European Journal of Psychiatry最新文献_第7页

Social support and emotion dysregulation: A serial pathway from child maltreatment to depressive symptoms in adults with affective disorders 社会支持和情绪失调：从儿童虐待到成人情感障碍抑郁症状的一系列途径

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-12-18 DOI: 10.1016/j.ejpsy.2024.100286

Rachel Hsiao Shen Tan , Sherilyn Shi Hui Chang , Wen Lin Teh , Nisha Chandwani , Mythily Subramaniam , Jianlin Liu

Background and objectives

Child maltreatment is a risk factor for psychopathology in adulthood, and it is important to elucidate avenues for intervention. Social support and emotion dysregulation are two psychosocial factors which mediate the relationship between child maltreatment and psychopathology; however, few studies have examined both simultaneously in an Asian clinical context. This study aimed to investigate the dual roles of social support and emotion dysregulation in the pathway from child maltreatment to depressive symptoms in adulthood by testing three competing pathway models.

Methods

A total of 200 participants (Mean age = 36.53; 78 % Chinese ethnicity) with a primary diagnosis of affective disorder were recruited from a tertiary psychiatric hospital in Singapore. Respondents completed self-report measures of child maltreatment exposure, depressive symptoms, perceived social support, and emotion dysregulation. Pathway analyses based on ordinary least squares regressions were conducted using the PROCESS 4.1 tool.

Results and conclusions

Higher exposure to child maltreatment was associated with lower perceived social support, greater emotion dysregulation, and more depressive symptoms. Pathway analyses revealed a significant indirect effect of child maltreatment on depressive symptoms via perceived social support and emotion dysregulation (b = 0.0172). This indirect effect was significant for emotional neglect while controlling for other forms of maltreatment (b = 0.0914). Findings provide conceptual support for the serial pathway involving social support and emotion dysregulation in the relationship between child maltreatment and depressive symptoms, highlighting the need to target both interpersonal and intrapersonal factors in treating clinical populations with child maltreatment exposure.

背景与目的儿童虐待是成年后精神病理的危险因素，阐明干预途径是重要的。社会支持和情绪失调是中介儿童虐待与精神病理关系的两个社会心理因素；然而，很少有研究在亚洲临床背景下同时检查这两种情况。本研究旨在通过测试三种相互竞争的通路模型，探讨社会支持和情绪失调在儿童虐待到成年期抑郁症状通路中的双重作用。方法共200例受试者(平均年龄36.53岁；从新加坡一家三级精神病院招募初步诊断为情感性障碍的患者（78%为华裔）。受访者完成了儿童虐待暴露、抑郁症状、感知到的社会支持和情绪失调的自我报告测量。采用PROCESS 4.1工具进行基于普通最小二乘回归的通路分析。结果与结论儿童虐待暴露程度越高，感知到的社会支持程度越低，情绪失调程度越高，抑郁症状越严重。途径分析显示，儿童虐待通过感知到的社会支持和情绪失调对抑郁症状有显著的间接影响（b = 0.0172）。当控制其他形式的虐待时，这种间接影响在情感忽视中是显著的（b = 0.0914）。研究结果为涉及社会支持和情绪失调的一系列途径在儿童虐待与抑郁症状之间的关系提供了概念上的支持，强调了在治疗儿童虐待暴露的临床人群时，需要针对人际和个人因素。

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引用次数: 0

Loneliness as a risk factor for dementia and its mediators: A longitudinal cohort analysis of UK Biobank data 孤独作为痴呆的风险因素及其中介：英国生物银行数据的纵向队列分析

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-12-17 DOI: 10.1016/j.ejpsy.2024.100284

Marine Echegut , Natalie Shoham , Naaheed Mukadam

Background and objectives

Growing evidence suggests that the feeling of loneliness correlates positively with the incidence of dementia, motivating our study of their longitudinal association. Additionally, we sought potential mediators of the association, following the hypotheses that lonely individuals are prone to greater stress and follow less healthy lifestyles, therefore are at greater risk of developping dementia.

Methods

Using longitudinal cohort data from the UK Biobank, we conducted a logistic regression analysis with loneliness as exposure and dementia diagnosis as outcome, and progressively adjusted for putative confounders. In addition, we investigated through mediation models the respective contributions of physiological and behavioural factors to the association between loneliness and dementia diagnosis.

