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Fernández T, Plana T, Tardón L, Marco O, Navarro L, Bartrés C, Colom J, Goikolea JM, Cavero M, Pacchiarotti I, Lens S, Forns X, Martín-Santos R, Mariño Z. Low risk of viral hepatitis amongst patients with severe mental disorders. Liver Int 2023; 43:1204-1212. [PMID: 37041668 DOI: 10.1111/liv.15569] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/15/2023] [Accepted: 03/22/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND AND AIMS Patients with severe mental disorders (SMD) have been classically considered as a particularly high-risk population for bloodborne virus infections. We performed a systematic screening of hepatitis B and C virus among the population with SMD in the area of influence of Hospital Clínic (Barcelona) in order to evaluate the real prevalence of these infections and achieve HCV microelimination in this subpopulation. METHODS We screened two cohorts for anti-HCV and HBsAg: Cohort A (hospitalized patients with SMD, done systematically) and Cohort B (outpatients, mental health centre-CSMA, done voluntarily). Risk factors and socio-demographic variables were collected. In positive cases, telematic review was activated by Hepatology, calculation of FIB-4 and prescription of direct-acting agents (DAA) in HCV or follow-up in HBV. RESULTS In Cohort A, 404 patients were screened. 3 HBV patients were detected (0.7%). In all of them, there was a history of drug use. 12 anti-HCV positive patients were detected (3%); 8 of them had a history of drug use. Among the HCV positive, only 2 patients were viraemic (received DAA, both achieving SVR) as most of them (n = 6) had already been cured with DAA. In cohort B, 305 patients were screened, after 542 (64% of the target population) declined to participate. No cases of HCV or HBV were detected. CONCLUSIONS HCV/HBV prevalence among SMD population with no history of drug use does not seem to be different from the general population. These data may be of interest for defining health policies.
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Affiliation(s)
- Tábatha Fernández
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Teresa Plana
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Liver Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - Laia Tardón
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Oriol Marco
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Lourdes Navarro
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Joan Colom
- Public Health Agency of Catalonia, Health Department, General Subdirection on Prevention, Control and Care on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain
| | - José Manuel Goikolea
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERsam), Madrid, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Myriam Cavero
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERsam), Madrid, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Isabella Pacchiarotti
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERsam), Madrid, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Sabela Lens
- Liver Unit, Hospital Clínic Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas (CIBERehd), Madrid, Spain
| | - Xavier Forns
- Liver Unit, Hospital Clínic Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas (CIBERehd), Madrid, Spain
| | - Rocío Martín-Santos
- Psychiatry and Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERsam), Madrid, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Zoe Mariño
- Liver Unit, Hospital Clínic Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas (CIBERehd), Madrid, Spain
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Adamis D, Fox N, de M de Camargo APP, Saleem F, Gavin B, McNicholas F. Prevalence of attention deficit hyperactivity disorder in an adult mental health service in the Republic of Ireland. Int J Psychiatry Med 2023; 58:130-144. [PMID: 35654762 DOI: 10.1177/00912174221106826] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Attention Deficit Hyperactivity Disorder (ADHD) is well recognised in childhood. However, recognition that it commonly persists into adulthood is relatively recent. This study is the 2nd phase of a two-phase epidemiological investigation of the prevalence of adult ADHD in outpatients in Ireland. METHOD In phase-1, 634 participants were screened with Adult ADHD Self-Report Scale (ASRS) and Wender Utah Rating Scale (WURS). Those scoring positive in both scales have been invited to participate in the 2nd phase where the scales Conners' Adult ADHD Diagnostic Interview (CAADID), Mini International Neuropsychiatric Interview (MINI), and Global Assessment of Functioning (GAF) were administered, plus clinical evaluation based in DSM-5. RESULTS 131 were eligible, 110 participated (84.0%). Using the CAADID (DSM-IV criteria) 71 were diagnosed with ADHD. Projecting to the total sample (N = 634) the prevalence was 13.25%, CI:95%:10.71-16.14. Converting the DSM-IV criteria to DSM-5, 89 had ADHD (prevalence:16.72%, CI: 13.9-19.86). Using clinical evaluation, 86 were diagnosed with ADHD (prevalence:16.09%, CI:13.31-19.18). Only 3 cases were diagnosed before with ADHD. Comorbidity was higher in those with ADHD, with the median number of additional diagnoses 2 (min 0 max 8, IQR 3) Also, they had significantly higher rates of depression and recurred depression. Agreement between DSM-IV and DSM-5 was high (rho = 0.90, p < .0001). CONCLUSIONS High rates of undiagnosed ADHD were found to be present among AMHS attendees. Clinicians in AMHS need to be knowledgeable and alert to possible ADHD among their caseloads, and offer appropriate intervention. Interventions are urgently required to increase the detection and treatment of adult ADHD.
