Psychiatric Quarterly最新文献

Young migrants in mainland China are vulnerable to mental health issues and are reluctant to seek help from professional sources. Shame is considered an important culture-specific emotion affecting professional help-seeking. The current study aimed to investigate the moderating role of shame in the association between psychological stress and help-seeking in young internal migrants in China. 415 internal migrants (mean age = 29.20; SD = 4.81) were recruited to participate in the survey study with oversampling of those who sought help before. Multiple linear regression and Zero-inflated Poisson regression models were used to examine the moderating effects of shame on the stress-intention and stress-behavior relations, respectively. Among the 65.0% of participants with high psychological stress, 62.6% of them never sought professional help for their mental health issues. The results demonstrate that shame significantly reduced the positive association between psychological stress and professional help-seeking behavior. Conversely, shame also played a protective role, mitigating the negative association between psychological stress and professional help-seeking intention. The findings underline the importance of addressing shame-related issue prior to therapy and developing promotion strategies to improve young migrants' mental health.

This study aimed to explore whether immediate recall, delayed recall, and verbal fluency mediated the relationship between meaning in life and depression in a large sample of older adults from 17 European countries. The study also sought to investigate potential differences in mediation trajectories by sex. The data used were from the eighth wave of the SHARE project (year 2019), involving 24,277 individuals (13,874 women). The variables analyzed were: meaning in life extracted from the CASP-19 scale, tests for immediate recall, delayed recall and verbal fluency, and depression (12-item EURO-D scale). Depression was more prevalent among women. For both sexes, meaning in life was positively associated with immediate recall, delayed recall, and verbal fluency, while meaning in life was negatively associated with depression, indicating its potential to alleviate depressive feelings. The three cognitive domains significantly mediated the relationship between meaning in life and depression. Differences in indirect mediation effects between men and women were identified in the pathways: meaning in life → delayed recall → depression and meaning in life → verbal fluency → depression. The total indirect models for men and women differed significantly.

The primary aim of this study was to examine the personality profile of adults with Specific Learning Disorders (SLDs) using the Personality Inventory for DSM-5 (PID-5) to assess maladaptive traits and explore the underlying network structure of these traits in comparison to healthy individuals. The sample included 181 adults with SLDs (mean age = 27.37 ± 6.82; 39.21% female) and 227 healthy adults (mean age = 30.08 ± 7.49; 35.36% female). All participants completed the PID-5 and a socio-demographic checklist. Group differences in PID-5 scores were analyzed using independent-sample t-tests. Network analysis, including the Network Comparison Test (NCT) and centrality assessments, was conducted to examine overall network organization and identify key traits within the maladaptive trait networks. The results showed that adults with SLDs had significantly higher scores in detachment (43.99 ± 22.70 vs. 32.27 ± 17.53, p < 0.05) and negative affectivity (111.97 ± 35.06 vs. 87.26 ± 40.58, p < 0.05) compared to healthy controls. Their personality trait network was more densely connected, with a global strength of 44.95, compared to 36.22 in the control group (p < 0.01). Key traits in the SLD network included suspiciousness (betweenness = 2.116, closeness = 2.286, strength = 1.266), anhedonia (betweenness = 2.240), and eccentricity (strength = 2.146, betweenness = 1.498), indicating stronger interactions among maladaptive traits. A particularly strong connection (edge weight = 0.4059) was observed between withdrawal and anhedonia. In contrast, the control group's network was more balanced, with the most dominant node (N5) exhibiting a strength of 2.1859 and betweenness of 3.5000. These findings highlight distinct personality patterns in individuals with SLDs, underscoring the need for tailored clinical interventions.

Studies have consistently highlighted a high prevalence of mental health difficulties following exposure to trauma. These symptoms can become even more prevalent if one experiences several traumatic events. This study is the first to explore the interaction effect of age and gender on the prevalence of psychological outcomes, including anxiety, depression, stress, and PTSD, investigating whether the impact of age on psychological health is different across genders. Our sample included 546 Lebanese adults who were exposed to both the 2020 Beirut Port explosion and the 2023 earthquakes. Participants completed the PCL-5, the DASS-21, and a series of demographic questions. Results showed that, in the context of direct exposure, the findings for male and female participants indicate that older age is associated with lower mental health symptomatology. Analyzing indirect exposure, age was not significantly correlated with psychological outcomes for males; however, significant negative relationships were observed for all outcomes for females. Findings are discussed from a cultural perspective, emphasizing recommendations for interventions targeting people affected by traumatic events, namely the importance of focusing on the young generation, namely females, who scored the highest on psychological difficulties following indirect exposure to trauma.

