Psychiatric Quarterly最新文献

In this study, we aimed to investigate the influence of resilience or public service motivation (PSM) on firefighters' work engagement during the coronavirus disease (COVID-19) pandemic. We conducted an online survey with 304 firefighters assigned to Gyeonggi-do between October 27 and 28, 2022, and collected their demographic information; work-related data; mood, anxiety and insomnia symptoms; and work-related attitudes. The leading causes of firefighters' stress were physical and mental health decline due to heavy workloads (46.4%), verbal abuse and assault from civilians (33.9%), conflict with coworkers (18.4%), and death of colleagues (13.2%). The results of the logistic regression analysis revealed that high levels of resilience (OR = 1.28, p < 0.001), service motivation (OR = 1.17, p < 0.001), and non-exposure to death (OR = 0.33, p = 0.005) led to high work engagement. Mediation analysis showed that resilience and PSM mediated the influence of depression on work engagement. The work engagement of firefighters is influenced by resilience, PSM, and exposure to death.

The aims of this study were to explore the influence of shift working nursing professionals' psychological inflexibility on their level of insomnia. Additionally, we investigated the mediation effect of depression and sleep-related cognitions on this association. An online survey was conducted among 202 nursing professionals at Asan Medical Center from July to August, 2023. Participants responded to questionnaires including the Insomnia Severity Index (ISI), Acceptance and Action Questionnaire-II (AAQ-II), Dysfunctional Beliefs and Attitudes about Sleep - 16 (DBAS-16), Glasgow Sleep Effort Scale (GSES), Patient Health Questionnaire-9 items (PHQ-9), and the Discrepancy between desired time in bed and desired total sleep time index (DBST index). Pearson's correlation and linear regression were performed to explore the factors predicting ISI scores. Mediation analysis was implemented. Linear regression revealed that insomnia severity was predicted by DBAS-16 (β = 0.15, p = 0.008), GSES (β = 0.48, p < 0.001), and PHQ-9 (β = 0.26, p < 0.001). Mediation analysis showed that the relationship between the psychological inflexibility of shift-working nursing professionals' and insomnia severity was fully mediated by depression, dysfunctional beliefs about sleep, and sleep effort. Psychological inflexibility does not directly influence insomnia severity, but depression, dysfunctional beliefs about sleep, and sleep effort fully mediate the relationship.

To examine the risks of long-term de novo psychiatric disease in women with primary infertiltiy compared to age-matched referrent women. Retrospective, population-based cohort of 1,001 women with primary infertility and 1,001 age-matched (± 1 year) referent women aged 18-50. The "index date" was date of first clinical note for infertility and included visits fromJanuary 1, 1980 to December 31, 1999. Baseline characteristics were collected by chart review. Outcome data was evaluated through December 31, 2020. Primary outcomes were baseline prevalence and de novo rates of subsequent psychiatric disorders including depression, anxiety, bipolar disorder, substance abuse, suicidality, and somatization evaluated by Cox proportional hazards modeling. Among women with primary infertility and referent women, the median duration of follow-up was 23.7 years. The risk of de novo psychiatric disorders was not significantly different between groups. Additionally, the risk of de novo psychiatric disorders did not significantly differ between those with isolated male factor versus isolated female factor infertility. Among women with primary infertility, the cumulative incidence of de novo depression and anxiety was significantly higher among women diagnosed with primary infertility in the 1990s compared to the 1980s. Women with primary infertility, in a historical population-based cohort, do not have a significantly different long-term risk of de novo psychiatric diagnoses compared to age-matched referent women. Our findings support the notion that infertility diagnosis and treatment present an acute period of stress and for some psychologic distress, neither of which persist or increase the risk for development of future psychiatric disease.

