General hospital psychiatry最新文献_第10页

A systematic review and meta-analysis of transdiagnostic interventions for common mental disorders in primary care 针对初级保健中常见精神障碍的跨诊断干预措施的系统回顾和荟萃分析

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-11-01 DOI: 10.1016/j.genhosppsych.2024.11.003

Marie Vogel , Christopher Ebert , Jochen Gensichen , Hanna Applis , Alkomiet Hasan , Kirsten Lochbühler , POKAL-Group

Objective

In primary care, treating common mental disorders according to the ICD or DSM is challenging. A transdiagnostic approach may facilitate the management of mental health problems by treating across psychiatric diagnoses.

This meta-analysis aims to identify and compare transdiagnostic interventions delivered in primary care and to determine the effectiveness of these interventions, focusing on common mental disorders.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching the databases Medline, Embase, Web of Science, and PsycINFO. Standardized mean differences (SMD) were calculated for the outcomes, and additional subgroup analyses were performed.

Results

From an initial set of 10,618 RCTs, 38 studies were included and retained for data extraction. Transdiagnostic interventions led to a significant reduction in symptoms of depression (SMD: −0.38) and anxiety (SMD: - 0.47). Treatment outcomes for somatoform disorders were not significant (SMD: - 0.22). About half of the interventions were provided by health professionals not specifically trained in psychotherapy; these interventions also proved to be effective (depression: SMD: −0.47; anxiety: −0.39).

Conclusion

This meta-analysis supports the use of transdiagnostic interventions for common mental disorders in primary care. Transdiagnostic interventions carried out by medical and health professionals not specifically trained in psychotherapy are feasible in PC, but emphasis should be placed on adequate training for them.

Trial registration: The protocol for this study is registered with PROSPERO: CRD42024459073, Date of registration: 2024/01/03.

目标在初级医疗中，根据 ICD 或 DSM 治疗常见精神障碍具有挑战性。方法通过检索 Medline、Embase、Web of Science 和 PsycINFO 等数据库，对随机对照试验 (RCT) 进行了系统综述和荟萃分析。结果在最初的 10,618 项随机对照试验中，有 38 项研究被纳入并保留用于数据提取。跨诊断干预显著减轻了抑郁症状（SMD：-0.38）和焦虑症状（SMD：-0.47）。躯体形式障碍的治疗效果不显著（SMD：- 0.22）。约有一半的干预措施是由未接受过心理治疗专门培训的医疗专业人员提供的；这些干预措施也被证明是有效的（抑郁症：SMD：-0.47；焦虑症：-0.39）。由未接受过心理治疗专门培训的医疗卫生专业人员进行跨诊断干预在 PC 中是可行的，但应重视对他们的充分培训：本研究方案已在 PROSPERO 注册：CRD42024459073，注册日期：2024/01/03。

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引用次数: 0

The Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale: Longitudinal psychometric syntheses with 10-year cohort multi-center evidence in an adult sample 八项流行病学研究中心抑郁量表的中文版：成人样本中10年队列多中心证据的纵向心理测量综合

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-11-01 DOI: 10.1016/j.genhosppsych.2024.11.008

Chen Jiang , Jiaqi Sun , Yingbo Lv , Sujun Hu, Wei Cheng, Xudong Zhao, Yi Zheng, Xiangping Wu, Lanqiu Lv

Objective

To evaluate cross-sectional (CMI), longitudinal (LMI), and cross-measurement invariance (C-LMI) of the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale (CES-D 8) and reconfirm other properties for measuring depression construct.

Methods

11,479 Chinese adults from China Family Panel Studies were enrolled and randomly split into two halves. The exploratory half was used to reidentify the structures of the CES-D 8 by bootstrap exploratory graph analysis (bootEGA) and the confirmatory half was used to compare and choose the structure by confirmatory factor analysis (CFA).

Results

The original two-factor model was found satisfactory as the solution for the Chinese CES-D 8 because of the relatively best fit. The CMI, LMI, and C-LMI were supported within groups of gender, age, marital status, and time with indices that have met the expectations. The Chinese CES-D 8 also showed sufficient internal consistencies with Cronbach's alpha valuing 0.795–0.868 and McDonald's omega valuing 0.850–0.870.

