Pub Date : 2022-10-01DOI: 10.1016/j.ejpsy.2022.05.002
I. Elfeddali , E. Jacobs , C.M. van der Feltz-Cornelis
Background and objectives
In this study, we introduce the concept of benign versus harmful work stress. Our objectives are to explore how to discern benign work stress from harmful work stress and to identify the factors that promote work resilience.
Methods
An online Delphi study with three rounds, incorporating open-ended questions and statements, was administered to mental health employees and experts. Statements were rated on a 7-point scale: an interquartile deviation (IQD ≤ 1) was considered as consensus.
Results
In the first round 20 employees and 14 experts were included, in the second round 87 employees and 35 experts, and in the third round 53 employees and nine experts. There was consensus about seven characteristics of harmful stress, eight of benign work stress, 24 individual factors that promote resilience, and eight team factors that promote resilience.
Conclusion
Consensus was achieved about factors relevant to benign versus harmful work stress and resilience at work
{"title":"Harmful and benign work stress and work resilience: A Delphi-study in employees and experts","authors":"I. Elfeddali , E. Jacobs , C.M. van der Feltz-Cornelis","doi":"10.1016/j.ejpsy.2022.05.002","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.05.002","url":null,"abstract":"<div><h3>Background and objectives</h3><p>In this study, we introduce the concept of benign versus harmful work stress. Our objectives are to explore how to discern benign work stress from harmful work stress and to identify the factors that promote work resilience.</p></div><div><h3>Methods</h3><p>An online Delphi study with three rounds, incorporating open-ended questions and statements, was administered to mental health employees and experts. Statements were rated on a 7-point scale: an interquartile deviation (IQD ≤ 1) was considered as consensus.</p></div><div><h3>Results</h3><p>In the first round 20 employees and 14 experts were included, in the second round 87 employees and 35 experts, and in the third round 53 employees and nine experts. There was consensus about seven characteristics of harmful stress, eight of benign work stress, 24 individual factors that promote resilience, and eight team factors that promote resilience.</p></div><div><h3>Conclusion</h3><p>Consensus was achieved about factors relevant to benign versus harmful work stress and resilience at work</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213616322000398/pdfft?md5=047bb5eb2d7a6af1532f17d565feeb1b&pid=1-s2.0-S0213616322000398-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794457","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.01.003
E. Delgado-Parada , D. Morillo-Cuadrado , J Saiz-Ruiz , A. Cebollada-Gracia , J.L. Ayuso-Mateos , A.J. Cruz-Jentoft
Background and objectives
The 4AT scale is a sensitive tool for screening delirium, which can be applied rapidly in clinical settings without any specific training. It has not been translated, adapted, and validated to assess Spanish older adults. The aims of the study are: to translate and adapt to Spanish culture the 4AT scale, to present evidence of the diagnostic accuracy of this version (4AT-ES) when applied in non-specialized hospital wards, and to assess the loss of diagnostic accuracy in presence of risk factors.
Methods
A prospective sample was independently assessed on the 4AT-ES and the reference standard. One hundred and twenty-one inpatients (70+ years) for whom a psychiatric assessment was requested were included. Out of them, 50 were diagnosed with delirium. Nurses without specific training applied the 4AT-ES, and experienced psychiatrists cast the reference standard diagnosis (DSM-V criteria).
Results
Patients with delirium were older and had more risk factors (more previous delirium episodes, a higher likelihood of prior dementia/cognitive impairment) than controls. The 4AT-ES had excellent validity, sensitivity (96%) , and specificity (83.1%). The area under the curve was 0.918; in the subsample with any of those risk factors, its value did not decrease.
Conclusion
The 4AT-ES version of the 4AT scale was developed. When applied by non-specifically trained, nursing staff it showed excellent validity, sensitivity, and specificity, even in a subsample with previous risk factors. All indices were comparable to the original version. We recommend its use for efficient delirium screening in hospitalized older patients with suspected delirium.
