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Screening time for delirium in dementia patients matters: Validation of the Spanish version of the RADAR 痴呆患者谵妄的筛查时间:西班牙语版RADAR的验证
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2024-12-20 DOI: 10.1016/j.ejpsy.2024.100272
Esteban Sepúlveda , Ester Bermúdez , Lourdes Vallinoto , Julia Sánchez , Paola Saura , Pau Piany , Eva Viñuelas , Marta Ciutat , José Palma , Imma Grau , Elisabet Vilella , Philippe Voyer , José G. Franco

Background and objectives

Delirium is frequently underdiagnosed in patients with dementia. The Repérage Actif du Delirium Adapté à la Routine (RADAR) can be adapted to nursing routines for delirium screening. We validated the Spanish RADAR version and determined the best time of day for its administration.

Methods

All dementia patients admitted to a postacute care centre on one day were independently assessed by nurses using the RADAR at the morning and midday and by geriatricians with the Delirium Diagnostic Tool-Provisional (DDT-Pro) reference standard for delirium and subsyndromal delirium (SSD). We evaluated the test–retest temporal stability of the morning and midday RADAR assessments, the RADAR validity considering these two time points and then, the suitability of the DDT-Pro for diagnostic confirmation.

Results

Of 34 dementia patients included, 47.1 % had delirium, and 83.3 % had behavioural, mental or neurological disturbances that made diagnostic assessment difficult. The test–retest temporal stability of the RADAR was moderate, which is consistent with the fact that the diagnostic accuracy of the midday assessment for delirium (79.4 %) was better than that of the morning (73.5 %). The screening accuracy when also considering SSD, accounting for either assessment time, was 79.4 %. Several correspondence and correlation analyses support the use of DDT-Pro for confirmation and assessment of delirium severity after RADAR screening.

Conclusion

The RADAR is useful for the screening of delirium and SSD by nurses in dementia patients and midday assessments have greater diagnostic validity than morning assessments. Screened patients need subsequent diagnosis confirmation before starting therapeutic measures.
背景与目的谵妄常被误诊为痴呆患者。雷达(RADAR)可适用于谵妄筛查的护理程序。我们验证了西班牙雷达版本,并确定了一天中管理它的最佳时间。方法所有急性后护理中心收治的痴呆患者均由护士在上午和中午使用RADAR进行独立评估,老年医师使用谵妄诊断工具-临时(DDT-Pro)谵妄和亚综合征性谵妄(SSD)参考标准进行评估。我们评估了早晨和中午RADAR评估的重测时间稳定性,考虑这两个时间点的RADAR效度,然后评估了DDT-Pro诊断确认的适用性。结果34例痴呆患者中,47.1%有谵妄,83.3%有行为、精神或神经障碍,使诊断评估困难。RADAR的重测时间稳定性中等,这与中午评估谵妄的诊断准确率(79.4%)优于早晨评估谵妄的诊断准确率(73.5%)是一致的。同时考虑SSD的筛查准确率为79.4%。一些对应和相关分析支持使用DDT-Pro来确认和评估雷达筛查后谵妄严重程度。结论RADAR可用于痴呆患者谵妄和SSD的筛查,午间评估的诊断效度高于晨间评估。筛查的患者需要在开始治疗措施之前进行诊断确认。
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引用次数: 0
Burnout in mental health professionals and its relation with their attitudes towards mental illness 精神卫生专业人员的职业倦怠及其与精神疾病态度的关系
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2024-12-18 DOI: 10.1016/j.ejpsy.2024.100289
Francisco Del Olmo-Romero , Carlos Rebolleda-Gil , Pedro Varandas , Manuel Martín-Carrasco , María González-Blanco , Giampaolo Perna , Edith Pomarol-Clotet , Ana C. Martinez-Cabezón , Raúl Huerta-Ramírez , Raymond Salvador , The Inter NOS Working Group

Background and objectives

Staff burnout is a concern in the mental health field, in terms of its prevalence and its association with a range of undesirable outcomes. Recent research suggests there is a relationship between mental health professionals’ (MHPs) burnout and stigmatizing attitudes towards their patients, probably leading to deleterious effects on the quality of their care. We measured burnout in a sample of professionals working in a wide range of mental health facilities in Spain, Portugal and Italy, and analyzed (1) its relationship with a set of relevant sociodemographic variables and (2) its influence on their stigmatizing attitudes.

Methods

We administered a survey including the Maslach Burnout Inventory (MBI) and two questionnaires related to stigmatizing attitudes: The Community Attitudes towards the Mentally Ill (CAMI) and the Attribution Questionnaire (AQ-27). Sociodemographics including information on profession, work setting and country were also registered.