Conclusions

The CES-D 8 presents sufficient psychometric syntheses for assessing depressive symptoms to adulthood. These results demonstrate adequate measurement invariances and can be reliably used at different genders, ages, and long-term time points in Chinese cultural backgrounds.

目的评价8项美国流行病学研究中心抑郁量表（ces - d8）的横截面不变性（CMI）、纵向不变性（LMI）和交叉测量不变性（C-LMI），并再次确认其他测量抑郁结构的性质。方法从中国家庭小组研究中招募了11479名中国成年人，随机分为两组。探索性半部分采用自举探索性图分析（bootstrap exploratory graph analysis, bootEGA）对ces - d8的结构进行重新识别，验证性半部分采用验证性因子分析（confirmatory factor analysis， CFA）对结构进行比较和选择。结果原双因子模型拟合效果较好，可作为中国ces - d8的理想解。CMI、LMI和C-LMI在性别、年龄、婚姻状况和时间分组中得到支持，指标符合预期。中国的ce - d8与Cronbach的alpha值0.795-0.868和麦当劳的omega值0.850-0.870也表现出足够的内部一致性。结论ce - d8量表具有足够的心理测量综合评价成年期抑郁症状的能力。这些结果显示了足够的测量不变性，可以可靠地用于不同性别、年龄和中国文化背景下的长期时间点。

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引用次数: 0

Comment on: “Prevalence and incidence of suicide, suicidal ideation and self-harm in caregivers of cancer patients: A systematic review and meta-analysis” 评论"癌症患者照顾者自杀、自杀意念和自残的流行率和发生率：系统回顾和荟萃分析"。

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-11-01 DOI: 10.1016/j.genhosppsych.2024.09.016

Ankur Kapoor , Rachana Mehta , Sanjit Sah , Ganesh Bushi

引用次数: 0

Cost savings of a perinatal psychiatry access program in Vermont 佛蒙特州围产期精神病治疗项目的成本节约。

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-11-01 DOI: 10.1016/j.genhosppsych.2024.07.009

Isabel S. Platt , Emma L. Pendl-Robinson , Sasigant So O'Neil , Divya Vohra , Laura Pentenrieder , Kara Zivin

引用次数: 0

Identifying opportunities to improve depression screening in specialty care: Implications for population health management 确定改善专科护理中抑郁症筛查的机会：对人口健康管理的影响

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-11-01 DOI: 10.1016/j.genhosppsych.2024.07.012

Jason B. Liu , Carlos G. Fernandez-Robles , Trina E. Chang , Sri Harshini Malapati , Finn Tobias , Chengbo Zeng , Jianyi Zhang , Rachel C. Sisodia , Andrea L. Pusic , Maria O. Edelen

引用次数: 0

Prevalence and measurement of post-exertional malaise in post-acute COVID-19 syndrome: A systematic review and meta-analysis 急性 COVID-19 后综合征中劳累后乏力的患病率和测量方法：系统回顾和荟萃分析

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-10-20 DOI: 10.1016/j.genhosppsych.2024.10.011

Yi An, Ziyu Guo, Jin Fan, Tingting Luo, Huimin Xu, Huiying Li, Xi Wu

Objective

Post-exertional malaise (PEM) is a common and debilitating symptom of post-acute COVID-19 syndrome (PACS), and it is also included in the core outcome set for PACS. Our aims are to determine the prevalence of PEM in patients with PACS, and to review the measurement tools utilized in studies assessing PEM among these patients.

Methods

A systematic literature search was conducted up to 29 February 2024 across four databases: PubMed, EMBASE, Web of Science, and Cochrane Library. Studies were included if they evaluated PACS individuals who had at least one persistent symptom, with the mean or median follow-up duration of at least 3 months after COVID-19 diagnosis or hospital discharge, and specially reported on PEM or any measurement tools utilized to assess PEM. Data extraction and quality assessment were performed independently by two authors.

Results

After screening 953 articles, 12 studies comprising 2665 patients were included in the meta-analysis, and 16 studies were included in the narrative review. The pooled prevalence of PEM among PACS patients at 3 months or more after COVID-19 diagnosis was 0.55 (95 % CI, 0.38, 0.71). Moreover, narrative review identified seven questionnaires used to assess PEM in PACS individuals, with the DePaul Symptom Questionnaire–Post Exertional Malaise (DSQ-PEM) being the most frequently utilized instrument.

