, Canada.
| | - Frédérique Desjardins
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Département de psychologie, Université de Montréal, Montreal, Quebec, Canada
| | - Pasquale Roberge
- Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Montreal, Quebec, Canada
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, Quebec, Canada
| | - Sebastien Grenier
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Département de psychologie, Université de Montréal, Montreal, Quebec, Canada
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40
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d'Onofrio F, de Falco A, Costanzo A, Spitaleri D, Casucci G, Raimo S. Impulse control disorders in chronic migraine with medication overuse after onabotulinumtoxinA: A single-center prospective cohort study. J Clin Neurosci 2020; 80:152-5. [PMID: 33099338 DOI: 10.1016/j.jocn.2020.07.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/16/2020] [Accepted: 07/31/2020] [Indexed: 01/17/2023]
Abstract
Chronic migraine (CM) with medication overuse headache (MOH) is one of the most common and disabling chronic headache disorders associated with both frequencies of use of medication and behavioral alterations, including psychopathology and psychological drug dependence. Several previous studies on large patient samples have demonstrated the efficacy of Onabotulinum toxin A (OnabotA) on physical symptomatology treatment of headache, but effects on behavioral alterations remain still debate. Our study investigated the effects of OnabotA on psychiatric comorbidities and on quality of life of patients with CM and MOH that failed on traditional therapies. OnabotA was injected, according to the PREEMPT paradigm, 40 patients with CM and MOH and data on headache-related impairment, before and after the OnabotA injections were collected from the patient's headache diaries. Data on depressive, anxiety symptomatology and impulse control disorders also were collected by means of self-report scales and a semi-structured interview. After six months, patients with CM and MOH showed a significant decrease in monthly headache attacks (from 19.3 ± 5.9 to 11.8 ± 8.5, p = 0.003), monthly headache days (from 23 ± 8.9 to 11.1 ± 6.2, p = 0.001), numbers of analgesics used per month (from 18.2 ± 6.3 to 8.5 ± 4.7, p < 0.0001). The anxiety symptomatology (p ≤ 0.003) and impulse control disorders (from 30% to 10%), but not depressive symptomatology (p = 0.81), were significantly reduced from throughout the study. The treatment with OnabotA proved beneficial effects on anxiety symptomatology and on impulse control disorders in our clinical practice with CM and MOH and further studies should shed light in larger patient samples on long-term behavioural effects.
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41
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Evald L, Evald J, Hansen D, Bonne NL, Hansen JK. Cerebellar Cognitive Affective Syndrome in Children With Acute Postinfectious Cerebellar Ataxia. Pediatr Neurol 2020; 110:71-79. [PMID: 32389491 DOI: 10.1016/j.pediatrneurol.2020.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/18/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Acute postinfectious cerebellar ataxia is the most common cause of acute ataxia in childhood. One previous case study has suggested that cerebellar cognitive affective syndrome may be comorbid with acute postinfectious cerebellar ataxia, but this was not confirmed by formal assessments. METHODS Children aged three to 15 years with a confirmed diagnosis of acute postinfectious cerebellar ataxia were invited to participate. Three patients were included and assessed by a pediatrician, neuropsychologist, and logopedist at the subacute stage (less than 14 days post-onset) and after six months and one year of follow-up. RESULTS All three children complied with the diagnostic criteria of cerebellar cognitive affective syndrome. The cognitive and affective symptoms persisted longer than the motor symptoms. Child A (girl, aged three years and eight months) was most severely affected with slow progression of motor cerebellar symptom; the cerebellar cognitive affective symptoms had not entirely remitted at one-year follow-up. Child B (boy, aged four years and four months) had more subtle motor cerebellar symptoms that swiftly remitted within the first week; the cerebellar cognitive affective symptoms were also more subtle. Child C (boy, aged seven years and eleven months) was considerably affected by motor cerebellar symptoms but showed marked improvement within the first month; the cerebellar cognitive affective symptoms had not entirely remitted at one-year follow-up. CONCLUSION Cognitive affective cerebellar syndrome may be an overlooked complication of acute postinfectious cerebellar ataxia. The severity of cerebellar cognitive affective symptoms seemed to correspond to the severity of the cerebellar motor symptoms, but the improvement was remarkably slower.