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Affiliation(s)
- Dimitrios Adamis
- School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland.,603698Sligo Mental Health Services, Sligo, Ireland.,Research and Academic Institute of Athens, Greece
| | - Naoimh Fox
- 603698Sligo Mental Health Services, Sligo, Ireland.,Adult mental health in Newcastle upon Tyne, Newcastle, UK
| | - Ana Paula P de M de Camargo
- 603698Sligo Mental Health Services, Sligo, Ireland.,Professor in Psychology Dublin Business School, Dublin, Ireland
| | | | - Blánaid Gavin
- School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
| | - Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland.,CHI, Crumlin, Lucena SJOG, Dublin, Ireland
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Marcu GM, Radu AM, Bucuță MD, Fleacă RS, Tanasescu C, Roman MD, Boicean A, Bacilă CI. Cognitive and Behavioral Factors Predicting the Decision to Vaccinate against COVID-19 in Clinical Psychiatric Population-A Cross-Sectional Survey. Vaccines (Basel) 2023; 11:vaccines11020441. [PMID: 36851318 PMCID: PMC9961952 DOI: 10.3390/vaccines11020441] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
The spread of the COVID-19 virus created more than a medical crisis, while it also negatively affected the mental health of the general population. This context increased the vulnerability of the psychiatric population. While research interest highly targeted vaccine hesitancy and acceptance, many studies focused on trust issues-both in vaccine efficacy and in communication with authorities. Less is known about the psychological underpinnings of the COVID vaccination decision, specifically in the high-uncertainty circumstances due to the novelty of the virus. In a cross-sectional study, we investigated the predictive value of several cognitive (perceived risk, vulnerability, uncertainty, and trust in one's decision) and behavioral (previous vaccinations, social media use, and practicing preventive behavior) factors, for the vaccination decision against COVID-19, for 252 psychiatric inpatients (data collected between September 2021 and February 2022). Demographics and diagnostics were also considered. We found a significant relationship between the "Perceived risk of vaccination" and the choice of vaccination (χ2(2, N = 252) = 58.59, p ≤ 0.001), and between the "Trust in own decision to vaccinate" and the decision to vaccinate (χ2(2, N = 252) = 31,5, p ≤ 0.001). The overall regression model was statistically significant (χ2 (9, N = 252) = 97.1, p < 0.001), with between 30% and 45% of the variance in the odds of a positive decision explained by the predictor set. The model coefficients analysis showed that an individual with a psychiatric disorder but with higher confidence in their decision had significant (p < 0.001) increased odds of the decision to vaccinate against COVID-19 by 893%. A former voluntary vaccination did not significantly associate with the decision to vaccinate against COVID-19 (χ2(1, N = 252) = 2.74, p > 0.05) in this special population. No other behavioral factors, diagnosis, or demographics were significant as predictors, for the clinical psychiatric population surveyed, except the educational level. Implications for future vaccination acceptance of this special population are discussed.
