European Journal of Psychiatry最新文献

Access to digital devices and digital services increases accessibility to mental health services. We investigated access to smartphones and digital identification methods (digital-IDs) in an outpatient unit focusing on patients with psychotic disorders and functional impairments. Patients’ case managers completed an online anonymous survey. Most patients (85%) did not have digitalIDs, which is required in Sweden to access digital health care. High age and living in assisted living facilities influenced patients' access to smartphones and digitalID negatively. Even in a highly digitalized society, outpatients with psychotic disorders and functional impairments have much less access to digital technology than the population on average.

Background and objectives

The human rights violation of human trafficking and modern slavery could be described as multiple and prolonged traumatisation. This corresponds to the type of trauma identified as most likely to be associated with ‘complex post-traumatic stress disorder’ (CPTSD) as identified in the new 11^th edition of the International Classification of Diseases (ICD-11). This review aims to collate the evidence of complex post-traumatic stress disorder in populations that have been trafficked, with the intention to highlight important considerations to be made in terms of managing survivor's health care needs and minimising further traumatisation.

Methods

Five databases were searched using key terms related to human trafficking, modern slavery, and complex post-traumatic stress disorder.

Results

Five studies reporting on a total of 342 participants were included in the review. These studies indicated that an average of 41% of survivors of modern slavery and human trafficking had CPTSD. This was higher than the 14% diagnosed with PTSD. Post-trafficking stress, endured whilst living in refugee camps, was higher in individuals with CPTSD than in those living with PTSD. Healthcare was more difficult to access by populations with PTSD and CPTSD compared to those with no diagnosis.

Conclusion

There is a high prevalence of CPTSD in modern slavery and trafficking survivors therefore a need for identification and specialised treatment. Consideration should be given to consequent biopsychosocial needs, particularly access to healthcare and minimisation of post-trafficking stress.

Background and objective

To our knowledge, this is the first meta-analysis conducted about the association between congenital heart disease (CHD) and the risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorders (ASD) based on observational studies.

Methods

PubMed, Web of Science, and Scopus were systematically searched from the earliest possible year to December 2020. Heterogeneity was conducted using the chi-square test and its quantity was measured using the I² statistic. The publication bias was assessed using Egger's and Begg's line regression tests. The results were reported using the odds ratio (OR) estimated with its 95% confidence interval (CI) using a random-effects model.

Results

In total, 812 citations were included in the search initial until December 2020 with 467,164 children. Based on the random effect model, the estimated OR of the risk of ASD associated with CHD was OR=1.35 (95% CI: 1.17, 1.52; 6 studies; I²=0.0%) and the risk of ADHD associated with CHD was OR=3.04 (95% CI: 1.58, 4.49; 15 studies; I²=88.1%).

Conclusions

Our findings suggested that CHD is a risk factor for ASD and ADHD. Therefore, Screening for ASD and ADHD should be considered among young children with CHD.

Background and objective

Schizophrenia (SCZ) is a severe mental biological disorder with a multifactorial manner of transmission and inheritance associated with environmental, developmental, and genetic set-off. It is a heritable disorder that involves genes and metabolic mechanisms in a combined effect, each conferring a small increase in the overall disease burden. Its etiology is not fully understood, although recent studies showed a relationship between SCZ and inflammation. Evidence from various studies indicates that dysregulation of TLR genes may have a role in the physiopathology of schizophrenia. In the present study, 4 polymorphisms, each in TLR1, TLR2, TLR4, and TLR6, were studied to explore their role in susceptibility to SCZ in the Dogra population of the Jammu region.

Methods

Five hundred (500) individuals including 200 SCZ and 300 healthy controls were included in the study. DNA was isolated and Sanger's sequencing was performed after PCR amplification.

Results

Statistically significant association of TLR2 (rs3804099) was observed in the study population, the C allele of rs3804099 is associated with the increased risk for SCZ (OR=2.667; [1.4196–5.0093 at 95%CI] P = 0.0023). No statistically significant associations with SCZ were observed in the target population at TLR1, TLR4, and TLR6.