Results

1525 professionals of the surveyed population (34.06 %) completed the survey. Burnout scores were significantly related to many of the sociodemographic variables. Profession and country were the strongest and most consistently associated to the three dimensions of burnout (i.e., Emotional Exhaustion (EE), Depersonalization (Dp) and Personal Achievement (PA)) always with a p < 0.001. Fittings of linear models predicting stigmatizing attitudes from burnout pointed to PA as the most influential variable, being statistically significant for 11 of the 13 stigma variables, followed by both EE and Dp which were significant for 6 of the variables. Finally, higher adjusted R2 from the fitted models showed that burnout was more influential than profession, work setting or country in many of the stigma variables including Anger, Dangerousness, Fear, Help, Restrictiveness and Ideology.

Conclusion

Results from this study indicate that burnout of MHPs is related to a wide range of sociodemographic factors, with profession and country being remarkably significant. MHPs reporting higher burnout (especially lower personal achievement at work) have more negative attitudes towards their patients and support more coercive and restrictive approaches in their care. Staff burnout seems to explain most of their stigmatizing attitudes more than personal and professional variables. Thus, interventions to diminish burnout might have a positive influence on mental health care. Future studies should include organizational variables, more specific scales for stigma in MHPs, and have a follow-up design.
背景和目的就其普遍性及其与一系列不良后果的关联而言,工作人员职业倦怠是心理健康领域关注的问题。最近的研究表明,心理健康专业人员(MHPs)的倦怠与对患者的污名化态度之间存在联系,这可能会对他们的护理质量产生有害影响。我们测量了在西班牙、葡萄牙和意大利的精神卫生机构工作的专业人员的倦怠样本,并分析了(1)它与一组相关的社会人口变量的关系,(2)它对他们的污名化态度的影响。方法采用Maslach职业倦怠量表(MBI)和社区精神疾病态度问卷(CAMI)和归因问卷(AQ-27)进行污名化态度调查。还登记了社会人口统计信息,包括专业、工作环境和国家信息。结果调查人群中专业人员1525人(34.06%)完成调查。倦怠得分与许多社会人口学变量显著相关。职业和国家与职业倦怠的三个维度(即情绪耗竭(EE)、人格解体(Dp)和个人成就(PA))的相关性最强且最一致,并伴有p <;0.001. 预测倦怠造成的污名化态度的线性模型拟合表明,PA是影响最大的变量,对13个污名化变量中的11个具有统计显著性,其次是情感表达和Dp,对6个变量具有显著性。最后,从拟合模型中调整后的R2显示,倦怠对包括愤怒、危险、恐惧、帮助、限制和意识形态在内的许多污名变量的影响大于职业、工作环境或国家。结论MHPs的职业倦怠与多种社会人口学因素有关,其中职业和国家的影响显著。报告倦怠程度较高(特别是个人工作成就较低)的MHPs对患者的态度更为消极,并在护理中支持更多的强制性和限制性方法。员工倦怠似乎比个人和职业变量更能解释他们大部分的污名化态度。因此,减少倦怠的干预措施可能对心理卫生保健产生积极影响。未来的研究应包括组织变量,MHPs中更具体的病耻感量表,并有随访设计。
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引用次数: 0
The effectiveness of the TaySH (Transitional Age Youth Self-Harm) Program in the management of Non-Suicidal Self-Harm (NSSI) in outpatient adolescents and young adults: A non-randomized controlled pilot study 过渡年龄青少年自我伤害项目在管理门诊青少年和年轻人非自杀性自我伤害(NSSI)方面的有效性:一项非随机对照试点研究
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2024-12-18 DOI: 10.1016/j.ejpsy.2024.100288
Natalia Calvo , Silvia Amoretti , Jorge Lugo-Marín , Montserrat Oriol , Citlallí Perez , Josep Antoni Ramos-Quiroga , Marc Ferrer

Background and objectives

Non-suicidal self-injury (NSSI) has become one of the most severe mental health problems among adolescents and young adults worldwide, especially in clinical populations. The main objective of this non-randomized pilot study is to demonstrate the effectiveness of the TaySH Program in a clinical sample of 37 outpatients aged 14 to 25 years (M = 16.70, SD= 1.51), TAY (Transitional age youth) developmental stage.

Methods

All participants underwent the baseline or pre-treatment assessment and 28 patients completed the 12-week intervention treatment and underwent post-treatment evaluation through different interviews and self-reports. The primary outcome was the reduction of NSSI, and the secondary outcomes were suicide risk, emotional dysregulation, the psychopathological clinical manifestations of impulsivity, depressive symptoms and anxiety, and psychosocial functioning.