Results

The logistic regression models illustrated a significant positive association between loneliness and a subsequent dementia diagnosis, overall indicating a higher odds of developing dementia in the lonely population (Adjusted Odds Ratio (AOR) = 1.39; 95 % (Confidence Interval) CI 1.24 – 1.56, P < 0.001). The mediation models highlighted that there was very little evidence of mediation by hypertension and unhealthy behaviours, respectively explaining 1 % and 2 % of the effect of loneliness on dementia risk. No indication of mediation was seen between baseline CRP-levels and all-cause dementia. Every mediation model described a positive correlation between loneliness and each potential mediating factor, illustrating the widespread negative impact of loneliness on health.

Conclusion

Our findings confirm the association between loneliness and risk of dementia. They show minimal mediation by hypertension and unhealthy behaviours, highlighting the need for investigation into other potential mediators as targets for modification.

背景和目的越来越多的证据表明，孤独感与痴呆的发病率呈正相关，这促使我们对它们之间的纵向关联进行研究。此外，我们寻找了这种关联的潜在中介，假设孤独的人容易承受更大的压力，生活方式不太健康，因此患痴呆症的风险更大。方法使用来自英国生物银行的纵向队列数据，我们进行了logistic回归分析，以孤独为暴露，痴呆诊断为结果，并逐步调整假定的混杂因素。此外，我们还通过中介模型探讨了生理和行为因素在孤独与痴呆诊断之间的作用。结果logistic回归模型显示孤独与随后的痴呆诊断之间存在显著正相关，总体上表明孤独人群患痴呆的几率更高(调整优势比(AOR) = 1.39；95%（置信区间）CI 1.24 - 1.56, P <；0.001)。中介模型强调，高血压和不健康行为的中介证据非常少，分别解释了孤独对痴呆风险影响的1%和2%。没有迹象表明基线crp水平与全因痴呆之间存在中介作用。每个中介模型都描述了孤独与每个潜在中介因素之间的正相关关系，说明了孤独对健康的广泛负面影响。结论：我们的研究结果证实了孤独感与痴呆风险之间的联系。它们显示高血压和不健康行为的调解作用最小，强调需要调查其他潜在的调解作为修改的目标。

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引用次数: 0

Identification of a linoleic acid derivative in elderly female patients with schizophrenia from rural regions using untargeted metabolomics 利用非靶向代谢组学方法鉴定农村地区老年女性精神分裂症患者的亚油酸衍生物

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-12-17 DOI: 10.1016/j.ejpsy.2024.100285

Bo Pan , Li Qu , Chuan-Lan Wang , Jianjun Weng , Jian-Feng Yu , Yanqing Liu , Xing-Chen Wang

Background and objectives

Schizophrenia is a chronic and severe mental illness, affecting a large number of general populations. It was well documented that metabolic dysregulation is associated with schizophrenia. In order to define reliable peripheral biomarkers for schizophrenia in patients with specific age, sex, and locations, plasma metabolic profiling of elderly female schizophrenic patients in rural regions was investigated in this study.

Methods

A total of 20 female schizophrenic patients (average age: 68.65 ± 4.11) and 20 matched healthy controls were recruited. An untargeted metabolomics analysis was performed with their plasma samples of the participants. Differentially-expressed metabolites (DEMs) were identified, followed by a pathway enrichment analysis to reveal related signalling pathways. Then, machine learning analyses, including random forest (RF) and support vector machines-recursive feature elimination (SVM-RFE), were implemented to determine signature metabolite(s).

Results

A total number of 2764 metabolites were identified, among which 61 DEMs were identified, including 38 down-regulated and 23 up-regulated metabolites. The enrichment analysis showed that glycerophospholipid metabolism and sphingolipid signalling pathway were the most significantly affected pathways. The ROC analysis indicated that metabolites belonging to the class of fatty acyls have higher power to discriminate schizophrenia. Finally, a linoleic acid derivative (Dg(16:0/18:2(9z,12z)/0:0)[Iso2]) was revealed as signature metabolite by the RF and SVM-RFE machine learning analyses.

Conclusion

The present study investigated the plasma metabolic profiling of elderly female patients with schizophrenia and identified a peripheral linoleic acid derivative that might help discriminate schizophrenia and develop specific treatment strategies for elderly female patients in rural regions.

