Psychiatric Quarterly最新文献

Suicidal behaviour among young people is a serious public health concern. Each suicide attempt is related to further suicide attempts and completed suicide. This study aims to explore risk factors associated with repeated suicide attempt among adolescents and young adults. The cohort included 510 patients aged 12-29 years residing in Piedmont Region in North-Western Italy, who had been admitted to hospital or emergency department with a diagnosis of suicide attempt between 2010 and 2020. Cox regression models were used to evaluate potential risk factors for repeated suicide attempt. During the 11-years follow-up, 20.6% of adolescents and young adults repeated suicide attempt, 24.8% of females and 12.3% of males. Nearly 90% of youth who attempted suicide had a diagnosis of psychiatric disorder. After adjustment, younger age of onset of suicidal behaviour, and diagnosis of schizophrenia, bipolar disorder, depressive disorder, anorexia nervosa and personality disorder were significantly associated with repeated suicide attempt. The early identification of patients at higher risk of repetition of suicidal behaviour is of crucial importance. Better understanding of risk factors and effective treatment of mental disorders could help suicide prevention to reduce the burden of the problem among young people. Special attention should be paid during the initial months following discharge from hospital or emergency department, when suicide reattempt risk is very high.

With the ever-increasing prevalence of mental health issues worldwide, a robust synthesis of existing epidemiological data on the prevalence of Conduct disorder (CD) in children and adolescents is needed to strengthen the knowledge base. This quantitative umbrella review aims to provide a robust synthesis of evidence on the prevalence of CD children and adolescents from meta-analytic systematic reviews. We searched PubMed, Web of Science, PsychINFO, and Scopus to identify relevant articles. The study protocol has been registered with PROSPERO (CRD42023447620). The methodological quality of the studies was evaluated by using a Measurement Tool to Assess Systematic Reviews (AMSTAR). Invariance variance weighted random-effect meta-analysis was performed to pool prevalence estimates from the included articles. Seven meta-analyses, encompassing 138 primary studies and slightly over 48 million CD cases were included in this umbrella review. The quantitative analysis of these studies found a pooled prevalence of CD 3.0% (95%CI 2.0-5%) in children and adolescents, based on random effect meta-analyses. In a stratified analysis, the prevalence estimate of CD was 2.6 times higher in boys compared to girls. Evidence from our quantitative umbrella review showed that the prevalence of CD is relatively high in children and adolescents with boys 2.6 times more likely to experience the disorders when compared to girls. Our findings underlie that attention should be given to preventing, identifying, and treating CD in children and adolescents.

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

This study explored the economic, social, and spatial correlates of treatment prevalence, retention, and service utilization for substance use disorder (SUD) in South Sardinia. Data from 1,667 patients with an ICD-10 diagnosis of SUD were extracted from the medical records of individuals assisted by three public addiction services in 2019. We used a spatial autoregressive model, a parametric proportional hazard model, and Poisson regression to examine the associations of spatial factors and residents' socioeconomic status with the prevalence of treatment at the census block level, treatment retention, and SUD service utilization at the individual level. The prevalence was higher among residents of areas closer to competent treatment centers, with the worst building conservation status, a lower percentage of high school and university graduates, and a higher percentage of unemployed, divorced, separated, or widowed residents. Men who were older at the time of their first treatment access; primary users of cocaine, cannabis, and alcohol; had higher education level; and who lived far from competent treatment centers and closer to drug trafficking centers interrupted their treatment earlier. Primary heroin users experienced more SUD treatment encounters. Living in economically and socially disadvantaged areas and near treatment facilities was associated with a higher prevalence, whereas living near drug-dealing centers and far from competent treatment centers was associated with a decrease in treatment retention.