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Affiliation(s)
- Gabriela Mariana Marcu
- Department of Psychology, Faculty of Social Sciences and Humanities, “Lucian Blaga” University of Sibiu, 550201 Sibiu, Romania
- Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital “Dr. Gheorghe Preda”, 550082 Sibiu, Romania
- Division of Physiology and Neuroscience, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ana Maria Radu
- Department of Psychology, Faculty of Social Sciences and Humanities, “Lucian Blaga” University of Sibiu, 550201 Sibiu, Romania
- Psychology Department, Faculty of Sociology and Psychology, West University of Timișoara, 300223 Timișoara, Romania
- Correspondence:
| | - Mihaela Dana Bucuță
- Department of Psychology, Faculty of Social Sciences and Humanities, “Lucian Blaga” University of Sibiu, 550201 Sibiu, Romania
| | - Radu Sorin Fleacă
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Tanasescu
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Mihai Dan Roman
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Adrian Boicean
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Ionuț Bacilă
- Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital “Dr. Gheorghe Preda”, 550082 Sibiu, Romania
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
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Xu X, Xu J, Li C, Wang G, Wang W, Ye Y, Chen Y, Liu T, Zhao M, Wang X, Zhong N, Jiang H. Hazardous use of benzodiazepine receptor agonists in psychiatric clinics in China: electronic prescription database study. BJPsych Open 2022; 8:e188. [PMID: 36254807 PMCID: PMC9634586 DOI: 10.1192/bjo.2022.589] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Benzodiazepine receptor agonists (BZRAs) are commonly used clinically and data on their hazardous use from large populations of psychiatric patients is limited. AIMS To assess the current status of hazardous BZRA use and related factors in Chinese out-patient psychiatric settings. METHOD The study included out-patients with at least one BZRA prescription from five psychiatric settings in east, central and west China in 2018. Demographic and prescription information were extracted from the electronic prescription database. We defined the co-occurrence of overdose and long-term use as hazardous use, and patients whose recorded diagnoses did not meet any indications approved by the Chinese Food and Drug Administration as over-indication users. Additionally, 200 hazardous users were randomly selected for follow-up interview to confirm the actual situation. RESULTS Among 720 054 out-patients, 164 450 (22.8%) had at least one BZRA prescription; 55.9% of patients were prescribed over-indication and 3% were defined as hazardous users. Multilevel multivariate regression analysis with hospital as a random effect showed that factors associated with hazardous use were older age (18-64 years: β = 0.018; 95% CI 0.013-0.023; >65 years: β = 0.015; 95% CI 0.010-0.021), male (β = 0.005, 95% CI 0.003-0.007), over-indication (β = 0.013, 95% CI 0.012-0.015), more out-patient visits (β = 0.006, 95% CI 0.006-0.006) and more visits to different doctors (β = 0.007, 95% CI 0.007-0.008); 98.5% of hazardous users (197/200) could not be contacted. CONCLUSIONS BZRAs are commonly used and there is a relatively large proportion of over-indication users among Chinese psychiatric out-patients. However, only a small proportion of hazardous users were detected. The study highlights how to use prescription data to support improvements in clinical practice.
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Affiliation(s)
- Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajun Xu
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Chuanwei Li
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan, China
| | - Wenzhe Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujian Ye
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Chen
- Department of Patient & Health Impact, Pfizer Inc., Collegeville, Pennsylvania, USA
| | - Tieqiao Liu
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; and CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Xuyi Wang
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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5
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Adamis D, Flynn C, Wrigley M, Gavin B, McNicholas F. ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics. J Atten Disord 2022; 26:1523-1534. [PMID: 35373645 DOI: 10.1177/10870547221085503] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Systematic review and meta-analysis to estimate the pooled prevalence of ADHD in adult attendees of outpatient mental health clinics and to investigate factors influencing prevalence rates. METHODS The following were extracted: demographics, design of the study (screening only or two-phase), scales/criteria for diagnosis of ADHD, number of ADHD, and non-ADHD participants. RESULTS The pooled prevalence of ADHD from screening studies (n = 9) was 26.7%, (95% CI [17.2-37.4]), ADHD = 1727, No ADHD = 3,578. From studies employing a two-stage design (n = 5), prevalence was 14.61%, CI [10.39-19.41], ADHD = 561, No ADHD = 3,578. Age and gender did not have any significant effect on the estimated prevalence. By contrast exclusion of psychotic disorders lowers prevalence. The screening scale used also influence prevalence rates. CONCLUSION Meta-analysis shows high rates of adult ADHD among psychiatric outpatient clinics. Applying DSM-5 criteria increased prevalence rates. More methodologically robust studies, using two-stage design, need to be conducted to help assist in service planning.