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Affiliation(s)
- Lars Evald
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.
| | - Jane Evald
- Pediatric Neuropsychologist, Private Practice, Aarhus, Denmark
| | - Dorthe Hansen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
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42
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Ouallet JC, Radat F, Creange A, Abdellaoui M, Heinzlef O, Giannesini C, Hautecoeur P, Lamargue Hamel D, Deloire M, Brochet B, Jean Deleglise AS, Lehert P. Evaluation of emotional disorders before and during treatment with interferon beta in patients with multiple sclerosis. J Neurol Sci 2020; 413:116739. [PMID: 32151852 DOI: 10.1016/j.jns.2020.116739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Domains encompassing emotional disorders in relapsing-remitting MS (RRMS) patients are still unclear. METHODS We performed a 24-month, multicenter, single-arm, prospective study. RRMS patients started IFN-β treatment at baseline. The primary endpoint was lack of emotional control, measured using the "Echelle d'HumeurDépressive" (EHD) scale three times at baseline and at 10 post-treatment visits. Secondary endpoints were emotional blunting, irritability, fatigue, depression and anxiety. A linear mixed covariance model assessed change from baseline on an intention-to-treat basis, under the assumption of no mood disorder effect (one-sided 97.5% level), in which autoregressive type of autocorrelation was tested. RESULTS Out of 79 recruited patients, 70 were analyzed: 80% female; mean (SD) age, 37.0 (11.5) years. Mean (SD) lack of emotional control score at baseline and Month 24 was 12.7 (4.4) and 12.6 (5.5), respectively, versus 10.1 (3.2) in a healthy control population matched for age and sex. Stepwise analysis identified younger age, male sex and antidepressant use as significant predictors of higher lack of emotional control values. CONCLUSIONS Based on 24 months of prospective follow-up, the results of this study highlights a broad spectrum of emotional disorders in the MS population at the time of disease modifying drugs initiation but no major IFN-β-related emotional disorders (mood dyscontrol, anxiety, depression) were observed. However, sporadic occurrences of severe mood disorders and suicidality cannot be excluded.
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Affiliation(s)
- Jean-Christophe Ouallet
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
| | - Françoise Radat
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Alain Creange
- Service de Neurologie, Groupe Hospitalier Henri Mondor, APHP, Université Paris Est-Créteil, Creteil, France
| | - Mohamed Abdellaoui
- Service de Neurologie, Groupe Hospitalier Henri Mondor, APHP, Université Paris Est-Créteil, Creteil, France
| | - Olivier Heinzlef
- Service de Neurologie, Centre Hospitalier de Poissy, Poissy, France
| | - Claire Giannesini
- Service de Neurologie, Centre Hospitalier Universitaire St Antoine, APHP, Paris, France
| | | | | | - Mathilde Deloire
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Bruno Brochet
- Service de Neurologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France; NeuroCentre Magendie, INSERM U862, University of Bordeaux, Bordeaux, France
| | | | - Philippe Lehert
- Faculty of Economics, Louvain University, Belgium; Faculty of Medicine, University of Melbourne, Australia
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43
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Fischer CE, Kortebi I, Karameh WK, Kumar S, Gallagher D, Golas A, Munoz D, Barfett J, Butters MA, Bowie CR, Flint A, Rajji T, Herrmann N, Pollock BG, Mulsant B, Schweizer TA, Mah L. Examining the Link Between Cardiovascular Risk Factors and Neuropsychiatric Symptoms in Mild Cognitive Impairment and Major Depressive Disorder in Remission. J Alzheimers Dis 2020; 67:1305-1311. [PMID: 30741676 DOI: 10.3233/jad-181099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular risk factors (CVRFs) have been linked to both depression and cognitive decline but their role in neuropsychiatric symptoms (NPS) has yet to be clarified. OBJECTIVE Understanding the role of CVRFs in the etiology of NPS for prospective treatments and preventive strategies to minimize these symptoms. METHODS We examined the distribution of NPS using the Neuropsychiatric Inventory (NPI) scores in three cohorts from the Prevention of Alzheimer's Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt-MD) study: older patients with a lifetime history of major depressive disorder (MDD) in remission, patients with mild cognitive impairment (MCI), and patients with combined MCI and MDD. We also examined the link between individual NPS and CVRFs, Framingham risk score, and Hachinski ischemic score in a combined sample. RESULTS Analyses were based on a sample of 140 subjects, 70 with MCI, 38 with MCI plus MDD, and 32 with MDD. There was no effect of age, gender, education, cognition, or CVRFs on the presence (NPI >1) or absence (NPI = 0) of NPS. Depression was the most prevalent affective NPS domain followed by night-time behaviors and appetite changes across all three diagnostic groups. Agitation and aggression correlated negatively while anxiety, disinhibition, night-time behaviors, and irritability correlated positively with CVRFs (all p-values <0.05). Other NPS domains showed no significant association with CVRFs. CONCLUSION CVRFs are significantly associated with individual NPI sub-scores but not with total NPI scores, suggesting that different pathologies may contribute to different NPS domains.