背景与目的精神分裂症是一种影响广大人群的慢性重症精神疾病。代谢失调与精神分裂症有关是有充分证据证明的。为了确定具有特定年龄、性别和地区的精神分裂症患者的可靠外周生物标志物，本研究调查了农村地区老年女性精神分裂症患者的血浆代谢谱。方法选取20例女性精神分裂症患者（平均年龄：68.65±4.11岁）和20例健康对照。对参与者的血浆样本进行了非靶向代谢组学分析。鉴定了差异表达代谢物（DEMs），随后进行途径富集分析以揭示相关信号通路。然后，通过机器学习分析，包括随机森林（RF）和支持向量机递归特征消除（SVM-RFE），来确定特征代谢物。结果共鉴定出2764种代谢物，其中dem 61种，其中下调代谢物38种，上调代谢物23种。富集分析表明，甘油磷脂代谢和鞘脂信号通路受影响最显著。ROC分析表明，属于脂肪酰基类的代谢物具有更高的区分精神分裂症的能力。最后，通过RF和SVM-RFE机器学习分析，发现亚油酸衍生物Dg(16:0/18:2(9z,12z)/0:0)[Iso2]是特征代谢物。结论本研究对老年女性精神分裂症患者的血浆代谢谱进行了研究，发现了一种外周亚油酸衍生物，可能有助于区分精神分裂症，并为农村地区老年女性患者制定特异性治疗策略。

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引用次数: 0

Validation study for the individual recovery outcomes counter (I.ROC) in a Spanish population. 西班牙人群个体恢复结果计数器（I.ROC）的验证研究。

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-12-16 DOI: 10.1016/j.ejpsy.2024.100287

José A. Garrido-Cervera , María I. Ruiz-Granados , Antonio I. Cuesta-Vargas , Antonio J. Sánchez-Guarnido

Background and Objective

To improve mental health recovery, it is necessary to have validated instruments. At present, however, there is a lack of valid instruments capable of measuring the recovery process in Spanish-speaking populations. The objective of this study was therefore to translate, culturally adapt and validate the Individual Recovery Outcomes Counter (I.ROC) for use in Spanish populations.

Methods

The methodology applied was that recommended for cultural adaptations of questionnaires. It included the following phases: translation, back translation, cultural adaptation and understandability analysis. To assess its psychometric properties, the translated version of the I.ROC was administered to 307 people with severe mental disorders (SMDs).

Results

The questionnaire's internal consistency was satisfactory (Cronbach's alpha = 0.894). Its stability over time was also appropriate, with no significant differences being found in any of the items in the two evaluations. Concurrent validity with the Recovery Assessment Scale (RAS-24) was also acceptable (r = 0.663 p < 0.001). The exploratory factor analysis (EFA) results were concordant with a division into the 4 original factors, but also compatible with two or even with one single general factor.

Conclusion

The results of the study suggest that the Spanish version of the I.ROC is a valid, reliable instrument for charting recovery in people with mental disorders (MD).

背景与目的提高心理健康康复水平，有必要建立有效的心理康复工具。但是，目前缺乏能够衡量西班牙语人口恢复进程的有效工具。因此，本研究的目的是翻译、文化适应和验证个人恢复结果计数器（I.ROC）在西班牙人群中的应用。方法采用问卷文化适应性推荐方法。包括翻译、反译、文化适应和可理解性分析四个阶段。为了评估其心理测量特性，对307名重度精神障碍（smd）患者进行了翻译版的I.ROC。结果问卷内部一致性良好（Cronbach’s alpha = 0.894）。它在一段时间内的稳定性也是适当的，在两次评价中没有发现任何项目有重大差异。与恢复评估量表（RAS-24）的并发效度也可以接受(r = 0.663 p <；0.001)。探索性因子分析（EFA）结果既符合4个原始因子的划分，也符合2个甚至1个一般因子的划分。结论西班牙语版I.ROC量表是一种有效、可靠的精神障碍患者康复量表。

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引用次数: 0

The role of communication and social support in suicidal behaviour in adults aged between 18–40 years: A systematic review 沟通和社会支持在 18-40 岁成年人自杀行为中的作用：系统综述

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-11-23 DOI: 10.1016/j.ejpsy.2024.100266

Noelia Lucía Martínez-Rives , María Pilar Martín Chaparro , Yasuhiro Kotera , Bibha Dhungel , Stuart Gilmour

Background and objectives

Social support and quality communication are crucial in suicide prevention. This systematic review aimed to identify and summarize the research on the link between these variables and suicidal behavior in adults, and their differences depending on gender.