Self-stigma is a major barrier to personal and clinical recovery in people with mental illness. Although psychosocial interventions have been developed to reduce self-stigma, the exploration of group CBT-based interventions for hospitalised patients are less represented. The purpose of this trial is to investigate the effectiveness of a group CBT-based intervention aiming to reduce self-stigma and improve recovery-related outcomes such as self-esteem, stigma resistance and sense of coherence, which comes down to saying, "I am what I am". A total of 104 patients admitted to the inpatient therapy were recruited to participate in a randomised controlled clinical trial, and 77 participants (46 in the intervention group and 31 in the control group) completed the trial. Constructs of interest were measured before and after the intervention. The results showed that the evaluated intervention was effective in improving sense of coherence and stigma resistance, compared to treatment as usual (TAU). The level of self-stigma significantly decreased in both the intervention and control groups, but no statistically significant difference was observed between the groups. The limitations of the study include: the lack of assessment of the sustainability of the effects of therapy (follow-up), the presence of intensive interventions of the ward's programme and patients pre-qualified for the ward based on admission criteria. The intervention "I am what I am," has proven to be effective, especially in increasing the level of personal resources needed to build clinical and personal recovery and to counteract the negative consequences of self-stigma.

The UK National Institute for Health and Care Excellence (NICE) guidance for the treatment of depression is widely followed and has international influence. According to these guidelines, antidepressant medications are recommended for moderate to severe depression. Nonetheless, antidepressants are increasingly prescribed, including for cases of subthreshold and mild depression. This may indicate that a proportion of depressed patients uses pharmacological interventions with unclear evidence-base, though other factors such as physical and mental health comorbidities need to be accounted for. This study aims to investigate the prevalence and trends of antidepressant prescriptions among community-dwelling adults diagnosed with depression according to NICE recommendations. We conducted a systematic review of PsycInfo, PubMed/MEDLINE, and Scopus databases. Observational studies reporting on the prevalence of antidepressant treatments in UK adults diagnosed with depression were sought. Fifteen studies were included. The prevalence of antidepressants for depression treatment ranged from 30.8 to 95% and mainly concerned selective serotonin reuptake inhibitors (SSRIs) among classes of antidepressant drugs. Little information about depression severity as well as comorbid conditions was reported. High prevalence rates of antidepressant drug use highlight the widespread adoption of pharmacological interventions, while also raising concerns about compliance with NICE guidelines. Careful assessment of depressive illness severity and comorbidities is needed to ensure the delivery of adequate care to people with depression. Systematic Review Registration Number (PROSPERO) CRD42023448152.

Loneliness and depression are serious public mental health problems. Meaning in life (MIL) is associated with reduced loneliness and depression. This study aimed to: (1) investigate associations between loneliness, MIL, and depression, differentiated by sex in individuals aged ≥ 50 years, residing in 26 European countries and Israel, and (2) to examine in men and women separately whether MIL mediated the relationship between loneliness and depression. We included 41,372 individuals (23,789 women) who responded to wave 8 of the SHARE project. The variables analyzed were loneliness (UCLA), depression (EURO-D scale), and MIL (CASP-19). The analytical procedures included regression analysis and exploratory mediation analysis. Among men and women, the odds of loneliness increasing depression were 3.6 and 3.3 times higher, respectively. Among men, feeling MIL sometimes or often had odds for reducing depression by 0.53 and 0.21, respectively. In women, feeling MIL sometimes or frequently reduced the odds of depression by 0.37 and 0.19, respectively. Regardless of sex, mediation analyses showed a positive association between loneliness and depression, while MIL was negatively associated with loneliness and depression. MIL partially mediated the association between LON and depression in male and female models by approximately 83.2% and 80.7%, respectively. No differences were found between men's and women's mediation models. Regardless of sex, high levels of MIL seem to be effective in benefiting the mental health of Europeans aged 50 and over. MIL proved to be a significant mediator of the relationship between loneliness and depression, while loneliness and depression strengthened each other.

Studies on problematic online activities commonly focus on one type of online activity, such as social media. However, individuals often use their Smartphones for more than one online activity. This study examined four types of online activities (social networking, gaming, information acquisition, and short-form video viewing). Based on a combinatory assessment of problematic smartphone use and hours spent online, two groups were created from a larger sample (N = 642): a problematic smartphone user group (PSU; N = 230; F = 72%; Age = 24.99 ± 6.60) and a non-problematic smart phone user group (NPSU; N = 87; F = 62%; Age = 30.49 ± 10.22). As compared to the NPSU group, the PSU group engaged in more social networking, gaming, information acquisition, and short-form video seeing. The PSU group also scored higher on psychological distress, sleep disturbance, fear of missing out, metacognitions about Smartphone use (MSU), desire thinking (DT), and lower on satisfaction with life and cognitive reappraisal. Regression analyses were employed to probe correlates of each online activity among the PSU and NPSU groups. The findings are discussed in light of the metacognitive model of addictive behaviors and future directions are provided concerning the challenges of distinguishing individuals for problematic Internet-related behaviors.