Results

The frequency of NSSI behaviors decreased significantly from a mean of 3.32 (SD=4.07) episodes per week at baseline to 0.29 (SD=0.98) episodes per week post-treatment (p < 0.001, Cohen's d = 0.458). This reduction was accompanied by an improvement in associated psychopathological symptoms, leading to better psychosocial functioning among program participants.

Conclusions

The results suggest that the TaySH Program is a promising early intervention for managing NSSI in this population. Future studies should examine the maintenance of the changes achieved, especially concerning the reduction of the psychopathology's tendency toward chronicity.
背景与目的非自杀性自伤(non - suicide self injury,简称NSSI)已成为全球青少年中最严重的心理健康问题之一,尤其是在临床人群中。这项非随机试点研究的主要目的是证明TaySH计划在37名14至25岁(M = 16.70, SD= 1.51) TAY(过渡年龄青年)发育阶段门诊患者的临床样本中的有效性。方法所有参与者均进行基线或治疗前评估,28例患者完成12周干预治疗,并通过不同的访谈和自我报告进行治疗后评估。主要结局是减少自伤,次要结局是自杀风险、情绪失调、冲动的精神病理临床表现、抑郁症状和焦虑以及社会心理功能。结果自伤行为的频率从基线时的平均每周3.32 (SD=4.07)次显著下降到治疗后的平均每周0.29 (SD=0.98)次(p <;0.001, Cohen’s d = 0.458)。这种减少伴随着相关精神病理症状的改善,导致项目参与者更好的社会心理功能。结论:在这一人群中,TaySH计划是一种很有前景的早期干预措施。未来的研究应该检查所取得的变化的维持,特别是关于减少精神病理的慢性倾向。
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引用次数: 0
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 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。
{"title":"Social support and emotion dysregulation: A serial pathway from child maltreatment to depressive symptoms in adults with affective disorders","authors":"Rachel Hsiao Shen Tan ,&nbsp;Sherilyn Shi Hui Chang ,&nbsp;Wen Lin Teh ,&nbsp;Nisha Chandwani ,&nbsp;Mythily Subramaniam ,&nbsp;Jianlin Liu","doi":"10.1016/j.ejpsy.2024.100286","DOIUrl":"10.1016/j.ejpsy.2024.100286","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results and conclusions</h3><div>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 (<em>b</em> = 0.0172). This indirect effect was significant for emotional neglect while controlling for other forms of maltreatment (<em>b</em> = 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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 2","pages":"Article 100286"},"PeriodicalIF":2.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172702","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
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 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。
{"title":"Loneliness as a risk factor for dementia and its mediators: A longitudinal cohort analysis of UK Biobank data","authors":"Marine Echegut ,&nbsp;Natalie Shoham ,&nbsp;Naaheed Mukadam","doi":"10.1016/j.ejpsy.2024.100284","DOIUrl":"10.1016/j.ejpsy.2024.100284","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>P</em> &lt; 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 2","pages":"Article 100284"},"PeriodicalIF":2.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172286","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
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 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 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 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 ,&nbsp;María Pilar Martín Chaparro ,&nbsp;Yasuhiro Kotera ,&nbsp;Bibha Dhungel ,&nbsp;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 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。
{"title":"Influence of 5-HTT, COMT, and BDNF functional polymorphisms and their interaction with parental bonding in attachment anxiety, among adults with personality disorders","authors":"Leire Erkoreka ,&nbsp;Iker Zamalloa ,&nbsp;Pedro Muñoz ,&nbsp;Santiago Rodriguez ,&nbsp;Aurora Arrue ,&nbsp;Miguel Angel Gonzalez-Torres","doi":"10.1016/j.ejpsy.2024.100270","DOIUrl":"10.1016/j.ejpsy.2024.100270","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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 <em>5-HTTLPR, COMT</em> Val158Met and <em>BDNF</em> 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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div><em>COMT</em> ValVal homozygotes and <em>BDNF</em> Met-carriers were associated with significantly higher scores in attachment anxiety (COMT: ValVal 4.95±1.25 vs Met-carriers 4.42±1.30, <em>t</em>=-2.096, <em>p</em>=0.038; BDNF: ValVal 4.38±1.31 vs Met-carriers 4.95±1.24, <em>t</em> = 2.833, <em>p</em>=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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 1","pages":"Article 100270"},"PeriodicalIF":2.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701756","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
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 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。
{"title":"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","authors":"G Castelpietra ,&nbsp;T Niyonsenga ,&nbsp;A Iruin ,&nbsp;U Albert ,&nbsp;A Gabilondo ,&nbsp;L Salvador-Carulla","doi":"10.1016/j.ejpsy.2024.100278","DOIUrl":"10.1016/j.ejpsy.2024.100278","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div><strong>:</strong> 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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 1","pages":"Article 100278"},"PeriodicalIF":2.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701758","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
期刊
European Journal of Psychiatry
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