Conclusion

Our findings indicate that over half of the PACS individuals experience PEM, and seven questionnaires have been identified for researchers to assess PEM. It is imperative to develop effective intervention strategies to treat and alleviate the burden of PEM.

目的劳累后乏力（PEM）是急性 COVID-19 后综合征（PACS）的一种常见且使人衰弱的症状，也被列入 PACS 的核心结果集。我们的目的是确定 PACS 患者中 PEM 的患病率，并回顾评估这些患者 PEM 的研究中所使用的测量工具：PubMed、EMBASE、Web of Science 和 Cochrane Library。如果研究对至少有一种持续性症状的 PACS 患者进行了评估，且平均或中位随访时间至少为 COVID-19 诊断或出院后 3 个月，并对 PEM 或用于评估 PEM 的任何测量工具进行了专门报告，则纳入该研究。数据提取和质量评估由两位作者独立完成。结果在筛选了953篇文章后，有12项研究（共2665名患者）被纳入荟萃分析，16项研究被纳入叙述性综述。在 COVID-19 诊断后 3 个月或更长时间的 PACS 患者中，PEM 的汇总患病率为 0.55（95 % CI，0.38，0.71）。结论我们的研究结果表明，半数以上的 PACS 患者患有 PEM，研究人员已确定了七种用于评估 PEM 的问卷。当务之急是制定有效的干预策略，以治疗和减轻 PEM 的负担。

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引用次数: 0

Association of depressive symptoms and incident chronic kidney disease in middle-aged and older adults 中老年人抑郁症状与慢性肾病发病率的关系。

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-10-19 DOI: 10.1016/j.genhosppsych.2024.10.012

Fan Zhang , Yan Bai , Rui Zhou , Jing Liao , Yi Li , Yifei Zhong

Background

Emerging evidence suggests that depressive symptoms may be a risk factor for the development of Chronic kidney disease (CKD). This study aimed to investigate the association between depressive symptoms and the incidence of CKD in middle-aged and older Chinese adults.

Methods

We utilized data from the 2011–2020 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). Incident CKD was defined based on the estimated glomerular filtration rate ≤ 60 mL/min/m² or self-reported. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95 % confidence intervals (95 % CI) for incident CKD, adjusting for potential confounders.

Results

Among the 10,996 participants without baseline CKD, 890 developed CKD during a median follow-up of 9.0 years. After adjusting for potential covariates, participants with depressive symptoms had a significantly higher risk of developing CKD compared to those without depressive symptoms (HR: 1.450; 95 % CI: 1.249–1.682). The association remained statistically significant when the CES-D was scored according to the severity of depressive symptoms, i.e., quintiles. A linear positive association between total CES-D score and risk of incident CKD was also found using restricted cubic spline regression (P _{for non-linearity} = 0.114).

Conclusions

Depressive symptoms are significantly associated with an increased risk of incident CKD in middle-aged and older Chinese adults. These findings underscore the importance of mental health screening and interventions in preventing CKD in this population.

背景：新的证据表明，抑郁症状可能是慢性肾脏病（CKD）发病的一个危险因素。本研究旨在调查中国中老年人抑郁症状与慢性肾脏病发病率之间的关系：我们利用了 2011-2020 年中国健康与退休纵向研究（CHARLS）的数据。抑郁症状采用 10 项流行病学研究中心抑郁量表（CES-D）进行评估。根据估计的肾小球滤过率≤ 60 mL/min/m2 或自我报告的情况来界定是否患有慢性肾功能衰竭。在对潜在混杂因素进行调整后，采用 Cox 比例危险模型来估算发生 CKD 的危险比（HR）和 95 % 置信区间（95 % CI）：在 10996 名无基线 CKD 的参与者中，有 890 人在中位 9.0 年的随访期间患上了 CKD。在对潜在的协变量进行调整后，与无抑郁症状的参与者相比，有抑郁症状的参与者罹患慢性肾脏病的风险明显更高（HR：1.450；95 % CI：1.249-1.682）。如果根据抑郁症状的严重程度（即五分位数）对 CES-D 进行评分，这种关联在统计学上仍有意义。使用限制性三次样条回归法还发现，CES-D 总分与发生慢性肾脏病的风险呈线性正相关（非线性 P = 0.114）：结论：抑郁症状与中国中老年人罹患慢性肾脏病的风险增加密切相关。结论：抑郁症状与中国中老年人发生慢性肾脏病的风险增加密切相关，这些发现强调了心理健康筛查和干预对预防中老年人慢性肾脏病的重要性。