This study aimed to identify the prevalence of anxiety and depression, as well as the associations of lifestyle behaviors with anxiety and depression in type 2 diabetes mellitus (T2DM) patients with hypertension. This cross-sectional study was conducted in Hunan Province of China, with 475 participants included. Data on sociodemographic, lifestyle behaviors, and disease-related characteristics were collected. Anxiety and depression were assessed using self-report questionnaires. This study indicated that the prevalence of anxiety and depression was 37.47% (95% confidence interval [95% CI]: 33.37-42.07%) and 40.63% (95% CI: 36.43-45.26%), respectively. Multivariable logistic regression analyses showed that playing cards or mahjong (adjusted odds ratio [aOR] = 0.46 [95% CI: 0.28-0.76] and aOR = 0.57 [95% CI: 0.34-0.94] for anxiety and depression, respectively) and performing physical activity for > 30 min per day (aOR = 0.32 [95% CI: 0.19-0.52] and aOR = 0.23 [95% CI: 0.14-0.38] for anxiety and depression, respectively) were associated with lower odds of both anxiety and depression, while reading books or newspapers (aOR = 0.34, 95% CI: 0.12-0.93) were associated with lower odds of anxiety alone. Therefore, regular reading, social activities and physical activities can be considered as intervention targets for the prevention and management of anxiety and depression in T2DM patients with hypertension.

To determine whether combination therapy (semaglutide + metformin) is more efficacious than monotherapy (metformin alone) in reducing the risk of antipsychotic-induced weight gain (AIWG) in patients with Type 2 Diabetes Mellitus (T2DM). This was a single-center, retrospective study evaluating patients ≥ 18 years of age receiving care at Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) from January 2021 to December 2022. Subjects were identified by use of antipsychotic (quetiapine, risperidone, paliperidone, olanzapine, clozapine) with concomitant use of monotherapy or combination therapy. Key exclusion criteria included other medications impacting weight, unstable medical illness, active substance use disorder, and dual antipsychotic use. The primary endpoint was defined as weight loss ≥ 5% from baseline. Secondary outcomes included BMI % difference and HbA1c difference from baseline. Data was analyzed using descriptive statistics. 31 patients were evaluated in each group for the final analysis. 38.7% (12/31) of patients in the monotherapy group achieved the primary outcome of weight loss ≥ 5% from baseline vs. 61.29% (19/31) in the combination group (p = 0.04). For secondary outcomes, the BMI % difference from baseline in the monotherapy group was -3.88% vs. -5.58% in the combination group (p = 0.129). The monotherapy group had a difference in HbA1c % from baseline of 0.14% vs -0.9% in the combination group (p = 0.007). Among T2DM patients on antipsychotics, more patients in the combination group achieved weight loss ≥ 5% within the study period compared to metformin monotherapy. Future research should account for non-diabetic patients, assess lifestyle factors, and exclude other psychotropic medications that may affect weight.

We sought to assess the augmentation of brief behavioral therapy for insomnia (BBTI) with eszopiclone (ESZ) over BBTI alone for the treatment of chronic insomnia on sleep quality, sleep indices, and continuous positive airway pressure (CPAP) adherence in PTSD veterans with COMISA. The pilot trial involved 53 PTSD patients (46 males and 7 females, mean age 48.2±8.3 years) with COMISA randomized to combination therapy of BBTI plus 2 weeks of eszopiclone (2 mg/d) or BBTI alone with follow-up visits conducted at 6 and 24 weeks. The main outcome measure was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI). A significant decrease in PSQI scores was observed between baseline and 24 weeks for BBTI plus ESZ (-5.24 [95% CI, -6.55 to -3.94]; p < 0.001) and BBTI-only (-5.45 [95%CI, -6.75 to -4.14]; p < 0.001). No significant group allocation effects x time interactions were detected. Similar improvements were recorded for ISI between baseline and 24 weeks (BBTI plus ESZ (-8.32 [95%CI, -10.51 to -6.14]; p < 0.001) and BBTI-only (-8.64 [95%CI, -10.88 to -6.41]; p < 0.001)) with no interaction effect between treatment groups x time. Combination therapy produced a higher remission rate of insomnia at 6 weeks, with both interventions achieving comparable rates at 24 weeks. Results of the mixed effect models for CPAP use revealed no group x time interaction effects. In patients with COMISA, the combination of eszopiclone with BBTI resulted in comparable improvement in sleep quality of life to that achieved with BBTI-only therapy. Although the addition of eszopiclone to BBTI conferred an early benefit in remission rate of insomnia relative to BBTI, both modalities achieved similar outcomes at long-term follow-up.Clinical Trial Registration This study was registered with ClinicalTrials.gov (Identifier NCT03937713).

