Clinical Practice and Epidemiology in Mental Health最新文献

Introduction: This review aims to explore the psychological, psychiatric, and neurocognitive dimensions of Crohn's disease. We examine the bidirectional interactions between the gut and brain, analyze the most widely used psychological assessment tools, and discuss current intervention models.

Methods: A comprehensive narrative review was conducted, integrating the literature research findings of , psychosomatic medicine, neuropsychology, psychoneuroimmunology, and gut-brain axis. Attention was given to validated psychometric tools and emerging therapeutic approaches.

Results: The evidence reveals a consistent link between CD and emotional disturbances, cognitive deficits, and altered gut-brain communication. Common neuropsychological impairments include deficits in attention, memory, and executive functioning. Anxiety, depression, and alexithymia are prevalent in CD patients and are associated with worse disease outcomes. Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based interventions have demonstrated efficacy in enhancing both psychological well-being and disease management.

Discussion: Findings confirm the link between Crohn's disease, emotional disturbances, and cognitive deficits, highlighting the need to distinguish between primary impairments of inflammatory/neurobiological origin and those secondary to psychological distress or low illness insight. Key gaps remain regarding how these mechanisms interact over time and the long-term effects of psychological interventions. Integrating psychological assessment and support into clinical care is crucial for enhancing adherence, resilience, and overall quality of life.

Conclusion: Understanding CD through a biopsychosocial lens highlights the necessity of integrating psychological assessment and intervention into standard IBD care. Early identification and tailored treatment of emotional and cognitive disturbances can significantly improve patients' quality of life and overall clinical outcomes.

Introduction: Exercise intensity preference-the tendency to favor a specific effort level during self-paced activity-may influence adherence and affective responses to exercise. However, the relationship between depressive symptoms and exercise intensity preference remains unclear, particularly among physically active adults. This study investigated the association between depressive symptoms and exercise intensity preference in physically active adults.

Methods: A cross-sectional analysis was conducted using baseline data from the ELDAF study, which included non-faculty civil servants from a public university in Brazil. Depressive symptoms and exercise intensity preference were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Preference for and Tolerance of the Intensity of Exercise Questionnaire (PRETIE-Q), respectively.

Results: A total of 1,160 individuals participated in the study, with 639 (55%) classified as active or very active. Among them, 6.6% exhibited depressive symptoms. No overall association was found between depressive symptoms and exercise intensity preference in either crude (p = 0.19) or adjusted (p = 0.40) models. Regarding sex distribution, 275 females (43%) and 364 males (57%) were included. Stratified analysis by sex revealed no association in females (crude: p = 0.77; adjusted: p = 0.60), but a significant association was observed in males (crude: p = 0.026; adjusted: p = 0.024).

Discussion: Males may favor higher-intensity exercise as a form of behavioral activation or to elicit stronger physiological responses that help regulate mood.

Conclusion: Males with depressive symptoms were more likely to prefer high-intensity exercise compared to those without, whereas no such association was identified among females.

Introduction: Psychological distress is common among medical students worldwide. However, psychological stigma remains a significant barrier to seeking help. This study explores the association between psychological distress, stigma, and attitudes toward help-seeking among medical students in the unique cultural context of Saudi Arabia.

Methods: A cross-sectional study was conducted using an online survey distributed to medical students across Saudi Arabia, yielding 1,077 completed responses. Sociodemographic data were collected, along with responses to the Kessler Psychological Distress Scale (K6), the Stigma Scale for Receiving Psychological Help (SSRPH-A), and the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPH-SF-A). Data were analyzed using descriptive statistics, Spearman's correlation, and factor analysis.

Results: Overall, 32.2% of students reported low distress, 34.5% moderate distress, and 33.4% high distress. Female students exhibited higher distress but greater openness to seeking help, while males reported higher stigma. Lower GPA and income were associated with increased distress and reduced help-seeking attitudes. Regional variations were observed, with Najran reporting the highest distress, and Madinah and Qassim showing higher openness to help-seeking.

Discussion: Findings are consistent with the international studies, indicating that stigma significantly hinders service utilization despite need. Cultural norms, socioeconomic status, and educational systems further shape attitudes. Digital healthcare transformation in Saudi Arabia offers opportunities to reduce stigma and expand access.