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引用次数: 0

Reciprocal relations between acute interpersonal negative life events and acute alcohol use: An examination of the 24 h preceding suicide attempts among hospitalized patients 急性人际负面生活事件与急性饮酒之间的相互关系：对住院病人自杀未遂前24小时的研究。

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-10-18 DOI: 10.1016/j.genhosppsych.2024.10.010

K.G. Saulnier , D.M. McCarthy , A.K. Littlefield , S.M. Cohen , E.V. Barbour , C.L. Bagge

Objective

To examine the within-person relations between acute alcohol use and interpersonal negative life events (INLEs) in the 24 h preceding suicide attempts.

Method

Participants were 151 adult patients (67.55 % female; M age = 36.00) who were hospitalized within 24 h of a suicide attempt. Participants completed the Timeline Follow-back for Suicide Attempts interview to gather information about hourly events for the 24 h preceding their suicide attempt. Hierarchical logistic models were estimated to examine the influence of acute INLEs on next-hour alcohol use and acute alcohol use on next-hour INLEs. Biological sex and chronic alcohol use (past year) were evaluated as potential moderators.

Results

Overall, acute alcohol use was associated with increased odds of next-hour INLEs and acute INLEs were associated with increased odds of next-hour alcohol use. Moderator analyses indicated that the influence of alcohol use on INLEs increased as participants' level of chronic alcohol use decreased, and relations did not vary by biological sex.

Conclusions

There is a bidirectional relation between INLEs and alcohol use in the hours preceding suicide attempts. Understanding that these within-person interrelations may differ in strength depending on one's level of chronic alcohol use has practical utility for providers tasked with clinical decision making.

目的研究自杀未遂前24小时内急性酒精使用与人际负面生活事件（INLEs）之间的人际关系：参与者为 151 名在自杀未遂后 24 小时内住院的成年患者（67.55% 为女性；M 年龄 = 36.00）。受试者完成了自杀未遂时间跟踪采访，以收集自杀未遂前 24 小时内的每小时事件信息。对层次逻辑模型进行了估计，以研究急性 INLE 对下一小时酒精使用的影响，以及急性酒精使用对下一小时 INLE 的影响。生物性别和长期饮酒（过去一年）作为潜在的调节因素进行了评估：总体而言，急性饮酒与下一小时 INLEs 的几率增加有关，急性 INLEs 与下一小时饮酒的几率增加有关。调节因素分析表明，随着参与者长期饮酒水平的降低，饮酒对INLEs的影响也随之增加，而两者之间的关系并不因生理性别而异：结论：INLEs 与自杀未遂前数小时内饮酒之间存在双向关系。了解这些人内相互关系的强度可能会因个人长期饮酒的程度而有所不同，这对负责临床决策的医疗人员具有实际意义。

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引用次数: 0

Transitional care programs to improve the post-discharge experience of patients with multiple chronic conditions and co-occurring serious mental illness: A scoping review 改善患有多种慢性疾病和并发严重精神疾病的患者出院后体验的过渡性护理计划：范围综述。

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-10-15 DOI: 10.1016/j.genhosppsych.2024.10.007

Heather Brom , Kathy Sliwinski , Kelvin Amenyedor , J. Margo Brooks Carthon

The transition from hospital to home can be especially challenging for those with multiple chronic conditions and co-occurring serious mental illness (SMI). This population tends to be Medicaid-insured and disproportionately experiences health-related social needs. The aim of this scoping review was to identify the elements and outcomes of hospital-to-home transitional care programs for people diagnosed with SMI. A scoping review was conducted using Arksey and O’Malley's methodology. Three databases were searched; ten articles describing eight transitional care programs published from 2013 to 2024 met eligibility criteria. Five programs focused on patients being discharged from a psychiatric admission. Five of the interventions were delivered in the home. Intervention components included coaching services, medication management, psychiatric providers, and counseling. Program lengths ranged from one month to 90 days post-hospitalization. These programs evaluated quality of life, psychiatric symptoms, medication adherence, readmissions, and emergency department utilization. Notably, few programs appeared to directly address the unmet social needs of participants. While the focus and components of each transitional care program varied, there were overall positive improvements for participants in terms of improved quality of life, increased share decision making, and connections to primary and specialty care providers.