Borderline personality disorder (BPD) is considered to be a heterogeneous diagnostic entity, with multiple facets of the disorder influencing its course. Disentangling the structure of BPD criteria is fundamental to better understanding the disorder and targeting problematic behaviors. To identify and critically appraise factor analytic studies examining the structure of BPD criteria. A systematic review was conducted according to PRISMA guidelines. Three computerized databases (Pubmed, Scopus,PsycNET) were searched, resulting in the inclusion of 27 relevant studies. The unified model of BPD has been confirmed by a number of studies, while among multidimensional models, a three-factor model has also gained considerable empirical support. Multidimensional models of BPD tend to cluster together "disordered self" symptoms (identity disturbance and emptiness), affective symptoms (affective instability and anger), and behavioral symptoms (impulsivity and self-harming behaviors). Unidimensional and multidimensional models of the BPD structure are not necessarily in competition. An understanding of BPD as a unified diagnosis composed of three underlying dimensions, could serve the purpose of recognizing and targeting different aspects of the disorder, while maintaining a robust, and clinically useful diagnosis.

Introduction: The diagnosis of Autism Spectrum Disorder (ASD) can be difficult to achieve, especially since the diagnostic criteria have changed in the last decade. This challenge is even greater for Romanian clinicians, as there are currently no screening tools validated for diagnosing ASD in adults within the Romanian population.

Purpose: This study aims to validate two screening instruments used to identify autistic traits in the Romanian general population: the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ).

Methods: Data was collected by administering the Romanian version of the scales to a sample of 916 Romanian native speakers from the non-clinical population. 108 individuals were re-tested after 2 years. The scales were validated by determining their reliability with respect to the stability of the results and evaluating their construct and structural validity in correlation with the following instruments: QCAE (Questionnaire of Cognitive and Affective Empathy), PAQ (Perth Alexithymia Questionnaire) and BVAQ (Bermond-Vorst Alexithymia Questionnaire).

Results: Our data revealed that, regarding reliability, the Romanian version of AQ presents slightly lower internal consistency compared to the original validation study. Concerning structural validity, confirmatory factor analysis (CFA) revealed suboptimal fit indices for the original 5-factor structure. Based on a subsequent exploratory factor analysis (EFA), a 2-factor solution returned improved fit indices.

Conclusion: Despite employing more items to measure the constructs than needed, this study confirmed that both instruments present a valuable resource for clinicians working with neurodivergent patients, as interest in this area of pathology has increased greatly in Romania over the past few years. Practical implications and methodological issues regarding the two instruments are discussed.

Objective: During the COVID-19 pandemic, telemental health (TMH) use rapidly increased. Though patients report satisfaction with TMH, acceptability among different psychiatric providers (inpatient, outpatient, nurses) and for various diagnoses is less understood. This study aimed to expand understanding by examining TMH acceptability, benefits, and barriers for providers and patients during the early transition to TMH in the COVID-19 pandemic.

Methods: Online anonymous surveys evaluated patient (n = 64) and provider (n = 39) satisfaction with and perceived benefits and challenges to TMH from October-December 2020 on 5-point Likert scales. Qualitative data was collected and themes identified.

Results: Outpatient (3.97 ± 1.05) and inpatient (3.11 ± 1.6) providers, including nurses, reported high satisfaction with TMH, despite over 50% never having used TMH prior to the pandemic. TMH was viewed as acceptable across diagnoses, including serious mental illness and substance use. Provider-rated benefits of outpatient TMH versus in-person visits included COVID safety (mean difference[MD] = 3.05), travel (MD = 2.95), and reduced cancellations (MD = 1.81). Inpatient TMH similarly included COVID safety benefits (MD = 3.31), but also challenges related to team-based service provision (MD = 1.68) and working with trainees (MD = 1.19). Qualitative themes identified TMH challenges (e.g., technological: 56.7% patients, 66.7% providers) and benefits (e.g., convenience/flexibility: 80% patients, 81.5% providers).

Conclusions: TMH was associated with high satisfaction for patients and across provider types and patient diagnoses. This study provides further support that TMH across clinical settings allows for greater flexibility and accessibility to evidence-based care, and ongoing benefits even outside the context of the COVID-19 pandemic. It suggests the benefits of ongoing training of staff and trainees in TMH.