Clinical Practice and Epidemiology in Mental Health最新文献

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.

Introduction: Alzheimer's disease (AD) is a growing concern worldwide in healthcare. In Ecuador, the increasing life expectancy has raised the prevalence of age-related diseases, including dementias. The main objective of this study was to analyze the mortality from AD and other dementias in Ecuador from 2012 to 2022.

Methodology: A retrospective, descriptive time series analysis was conducted on adult subjects with AD and other dementias across various geographic regions of Ecuador during the 2012-2022 period. A sample of 855,122 individuals registered in the databases of the National Institute of Statistics and Censuses (INEC) was analyzed.

Results: Out of the total evaluated subjects, 4,836 deaths were due to AD (0.56%) and 1,317 deaths from other types of dementia (0.15%). For AD, the distribution of deaths by sex showed a predominant trend in women (n=3,008) within the group aged 65 years or older (n=4,749). For other dementias, women were also the main group (n=766), along with those aged 65 years and older (n=1,294). The national mortality rate showed an upward trend during this decade, increasing from 2.2 per 100,000 inhabitants in 2012 to 4.86 per 100,000 inhabitants in 2022.

Discussion: This study reveals a worrying increase in mortality from Alzheimer's disease (AD) and other dementias in Ecuador between 2012 and 2022, especially among women, adults over 65 years of age, and residents of the Sierra region. Several factors that could negatively influence cognitive function were observed. These findings are consistent with global trends and suggest that biological, environmental, and social variables, such as aging, postmenopausal hormonal changes, chronic exposure to hypoxic altitude conditions, and unequal access to health services, could play a key role in this disease.

Conclusion: Mortality from Alzheimer's disease and other dementias in Ecuador showed a sustained increase between 2012 and 2022, reflecting a growing burden of these pathologies in the population and the urgent need to strengthen prevention, early diagnosis, and comprehensive treatment strategies. The disproportionate impact on women, adults over 65 years of age, and residents of the Sierra region suggests the involvement of various biological, environmental, and social determinants of health, which requires more rigorous surveillance and a differentiated approach for these particularly vulnerable populations.

Background: Differing conceptualizations of recurrent and persistent depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) lead to diagnostic inconsistencies. This scoping review analyzed epidemiological studies on the lifetime prevalence of recurrent and persistent depression in the general population.

Methods: Following PRISMA-ScR guidelines, we searched MEDLINE and the Russian Science Citation Index without time or language restrictions. Inclusion criteria were original epidemiological studies of the general population reporting lifetime prevalence of recurrent or persistent depression, using DSM-III/IV/5 or ICD-9/10/11 criteria.

Results: Only three studies on recurrent depression were identified - from Switzerland, the USA, and Hungary - showing a consistent lifetime prevalence of 10.3% to 10.5%. In contrast, major depressive disorder had a lifetime prevalence of 1.5 to 2.5 times higher in these studies. Dysthymia and persistent depression showed lifetime prevalences ranging from 1.1% to 6.4% and 1.6% to 18%, respectively. Women represented about two-thirds of cases of both recurrent and persistent depression.

Conclusion: The underrepresentation of recurrent depression may stem from the DSM's dominant influence in psychiatric diagnostics. Our findings highlight the need for refined diagnostic criteria and more comprehensive epidemiological studies that separately identify recurrent and persistent depression.

Introduction: A competition is considered a stressful situation since it causes physiological and emotional changes in the responses of athletes and consequently influences their performance. The aim of our study was to investigate competitive anxiety and heart rate variability (HRV) in professional eSports athletes, comparing the responses before and after matches based on whether they won or lost. We hypothesized that victorious players would display more favorable autonomic and anxiety-related responses after the matches compared to those who were defeated.

Methods: We recruited fifty male esports players from 10 different Brazilian teams and carried out the experiment across two sessions. Initially, 24 hours before the game, players signed the informed consent form, and sample characterization, along with player familiarization with anxiety and HRV, was performed. Following this, the players recorded their anxiety levels and HRV at rest for 10 minutes, both 60 and 30 minutes prior to the game (baseline time points), as well as 10 minutes after the conclusion of the game.

Results: Regarding anxiety, our results demonstrated that the victory group (VG) exhibited significantly lower scores for both cognitive and somatic anxiety in the post-game time point, coupled with increased scores for self-confidence when compared to the baseline (BL) and pre-game time points. In opposition, the defeated group (DG) displayed significantly elevated scores for cognitive and somatic anxiety during the post-game time point, accompanied by decreased self-confidence scores compared to the baseline and pre-game time points. Regarding heart rate variability (HRV), the victory group (VG) demonstrated a significant increase in SDNN, rMSSD, and HF measures, coupled with a significant decrease in the LF/HF ratio. Conversely, the defeated group (DG) exhibited a significant decrease in SDNN and rMSSD, along with a significant increase in the LF/HF ratio.

Discussion: Our results revealed that VG exhibited better HRV responses, indicating greater parasympathetic activation. VG also showed lower levels of cognitive and somatic anxiety and higher levels of self-confidence in the post-game time. In contrast, DG demonstrated worse HRV responses, indicating greater sympathetic activation, along with higher levels of cognitive and somatic anxiety and lower levels of self-confidence in the same post-game period.

Conclusion: In summary, the VG exhibited superior HRV responses in conjunction with lower levels of anxiety compared to the DG.