Clinical Practice and Epidemiology in Mental Health最新文献

Aims: The present paper focused on compare the PID-5 mean score levels across two matched community and clinical samples of Portugal and the UAE.

Background: The generalizability and universality of the Alternative Model of Personality Disorders has been thoroughly studied through the Personality Inventory for DSM-5 (PID-5) across countries and languages. However, studies comparing Western and Middle Eastern countries are still limited, in particular those who assess the PID-5 measurement invariance.

Objectives: We examined measurement invariance of the PID-5 scales across matched Emirati and Portuguese clinical and nonclinical groups, as well as compare and contrast the PID-5 mean score levels across both countries and samples.

Methods: The Arabic and the Portuguese versions of the PID-5 was administered to Emirati community participants (N = 300, 80% women and 20% men, M_age = 27.95) which were matched with Portuguese community participants (N = 300, 80.3% women and 19.7% men, M_age = 28.96), as well as clinical participants of the UAE (N = 150, 61.3% women and 38.7% men, M_age = 31.29) and Portugal (N = 150, 52% men and 48% women, M_age = 44.97). We examined measurement invariance through an unrestricted Factor Analysis based program, and mean scores levels were compared and analyzed.

Results: Our findings supported the PID-5 measurement invariance across the Emirati and Portuguese clinical samples pointing to the universality and generalizability of the Alternative Model of Personality Disorders. The Emirati psychiatric sample exhibited somehow higher results than the Portuguese psychiatric participants, albeit the small effect size for most of the PID-5 scales.

Conclusion: Further research is needed to examine the applicability of the PID-5 across non-clinical representative samples of Portugal and the UAE, and other Middle Eastern countries.

Previous research has recently shown that high cognitive and somatic anxiety and low self-confidence, before and during sport competitions have a significant correlation with heart rate variability (HRV) changes and can reduce overall athletic performance. Therefore, interventions, such as transcranial direct current stimulation (tDCS), can be a potential tool to reduce psychophysiological anxiety-related and enhance athletic performance. We present a case of a male professional athlete of eSports. We explored the effects of a single session of anodal tDCS (a-tDCS) at 2mA over the dosrsolateral prefrontal cortex (DLPFC) on competitive anxiety and HRV assessed in baseline (BL), pre-tDCS, post-tDCS and post-game moments and compared between moments. Here, we found a decrease in somatic and cognitive anxiety, as well as an increase in self-confidence and in SDNN index in the post-tDCS moment compared with BL, pre-tDCS and post-game moments. These findings can be a result of an acute change in the attentional state, influencing the processing of threatening information essential for cognitive anxiety and of a self-regulatory process, which can regulate physiological arousal response, such as HRV.

Background: A mental crisis is a dangerous state with many subsequent harmful effects on the adolescent. It is a state in which the adolescent needs help and must get that help immediately. If they do not receive the assistance they require, they may end up isolating themselves from social interaction and become completely preoccupied with themselves. The counseling program is therefore being put into effect to strengthen the mental crisis management capacity of adolescents and to offer counseling and assistance to students who find themselves beset with a mental crisis so that they will be fully able to manage their mental crises, restore a sense of balance to their psyches, and carry on with their lives effectively.

Objective: The aim of the study was to compare the life crisis awareness scores of adolescent students enrolled in a program of study at Thammasat University.

Methods: This research was quasi-experimental and consisted of a two-group pretest-post test design. They were subdivided into two groups of 30 students each by simple random sampling, of which one group was the experimental group and the other was control group. The experimental group underwent a counseling program of bolstering mental crisis management capacity once a week for a period of six weeks. Results were assessed using a crisis awareness evaluation form. Results were assessed twice, before testing and after testing. The data were analyzed by the statistics of percentage, mean, dependent t-test, and independent t-test.

Results: 1. The average life crisis awareness scores of the adolescents in the experimental group following acceptance into the counseling program by fortifying their mental crisis management capacity (M=132.77, SD=11.03) were higher than they were prior to program entry (M=113.73, SD=14.40), with a statistical significance (t=6.81, p<0.001).2. The average life crisis awareness scores of the experimental group that had been accepted into the above-mentioned counseling program were higher after undergoing testing (M=132.77, SD=11.03) than the scores for the control group (M=118.83, SD=10.73), with a statistical significance (t=4.95, p<0.001).

Conclusion: This program thus helps the adolescent restore a sense of mental balance and live a normal happy life.

Introduction: Social support is a leading contributing factor for older adults' well-being. The present study aimed to compare the impact of two-way (providing and receiving) social support on the well-being of Iranian older adults.