This study aimed to compare dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and mindfulness based stress reduction (MBSR) effects on irritable bowel syndrome (IBS) symptoms, quality of life (QOL), anxiety and depression among patients with IBS. Eighty three eligible patients with a Rome- IV diagnosis were randomly allocated in DBT, MBSR, ACT, and control groups (n = 22 per group). All the patients were evaluated for IBS symptoms by IBS Severity Scoring System (IBS-SSS), QOL by irritable bowel syndrome quality of life (IBS-QOL), anxiety by Beck's Anxiety Inventory (BAI) and depression by Beck Depression Inventory- II (BDI-II) on the studied groups at the time of their inclusion in the study and 8 weeks after it. Each of the intervention groups took part in 8 group sessions. Conversely, the control group were evaluated without any intervention. 54 male and 29 female in 4 groups completed the study: DBT (n = 20), MBSR (n = 19), ACT (n = 22), and control groups (n = 22). The results showed significant differences between the groups based on the variables of the IBS-SSS, IBS-QOL, BAI and BDI-II (p < 0.05). Furthermore, the ACT intervention had considerably lower levels of IBS symptoms, anxiety, and depression compared to the other groups; also, the significant impacts of the QOL variable showed the higher scores of the ACT compared to the treatment groups. The therapies could not be applied to other groups of people. Other shortcomings were the absence of a follow-up strategy. This research offers preliminary evidence that ACT is more successful than other therapy groups in reducing IBS symptoms, anxiety and sadness, and improving QOL in IBS patients.

The objective was to determine if adding low-frequency right-sided rTMS treatment to the standard high-frequency left-sided treatment (LUL), referred to as sequential bilateral treatment (SBT), confers additional benefit for depression or anxiety outcomes. A retrospective chart review from January 2015 through December 2018 yielded 275 patients, all of whom were treated with a figure-8 coil for a major depressive episode. Their protocol was either LUL or SBL. Outcome measures were the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9). There was no significant difference in GAD-7 change scores between patients who had LUL or SBL (4.2 vs 4.8). This was also true when the sample was restricted to only patients who started with high GAD-7 scores. There was likewise no significant difference in PHQ-9 change scores between patients who had LUL or SBL (6.8 vs 5.1). Patients switching from LUL to SBL mid-course had poorer overall outcomes as compared to patients who stayed with the same protocol throughout treatment. This large naturalistic study shows no advantage for SBL treatment any group or condition examined. The results of this study have clinical applicability and sound a cautionary note regarding the use of combination rTMS protocols.

A growing number of studies have examined alcohol use during the COVID-19 pandemic. However, few longitudinal studies evaluated the prevalence and correlates of different trajectories of problematic alcohol use in vulnerable segments of the population, such as US veterans, over the 3-year course of the COVID-19 pandemic. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 2,441 US veterans. Latent growth mixture modeling was used to identify the trajectories and correlates of problematic alcohol use. Four trajectories were identified: consistent (N = 170, weighted 7.2%), decreasing (N = 38, weighted 2.2%), increasing (N = 22, weighted 1.2%), and low (N = 2,211, weighted 89.4%) problematic alcohol use. Greater household income, pre-pandemic drug use disorder (DUD), lower social support, and COVID-19 infection to self or non-household members were associated with an increasing relative to decreasing problematic alcohol use trajectory. Greater household income, adverse childhood experiences (ACEs), pre-pandemic DUD, lower social support, and greater COVID-related social restriction stress were associated with an increasing relative to a low problematic alcohol use trajectory. Younger age, male sex, ACEs, pre-pandemic DUD, lower pre-pandemic and greater decline in protective psychosocial characteristics, COVID-19 infection to non-household member, and lower COVID-related financial stress were associated with a consistent relative to a low problematic alcohol use trajectory. Overall, pre-pandemic greater income, DUD, and lower social support were associated with an increase in problematic alcohol use among US veterans during the COVID-19 pandemic. Results may help inform prevention efforts to mitigate problematic alcohol use during prolonged crises in this population.