{"title":"Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients","authors":"E. Delgado-Parada , D. Morillo-Cuadrado , J Saiz-Ruiz , A. Cebollada-Gracia , J.L. Ayuso-Mateos , A.J. Cruz-Jentoft","doi":"10.1016/j.ejpsy.2022.01.003","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.01.003","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The 4AT scale is a sensitive tool for screening delirium, which can be applied rapidly in clinical settings without any specific training. It has not been translated, adapted, and validated to assess Spanish older adults. The aims of the study are: to translate and adapt to Spanish culture the 4AT scale, to present evidence of the diagnostic accuracy of this version (4AT-ES) when applied in non-specialized hospital wards, and to assess the loss of diagnostic accuracy in presence of risk factors.</p></div><div><h3>Methods</h3><p>A prospective sample was independently assessed on the 4AT-ES and the reference standard. One hundred and twenty-one inpatients (70+ years) for whom a psychiatric assessment was requested were included. Out of them, 50 were diagnosed with delirium. Nurses without specific training applied the 4AT-ES, and experienced psychiatrists cast the reference standard diagnosis (DSM-V criteria).</p></div><div><h3>Results</h3><p>Patients with delirium were older and had more risk factors (more previous delirium episodes, a higher likelihood of prior dementia/cognitive impairment) than controls. The 4AT-ES had excellent validity, sensitivity (96%) , and specificity (83.1%). The area under the curve was 0.918; in the subsample with any of those risk factors, its value did not decrease.</p></div><div><h3>Conclusion</h3><p>The 4AT-ES version of the 4AT scale was developed. When applied by non-specifically trained, nursing staff it showed excellent validity, sensitivity, and specificity, even in a subsample with previous risk factors. All indices were comparable to the original version. We recommend its use for efficient delirium screening in hospitalized older patients with suspected delirium.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71726813","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.01.001
Arda Karagöl M.D., Zulal Törenli Kaya Ph.D.
Background and objectives
During the pandemic, all healthcare workers have tried to cope with mental challenges. This study evaluated the healthcare workers' levels of burn-out, hopelessness, fear of COVID-19 and perceived social support, the relation between these factors, and other possible related components.
Methods
Four hundred and fifty-one HCW (healthcare workers) all across Turkey were included in the study. Sociodemographic information form, Maslach Burn-out Inventory, Beck Hopelessness Scale, Multidimensional Scale of Perceived Social Support, and the Fear of COVID-19 Scale were given to the participants. This was a cross-sectional study via various online platforms.
Results
The participants who were on duty in the COVID-19 clinic, complaining about the low salary or not having enough time for themselves or their own family, had significantly higher scores on three subscales of burn-out scale, and hopelessness scale. Working at governmental hospitals, working at departments containing a high risk of COVID-19 infection, and having a history of COVID-19 infection were found to be significantly associated with emotional exhaustion, depersonalization, and hopelessness. Feeling control of your profession and getting social support from others were the two factors that tackle burnout in HCW. Family support is the only support that tackles all 3 subscales of burn-out and hopelessness.
Conclusion
The findings emphasized that to tackle the burn-out and hopelessness of HCW, it is important for HCW to receive financial compensation for their hard work, to work under improved conditions, and to receive adequate social support.
{"title":"Healthcare workers’ burn-out, hopelessness, fear of COVID-19 and perceived social support levels","authors":"Arda Karagöl M.D., Zulal Törenli Kaya Ph.D.","doi":"10.1016/j.ejpsy.2022.01.001","DOIUrl":"10.1016/j.ejpsy.2022.01.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p>During the pandemic, all healthcare workers have tried to cope with mental challenges. This study evaluated the healthcare workers' levels of burn-out, hopelessness, fear of COVID-19 and perceived social support, the relation between these factors, and other possible related components.</p></div><div><h3>Methods</h3><p>Four hundred and fifty-one HCW (healthcare workers) all across Turkey were included in the study. Sociodemographic information form, Maslach Burn-out Inventory, Beck Hopelessness Scale, Multidimensional Scale of Perceived Social Support, and the Fear of COVID-19 Scale were given to the participants. This was a cross-sectional study via various online platforms.</p></div><div><h3>Results</h3><p>The participants who were on duty in the COVID-19 clinic, complaining about the low salary or not having enough time for themselves or their own family, had significantly higher scores on three subscales of burn-out scale, and hopelessness scale. Working at governmental hospitals, working at departments containing a high risk of COVID-19 infection, and having a history of COVID-19 infection were found to be significantly associated with emotional exhaustion, depersonalization, and hopelessness. Feeling control of your profession and getting social support from others were the two factors that tackle burnout in HCW. Family support is the only support that tackles all 3 subscales of burn-out and hopelessness.</p></div><div><h3>Conclusion</h3><p>The findings emphasized that to tackle the burn-out and hopelessness of HCW, it is important for HCW to receive financial compensation for their hard work, to work under improved conditions, and to receive adequate social support.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9631131","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.01.002
TTK Nguyen , C McDonald , B Hallahan
Background and Objectives
Long-acting injectable (LAI) antipsychotics increase patient adherence, reduce relapse rates and facilitate regular interaction with community mental health teams. Antipsychotics are however associated with adverse effects including metabolic syndrome. This review outlines the rates of monitoring for and rates of metabolic syndrome in patients treated with LAI antipsychotics.
