Psychiatric Quarterly最新文献

Patients with acute psychosis are often confronted with the prejudice that they refuse all treatment due to lack of insight. This study examined and compared the aims and preferences for treatment of patients with acute psychosis and of psychiatric inpatient staff. A total of 142 inpatients being treated for a psychotic disorder on either a locked or an open ward indicated which of a range of symptoms they want to be treated and which of various biopsychosocial treatment options they would like to receive. Staff members from the same wards reported which psychiatric symptoms they deemed relevant in the treatment of psychosis and which treatment options should be offered. Patients assigned the highest treatment need to neurocognitive symptoms, followed by affective and positive symptoms. In contrast, staff assigned the highest treatment need to positive symptoms, followed by neurocognitive and affective symptoms. Patients and staff on open wards expressed more treatment needs overall than did patients and staff on locked wards. Patients' desire for treatment differed across treatment types. In comparing patients on locked versus open wards, patients on open wards expressed higher approval of medication than patients on locked wards. Even patients with highly acute psychosis being treated on locked psychiatric wards endorsed treatment. Treatment preferences of this group deviated markedly in some instances from staffs' preferences. Considering their specific needs may contribute to increasing patient self-efficacy, and improving adherence to treatment.

Natural disasters such as earthquakes leave deep psychological effects on individuals that can lead to posttraumatic stress disorder, and understanding these effects is vital to support psychological recovery processes after trauma. In this context, the aim of this study was to examine the mediating role of emotion regulation difficulties, religious coping, positive reappraisal and seeking social support in the relationship between posttraumatic cognitive attributions and posttraumatic stress disorder in 2023 Kahramanmaraş Pazarcık, Elbistan and Hatay Yayladağı earthquake survivors (N = 408). The findings from the multiple mediation analysis showed the indirect effect of posttraumatic cognitive attribution on PTSD through difficulties in emotion regulation, religious coping, positive reappraisal, and seeking social support. Therefore, difficulties in emotion regulation may be a risk factor for PTSD, while religious coping, positive reappraisal and seeking social support may be protective factors. Strategies to reduce difficulties in emotion regulation and to improve religious coping, positive reappraisal and social support seeking in earthquake survivors may be necessary to reduce PTSD that may be caused by the earthquake.

This study aimed to examine the psychometric properties of the Arabic version of a short version of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST-PQ-S) among a sample of 700 patients with anxiety disorders (53.1% were female). Participants completed the RST-PQ-S, NEO-FFI, Positive Mental Health (PMH), and Kessler Psychological Distress scale. Both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were employed to test the construct validity of the scale. This study also utilized a network perspective, incorporating Exploratory Graph Analysis (EGA) and centrality measures. As a result of the EFA and CFA, it was determined that the scale consists of 22 items and six subdimensions. These subdimensions were named as follows: "Flight Fight-Freeze System", "Behavioral Inhibition System", "Reward Interest", "Reward Reactivity", "Goal-Drive Persistence", and "Impulsivity". Additionally, the network analysis's findings confirmed the six-factor structure derived from the construct validity assessment. The results of this study demonstrated that the Arabic version of the personality scale is a valid and reliable tool for assessing personality in Arabic-speaking individuals with anxiety disorders. It has the potential to serve as an important diagnostic instrument in clinical and research settings. These findings may assist psychologists and clinicians in Arabic-speaking countries to better understand how the personality traits and anxiety disorders are related.

Mental disorders are a global health issue affecting millions of individuals. People with mental disorders often face barriers to treatment, including stigma and discrimination, social, religious, and familial barriers, and a lack of knowledge about available treatment options. These barriers can lead to delayed or untreated mental illnesses, with serious consequences for the individuals, their families, and communities. This cross-sectional study explores the treatment barriers for different mental disorders as they significantly impact people's lives. It includes patients diagnosed with mental disorders. The data were collected from the patients or their companions attending Qassim Mental Health Hospital's outpatient clinic. We used a self-administered online questionnaire, sociodemographic variables, and the barrier to access to care evaluation (BACE) scale. Our sample included 332 adult patients with mental disorders (men, 63.9%; women, 36.1%). The mean percentage scores for stigma-, attitude-, and instrument-related barriers were 26.7%, 33.0%, and 18.7%, respectively. Younger age was associated with higher scores in all three BACE domains. Patients with psychotic disorders faced stigma- and attitude-related barriers, but not instrument-related barriers. Patients with multiple mental conditions faced increased stigma- and instrument-related barriers but not attitude-related barriers. Further longitudinal studies are required to better understand these barriers to help patients with mental conditions.

This study reports the prevalence of inpatient, emergency department (ED), and outpatient mental health service usage of children/youth before, during, and after onset of the COVID-19 pandemic in Rhode Island. Additionally, we identify significant changes in usage across these time periods and the prevalence of each service type contingent upon various demographic profiles. This retrospective observational analysis used Rhode Island Medicaid claims to identify the unique children and youth who used inpatient, ED, and outpatient mental health services across three key time periods: pre-onset (March 2019-February 2020); onset (March 2020-February 2021); and post-onset (March 2021-February 2022). We used z-tests to analyze changes in the proportion of children/youth who accessed these services in each period. We examined relationships between demographic characteristics and time period with chi-square tests. Significant decreases in inpatient and ED usage were identified from pre-onset to onset (p < .05). While inpatient nearly returned to pre-pandemic usage in post-onset, ED usage remained lower. Outpatient usage increased significantly leading up to the pandemic but remained at similar levels between pre-onset and post-onset. From pre-onset to post-onset, females grew as a percentage of all inpatient, ED, and outpatient users. Over this same period, the proportion of inpatient users aged 12-18 increased and the proportion of ED and outpatient users aged 19-24 increased. Female usage of mental health services increased significantly, and older children/youth seemed to drive any significant increases. Future public health and disaster preparedness policies should focus on the unique mental health needs of these socially vulnerable groups.