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Affiliation(s)
- Corinne E Fischer
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada
| | | | - Wael K Karameh
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Damien Gallagher
- University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Angela Golas
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - David Munoz
- Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Joseph Barfett
- Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh School of Medicine, USA
| | - Christopher R Bowie
- Centre for Addiction and Mental Health, Toronto, Canada.,Queen's University, Kingston, Canada
| | - Alastair Flint
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Mental Health, University Health Network, Toronto, Canada
| | - Tarek Rajji
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada
| | - Benoit Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Linda Mah
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Canada
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Neumann D, Zupan B. Sex Differences in Emotional Insight After Traumatic Brain Injury. Arch Phys Med Rehabil 2020; 101:1922-1928. [PMID: 32445846 DOI: 10.1016/j.apmr.2020.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare sex differences in alexithymia (poor emotional processing) in males and females with traumatic brain injury (TBI) and uninjured controls. DESIGN Cross-sectional study. SETTING TBI rehabilitation facility in the United States and a university in Canada. PARTICIPANTS Sixty adults with moderate to severe TBI (62% men) and 60 uninjured controls (63% men) (N=120). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Toronto Alexithymia Scale-20 (TAS-20). RESULTS Uninjured men had significantly higher (worse) alexithymia scores than uninjured female participants on the TAS-20 (P=.007), whereas, no sex differences were found in the TBI group (P=.698). Men and women with TBI had significantly higher alexithymia compared with uninjured same-sex controls (both P<.001). The prevalence of participants with scores exceeding alexithymia sex-based norms for men and women with TBI was 37.8% and 47.8%, respectively, compared with 7.9% and 0% for men and women without TBI. CONCLUSIONS Contrary to most findings in the general population, men with TBI were not more alexithymic than their female counterparts with TBI. Both men and women with TBI have more severe alexithymia than their uninjured same-sex peers. Moreover, both are equally at risk for elevated alexithymia compared with the norms. Alexithymia should be evaluated and treated after TBI regardless of patient sex.
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Affiliation(s)
- Dawn Neumann
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, NC, Canada.