Methods
We searched Medline, EMBASE, and Cochrane for Medical Subject Heading (MeSH) terms including metabolic syndrome or MetS and depot or LAI antipsychotics. We included data regarding participants’ clinical characteristics, dose and type of antipsychotics administered, rates of monitoring for- and rates of metabolic syndrome and individual metabolic parameters (body mass index or measure of central obesity, blood pressure, lipid levels, plasma glucose and/or HbA1C levels).
Results
Six studies were included that evaluated rates of monitoring for- and 39 studies examined rates of metabolic syndrome or individual metabolic parameters. Metabolic parameters were not routinely measured in approximately 75% of patients. Rates of metabolic syndrome ranged between 24.3% and 53.2%, with most studies finding no significant differences between oral and LAIs; however, a more preferable weight and lipid profile was detected with LAIs compared to the oral antipsychotics olanzapine and clozapine. Rates of metabolic syndrome and abnormalities of metabolic parameters were comparable among first- and second-generation and between second-generation LAIs.
Conclusions
LAI antipsychotics are associated with high rates of metabolic syndrome but low rates of regular monitoring. A robust screening plan to monitor for metabolic syndrome in individuals treated with LAIs is advised including measurement of individual metabolic parameters.
{"title":"The association of metabolic syndrome and long acting injectable antipsychotics: A systematic review","authors":"TTK Nguyen , C McDonald , B Hallahan","doi":"10.1016/j.ejpsy.2022.01.002","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.01.002","url":null,"abstract":"<div><h3>Background and Objectives</h3><p>Long-acting injectable (LAI) antipsychotics<span><span> increase patient adherence, reduce relapse rates and facilitate regular interaction with community mental health teams. Antipsychotics are however associated with adverse effects including </span>metabolic syndrome<span>. This review outlines the rates of monitoring for and rates of metabolic syndrome in patients treated with LAI antipsychotics.</span></span></p></div><div><h3>Methods</h3><p>We searched Medline, EMBASE, and Cochrane for Medical Subject Heading (MeSH) terms including metabolic syndrome or MetS and depot or LAI antipsychotics. We included data regarding participants’ clinical characteristics, dose and type of antipsychotics administered, rates of monitoring for- and rates of metabolic syndrome and individual metabolic parameters (body mass index or measure of central obesity, blood pressure, lipid levels, plasma glucose and/or HbA1C levels).</p></div><div><h3>Results</h3><p><span>Six studies were included that evaluated rates of monitoring for- and 39 studies examined rates of metabolic syndrome or individual metabolic parameters. Metabolic parameters were not routinely measured in approximately 75% of patients. Rates of metabolic syndrome ranged between 24.3% and 53.2%, with most studies finding no significant differences between oral and LAIs; however, a more preferable weight and lipid profile was detected with LAIs compared to the oral antipsychotics olanzapine and </span>clozapine. Rates of metabolic syndrome and abnormalities of metabolic parameters were comparable among first- and second-generation and between second-generation LAIs.</p></div><div><h3>Conclusions</h3><p>LAI antipsychotics are associated with high rates of metabolic syndrome but low rates of regular monitoring. A robust screening plan to monitor for metabolic syndrome in individuals treated with LAIs is advised including measurement of individual metabolic parameters.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71726811","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.03.003
Christoph Augner
Background and objectives
Recent evidence indicates a positive relationship of computer and internet use with mental health and life quality of elderly. However, the role of computer skills is unclear. This study evaluates self-rated computer skills of elderly and their relationship with mental health, cognitive abilities and related variables.
Methods
We used data recently collected by Survey of Health, Ageing and Retirement in Europe (SHARE) and included individuals across Europe aged 65 and above. The sample consisted of N=26,525, 55.6% were female. Mean age of the sample was 74.57 (SD=7.12).
Results
We observed significant relationships between self-rated computer skills level and mental health, cognitive abilities and physical health. Having a partner, education level and self-rated writing skills turned out to be the best predictors for self-rated computer skills level in elderly.