对于那些患有多种慢性疾病和并发严重精神疾病（SMI）的人来说，从医院到家庭的过渡尤其具有挑战性。这部分人群往往由医疗补助计划提供保险，而且在健康相关的社会需求方面表现得尤为突出。本次范围界定审查旨在确定针对确诊为 SMI 患者的医院到家庭过渡性护理项目的要素和结果。采用 Arksey 和 O'Malley 的方法进行了范围界定综述。我们检索了三个数据库，其中有十篇文章介绍了 2013 年至 2024 年间发表的八项过渡性护理计划，符合资格标准。其中五项计划主要针对从精神病院出院的患者。其中五项干预在家中进行。干预内容包括指导服务、用药管理、精神科医生和心理咨询。项目时间从入院后一个月到 90 天不等。这些项目对患者的生活质量、精神症状、服药依从性、再入院率和急诊使用率进行了评估。值得注意的是，很少有项目直接解决参与者未得到满足的社会需求。虽然每项过渡性护理计划的重点和内容各不相同，但总体而言，参与者在改善生活质量、提高决策份额以及与初级和专科护理提供者建立联系等方面都取得了积极的改善。

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引用次数: 0

Illness invalidation and psychological distress in adults with chronic physical health symptoms 有慢性身体健康症状的成年人的疾病无效感和心理困扰。

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry

Pub Date : 2024-10-09 DOI: 10.1016/j.genhosppsych.2024.10.001

Thomas Woldhuis , Milena Gandy

Objectives

Illness invalidation is a term used to describe when someone's illness experience is delegitimised by another person in the social environment. This study investigated whether illness invalidation was associated with psychological distress in Australian adults managing symptoms of chronic physical health conditions (CPHCs), and whether illness factors were related to levels of illness invalidation experienced.

Methods

In 2022, a large cross-sectional online survey was conducted on adults managing symptoms of CPHCs (e.g., chronic pain, fatigue). Participants self-reported demographic and illness information, health-related self-efficacy, psychological distress, and illness invalidation using validated scales.

Results

The sample data revealed (N = 1610) that illness invalidation was experienced across many symptom categories. Hierarchical regressions indicated that discounting from family members, medical professionals, and the spouse/partner, as well as lack of understanding from family members, was significantly and uniquely associated with psychological distress while controlling for adjustment-related factors. Adults with multiple CPHCs, longer symptom durations and suspected/unconfirmed CPHC diagnoses experienced higher illness invalidation.

Conclusions

Illness invalidation, particularly discounting, is common in people managing symptoms of CPHCs and appears to be uniquely associated with psychological distress. Future research should attend to illness invalidation in adjustment and reducing invalidating experiences for people with CPHCs.

目的：疾病无效是一个术语，用来描述某人的疾病经历被社会环境中的其他人否定。本研究调查了疾病失效是否与澳大利亚成年慢性病患者的心理压力有关，以及疾病因素是否与所经历的疾病失效程度有关：方法：2022 年，我们对有慢性躯体疾病症状（如慢性疼痛、疲劳）的成年人进行了一次大型横断面在线调查。参与者使用经过验证的量表自我报告人口和疾病信息、健康相关自我效能感、心理困扰和疾病无效感：样本数据显示（N = 1610），许多症状类别都存在疾病无效感。分层回归结果显示，在控制调整相关因素的情况下，家庭成员、医疗专业人员和配偶/伴侣的漠视以及家庭成员的不理解与心理困扰有显著且独特的关联。患有多种 CPHC、症状持续时间较长以及疑似/未确诊 CPHC 的成人的疾病无效性更高：疾病无效感，尤其是折扣感，在处理 CPHC 症状的人群中很常见，而且似乎与心理困扰有着独特的联系。未来的研究应关注疾病无效在调整和减少 CPHC 患者无效经历中的作用。

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引用次数: 0