| | - Barbra Zupan
- Department of Applied Linguistics, Brock University, St. Catharines, ON, Canada
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45
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Wang J, Lloyd-Evans B, Marston L, Mann F, Ma R, Johnson S. Loneliness as a predictor of outcomes in mental disorders among people who have experienced a mental health crisis: a 4-month prospective study. BMC Psychiatry 2020; 20:249. [PMID: 32434492 PMCID: PMC7238641 DOI: 10.1186/s12888-020-02665-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loneliness has not until recently been a prominent focus in research on outcomes of mental illness. The aim of this study was to determine whether loneliness at baseline predicts poor outcomes at 4-month follow-up for individuals who have experienced mental health crises. The outcomes in this study included overall symptom severity, affective symptoms, self-rated recovery and health-related quality of life. METHODS Our study reports a secondary analysis of data from a randomised controlled trial. The sample (n = 399) was taken from patients who received treatment from community crisis services. Respondents (n = 310) completed the follow-up measurement 4 months after baseline. Loneliness at baseline was assessed using an eight-item UCLA Loneliness Scale. The four mental health outcomes were measured at both baseline and follow-up. Two scales (or part thereof) assessed objective social isolation and neighbourhood social capital at baseline. Regression analyses were conducted to investigate longitudinal associations between loneliness at baseline and mental health outcomes at follow-up. RESULTS Loneliness at baseline was associated with all four mental health outcomes at 4-month follow-up, adjusting for psychosocial, socio-demographic and clinical characteristics. A one-point higher loneliness score was associated with 0.74-point (95% CI 0.45, 1.02) and 0.34-point (95% CI 0.21, 0.47) increase in overall symptom severity score and affective symptoms score respectively, and with 1.08-point (95% CI -1.45, - 0.71) and 1.27-point (95% CI -1.79, - 0.75) decrease in self-rated recovery score and health-related quality of life score respectively. Loneliness was a better predictor of clinical outcomes than objective social isolation and social capital, even though the associations with clinical outcomes were reduced and no longer statistically significant following adjustment for their baseline values. A significant association with quality of life persisted after adjustment for its baseline score. CONCLUSIONS Greater loneliness at baseline predicted poorer health-related quality of life at follow-up. There were cross-sectional associations between loneliness and clinical outcomes, but their longitudinal relationship cannot be confirmed. Further research is needed to clearly establish their underpinning pathways. Reducing loneliness may be a promising target to improve recovery for mental health community crisis service users.
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Affiliation(s)
- Jingyi Wang
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Department of Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
| | - Brynmor Lloyd-Evans
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Louise Marston
- grid.83440.3b0000000121901201Research Department of Primary Care and Population Health, University College London, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - Farhana Mann
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Ruimin Ma
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK.
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46
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Liew TM. Neuropsychiatric symptoms in cognitively normal older persons, and the association with Alzheimer's and non-Alzheimer's dementia. Alzheimers Res Ther 2020; 12:35. [PMID: 32234066 DOI: 10.1186/s13195-020-00604-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022]
Abstract
Background Neuropsychiatric symptoms (NPS) have been reported to be useful in predicting incident dementia among cognitively normal older persons. However, the literature has not been conclusive on the differential utilities of the various NPS in predicting the subtypes of dementia. This study compared the risks of Alzheimer’s and non-Alzheimer’s dementia associated with the various NPS, among cognitively normal older persons. Methods This cohort study included 12,452 participants from the Alzheimer’s Disease Centers across USA, who were ≥ 60 years and had normal cognition at baseline. Participants completed the Neuropsychiatric Inventory-Questionnaire at baseline and were followed up almost annually for incident dementia (median follow-up = 4.7 years). Symptom clusters of NPS—as identified from exploratory and confirmatory factor-analyses—were included in the Cox regression to investigate their associations with incident dementia. Results The various NPS showed independent yet differential associations with incident dementia. Although psychotic symptoms were rarely endorsed by the participants, they predicted much higher risk of dementia (HR 3.6, 95% CI 2.0–6.4) than affective symptoms (HR 1.5, 95% CI 1.2–1.8) or agitation symptoms (HR 1.6, 95% CI 1.3–2.1). Psychotic symptoms predicted all dementia subtypes, while affective and agitation symptoms differentially predicted some subtypes. Across dementia subtypes, psychotic symptoms had relatively higher risk estimates than affective or agitation symptoms, with the risk estimates being particularly high in non-Alzheimer’s dementia. Conclusions Among cognitively normal individuals, the presence of NPS may warrant greater clinical vigilance as precursors to dementia and its subtypes. The findings highlight the need for further research to enrich our understanding on the neurobiological links between various NPS and dementia subtypes. They may also change the clinical approach in managing late-life psychotic symptoms, requiring a greater emphasis on dementia surveillance in the diagnostic criteria of late-life psychotic disorders.