Conclusion: Psychological distress and stigma remain prevalent among Saudi medical students, influenced by gender, socioeconomic, and regional factors. Targeted, culturally informed interventions are essential to reduce psychological stigma, promote awareness, and encourage positive help-seeking behaviors within academic environments.

Introduction: This study aimed to identify and analyze research on burnout in dentists, measured both prior to and during the COVID-19 pandemic, using the Maslach Burnout Inventory (MBI).

Methods: A systematic literature review was conducted across five databases using the search terms "Dentists" and "Burnout, Psychological." Articles published between 1981 and December 2024 that utilized the MBI were included. Studies were classified based on the time of data collection: either prior to or during the COVID-19 pandemic (defined as January 30, 2020, to May 5, 2023).

Results: We selected 15 of the 1,486 articles identified. Eleven of these reported means and standard deviations for the burnout scales. Among them, eight calculated scale means and standard deviations according to the guidelines recommended in the MBI manual; six studies were conducted prior to the pandemic, and two during it. An initial analysis suggests that mean levels of Emotional Exhaustion and Depersonalization increased during the pandemic, while mean levels of Personal Accomplishment remained comparable to pre-pandemic levels. However, five studies used different cutoff points to define low, moderate, or high burnout levels for each scale, limiting comparability across studies.

Discussion: Few articles have adequately utilized the MBI to assess burnout in dental surgeons either before or during the COVID-19 pandemic.

Conclusion: Theoretical arguments suggest that the COVID-19 pandemic may have adversely affected burnout levels in dentists. However, the studies we analyzed offer only limited evidence supporting an increase in the burnout dimensions of Emotional Exhaustion and Depersonalization during the pandemic.

The impact of Violent Video Games (VVGs) on childhood development remains a subject of debate. While virtual reality has shown promise in enhancing social cognition through mirror neuron activation, concerns persist regarding the potential for video games to foster learned aggression, particularly in the absence of empathic or punitive feedback. Evidence regarding short-term desensitization effects is mixed, and long-term studies are scarce. Importantly, most existing research focuses on individuals exposed to video games after the age of eight, overlooking critical developmental periods marked by heightened neural plasticity. Early childhood exposure to violent content may be influenced by insecure attachment patterns, and this interaction may have consequences in socio-emotional learning. Factors, such as hyperactivity and parental absence, may further correlate with these effects. Despite these concerns, the presence of engaged caregivers has been shown to mitigate potential harm. There is an urgent need for longitudinal research and policies that promote responsible, adult-mediated video game use in early childhood.

Introduction: Suicide attempts, recognized as a significant public health concern, have been categorized among antisocial behaviors. This study aims to examine the epidemiology of suicide and its associated individual, familial, and social factors in Bam City, Iran.

Methods: A historical cohort study was conducted on all recorded cases (N=3276) of suicide attempts registered in the hospital reporting system and healthcare center at Bam University of Medical Sciences from 2016 to 2022. Data were systematically extracted using a standardized checklist. Suicide attempt rates and mortality rates were calculated and presented in this study. Temporal trends in suicide mortality and attempts were analyzed using joinpoint regression.

Results: The findings indicate that men reported a significantly higher suicide completion rate compared to women, with hanging being identified as the most lethal method. While overall suicide rates declined by 1.3% during the study period, a concerning 14.2% increase was observed from 2020 to 2022. Suicide rates among individuals under 35 showed a slighty increasing trend, whereas those aged 35 and older experienced a decline. Additionally, poisoning emerged as the most prevalent method across both genders.

Discussion: The study underscores age-specific differences in suicide risk, highlighting the need for targeted prevention strategies. While the death rates increased among younger individuals during the pandemic, they declined for older adults, suggesting variations in vulnerability and coping mechanisms.

Conclusion: Suicide prevention should be tailored to different age groups, incorporating mental health support for youth facing economic and social pressures, as well as resources for older adults. Strengthening community programs, economic assistance, and access to mental health services remain essential in reducing suicide rates across diverse demographics.

Introduction: eHealth literacy is influenced by Internet access and is associated with health status. The aim of this study was to develop and validate an instrument called eHealth-Much to measure eHealth literacy in users of healthcare services.

Methods: An instrumental research design was used. Content validity was assessed by expert judgment and quantified using Aiken's V coefficient. A polychoric correlation matrix was used for the items. Sample adequacy was assessed through the Kaiser-Meyer-Olkin (KMO) index and Bartlett's test of sphericity before conducting exploratory factor analysis (EFA). The EFA was conducted using the Weighted Least Squares (WLS) extraction method with Oblimin rotation. Reliability was assessed using Cronbach's Alpha (α) and McDonald's Omega (ω) coefficients.