Methods

The Web of Science, Scopus and PsycInfo databases were searched from January 2012 to November 2022 using the terms [(suicide* OR “deliberate self-harm”* OR self- injur* OR “suicidal behavio”*) AND ("social support" OR "interpersonal relationship") AND (communication)]. Articles published in a peer-reviewed academic journal, written in English, with participants between 18 and 40 years old, assessing communication and/or social support were included.

Results

Finally, we included 12 articles. We identified characteristics such as not perceiving social networks as a helpful resource, or difficulties in understanding the messages. Also, the COVID-19 pandemic, highlighted the role that technology played in social support for the most vulnerable people. Communication difficulties of the individual with greater risk for suicide, showed the importance of social support and seeking help.

Conclusions

The community can contribute in suicide prevention by reducing the stigma surrounding mental illness and suicide through effective communication.

背景和目的社会支持和高质量的沟通对预防自杀至关重要。本系统综述旨在确定并总结有关这些变量与成年人自杀行为之间联系的研究，以及它们在性别上的差异。方法从 2012 年 1 月到 2022 年 11 月，使用[（自杀*或 "蓄意自残 "*或自伤*或 "自杀行为 "*）和（"社会支持 "或 "人际关系"）和（沟通）]等术语在 Web of Science、Scopus 和 PsycInfo 数据库中进行检索。结果最终，我们纳入了 12 篇文章。我们发现了一些特征，如不认为社交网络是有用的资源，或难以理解信息。此外，COVID-19 大流行凸显了技术在为最脆弱人群提供社会支持方面所发挥的作用。结论社区可以通过有效的沟通来减少围绕精神疾病和自杀的污名化，从而为预防自杀做出贡献。

{"title":"The role of communication and social support in suicidal behaviour in adults aged between 18–40 years: A systematic review","authors":"Noelia Lucía Martínez-Rives , María Pilar Martín Chaparro , Yasuhiro Kotera , Bibha Dhungel , Stuart Gilmour","doi":"10.1016/j.ejpsy.2024.100266","DOIUrl":"10.1016/j.ejpsy.2024.100266","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Social support and quality communication are crucial in suicide prevention. This systematic review aimed to identify and summarize the research on the link between these variables and suicidal behavior in adults, and their differences depending on gender.</div></div><div><h3>Methods</h3><div>The Web of Science, Scopus and PsycInfo databases were searched from January 2012 to November 2022 using the terms [(suicide* OR “deliberate self-harm”* OR self- injur* OR “suicidal behavio”*) AND (\"social support\" OR \"interpersonal relationship\") AND (communication)]. Articles published in a peer-reviewed academic journal, written in English, with participants between 18 and 40 years old, assessing communication and/or social support were included.</div></div><div><h3>Results</h3><div>Finally, we included 12 articles. We identified characteristics such as not perceiving social networks as a helpful resource, or difficulties in understanding the messages. Also, the COVID-19 pandemic, highlighted the role that technology played in social support for the most vulnerable people. Communication difficulties of the individual with greater risk for suicide, showed the importance of social support and seeking help.</div></div><div><h3>Conclusions</h3><div>The community can contribute in suicide prevention by reducing the stigma surrounding mental illness and suicide through effective communication.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 1","pages":"Article 100266"},"PeriodicalIF":2.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influence of 5-HTT, COMT, and BDNF functional polymorphisms and their interaction with parental bonding in attachment anxiety, among adults with personality disorders 人格障碍成人中 5-HTT、COMT 和 BDNF 功能多态性及其与父母亲情在依恋焦虑中的相互作用的影响

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-11-18 DOI: 10.1016/j.ejpsy.2024.100270

Leire Erkoreka , Iker Zamalloa , Pedro Muñoz , Santiago Rodriguez , Aurora Arrue , Miguel Angel Gonzalez-Torres

Background and objectives

Attachment is the tendency of human beings to create strong affective bonds towards specific figures, and has been described as a general vulnerability factor to diverse forms of psychopathology. Although attachment research has not tended to emphasize genetic contribution, heritability is estimated at 36–45 %. We explored the association between 5-HTTLPR, COMT Val158Met and BDNF Val66Met functional polymorphisms with attachment dimensions, as well as the gene-environment interaction, considering the perceived parental rearing styles, with both a vulnerability and a differential susceptibility approach.