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47
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Hua JPY, Trull TJ, Merrill AM, McCarty RM, Straub KT, Kerns JG. Daily-life affective instability in emotional distress disorders is associated with function and structure of posterior parietal cortex. Psychiatry Res Neuroimaging 2020; 296:111028. [PMID: 31911320 DOI: 10.1016/j.pscychresns.2019.111028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/17/2019] [Accepted: 12/27/2019] [Indexed: 12/22/2022]
Abstract
Affective instability (i.e., large and frequent shifts in negative emotions) is a key emotion dysregulation symptom in emotional distress disorders and can be reliably and validly assessed using ambulatory assessment. However, no study has examined whether affective instability is associated with brain function and structure. Using multimodal neuroimaging and ambulatory assessment, we examined associations between functional activation and cortical structure with ambulatory-assessed affective instability in emotional distress disorders (n = 27). Increased daily life-affective instability was associated with decreased neural activation on an emotion regulation task in a left inferior parietal region consistently associated with emotion regulation. Daily-life affective instability was also associated with hypogyria in this same left inferior parietal region, with hypogyria extending into additional posterior parietal regions. This study found evidence that daily-life affective instability was associated with both functionstructure of the posterior parietal cortex, a key attentional control region involved in emotion regulation.
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Affiliation(s)
- Jessica P Y Hua
- Department of Psychological Sciences, University of Missouri, 204A McAlester Hall, Columbia, MO 65211, United States; San Francisco VA Medical Center, San Francisco, CA 94121, United States
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, 204A McAlester Hall, Columbia, MO 65211, United States
| | - Anne M Merrill
- Department of Psychological Sciences, University of Missouri, 204A McAlester Hall, Columbia, MO 65211, United States; Kansas City VA Medical Center, Kansas City, MO 64128, United States
| | - Riley M McCarty
- Department of Psychological Sciences, University of Missouri, 204A McAlester Hall, Columbia, MO 65211, United States; National Institutes of Health, Bethesda, MD 20892, United States
| | - Kelsey T Straub
- Department of Psychological Sciences, University of Missouri, 204A McAlester Hall, Columbia, MO 65211, United States
| | - John G Kerns
- Department of Psychological Sciences, University of Missouri, 204A McAlester Hall, Columbia, MO 65211, United States.
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John A, Rusted J, Richards M, Gaysina D. Accumulation of affective symptoms and midlife cognitive function: The role of inflammation. Brain Behav Immun 2020; 84:164-172. [PMID: 31785399 DOI: 10.1016/j.bbi.2019.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/23/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of the present study was to test whether C-Reactive Protein (CRP), a proxy measure of inflammation, is elevated in people with higher childhood and adulthood affective symptoms and whether elevated CRP predicts midlife cognitive function. METHODS Data were used from the National Child Development Study (n = 6276). Measures of memory, verbal fluency, information processing speed and accuracy were available in midlife (age 50). Affective symptoms were assessed in childhood (ages 7, 11, 16) and in adulthood (ages 23, 33, 42, 50). The level of plasma CRP was measured at age 44. Pathway models, unadjusted and fully adjusted for sex, education, childhood socioeconomic position, childhood cognitive ability and affective symptoms at age 50, were fitted to test direct associations between affective symptoms and midlife cognitive function, and indirect associations via the inflammatory pathway (CRP level). RESULTS In a fully adjusted model, there were significant indirect associations between adulthood affective symptoms and immediate memory (β = -0.01, SE = 0.003, p = .03) and delayed memory (β = -0.01, SE = 0.004, p = .03) via CRP. In addition, there were significant indirect associations between affective symptoms in childhood and immediate memory (β = -0.001, SE = 0.00, p = .03) and delayed memory (β = -0.001, SE = 0.001, p = .03), via adulthood affective symptoms and associated CRP. Independent of CRP, there was a significant direct association between adulthood affective symptoms and information processing errors (β = 0.47, SE = 0.21, p = .02). There were no direct or indirect associations between affective symptoms and verbal fluency or information processing speed. CONCLUSIONS CRP at age 44 is elevated in people with higher affective symptoms from age 7 to 42, and elevated CRP is associated with poorer immediate and delayed memory at age 50.