Major depressive disorder (MDD) patients' personality traits and illness representations are linked to MDD severity. However, the associations between personality and illness representations in MDD and the mediating role of illness representations between personality and MDD severity have not been investigated. This study aimed to prospectively investigate the aforementioned associations and the possible mediating role of illness representations between personality and MDD severity. One hundred twenty-five patients with a MDD diagnosis, aged 48.18 ± 13.92 (84% females), participated in the study. Personality traits were measured with the Traits Personality Questionnaire at baseline. Illness representations were measured with the Illness Perception Questionnaire-Mental Health about five months later (mean = 5.08 ± 1.14 months). MDD severity was measured about 10 months after the baseline assessment (mean = 9.53 ± 2.36 months) with the Beck Depression Inventory. SPSS 29 and AMOS 27 were used to conduct correlational and parallel mediation analyses. According to the results, Neuroticism was positively and Extraversion was negatively linked to MDD severity. Negative MDD impact representations fully mediated these associations. Neuroticism and Extraversion are linked to future MDD severity through patients' representations of MDD's impact. Restructuring maladaptive representations about MDD's impact can be a promising way to reduce symptom severity in patients with high Neuroticism and low Extraversion levels.

Background: Military veterans often encounter multiple obstacles to mental health care, such as stigma, practical barriers (e.g., high cost), and negative beliefs about mental health care. To date, however, nationally representative data on the prevalence and key correlates of these barriers to care are lacking. Such data are critical to informing population-based efforts to reduce barriers and promote engagement in mental health treatment in this population.

Methods: Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed 4,069 US veterans, 531 (weighted 15.0%) of whom screened positive for a mental disorder but never received mental health treatment. Multivariable logistic regression and relative importance analyses were conducted to identify key predisposing, enabling, and need-based factors associated with endorsement of stigma, instrumental barriers, and negative beliefs about mental health care.

Results: A total 47.1% of veterans endorsed any barrier to care, with 38.7% endorsing instrumental barriers to care, 28.8% perceived stigma, and 22.0% negative beliefs about mental health care. Lower purpose in life, grit, and received social support were most consistently associated with these barriers to care.

Conclusions: Nearly half of US veterans with psychiatric need and no history of mental health treatment report barriers to care. Modifiable characteristics such as a low purpose in life, grit, and received support were associated with endorsement of these barriers. Results may help inform resource allocation, as well as prevention, psychoeducation, and treatment efforts to help reduce barriers and promote engagement with mental health services in this population.

COPD is one of the leading causes of death in the United States and results in increased healthcare costs and disability. Smoking is the main determinant of COPD development and continued use increases mortality as compared to those who have stopped smoking. Research has indicated that cigarette smoking may play a role in attempts to regulate distressing emotional experiences and thus, may be an important transdiagnostic process underlying continued smoking behavior among adults with COPD. The current study investigated the role of ER difficulties in relation to smoking status and cigarettes smoked per day among adults with COPD. This cross-sectional study included a sample was adults with COPD (N = 320). Participants self-reported current smoking status, daily smoking, and the Difficulties in Emotion Regulation Scale. All analyses were adjusted for age, sex, probable depression, probable anxiety, and dyspnea severity. DERS total scores were associated with greater odds of current smoking. With the exception of impulsivity, all other dimensions of emotion regulation were significantly associated with current smoking. Greater difficulties in emotional awareness were associated with greater cigarettes smoked per day. However, neither the DERS total score nor any other dimensions of emotional regulation were significantly associated with cigarettes smoked per day. The present study provides preliminary data linking ER difficulties to smoking behavior among adults with COPD. If corroborated by future research, these findings suggest that ER might be a potential target for smoking cessation programs among adults with COPD.