Methods

150 outpatients with a cluster B personality disorder participated in the study. Attachment was assessed using Experiences in Close Relationships-Revised and rearing styles by means of the Parental Bonding Instrument. Genotypes were analyzed using saliva samples. Statistical analyses were carried out with general linear models.

Results

COMT ValVal homozygotes and BDNF Met-carriers were associated with significantly higher scores in attachment anxiety (COMT: ValVal 4.95±1.25 vs Met-carriers 4.42±1.30, t=-2.096, p=0.038; BDNF: ValVal 4.38±1.31 vs Met-carriers 4.95±1.24, t = 2.833, p=0.005). From a differential susceptibility approach, plasticity genotypes were identified for the three functional polymorphisms, observing significant interactions with parental overprotection and differential outcomes in relation to attachment anxiety. No associations or interactions were found with regard to attachment avoidance and the care dimension.

Conclusion

Our results suggest that there are individuals more susceptible to rearing experiences in terms of adult attachment outcomes, which probably also implies a greater potential to benefit from environmental and psychotherapeutic interventions.

背景和目的依恋是人类对特定人物产生强烈情感纽带的倾向，被描述为导致各种形式精神病理学的普遍易感因素。尽管依恋研究并不倾向于强调遗传因素，但其遗传率估计为 36-45%。我们探讨了 5-HTTLPR、COMT Val158Met 和 BDNF Val66Met 功能多态性与依恋维度之间的关系，以及基因与环境之间的相互作用，同时考虑了感知到的父母养育方式，采用了易感性和差异易感性两种方法。研究使用《亲密关系经历-修订版》对依恋进行评估，并使用《父母关系工具》对养育方式进行评估。基因型通过唾液样本进行分析。结果COMT ValVal同源基因携带者和BDNF Met基因携带者的依恋焦虑得分明显更高（COMT：ValVal 4.95±1.25 vs Met-carriers 4.42±1.30，t=-2.096，p=0.038；BDNF：ValVal 4.38±1.31 vs Met-carriers 4.95±1.24，t=2.833，p=0.005）。通过差异易感性方法，确定了三种功能性多态性的可塑性基因型，观察到与父母过度保护的显著交互作用，以及与依恋焦虑有关的差异结果。结论我们的研究结果表明，就成人依恋结果而言，有些个体更容易受到抚养经历的影响，这可能也意味着他们更有可能从环境和心理治疗干预中受益。

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引用次数: 0

A collective case study of mental health systems’ response to COVID-19: Impact on patterns of care provision for depression and anxiety in two comparable regions of Southern Europe 精神卫生系统应对 COVID-19 的集体案例研究：对南欧两个可比地区抑郁症和焦虑症治疗模式的影响

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-11-18 DOI: 10.1016/j.ejpsy.2024.100278

G Castelpietra , T Niyonsenga , A Iruin , U Albert , A Gabilondo , L Salvador-Carulla

Background and Objectives

COVID-19 pandemic has affected the mental health system (MHS) globally, although significant geographical variation was found, particularly for depression and anxiety. The understanding of its impact at the regional level of the context of care is limited when compared to national evaluations.

Methods

Collective case study comparing the prior pattern of care with the first 11 months of COVID-19 in two sites: Gipuzkoa (Spain) and Friuli Venezia Giulia - FVG (Italy). Information from both sites derive from administrative data of MHS in the two regions harmonized for comparison. Data included prevalence of psychiatric diagnoses (ICD-10 F30-F39 and F40-F49 codes), number of hospitalisations, mean and range of psychiatric and psychological interventions. Significance of time-period and location difference was assessed using the Chi-square and the T-statistics for prevalence and count data, respectively.

Results

MHS is community-based in both sites. The prevalence of anxiety decreased in FVG, while a decrease in hospitalisations was found in Gipuzkoa. Both sites registered an increase in psychiatric visits for anxiety and depression. In both periods, FVG showed significant lower prevalence of diagnoses, but higher mean number of psychiatric interventions.

Conclusions

: The COVID-19 outbreak is a paradigmatic example of complex dynamic systems in public health and illustrates the importance of considering its local context and time dependency. The Standard mapping and coding of local MHS provision is essential to allow comparison and reduce ambiguity. This study highlights the importance of ecosystem research to better interpret epidemiological data and support the development of evidence-informed policymaking.