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Affiliation(s)
- Amber John
- EDGE Lab, School of Psychology, University of Sussex, Brighton, United Kingdom.
| | - Jennifer Rusted
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, Brighton, United Kingdom
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49
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John A, James SN, Rusted J, Richards M, Gaysina D. Effects of affective symptoms in adolescence and adulthood on trajectories of cognitive function from middle to late adulthood. J Affect Disord 2019; 259:424-431. [PMID: 31610999 DOI: 10.1016/j.jad.2019.08.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 05/30/2019] [Accepted: 08/23/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about the link between affective symptoms and cognitive function across the life course. This study aims to investigate whether affective symptoms in adolescence and adulthood predict trajectories of cognitive function from middle to late-adulthood. METHODS Data from the MRC National Survey of Health and Development (NSHD), a cohort of 5362 individuals born in mainland UK in 1946, were utilised. Linear mixed models were used to model cognitive trajectories (memory and processing speed) over a three-decade period (from 43 to 69) and to test effects of affective symptoms in adolescence (ages 13-15) and adulthood (ages 36 and 43) on cognitive function at first testing (age 43) and decline in cognitive function (from 43 to 69). Models were adjusted for sex, childhood cognition, childhood socioeconomic position, and education. RESULTS A quadratic model best fitted memory and processing speed data. Models revealed that adolescent affective symptoms were associated with lower memory (b = -1.11, SE = 0.53, p = .04) and processing speed (b = -18.17, SE = 7.53, p = .02) at first cognitive testing, but not with rates of decline from 43 to 69. There were no significant associations between adult affective symptoms and cognitive trajectories. LIMITATIONS Missing data is a potential limitation of this study. This was dealt with using maximum likelihood estimation and multiple imputation. CONCLUSIONS Findings suggest that adolescent, but not adult, affective symptoms are important predictors of cognitive function in midlife, but not rate of cognitive decline. This highlights the importance of early intervention to manage mental health in adolescence to protect later cognitive function.
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Affiliation(s)
- Amber John
- EDGE Lab, School of Psychology, University of Sussex, Pevensey 1 2C8, Brighton, United Kingdom.
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Jennifer Rusted
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, Pevensey 1 2C8, Brighton, United Kingdom
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Whitaker RC, Herman AN, Dearth-Wesley T, Hubbell K, Huff R, Heneghan LJ, Rowe PC. The association of fatigue with dispositional mindfulness: relationships by levels of depressive symptoms, sleep quality, childhood adversity, and chronic medical conditions. Prev Med 2019; 129:105873. [PMID: 31644898 DOI: 10.1016/j.ypmed.2019.105873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
Although mindfulness-based interventions may be effective in addressing the common symptom of fatigue, no population-based studies have examined the relationship between mindfulness and fatigue. We determined whether higher levels of dispositional mindfulness were associated with lower levels of fatigue. Cross-sectional data were obtained through the Pennsylvania Head Start Staff Wellness Survey, a 2012 web-based survey in which 2199 of 3375 (65%) eligible staff participated. The analytic sample was restricted to the 2083 female respondents with complete data on dispositional mindfulness (Cognitive and Affective Mindfulness Scale-Revised) and fatigue (Fatigue Severity Scale). We determined the mean covariate-adjusted fatigue scores in each quartile of dispositional mindfulness. This relationship was examined in the overall sample and within subgroups defined by levels of four variables: depressive symptoms, poor sleep quality, childhood adversity, and chronic medical conditions. The sample was 86% non-Hispanic White, and 61% had a bachelor's or more advanced degree. The mean (SD) Fatigue Severity Scale score was 3.3 (1.3). The adjusted mean fatigue score decreased significantly and in a graded manner across higher quartiles of mindfulness, with the adjusted fatigue score 1.4 points lower (95% confidence interval: -1.5, -1.2) among those in the highest quartile of dispositional mindfulness compared to the lowest. This significant graded relationship was present within each subgroup examined, and there was not a statistically significant interaction between dispositional mindfulness and any subgroup variable. Future trials of mindfulness-based interventions should consider assessing the outcome of fatigue in both clinical and non-clinical populations.
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Affiliation(s)
- Robert C Whitaker
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America; Bassett Research Institute, Cooperstown, NY, United States of America; Bassett Medical Center, Cooperstown, NY, United States of America.
| | - Allison N Herman
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Bassett Research Institute, Cooperstown, NY, United States of America; Bassett Medical Center, Cooperstown, NY, United States of America
| | - Tracy Dearth-Wesley
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Bassett Research Institute, Cooperstown, NY, United States of America; Bassett Medical Center, Cooperstown, NY, United States of America
| | - Kenneth Hubbell
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Ryan Huff
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Liam J Heneghan
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Peter C Rowe
- Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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