Conclusion

Study concludes that TLR2 (rs3804099) may be associated with schizophrenia in the targeted population. Advance studies can be carried out focusing on finding potential SNPs for establishing a candidate gene approach.

Background and Objectives

Biomarkers on the hands have been associated with a range of physical and mental health conditions. To systematically evaluate the evidence of dermatoglyphics, digit ratio and palmar crease hand biomarkers in relation to mental illness.

Methods

Web of Science, Scopus and MEDLINE were searched for eligible studies, the review was performed according to PRISMA.

Results

29 papers comprising of 13,030 participants were selected. Palmar crease research presented the most consistent correlations. Dermatoglyphics presented significant findings, although there were specific biometric inconsistencies in some results. Digit ratio produced the least consistent results, with some non-significant and contrasting results.

Conclusions

The evidence of this review suggests that all three fields, dermatoglyphics, palmar creases and digit ratio, can indicate mental disorders to varying degrees.

Background and objectives

This is the first multi-center study intended to document the prevalence, characteristics, and associations of depression in Medicine patients at the time of hospital discharge and their referral to Primary Care (PC).

Methods

Adult patients randomly selected among consecutive admissions to Medicine wards in 8 hospitals in Spain, covering health districts, were examined in a two-phase 'case-finding' procedure. Standardized, Spanish versions of instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI) and Cumulative Illness Rating Scale (CIRS). Cases of depression were diagnosed according to ICD-10 general hospital research criteria.

Results

Three hundred and twelve patients with treatable depression and 777 non-depressed controls were identified. In a conservative estimate, the global prevalence of major depression was 7.1%, dysthymia 4.2% and adjustment depression 7.1%, and 51.9% of cases were of moderate/ severe intensity. Depression was more frequent in women, the differences being significant in all categories of depression. The prevalence of depression was lower in individuals aged 85 or more years, the differences being significant in cases of both dysthymia and adjustment depression. A clear pattern of decreasing prevalence with age was observed in women. The depressed had as an average five medical systems affected, and higher CIRS scores compared with the controls, the differences being significant in cases of both major depression and dysthymia.

Conclusions

This is the first report showing a considerable prevalence of treatable cases of depression in Medicine patients at the time of hospital discharge and referral to PC. Depression is associated with the severity of the medical condition, and differences observed by age and sex have clinical implications. Paper read at the 3^rd Annual Meeting of the European Association of Psychosomatic Medicine, Nuremberg 2015.

Background and objectives

Previous research has shown high rates of alexithymia and emotion dysregulation in trichotillomania (TTM) and skin picking disorder (SPD). Unfortunately, there are no data on facial emotion recognition (FER) in TTM and SPD. The present study aimed to compare patients with TTM and SPD and a healthy control group for the severity of alexithymia and rates of FER.

Methods

Forty patients with SPD, 30 patients with TTM, and 30 healthy controls were enrolled in this study. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Clinical Global Impression (CGI), Toronto Alexithymia Scale (TAS-20), and the Facial Emotion Recognition Test were applied to the participants.

Results

Patients with TTM and SPD had less FER accuracy and higher alexithymia scores compared with healthy controls. According to ANCOVA analysis, when anxiety, depression, and alexithymia were fixed as covariates, disgusted facial expressions and total facial emotion recognition were still significantly lower in patients with SPD compared with the control group, but there was no difference between the TTM and control groups and TTM and SPD groups.

Conclusion

Alexithymia rates were high in patients with TTM and SPD. Interestingly, difficulty in recognizing disgusted facial expressions may be a distinctive sign in SPD. Future neuroimaging studies are needed to support possible FER impairment in patients with TTM/SPD.

Noncompliance is a worldwide problem in medical care, leading to prolonged recovery times and rehospitalizations. Especially in the field of psychiatry, consistent therapy compliance is crucial. Hence the Munich Integrated Care program for patients suffering from psychiatric disorders aims at improving patients’ compliance. To bring to light participants' personal experiences with the program, we conducted group interviews that we evaluated using qualitative methods. We shed light on what aspects make a psychiatric health care program so valuable in the eyes of its participants that it can develop its effect as a relapse-preventive agent. We found that in this program, patients experienced safety, stability, support, hope, motivation and understanding.