背景和目标COVID-19 大流行对全球精神卫生系统（MHS）产生了影响，但发现地域差异很大，尤其是在抑郁和焦虑方面。与国家评估相比，人们对其在地区层面的护理环境影响的了解十分有限：西班牙吉普斯夸省（Gipuzkoa）和意大利弗留利-威尼斯-朱利亚省（FVG）。两地的信息均来自两个地区的医疗健康管理机构的行政数据，并进行了统一比较。数据包括精神疾病的诊断率（ICD-10 F30-F39 和 F40-F49 编码）、住院人数、精神和心理干预的平均值和范围。对于流行率和计数数据，分别使用卡方和 T 统计量来评估时间段和地点差异的显著性。弗拉芒地区的焦虑症发病率有所下降，而吉普兹科阿地区的住院率有所下降。两地因焦虑症和抑郁症就诊的精神病患者人数都有所增加。在这两个时期，弗拉芒地区的诊断率明显较低，但精神病干预的平均次数却较高：COVID-19疫情是公共卫生领域复杂动态系统的典范，说明了考虑当地环境和时间依赖性的重要性。对当地提供的 MHS 进行标准映射和编码对于进行比较和减少模糊性至关重要。这项研究强调了生态系统研究对于更好地解释流行病学数据和支持循证决策发展的重要性。

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引用次数: 0

Testing implementation support strategies to facilitate an evidence-based substance use and mental health care intervention in veterans treatment courts: A hybrid type III trial protocol 测试实施支持策略，以促进退伍军人治疗法庭采取循证药物使用和心理健康护理干预措施：第三类混合试验方案

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-11-18 DOI: 10.1016/j.ejpsy.2024.100282

David A. Smelson , Vera Yakovchenko , Kathryn E. Bruzios , Thomas Byrne , Megan Mccullough , Paige M. Shaffer , A. Rani Elwy

Background and Objectives

Veterans Treatment Courts (VTCs) are alternative to incarceration programs for veterans involved in the criminal legal system. VTC participants have high rates of co-occurring mental health and substance use disorders (COD). Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking – Criminal Justice (MISSIONCJ) is an evidence-based, multicomponent intervention offered alongside VTCs to support veterans’ complex needs. Multicomponent interventions are often difficult to implement nationally, let alone when care is offered and coordinated across multiple systems. This protocol offers an overview of an implementation-effectiveness trial of MISSIONCJ in VTCs.

Methods

This quality improvement (QI) project will involve an adaptive, randomized design, in which VA staff in four geographically-dispersed regions across the U.S. will be invited to participate and receive varying implementation facilitation (IF) support (i.e., low/passive and high/active) for implementing MISSIONCJ. Sites will have a 9-month run-in period (e.g., orientation) followed by 9-months of low/passive IF. Sites that meet an implementation benchmark will then be randomized to continue low/passive IF or discontinue; and sites that do not meet the benchmark will be randomized to continue low/passive IF, or receive high/active IF for 12-months. Implementation outcomes are based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework (e.g., reaching eligible veterans, adoption rates, fidelity to MISSIONCJ, and maintenance/sustainment). MISSIONCJ effectiveness outcomes include treatment engagement and COD improvements.

Discussion

This QI project aims to determine the most effective type and intensity of IF to increase MISSIONCJ, while improving outcomes among VTC participants. As the first national trial to implement MISSIONCJ in VTCs, it has important implications for the criminal legal and implementation science fields.

Trial Registration

ISRCTN registry, ISRCTN13576289, Registered 21 December 2022, https://www.isrctn.com/ISRCTN13576289