Cognitive models of addictive behaviours have highlighted the central role of Desire Thinking (DT) - a conscious and voluntary cognitive process orienting to prefigure images and information about a positive target-related experience - in increasing craving and maintaining addictive behaviors. The metacognitive model of DT and craving posits that metacognition plays a central role in understanding dysregulation in DT. The current study aims to test the role of metacognitions about DT, DT, and craving in the relationship between Fear of Missing Out (FoMo), boredom proneness, negative emotional reactivity and Problematic Social Network Sites Use (PSNSU). A sample of 529 participants (M_age= 32.45 ± 13.33; F = 62.9%) completed an online survey. The hypothesised model produced an adequate fit to the data and accounted for 86% of PSNSU variance. FoMO predicted positive metacognitions about DT (PMDT), which predicted DT that, in association with craving, predicted PSNSU. Boredom proneness positively predicted PSNSU directly and indirectly through the serial mediation of PMDT, DT, and craving. A direct path between negative emotional reactivity and PSNSU was found. The current findings provide preliminary evidence for applying the metacognitive model of DT and craving in PSNSU. PMDT and DT may be central cognitive processes in craving and PSNSU for individuals who experience boredom proneness and FoMo.

Despite increasing recognition that positive psychological changes or posttraumatic growth (PTG) may develop after highly stressful or traumatic events, contemporary population-based data on the epidemiology of PTG in high-risk samples such as U.S. military veterans are lacking. Additionally, in light of emerging evidence suggesting an 8-factor model of posttraumatic stress disorder (PTSD) symptoms, an up-to-date characterization of how these symptom clusters relate to PTG can help inform efforts to help promote PTG. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 3,847 trauma-exposed U.S. veterans. Participants completed assessments of potentially traumatic events, PTSD symptoms, and PTG, as well as a broad range of sociodemographic, military, trauma, health, personality, and psychosocial characteristics. Results revealed that 63.2% of trauma-exposed veterans and 86.4% of veterans who screened positive for PTSD endorsed moderate-or-greater PTG; these prevalences are higher than those reported in an independent U.S. veteran sample in 2011 (50.1% and 72.0%, respectively). An inverted U-shaped association was observed between PTSD symptom severity and PTG levels, with scores of 31 to 51 on the PTSD Checklist for DSM-5 associated with the highest likelihood of PTG. Intrinsic religiosity and internally- and externally-generated intrusive symptoms of PTSD were identified as the strongest correlates of PTG. Results suggest that prevention and treatment efforts to mitigate severe PTSD symptoms, and help promote intrinsic religiosity, and more deliberate and organized rumination about traumatic experiences may help foster PTG in veterans.

Eating disorders frequently accompany autism spectrum disorder (ASD). One such novel eating disorder is avoidant/restrictive food intake disorder (ARFID). This study compares the eating attitudes, quality of life, and sensory processing of typically developing children (TDC), autistic children, and autistic children with ARFID. A total of 111 children aged 4–10 with a diagnosis of ASD and ARFID (n = 37), ASD without ARFID (n = 37), and typical development (n = 37) were recruited. After an interview in which Childhood Autism Rating Scale (CARS) was administered, Child Eating Behavior Questionnaire (CEBQ), Pediatric Quality of Life Inventory (PedsQL), Social Responsiveness Scale (SRS) and Sensory Profile (SP) were completed by caregivers. Autistic children with ARFID had higher scores in CEBQ subscales relating to low appetite and lower scores on the subscales associated with weight gain. Both groups of autistic children scored lower than TDC on all PedsQL subscales and autistic children with ARFID had lower social QL scores than both groups. SRS scores were highest in autistic children with ARFID, followed by autistic and typically developing children. CARS scores were similar in both groups of autistic children, but higher than TDC. Auditory, vision, touch, multi-sensory, oral processing scores; as well as all quadrant scores, were significantly lower in autistic children with ARFID. Oral sensory processing scores were found to be the most significant predictor of ARFID comorbidity in ASD and reliably predicted ARFID in autistic children in the clinical setting. Autistic children with ARFID demonstrate differences in social functioning, sensory processing, eating attitudes, and quality of life compared to autistic and TD children.