Methods: The present cross-sectional study was conducted on 1280 community-dwelling older adults in Tehran, Iran, 2020. The researcher used the clustered sampling method and the 2-way Social Support Scale (SSS) to collect samples and measure social support, respectively. The well-being was measured by the self-reported World Health Organization-Five Well-Being Index (WHO-5). Bivariate and hierarchical linear regression analyses were performed to compare the effects of social support aspects on well-being. Data were analyzed using SPSS 20.0. A significance level of p≤0.05 was considered statistically significant.

Results: The mean age of the respondents was 70.90 (SD=8.07), and about 70% of the sample was married. The mean scores of taking and providing social support were 20.70 ±7.52 and 17.71 ±7.82, respectively. The hierarchical regression analysis revealed that providing social support is significantly associated with the well-being of older adults beyond and over receiving social support and possible contributing factors (∆F=30.25; ∆R2= 0.39, p<0.05).

Conclusion: The results showed that providing social support is more important than receiving it. Older adults should participate in social activities to provide social support.

Introduction: Cognitive deficits are considered a fundamental component of bipolar disorder due to the fact that they negatively impact personal/social functioning. Cognitive remediation interventions are effective in the treatment of various psychosocial disorders, including bipolar disorder. The use of Virtual reality as a rehabilitation tool has produced scientific evidence in recent years, especially in cardiovascular, neurological, and musculoskeletal rehabilitation. This study aims at evaluating the feasibility of a Cognitive Remediation Virtual Reality Program (CEREBRUM) for people with bipolar disorder in psychiatric rehabilitation.

Material and methods: Feasibility randomized controlled cross-over clinical study; we randomized 50 people from the Consultation and Psychosomatic Psychiatry Center of the University Hospital of Cagliari (San Giovanni di Dio Civil Hospital) with a diagnosis of bipolar disorder. We propose a cognitive remediation program in virtual reality (CEREBRUM), 3 months with 2 weekly sessions, for the experimental group and a usual care program for the control group (psychiatric visit and/or psychotherapy).

Results: The results of the trial will be published in international peer-reviewed journals and will be disseminated at international meetings and congress.

Discussion: This RCT aims, with regards to its feasibility and design, to provide information about a confirmatory trial that evaluates the effectiveness of a Virtual Reality Cognitive Remediation program in psychiatric rehabilitation for the treatment of cognitive dysfunction in people with bipolar disorder.

Conclusion: The results that we analyzed at the end of the RCT will have an impact on psychiatric rehabilitation research with a focus on improving the application of technologies for mental health.Trial registration: ClinicalTrialsgov NCT05070065, registered on September 2021.

Background: This study aimed to verify, through a randomized controlled trial, whether a medium-intensity mixing/aerobic/anaerobic exercise (accessible to older adults even with mild chronic diseases) can effectively counteract depressive episodes. A characteristic of the trial was that the follow-up coincided (unscheduled) with the lockdown due to Covid-19.

Methods: Participants (N=120) were randomized into an intervention group, performing physical exercise, and a control group. Participants, aged 65 years and older, belonged to both genders, living at home, and cleared a medical examination, were evaluated with a screening tool to detect depressive episodes, the PHQ9, at pre-treatment, end of the trial (12-week), and follow-up (48-week).

Results: A decrease in the frequency of depressive episodes after the trial (T1) was found in both groups; however, a statistically significant difference was observed only in the control group (p=0.0039). From T1 to follow-up (conducted during the lockdown), the frequency of depressive episodes increased in the control group, reaching a frequency equal to the time of study entry (p=0.788). In the experimental group, the frequency of depressive episodes did not change at the end of the trial but reached a statistically significant difference compared to the start of the study (p = 0.004) and was higher than the control group (p=0.028).

Conclusion: Moderate-intensity physical exercise can be conducted safely, benefitting older adults even suffering from mild chronic disorders. Physical exercise seems to guarantee a long-term preventive effect towards depressive symptoms, especially in serious stressful situations such as the lockdown due to the Covid-19 pandemic.

Clinical trial registration number nct03858114:

Background: Cocaine/crack use affects immune system molecules and development of mental disorders has been identified.

Objective: To investigate the relationship of polymorphisms in the TNFA (-308G/A), IL-10 (-819C/T) and ENOS (-786T/C) genes with mental disorders in cocaine and crack users.

Methods: A case-control study was carried out, which included 107 cocaine and crack users and 115 controls who never used healthy cocaine and crack. The SNPs in the TNFA (-308G/A), IL-10 (-819C/T) and ENOS (-786T/C) genes were genotyped by real time PCR.