背景和目标退伍军人治疗法庭（VTC）是针对涉及刑事法律系统的退伍军人的监禁替代计划。退伍军人治疗法庭的参与者同时患有精神健康和药物使用障碍 (COD) 的比例很高。通过系统集成、外联和联网保持独立和清醒--刑事司法项目（MISSIONCJ）是一项以证据为基础的多成分干预措施，与 VTC 同时提供，以支持退伍军人的复杂需求。多成分干预措施通常很难在全国范围内实施，更不用说在多个系统之间提供和协调护理了。方法该质量改进（QI）项目将采用适应性随机设计，邀请美国四个地理位置分散地区的退伍军人事务部工作人员参与，并在实施 MISSIONCJ 时接受不同的实施促进（IF）支持（即低/被动和高/主动）。各站点将有 9 个月的磨合期（如指导），然后是 9 个月的低度/被动 IF。然后，达到实施基准的站点将被随机分配到继续实施低效/被动式综合框架或停止实施；未达到基准的站点将被随机分配到继续实施低效/被动式综合框架或接受为期 12 个月的高效/主动式综合框架。实施结果基于 RE-AIM（覆盖、有效性、采用、实施、维持）框架（例如，覆盖符合条件的退伍军人、采用率、对 MISSIONCJ 的忠实度以及维持/持续性）。讨论该 QI 项目旨在确定最有效的 IF 类型和强度，以增加 MISSIONCJ，同时改善 VTC 参与者的治疗效果。作为首个在职业治疗中心实施 MISSIONCJ 的全国性试验，它对刑事法律和实施科学领域具有重要意义。试验注册ISRCTN 注册表，ISRCTN13576289，注册日期为 2022 年 12 月 21 日，https://www.isrctn.com/ISRCTN13576289。

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引用次数: 0

Has psychiatric emergency care changed after the COVID-19 pandemic? A retrospective study in a tertiary hospital in Madrid, Spain COVID-19 大流行后精神科急诊护理是否发生了变化？西班牙马德里一家三级医院的回顾性研究

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-11-18 DOI: 10.1016/j.ejpsy.2024.100281

Carolina Fajardo , Simona Sciacchitano , Alba Maria Pozo-Prados , Ana Izquierdo , Álvaro Orosa-Duarte , Eduardo Delgado-Parada , Jose Luis Ayuso-Mateos , Iosune Torio

Background and objectives

The COVID-19 pandemic and the ensuing restrictive measures had a detrimental impact on the mental health of the population, potentially altering the pattern of seeking psychiatric care. A retrospective cross-sectional study was conducted to compare Psychiatric Emergencies after the most restrictive phases of the pandemic with an equivalent pre-pandemic period. Additionally, we aimed to investigate a possible association between the influx of patients to the emergency department (ED) and the cumulative incidence of COVID-19 cases.

Methods

Data from the psychiatric ED of a tertiary hospital in Madrid, Spain, during the so-called “new normal” phase (October 2020 - May 2021) were compared with a corresponding period (October 2018 - May 2019).

Results

The number of visits to the ED significantly increased from 879 to 980 after the pandemic. Patients were more likely to be compulsorily transferred (M = 281, SD 28.7 vs. M = 209, SD 23.8) and had a higher likelihood of requiring psychiatric hospitalization (M = 323, SD 33.0 vs. M = 246, SD 28.0). Notably, the number of visits related to suicide attempts was significantly higher during the pandemic (M = 147, SD 15.0 vs. M = 86, SD 9.8), while the proportion of patients with bipolar disorder decreased (M = 89, SD 9.1 vs. M = 121, SD 13.8). No significant results were found regarding a possible association between the number of patients in the ED and the COVID-19 incidence rate.

Conclusions

These results suggest critical changes in psychiatric emergency care and an increasing trend of suicide attempts during the pandemic, emphasizing the need for the reorganization of emergency care in future health crises.

背景和目标 COVID-19 大流行和随之而来的限制性措施对人们的心理健康产生了不利影响，可能会改变人们寻求精神科治疗的模式。我们开展了一项回顾性横断面研究，将大流行最严格阶段后的精神科急诊情况与大流行前的同等情况进行比较。此外，我们还旨在调查涌入急诊科（ED）的患者与 COVID-19 病例累积发病率之间可能存在的关联。方法将西班牙马德里一家三甲医院在所谓的 "新常态 "阶段（2020 年 10 月至 2021 年 5 月）的精神科急诊数据与相应时期（2018 年 10 月至 2019 年 5 月）的数据进行比较。结果大流行后，急诊科就诊人数从 879 人次大幅增至 980 人次。患者更有可能被强制转院（M = 281，SD 28.7 vs. M = 209，SD 23.8），更有可能需要精神科住院治疗（M = 323，SD 33.0 vs. M = 246，SD 28.0）。值得注意的是，在大流行期间，与自杀未遂有关的就诊人数明显增加（中=147，标化15.0 vs. 中=86，标化9.8），而躁狂症患者的比例则有所下降（中=89，标化9.1 vs. 中=121，标化13.8）。结论：这些结果表明，在大流行病期间，精神科急诊护理发生了重大变化，自杀企图呈上升趋势，强调了在未来的健康危机中重组急诊护理的必要性。