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Affiliation(s)
- Dimitrios Adamis
- Sligo Mental Health Services, Ireland.,University College Dublin, Ireland.,Research and Academic Institute of Athens, Greece
| | | | - Margo Wrigley
- National Clinical Programme for Adult ADHD, Dublin, Ireland
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Zolezzi M, Elhakim A, Elamin WM, Homs S, Mahmoud DE, Qubaiah IA. Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population. Neuropsychiatr Dis Treat 2021; 17:3395-3405. [PMID: 34848960 PMCID: PMC8612668 DOI: 10.2147/ndt.s334350] [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: 08/15/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND QTc interval (QTcI) prolongation leads to serious complications, making it a concern for clinicians. Assessing the risk of QTcI prolongation in the psychiatric population is important because they are exposed to multiple medications known to increase the risk of life-threatening arrhythmias. AIM The study aims to validate the content of an algorithm for the assessment, management and monitoring of drug-induced QTc prolongation in the psychiatric population. METHODOLOGY Qualitative semi-structured interviews of cardiologists, to gather information regarding their approach in assessing the risk of drug-induced QTc prolongation at the time of prescribing. After the interview, an orientation to the algorithm was provided with a link to a cross-sectional, anonymous survey. The online survey included quantitative and qualitative components to gather feedback on the relevance and appropriateness of each step in the algorithm. RESULTS Interview responses were incorporated into 4 themes. Responses indicated a lack of a unified protocol when assessing QTcI prolongation, which supports the need of an algorithm that includes a verified risk scoring tool. Quantitative survey results showed a mean score ranging from 3.08 to 3.67 out of 4 for the appropriateness of the algorithm's steps, 3.08 to 3.58 for the safety and 3.17 to 3.75 for the reliability of references used. Additional analysis using the modified kappa and I-CVI statistical measures indicate high validity of contents and high degree of agreement between raters. As per the open-ended questions, cardiologists supported the implementation of the algorithm; however, they recommended simplification of the steps as they appear to be cumbersome. CONCLUSION The results demonstrate that the implementation of the algorithm after minor alterations can prove to be useful as a tool for the risk assessment of QTc prolongation. Further validation of the algorithm with mental health pharmacists and clinicians will be conducted as a separate phase of the study.
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Affiliation(s)
- Monica Zolezzi
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Athar Elhakim
- School of Health Sciences, College of North Atlantic Qatar, Doha, Qatar
| | - Waad M Elamin
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Shorouk Homs
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Doaa E Mahmoud
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Iman A Qubaiah
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Seow LSE, Verma SK, Mok YM, Kumar S, Chang S, Satghare P, Hombali A, Vaingankar J, Chong SA, Subramaniam M. Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population. J Clin Sleep Med 2018; 14:237-244. [PMID: 29394962 DOI: 10.5664/jcsm.6942] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 10/25/2017] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES With the introduction of insomnia disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), greater emphasis has been placed on the diagnosis and treatment of sleep disorder even in the presence of a coexisting mental disorder. The current study seeks to explore the clinical picture of insomnia in the context of psychiatric disorders commonly associated with sleep complaints by assessing the prevalence and correlates of DSM-5 insomnia disorder, and examining the extent to which insomnia symptoms have been addressed in this population. METHODS Four hundred treatment-seeking outpatients suffering from depressive, bipolar affective, anxiety, and schizophrenia spectrum disorders were recruited. DSM-5 insomnia was established using the modified Brief Insomnia Questionnaire. Differences in sociodemographic factors, clinical status, impairment outcomes, and mental health services utilization were compared. Information on patients' help-seeking experiences for insomnia-related symptoms was collected to determine the treatment received and treatment effectiveness. RESULTS Almost one-third of our sample (31.8%) had DSM-5 insomnia disorder. Those with insomnia disorder had significantly higher impairment outcomes than their counterparts but no group difference was observed for mental health services utilization. Findings based on past treatment contact for sleep problems suggest that diagnosis and treatment of insomnia is lacking in this population. CONCLUSIONS With the new calling from DSM-5, clinicians treating psychiatric patients should view insomnia less as a symptom of their mental illnesses and treat clinical insomnia as a primary disorder. Patients should also be educated on the importance of reporting and treating their sleep complaints. Nonmedical (cognitive and behavioral) interventions for insomnia need to be further explored given their proven clinical effectiveness.