Results: As for the individuals included in this study, the average age of 31.4 years (± 8.59). We identified that the G/A genotype to TNFA (-308) (OR = 0.24; p = 0.03) and the A allele (OR = 0.30; p = 0.03) were associated with reduced risk for dysthymic disorder. The T allele of the IL-10 (-819) polymorphism was associated with decreased risk of developing panic disorder (OR = 0.44; p = 0.01), while the C allele was correlated with an increased risk for alcohol dependence (OR = 1.97; p = 0.04), alcohol abuse (OR = 1.81; p = 0.04) and psychotic syndrome (OR = 2.23; p = 0.01). C/C genotype was correlated with increased chances of developing current psychotic syndrome (OR = 4.23; p = 0.01).

Conclusion: Our results suggest that genetic polymorphisms promote susceptibility or promote protection for clinical phenotypes of psychiatric comorbidities in cocaine and crack users and be considered as good prognostic markers.

Background: There is an inverse association between cardiorespiratory fitness and general anxiety levels in adolescents. Obesity also is associated with a higher risk of anxiety in this population. However, little is known about the association between other health-related fitness elements with anxiety symptoms in this population. The authors explored the relationship between health-related fitness and anxiety symptoms in a large sample of Brazilian youth.

Methods: This was an observational cross-sectional study with a sample comprised of 257 school adolescents, who were 136 girls (52.9%) and 121 boys (47.1%). The health-related fitness elements were evaluated by FitnessGram® test and anxiety levels by Multidimensional Anxiety Scale for Children - 39. Hierarchical regression analyses were used to determine the association between health-related fitness elements and anxiety symptoms in both sexes.

Results: In male adolescents, only the cardiorespiratory fitness was significantly associated with anxiety symptoms (F_{(1, 119)} = 6.472; P = 0.012; R² = 0.052; adjusted R² = 0.044). In turn, the anxiety symptoms showed an inverse small relationship with cardiorespiratory fitness (r = - 0.227; P < 0.01). However, in female adolescents, no association was found between health-related fitness elements and anxiety symptoms.

Conclusion: The level of cardiorespiratory fitness may represent a marker of anxiety in male adolescents.

Background: Social distancing as a preventive measure to contain the spread of the COVID-19 pandemic has resulted in many people working from home, using online digital resources. Staying at home has led to the adaptation of many work activities to allow continuity of people´s jobs. It can also affect home routines and ways of working, thereby leading to changes in behavior, as the main interest of this study.

Objective: The study aimed to assess the impact on human behavior of working conditions in home office format due to social distancing.

Methods: Data collection was done online, using a specific computational tool (Google Forms) for this type of research, using the Home Office Work Scale (HOWS) validated and published in Mental Health and Addiction Research in 2021, with a total sample of 1,056 valid questionnaires. After the data collection, a database was created for statistical analysis of the results.

Results: More women than men volunteered to answer the questionnaire, although the results were similar between women and men. Home office work has impacts on human behavior and results in changes in routines and adaptations in people´s personal and professional lives.

Conclusion: Proportionally, more women participated, and there was low participation by young and elderly people. In general, people accepted home office work and the possibility of continuing to work in this format. Changes to routines and restrictive adaptations were necessary. The limitations reported for applying the scale did not compromise the results.

Background: Behavioral health integration allows for patient-centered care, leads to higher levels of provider-patient engagement, and is key to improving patient outcomes. However, behavioral health integration is administratively burdensome and therefore is often not adopted. Technology presents opportunities to increase care team efficiency and improve patient outcomes. The goal of this study was to retrospectively compare clinical outcomes and emergency department utilization in patients using a technology platform compared to patients receiving treatment as usual.

Methods: The technology platform, NeuroFlow, was deployed to deliver technology-enabled behavioral health integration in 30 clinics, and 598 electronic health records were analyzed.

Results: In the six-month period following technology-enabled behavioral health integration implementation, emergency department utilization decreased by 34% in the treatment group (n=259), while increasing by 58% in the treatment as usual group (n=339). Additionally, statistically significant (p < .01) decreases in PHQ-9 (-17.3%) and GAD-7 (-12.4%) scores were only observed in the treatment group.

Conclusion: Findings from this study support use of a technology-enabled behavioral health tool to decrease emergency department use and highlight the importance of measurement-based care. Future research will be key to enhancing behavioral health technology and integration to further improve patient outcomes and reduce emergency department utilization.