{"title":"Has psychiatric emergency care changed after the COVID-19 pandemic? A retrospective study in a tertiary hospital in Madrid, Spain","authors":"Carolina Fajardo , Simona Sciacchitano , Alba Maria Pozo-Prados , Ana Izquierdo , Álvaro Orosa-Duarte , Eduardo Delgado-Parada , Jose Luis Ayuso-Mateos , Iosune Torio","doi":"10.1016/j.ejpsy.2024.100281","DOIUrl":"10.1016/j.ejpsy.2024.100281","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The COVID-19 pandemic and the ensuing restrictive measures had a detrimental impact on the mental health of the population, potentially altering the pattern of seeking psychiatric care. A retrospective cross-sectional study was conducted to compare Psychiatric Emergencies after the most restrictive phases of the pandemic with an equivalent pre-pandemic period. Additionally, we aimed to investigate a possible association between the influx of patients to the emergency department (ED) and the cumulative incidence of COVID-19 cases.</div></div><div><h3>Methods</h3><div>Data from the psychiatric ED of a tertiary hospital in Madrid, Spain, during the so-called “new normal” phase (October 2020 - May 2021) were compared with a corresponding period (October 2018 - May 2019).</div></div><div><h3>Results</h3><div>The number of visits to the ED significantly increased from 879 to 980 after the pandemic. Patients were more likely to be compulsorily transferred (<em>M</em> = 281, SD 28.7 vs. <em>M</em> = 209, SD 23.8) and had a higher likelihood of requiring psychiatric hospitalization (<em>M</em> = 323, SD 33.0 vs. <em>M</em> = 246, SD 28.0). Notably, the number of visits related to suicide attempts was significantly higher during the pandemic (<em>M</em> = 147, SD 15.0 vs. <em>M</em> = 86, SD 9.8), while the proportion of patients with bipolar disorder decreased (<em>M</em> = 89, SD 9.1 vs. <em>M</em> = 121, SD 13.8). No significant results were found regarding a possible association between the number of patients in the ED and the COVID-19 incidence rate.</div></div><div><h3>Conclusions</h3><div>These results suggest critical changes in psychiatric emergency care and an increasing trend of suicide attempts during the pandemic, emphasizing the need for the reorganization of emergency care in future health crises.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 1","pages":"Article 100281"},"PeriodicalIF":2.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Systematic review of psychological assessment tools in emergencies, crises, and disasters 系统审查紧急情况、危机和灾难中的心理评估工具

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2024-11-18 DOI: 10.1016/j.ejpsy.2024.100271

Alba Pérez-González , Adolfo Jarne

Objectives

We conducted a systematic review to determine which psychological assessment measures are most commonly used by emergency services to assess the psychological response of the general population in a crisis event and the time point at which the assessment is carried out.

Method

A systematic review was performed based on PRISMA recommendations and registered with PROSPERO by searching in electronic citation databases (Web of Science, PubMed, and PsycInfo).

Results

Twelve studies were included. The flowchart shows the entire decision-making process. Among the variables assessed, self-report measures that assess PTSD stand out above all others, followed by self-report measures that assess negative emotional states (anxiety and depression). Psychologists frequently appeared among the professionals involved in the assessments. None of the experiences analyzed were an assessment carried out immediately after the event.

Conclusion

Very few psychological assessment instruments have been developed in the context of emergencies, and those that are used are translations of others designed in a clinical context. According to the latest research, studies tend to overlook the importance of the time elapsed between the event and assessment.

目标我们进行了一项系统性综述，以确定应急服务机构最常用哪些心理评估措施来评估普通人群在危机事件中的心理反应，以及进行评估的时间点。方法根据 PRISMA 建议进行了一项系统性综述，并通过在电子引文数据库（Web of Science、PubMed 和 PsycInfo）中搜索，在 PROSPERO 中进行了注册。流程图显示了整个决策过程。在所评估的变量中，评估创伤后应激障碍的自我报告测量结果高于其他所有变量，其次是评估负面情绪状态（焦虑和抑郁）的自我报告测量结果。参与评估的专业人员中经常出现心理学家。结论针对突发事件开发的心理评估工具寥寥无几，所使用的也都是在临床背景下设计的其他工具的译本。根据最新的研究，研究往往忽视了事件与评估之间时间间隔的重要性。

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引用次数: 0