Conclusions
The findings underscore the importance of computer skills in the elderly. Programs designed to enhance the ability to engage in computer and internet activities may be useful to counteract the digital divide.
{"title":"Digital divide in elderly: Self-rated computer skills are associated with higher education, better cognitive abilities and increased mental health","authors":"Christoph Augner","doi":"10.1016/j.ejpsy.2022.03.003","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.03.003","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Recent evidence indicates a positive relationship of computer and internet use with mental health and life quality of elderly. However, the role of computer skills is unclear. This study evaluates self-rated computer skills of elderly and their relationship with mental health, cognitive abilities and related variables.</p></div><div><h3>Methods</h3><p>We used data recently collected by Survey of Health, Ageing and Retirement in Europe (SHARE) and included individuals across Europe aged 65 and above. The sample consisted of N=26,525, 55.6% were female. Mean age of the sample was 74.57 (SD=7.12).</p></div><div><h3>Results</h3><p>We observed significant relationships between self-rated computer skills level and mental health, cognitive abilities and physical health. Having a partner, education level and self-rated writing skills turned out to be the best predictors for self-rated computer skills level in elderly.</p></div><div><h3>Conclusions</h3><p>The findings underscore the importance of computer skills in the elderly. Programs designed to enhance the ability to engage in computer and internet activities may be useful to counteract the digital divide.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71726812","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.04.002
Louise Miglianico , Divi Cornec , Valérie Devauchelle-Pensec , Sofian Berrouiguet , Michel Walter , Florian Stéphan
Background and objectives
Fatigue, depression, and anxiety are common burdens present in primary Sjögren's syndrome patients. Those symptoms have all been linked to inflammatory dysregulations. To explore the link between inflammatory biomarkers and fatigue, depression, and anxiety in pSS patients, we aim to do a systematic literature review.
Methods
The systematic review protocol and data extraction forms were designed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Our protocol has been registered on Prospero (ID CRD42020161952). The Cochrane Library, PubMed, Scopus, and PsycInfo were used, from inception to December 2019.
Results
The literature search initially identified 445 articles. Finally, 12 articles were included in this systematic review. The population in studies was quite similar with mainly middle-aged women. Dates of publication extended from 2008 to 2019. Different scales were used to measure fatigue, depression, and/or anxiety. Measured inflammatory biomarkers were very diverse across studies. In consequence, results in the different included studies were disparate. Only one study explored the link between depression/anxiety and inflammatory markers: patients with depression and/or anxiety were compared to pSS patients.
Conclusion
Even if the association between fatigue, depression, and/or anxiety with inflammatory markers in pSS is of interest, there are a lot of discrepancies. Sickness behavior and IFN pathways seem to be important in the inflammatory physiopathology of fatigue in pSS, and interest in depression. It also appears crucial to standardize clinical scales, inflammatory blood, and CSF tests in pSS patients to allow better generalization.
{"title":"Inflammatory biomarkers associated with depression, anxiety, and/or fatigue in primary Sjögren's syndrome – a systematic review","authors":"Louise Miglianico , Divi Cornec , Valérie Devauchelle-Pensec , Sofian Berrouiguet , Michel Walter , Florian Stéphan","doi":"10.1016/j.ejpsy.2022.04.002","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.04.002","url":null,"abstract":"<div><h3>Background and objectives</h3><p><span>Fatigue, depression, and anxiety are common burdens present in primary Sjögren's syndrome patients. Those symptoms have all been linked to inflammatory dysregulations. To explore the link between inflammatory biomarkers and fatigue, depression, and anxiety in pSS patients, we aim to do a </span>systematic literature review.</p></div><div><h3>Methods</h3><p>The systematic review protocol and data extraction forms were designed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Our protocol has been registered on Prospero (ID CRD42020161952). The Cochrane Library, PubMed, Scopus, and PsycInfo were used, from inception to December 2019.</p></div><div><h3>Results</h3><p>The literature search initially identified 445 articles. Finally, 12 articles were included in this systematic review. The population in studies was quite similar with mainly middle-aged women. Dates of publication extended from 2008 to 2019. Different scales were used to measure fatigue, depression, and/or anxiety. Measured inflammatory biomarkers were very diverse across studies. In consequence, results in the different included studies were disparate. Only one study explored the link between depression/anxiety and inflammatory markers: patients with depression and/or anxiety were compared to pSS patients.</p></div><div><h3>Conclusion</h3><p>Even if the association between fatigue, depression, and/or anxiety with inflammatory markers in pSS is of interest, there are a lot of discrepancies. Sickness behavior and IFN<span> pathways seem to be important in the inflammatory physiopathology of fatigue in pSS, and interest in depression. It also appears crucial to standardize clinical scales, inflammatory blood, and CSF tests in pSS patients to allow better generalization.</span></p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71726886","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2021.11.002
Dagmar Breznoscakova , Maria Pallayova
Background and objectives
Over the past few decades, research has revealed complex interactions between type 2 diabetes mellitus (T2DM) and a wide range of comorbid conditions. The present paper sought to examine the relationship between bipolar disorder and T2DM and clarify the clinical impact of therapeutic interventions, highlighting the interpretation and implications of recent literature reports.