Results: Twelve experts from five different countries participated in the content validation process, obtaining a V coefficient of 0.93 (95% CI: 0.79-0.97). A total of 1,068 health service users of both sexes participated in the construct validity testing. The median age was 32 years (IQR: 13, Q1: 26, Q3: 39; Min: 17, Max: 78). The KMO index was 0.92 (Bartlett's test, p < 0.001). The EFA suggested four factors labeled "Digital Literacy" (WLS1), "Digital Self-Management" (WLS4), "Digital Skill" (WLS3), and "Scientific Empowerment" (WLS2), which together explained 59.3% of the total variance. The reliability coefficients obtained were 0.86 for Cronbach's alpha and 0.90 for McDonald's omega. Percentile ranks and normative scores were also established for the sample.

Discussion: The factorial structure obtained theoretically supports the multidimensionality of the construct, aligning with previous models of digital health literacy.

Conclusion: The scale demonstrates adequate levels of validity and reliability. It may be considered a viable option for use in both primary care settings and hospital environments. Further studies are recommended to expand the psychometric analysis.

Introduction: Impostor Phenomenon (IP) is a common condition experienced by medical students and professionals who face high academic pressures and competitive environments, and is thought to be associated with other psychological conditions, such as anxiety, depression, and low self-esteem. Factors, such as gender and academic year, are also suspected to influence the development of IP experienced by individuals. This study aimed to analyze factors associated with IP among students at the Faculty of Medicine, Universitas Sumatera Utara.

Methods: This analytical study employed a cross-sectional design. Variables assessed included gender, academic year, depression, anxiety, and self-esteem. Several questionnaires were used for data collection, such as CIPS, PHQ-9, GAD-7, and RSES questionnaires. Data analysis utilized Chi-square tests to investigate the relationship between each independent variable and Poisson regression tests to evaluate the correlation between all independent variables using the Statistical Package for the Social Sciences (SPSS Inc.).

Results: A total of 347 students participated, revealing that 58.8% of medical students experienced IP, with a greater prevalence among females and the highest prevalence among second-year students. Data analysis revealed a significant association between IP and symptoms of depression (PR = 1.530; 95% CI = 1.229-1.904; P < 0.001), anxiety (PR = 1.317; 95% CI = 1.095-1.583, P = 0.003), and low self-esteem (PR = 1.237; 95% CI = 1.066-1.449; P = 0.008).

Discussion: This study reinforces that psychological factors, including depression, anxiety, and low self-esteem, are strongly associated with the impostor phenomenon (IP) among medical students, while gender and academic year are not. The findings highlight the need for early mental health support to help students manage self-doubt and academic stress.

Conclusion: The study highlights a high prevalence of IP among medical students, with a significant relationship between IP, depression, anxiety, and self-esteem.

Introduction: We aimed to assess the point prevalence and associated factors of Benzodiazepine (BZD) use in patients attending a Community Mental Health Team (CMHT) in Scotland.

Methods: This cross-sectional survey included 412 patients from the outpatient medical caseload over a three-month period in 2021. Patient records were reviewed to identify whether they were prescribed BZDs. The analysis aimed to determine the point prevalence rate of BZD use and compare characteristics between patients on and not on BZDs.

Results: The point prevalence rate was 16%. There were no significant sex differences (p=0.10) between patients on and not on BZDs. However, statistically significant differences were observed in relation to age (p=0.003), primary diagnosis (p=0.03), and the number of psychotropic medications (p= <0.001). Only the number of psychotropic medications varied significantly between long and short-term BZD use (p=0.005). Those on long-term BZD use of one year or longer had a higher number of psychotropic medications.

Discussion: Monitoring and comparing the prevalence rates of BZD prescription by CMHTs is essential for reducing adverse effects associated with BZDs. Such concerns can influence clinical practice and may sometimes lead to conflicts between secondary and primary care clinicians. This study involved only one CMHT in Scotland and, therefore, may not be fully representative of all CMHTs across the country.

Conclusion: A high number of psychotropic medications emerged as the only statistically significant factor associated with long-term BZD use. Consequently, diligent monitoring of BZD use is warranted in patients on a high number of psychotropic medications.