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Affiliation(s)
| | | | - Yee Ming Mok
- Department of General Psychiatry, Institute of Mental Health, Singapore
| | - Sunita Kumar
- Division of Pulmonary and Critical Care Medicine, Loyola University, Chicago, Illinois
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | | | - Aditi Hombali
- Research Division, Institute of Mental Health, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Griffioen BT, van der Vegt AA, de Groot IW, de Jongh A. The Effect of EMDR and CBT on Low Self-esteem in a General Psychiatric Population: A Randomized Controlled Trial. Front Psychol 2017; 8:1910. [PMID: 29167649 PMCID: PMC5682328 DOI: 10.3389/fpsyg.2017.01910] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 05/02/2017] [Accepted: 10/16/2017] [Indexed: 12/18/2022] Open
Abstract
Although low self-esteem has been found to be an important factor in the development and maintenance of psychopathology, surprisingly little is known about its treatment. This study investigated the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy and Cognitive Behavioural Therapy (CBT), regarding their capacities in enhancing self-esteem in a general psychiatric secondary health care population. A randomized controlled trial with two parallel groups was used. Participants were randomly allocated to either 10 weekly sessions of EMDR (n = 15) or CBT (n = 15). They were assessed pre-treatment, after each session, post treatment and at 3 months follow-up on self-esteem (Rosenberg Self-esteem Scale and Credibility of Core Beliefs), psychological symptoms (Brief Symptom Inventory), social anxiety, and social interaction (Inventory of Interpersonal Situations) (IIS). The data were analyzed using repeated measures ANOVA for the complete cases (n = 19) and intention-to-treat (n = 30) to examine differences over time and between conditions. Both groups, EMDR as well as CBT, showed significant improvements on self-esteem, increasing two standard deviations on the main parameter (RSES). Furthermore, the results showed significant reductions in general psychiatric symptoms. The effects were maintained at 3 months follow-up. No between-group differences could be detected. Although the small sample requires to exercise caution in the interpretation of the findings, the results suggest that, when offering an adequate number of sessions, both EMDR and CBT have the potential to be effective treatments for patients with low self-esteem and a wide range of comorbid psychiatric conditions. This study was registered at www.trialregister.nl with identifier NTR4611.
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Affiliation(s)
| | | | | | - Ad de Jongh
- Behavioural Sciences and Social Dentistry, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,School of Health Sciences, University of Salford, Manchester, United Kingdom.,Institute of Health and Society, University of Worcester, Worcester, United Kingdom
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9
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Nichols S, Javdani S, Rodriguez E, Emerson E, Donenberg G. Sibling teenage pregnancy and clinic-referred girls' condom use: The protective role of maternal monitoring. J Child Fam Stud 2016; 25:1178-1187. [PMID: 27172111 PMCID: PMC4860353 DOI: 10.1007/s10826-015-0306-4] [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: 06/05/2023]
Abstract
Younger sisters of teenage parents have elevated rates of engaging in unprotected sex. This may result from changes in parenting behavior after a sibling becomes pregnant or impregnates a partner, and be particularly pronounced for girls seeking mental health treatment. The current study examines condom use over time in 211 African-American girls recruited from outpatient psychiatric clinics. Findings indicate that having a sibling with a teenage pregnancy history predicts less consistent condom use two years later. After accounting for earlier condom use and mental health problems, maternal monitoring moderates condom use such that for girls with a sibling with a pregnancy history, more vigilant maternal monitoring is associated with increased condom use, while for girls with no sibling pregnancy history, maternal monitoring is unrelated to adolescents' condom use two years later. Findings suggest that targeted interventions to increase maternal monitoring of high-risk teens may be beneficial for girls with a sibling history of teenage pregnancy.