Methods
The PubMed electronic database was searched for keywords “bipolar disorder” AND “diabetes” OR “glucose”. Based on this literature search, 15 meta-analyses/systematic reviews and numerous research studies were identified that examined interrelationships between bipolar disorders and T2DM.
Results
Patients with bipolar disorder have higher rates of T2DM compared to the general population. Further, type 2 diabetic patients with comorbid bipolar disorder often experience deteriorated long-term glucose control and increased cardiovascular morbidity and mortality. Recent literature suggests shared risk factors and underlying disease mechanisms. In addition, genetic factors, sedentary life-style, lack of exercise, increased simple carbohydrate intake, adverse effects of bipolar pharmacotherapy, and bipolar depressive symptoms phenomenology may affect glucose metabolism.
Conclusions
The observed bidirectional interaction merits screening for psychiatric disorders in T2DM and vice versa to allow for early detection and treatment of this at risk population. Selection of drugs with neutral metabolic effects and dose individualization hold significant promise for optimizing therapy with antipsychotic and antidiabetic agents.
{"title":"Bipolar disorder and type 2 diabetes mellitus: A bidirectional relationship","authors":"Dagmar Breznoscakova , Maria Pallayova","doi":"10.1016/j.ejpsy.2021.11.002","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2021.11.002","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Over the past few decades, research has revealed complex interactions between type 2 diabetes mellitus (T2DM) and a wide range of comorbid conditions. The present paper sought to examine the relationship between bipolar disorder and T2DM and clarify the clinical impact of therapeutic interventions, highlighting the interpretation and implications of recent literature reports.</p></div><div><h3>Methods</h3><p>The PubMed electronic database was searched for keywords “bipolar disorder” AND “diabetes” OR “glucose”. Based on this literature search, 15 meta-analyses/systematic reviews and numerous research studies were identified that examined interrelationships between bipolar disorders and T2DM.</p></div><div><h3>Results</h3><p>Patients with bipolar disorder have higher rates of T2DM compared to the general population. Further, type 2 diabetic patients with comorbid bipolar disorder often experience deteriorated long-term glucose control and increased cardiovascular morbidity and mortality. Recent literature suggests shared risk factors and underlying disease mechanisms. In addition, genetic factors<span><span>, sedentary life-style, lack of exercise, increased simple carbohydrate intake, adverse effects of bipolar pharmacotherapy, and bipolar depressive symptoms phenomenology may affect </span>glucose metabolism.</span></p></div><div><h3>Conclusions</h3><p><span>The observed bidirectional interaction merits screening for psychiatric disorders in T2DM and vice versa to allow for early detection and treatment of this at risk population. Selection of </span>drugs<span> with neutral metabolic effects and dose individualization hold significant promise for optimizing therapy with antipsychotic and antidiabetic agents.</span></p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71792037","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.01.006
Jette Møllerhøj
Background and objectives
Over the past 20 years, the number of mentally disordered offenders (MDOs) has increased intensively in Denmark. Consequently, the number of caregivers, families and network involved with MDOs has also increased. Despite a heightened political focus on the involvement of caregivers as an important part of the patient pathway and recovery processes, knowledge of caregivers’ experiences is very limited. The aim of this study is to illuminate experiences and needs amongst caregivers taking care of MDOs in Denmark.
Methods
The study is based on semi-structured interviews with caregivers. The content of the interviews is analysed using content and textual analysis focusing on identifying patterns and themes.