The current paper aimed to estimate the network structure of general psychopathology (internalizing and externalizing symptoms/disorders) among 239 gifted children in Jordan. This cross-sectional study with a convenience sampling method was conducted between September 2023 and October 2024 among gifted children aged 7-12. The Child Behavior Checklist (CBCL) was employed to assess six symptom clusters: conduct problems, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant problems as externalizing symptoms, and affective problems, anxiety issues, and somatic complaints as internalizing symptoms. We used the network analysis perspective by graphical least absolute shrinkage and selection operator (gLASSO) and the Extended Bayesian Information Criterion (EBIC). These methods were used to determine network structure and important nodes in the estimated network. "Sleeps less" (centrality strength = 2.04, edge weight = 0.33) was the central symptom in the affective cluster. In contrast, "worries" (centrality strength = 1.89, edge weight = 0.28) and "headaches" (centrality strength = 2.35, edge weight = 0.41) were pivotal in the anxiety and somatic clusters, respectively. The findings suggested that these symptoms had critical roles in the context of the general psychopathology among gifted children. Accordingly, the mentioned symptoms should be assessed and targeted among gifted children. Future studies could evaluate the results of targeting these symptoms on gifted children's well-being and daily functions.

Coercive measures are commonly used in mental health settings despite their negative effects. The subjective experience of coercion varies widely, and its short- and long-term health impacts are not well understood. This study aimed to analyze the association between different types of coercive measures experienced during psychiatric hospitalization, the subjective experience of coercion, and both short- and long-term health outcomes. The study included 111 patients from two mental health units who experienced coercive measures (mechanical restraint, involuntary medication, or both). Perceived coercion was assessed during hospitalization. Short-term outcomes (post-traumatic stress and treatment satisfaction) were evaluated before discharge, while long-term outcomes (functionality improvement, risk of readmission, and suicidal behavior) were assessed at five-year follow-up. Perceived coercion was associated with higher post-traumatic stress (p < 0.001) and lower satisfaction with treatment (p < 0.001) in the short term. In the long term, perceived coercion showed no association with functionality, readmission risk, or suicidal behavior. However, combined coercive measures were linked to lower functionality improvement (p = 0.028) and higher readmission risk (p = 0.028) compared to involuntary medication alone. The findings suggest that efforts to reduce negative subjective experiences associated with coercive measures may improve patient satisfaction and reduce trauma risk during hospitalization. Combined coercive measures may be a risk factor for poorer long-term outcomes and should be carefully considered.

Introduction: Fibromyalgia is a chronic condition often accompanied by cognitive impairments, such as difficulties with sustained attention, and emotional disturbances, particularly depression and anxiety. Understanding how these emotional and cognitive factors interact is crucial to improving treatment for fibromyalgia patients. This study aimed to investigate the network structure of these interactions, focusing on the relationship between depression, anxiety, and cognitive performance.

Method: A total of one hundred ten participants diagnosed with fibromyalgia completed self-reported assessments of depression and anxiety, alongside cognitive performance tests. Key measures included Continuous Performance Tasks (CPT) for impulsivity and sustained attention, the Stroop Interference Index (StI), Stroop Color Naming (StC), and Stroop Word Reading (StW). Network analysis was conducted to estimate the relationships between emotional and cognitive variables and assess their centrality within the network.

Results: Errors in CPT emerged as the most significant indicators of the relationship between depression and cognitive performance, with high centrality values observed for the Stroop tasks (StI, StC, and StW). Additionally, Trait Anxiety (A_T) and Beck Depression Inventory (BDI) measures showed high centrality, underscoring the critical role of emotional states in the network of cognitive and emotional variables. The centrality values for cognitive flexibility, processing speed, and inhibitory control were found to be 0.85, 0.78, and 0.72, respectively.

Conclusion: This study highlights the strong association between depression symptoms and deficits in cognitive domains, emphasizing the need for integrated care approaches that address both cognitive and emotional health. Multidisciplinary treatment programs, including cognitive rehabilitation and psychological support, could improve patient outcomes by targeting the most influential variables in the cognitive-emotional network.

This study aimed to evaluate the role of neuroinflammation in neuronal and glial cells in the pathophysiology of Major Depressive Disorder (MDD) through different biomarkers.S100-B and VILIP-1 levels of patients diagnosed with MDD were evaluated before and after antidepressant treatment. A total of 65 patients diagnosed with MDD and 69 healthy controls were included. Serum levels of S100B and VILIP-1 were measured at the time of diagnosis and after eight weeks antidepressant treatment and compared with healthy controls. Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impression Scale (CGI) were applied to assess the severity of depression. In our study, although serum S100B levels were higher in patients before treatment compared to healthy controls, this difference was not statistically significant. Regarding VILIP-1 levels, there was no statistically significant difference between patients and healthy controls. A positive and statistically significant correlation was found between S100B and VILIP-1 levels in MDD group before the treatment. At the eighth week of treatment, a statistically significant positive correlation was also found between S100B and VILIP-1 levels. Our research is the first study to evaluate MDD through two separate biomarkers specific to glial and neuronal cells.The fact that S100B and VILIP-1 levels showed significant correlations in patients diagnosed with MDD both before and after treatment suggests that they may play a shared role in the pathophysiology of the disorder. The correlation between S100B and VILIP-1 may serve as a guide in understanding the pathophysiology of the disorder and in identifying new drug development targets.