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10
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Takei R, Matsuo J, Takahashi H, Uchiyama T, Kunugi H, Kamio Y. Verification of the utility of the social responsiveness scale for adults in non-clinical and clinical adult populations in Japan. BMC Psychiatry 2014; 14:302. [PMID: 25403232 PMCID: PMC4237729 DOI: 10.1186/s12888-014-0302-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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: 08/25/2013] [Accepted: 10/16/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Recently great attention has been paid to the still unmet clinical needs of most adults with autism spectrum disorder (ASD) who live in the community, an increasing number of whom visit psychiatric clinics to seek accurate diagnosis and treatment of concurrent psychiatric symptoms. However, different from the case of children diagnosed with ASD in childhood, it is difficult in adults to identify the ASD symptoms underlying psychopathology and to differentiate ASD from other psychiatric disorders in general psychiatric practice. This study aimed to verify the utility of the Social Responsiveness Scale-Adult version (SRS-A), a quantitative measure for identifying ASD symptoms, in non-clinical and clinical adult populations in Japan. METHODS The total sample aged 19 to 59 years consisted of a non-clinical population (n =592) and clinical population with and without ASD (n =142). We examined score distributions of the Japanese version of the scale, and the effects of gender, age, and rater on the distribution. We analyzed factor structure and internal consistency in the non-clinical normative sample, and analyzed convergent, divergent, and discriminative validities in the clinical sample. We applied receiver operator characteristic (ROC) analysis to determine optimal cutoff scores discriminating the ASD clinical population from the non-ASD clinical population. RESULTS The score distributed continuously, which replicated findings in children. For non-clinical adults, except in men aged 19 to 24 years, we found no or few gender, age, or rater effects. Both single- and two-factor models were supported for adults. Total SRS-A scores demonstrated high internal consistency and capably discriminated adults with ASD from those with non-ASD psychiatric disorders such as major depressive disorder, schizophrenia, and bipolar disorder with an overlap across diagnoses. Moderate to high correlations of the SRS-A with other-rated ASD measures indicated sufficient convergent validity. Based on the ROC analysis, we recommend cutoff points by gender for use in clinical settings. CONCLUSION This study provides additional supportive evidence that the Japanese version SRS-A can reliably and validly measure ASD symptoms in non-clinical and clinical adult populations, and thus can serve as a useful tool for ASD research as well as for secondary screening in Japanese adults.
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Affiliation(s)
- Reiko Takei
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hidetoshi Takahashi
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Tokio Uchiyama
- Department of Faculty of Human Development, Fukushima University Graduate School, Fukushima, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira 187-8553, Tokyo, Japan.
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Ledoux AA, Boyer P, Phillips JL, Labelle A, Smith A, Bohbot VD. Structural hippocampal anomalies in a schizophrenia population correlate with navigation performance on a wayfinding task. Front Behav Neurosci 2014; 8:88. [PMID: 24672451 PMCID: PMC3953714 DOI: 10.3389/fnbeh.2014.00088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 11/20/2013] [Accepted: 02/28/2014] [Indexed: 11/13/2022] Open
Abstract
Episodic memory, related to the hippocampus, has been found to be impaired in schizophrenia. Further, hippocampal anomalies have also been observed in schizophrenia. This study investigated whether average hippocampal gray matter (GM) would differentiate performance on a hippocampus-dependent memory task in patients with schizophrenia and healthy controls. Twenty-one patients with schizophrenia and 22 control participants were scanned with an MRI while being tested on a wayfinding task in a virtual town (e.g., find the grocery store from the school). Regressions were performed for both groups individually and together using GM and performance on the wayfinding task. Results indicate that controls successfully completed the task more often than patients, took less time, and made fewer errors. Additionally, controls had significantly more hippocampal GM than patients. Poor performance was associated with a GM decrease in the right hippocampus for both groups. Within group regressions found an association between right hippocampi GM and performance in controls and an association between the left hippocampi GM and performance in patients. A second analysis revealed that different anatomical GM regions, known to be associated with the hippocampus, such as the parahippocampal cortex, amygdala, medial, and orbital prefrontal cortices, covaried with the hippocampus in the control group. Interestingly, the cuneus and cingulate gyrus also covaried with the hippocampus in the patient group but the orbital frontal cortex did not, supporting the hypothesis of impaired connectivity between the hippocampus and the frontal cortex in schizophrenia. These results present important implications for creating intervention programs aimed at measuring functional and structural changes in the hippocampus in schizophrenia.
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Affiliation(s)
- Andrée-Anne Ledoux
- University of Ottawa Institute of Mental Health Research , Ottawa, ON , Canada ; School of Psychology, University of Ottawa , Ottawa, ON , Canada
| | - Patrice Boyer
- University of Ottawa Institute of Mental Health Research , Ottawa, ON , Canada ; Université Paris Diderot - Paris 7 , Paris , France
| | - Jennifer L Phillips
- University of Ottawa Institute of Mental Health Research , Ottawa, ON , Canada
| | - Alain Labelle
- University of Ottawa Institute of Mental Health Research , Ottawa, ON , Canada
| | - Andra Smith
- School of Psychology, University of Ottawa , Ottawa, ON , Canada
| | - Véronique D Bohbot
- Douglas Mental Health University Institute, McGill University , Montreal, QC , Canada
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