Results
Caregivers involved with MDOs perform various roles and tasks from practical support to acting as case managers. These tasks tend to put a remarkable pressure and challenges on caregivers. Furthermore, caregivers experience emotional stress such as loneliness, shame, sorrow and feelings of inadequacy. Caregivers spend a lot of time establishing sustainable narratives about mental illness and offences, in order to reduce stigma and come to terms with chaotic and extraordinary incidents, and they play an important role as carriers of hope on behalf of the patients to support processes of personal recovery.
Conclusion
The majority of caregivers in this study share a fundamental experience of neither having achieved sufficient support in the trajectories leading up to the forensic debut nor being involved or receiving enough and dedicated information while the often long-term sentences to treatment or placement are ongoing.
{"title":"“What if you listened to and involved the caregivers?” ‒ Experiences and needs amongst caregivers involved with mentally disordered offenders and mental health services","authors":"Jette Møllerhøj","doi":"10.1016/j.ejpsy.2022.01.006","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.01.006","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Over the past 20 years, the number of mentally disordered offenders (MDOs) has increased intensively in Denmark. Consequently, the number of caregivers, families and network involved with MDOs has also increased. Despite a heightened political focus on the involvement of caregivers as an important part of the patient pathway and recovery processes, knowledge of caregivers’ experiences is very limited. The aim of this study is to illuminate experiences and needs amongst caregivers taking care of MDOs in Denmark.</p></div><div><h3>Methods</h3><p>The study is based on semi-structured interviews with caregivers. The content of the interviews is analysed using content and textual analysis focusing on identifying patterns and themes.</p></div><div><h3>Results</h3><p>Caregivers involved with MDOs perform various roles and tasks from practical support to acting as case managers. These tasks tend to put a remarkable pressure and challenges on caregivers. Furthermore, caregivers experience emotional stress such as loneliness, shame, sorrow and feelings of inadequacy. Caregivers spend a lot of time establishing sustainable narratives about mental illness and offences, in order to reduce stigma and come to terms with chaotic and extraordinary incidents, and they play an important role as carriers of hope on behalf of the patients to support processes of personal recovery.</p></div><div><h3>Conclusion</h3><p>The majority of caregivers in this study share a fundamental experience of neither having achieved sufficient support in the trajectories leading up to the forensic debut nor being involved or receiving enough and dedicated information while the often long-term sentences to treatment or placement are ongoing.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021361632200009X/pdfft?md5=4962204a37f2ed63ba36965a4f54c02e&pid=1-s2.0-S021361632200009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71726814","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}
Pub Date : 2022-07-01DOI: 10.1016/j.ejpsy.2022.01.004
Yasin Hasan Balcioglu , Simge Seren Kirlioglu Balcioglu , Fatih Oncu , Ahmet Turkcan , Abdullah Coskun Yorulmaz
Background and objectives
An association between inflammation and psychopathological domains of psychotic disorders is widely acknowledged; however, the involvement of inflammatory processes in the underlying pathophysiology of violent behavior in schizophrenia is yet to be elucidated. In this study, we aimed to address the differences in impulsive and aggressive traits as well as C-reactive protein (CRP) to albumin ratio (CAR) as a marker of inflammation between schizophrenia patients with a history of homicide and those without any history of interpersonal violence or criminal background.
Methods
The study population consisted of 80 male DSM-5 schizophrenia patients who were classified into two groups: homicidal (n=40) and non-violent (n=40). Impulsive and aggressive traits were evaluated with Barratt Impulsivity Scale-11 (BIS-11), and the Buss-Warren Aggression Questionnaire (BWAQ), respectively. For the calculation of CAR, the CRP and albumin levels were obtained from the file records of routine blood screenings performed in the month before the patients were included in the study.
Results
When adjusted for age, all subscale scores of the BIS-11 as well as BWAQ Total, Physical and Hostility scores were significantly higher in the homicidal group than in the control group. CRP and CAR were significantly higher, and albumin was significantly lower in the homicidal patients than the controls when adjusted for age, body-mass index and smoking status. Univariate and stepwise multivariate regression models indicated that BIS-11 Non-planning, BWAQ Total, BWAQ Hostility and CAR were independent predictors of belonging to the homicidal patient group, after stepwise adjustment for all potential confounders.
Conclusions
Our findings suggest that certain impulsive and aggressive traits as well as CAR, as a proxy marker of peripheral inflammation, may contribute towards homicidal tendencies and may predict a specific predisposition towards lethal violence in schizophrenia. The study highlights inflammation as a potential biological correlate of a specific behavioral phenotype (homicide) in schizophrenia.
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