Trends in Psychiatry and Psychotherapy最新文献

Objective: Risky drinking (RD) is associated with an increased risk of chronic and infectious diseases, injuries, and violence. This study aimed to assess changes in RD in Brazil after coronavirus disease 2019 (COVID-19) outbreak, both overall and among individuals with self-reported chronic diseases and mental health disorders.

Methods: We conducted three independent, anonymous web surveys in Brazil including adult participants: Survey 1 (S1) (April/2020, n = 19,257), S2 (August/2020, n = 1,590), and S3 (January/2021, n = 859). Participants were recruited through adapted snowball sampling and sponsored social network advertisements. RD was assessed using the Alcohol Use Disorder Identification Test-Concise (AUDIT-C), designed to identify individuals at risk of alcohol-related problems. Logistic regression analyses with bootstrapping (B = 2,000) were performed, with stratification by sex, age, education, employment, household size, and the presence of chronic and mental health conditions, as well as lifestyle factors, to address sample imbalances.

Results: The estimated prevalence of RD was 45.8% (95% confidence interval [95%CI] 45.5-46.1) in S1, 35.3% (95%CI 34.9-35.6) in S2, and 33.7% (95%CI 33.3-34.0) in S3. Participants with chronic diseases consistently presented lower RD prevalence across all three surveys, compared to those without such conditions. Conversely, individuals with mental health disorders presented higher RD prevalence than those without such diagnoses in S1 and S2, but not in S3.

Conclusion: Despite the decrease in RD prevalence, monitoring of alcohol consumption trends remains essential for shaping effective public health policies. Additionally, the observed variations among individuals reporting chronic and mental health disorders highlight the need for targeted interventions in future crises.

Objective: Human sleep is fundamental for the proper occurrence of organic functions. Hence, lack of sleep can impair cognitive function, resulting in emotional problems, memory changes, and disease onset. However, it is worth noting that sleep is influenced by outside factors, such as drug use. In this sense, the aim of this review is to analyze studies that researched the influence of recreational marijuana on the sleep quality of adults.

Methods: High-sensitivity searches were conducted on databases (Biblioteca Virtual em Saúde [BVS], MEDLINE via PubMed, Cochrane, Embase, Web of Science, and Scopus) using descriptors related to marijuana and sleep habits.

Results: Eighteen studies from four countries were included with a total sample size of 29,858 participants. It was found that marijuana affects sleep characteristics - such as latency and duration - with these changes being more evident in users who make greater use of marijuana and in those with early onset of marijuana use.

Conclusion: It was observed that most articles demonstrated a detrimental effect of recreational cannabis use on the quality of sleep in adults.

Objective: This study aimed to evaluate mental health factors in individuals affected by the floods in Rio Grande do Sul from May 10 to June 6, 2024.

Methods: A real-time survey was conducted with 1,552 participants. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Acute Stress Disorder (ASD) symptom checklist were used to assess mental health outcomes. Sociodemographic factors, trauma exposure, rescue participation, and psychological support were evaluated. Statistical analyses included t-tests, ANOVA, linear regression, and MANCOVA.

Results: High rates of depressive and anxious symptoms were found, with over half of the individuals with moderate to severe symptoms reporting no prior history of these conditions. Participants directly affected by the floods, and those with close ones affected, had higher PHQ-9, GAD-7, and ASD scores compared to the unaffected group. Moreover, younger age, female sex, lower family income, participation in rescues, and unmet psychological support needs were correlated with worse mental health outcomes. Individuals who participated in rescues had significantly higher rates of suicide ideation. Notably, psychological support had the largest effect size in mitigating mental health symptoms, regardless of trauma exposure status, when controlled for age, sex, and income, according to MANCOVA.

Conclusion: The findings highlight the critical role of psychological support in disaster response and the importance of community resilience. Real-time data collection during crises can inform targeted interventions, emphasizing the need for robust mental health services and community support networks. These efforts are essential to reduce long-term psychological morbidity and foster recovery in vulnerable populations.

Objective: Digital psychiatry holds promise for expanding accessibility to mental health treatment, but concerns exist regarding its inclusivity and the potential for exacerbation of digital exclusion among vulnerable populations. This study aims to evaluate the inclusivity of digital psychiatry research and interventions, and to explore their potential to worsen digital exclusion.

Methods: We conducted a cross-sectional analysis of sociodemographic data from two clinical trials that utilize psychiatric online treatment modalities in Brazil. Participants were recruited nationwide through digital media platforms.

Results: The sample comprised 224 individuals, predominantly female (95.1%) and Caucasian (71.87%) participants, with an average of 15.12 years of schooling. It was observed that White individuals were overrepresented compared to national averages (42.8%). Additionally, participants had a higher average number of years of schooling compared to the national average (10.1 years). Our analysis revealed a clear profile among psychiatric patients with access to and interest in digital interventions, predominantly younger, White, educated, and female individuals.

Discussion: As digital therapeutic solutions advance, ensuring their inclusivity and accessibility for vulnerable individuals is crucial. Initiatives to promote digital inclusion and reassess participant recruitment strategies are needed to effectively address digital exclusion. By adopting multifaceted approaches, digital mental health care can be made more effective and accessible to all.

Objective: The present study has the following objectives: 1) identify differentially expressed proteins and pathways in blood samples of bipolar disorder (BD) compared to healthy controls (HC) by employing high-throughput proteomics and bioinformatics; and 2) characterize disease-related molecular signatures through in-depth analysis of the differentially expressed proteins and pathways.

Methods: Blood samples from patients with BD (n = 10) classified into high (BD+) or poor functioning (BD-), based on functional and cognitive status, and HC (n = 5) were analyzed using mass spectrometry-based proteomic analysis. Bioinformatics was performed to detect biological processes, pathways, and diseases related to BD.

Results: Eight proteins exclusively characterized the molecular profile of patients with BD+ compared to HC, while 26 altered proteins were observed in the BD- group. These altered proteins were mainly enriched in biological processes related to lipid metabolism, complement system and coagulation cascade, and cardiovascular diseases; all these changes were more prominent in the BD- group.

Conclusion: These findings may represent systemic alterations that occur with the progression of the illness and a possible link between BD and medical comorbidities. Such comprehensive understanding provides valuable insights for targeted interventions, addressing mental and physical health aspects in subjects with BD. Despite these promising findings, further research is warranted, encompassing larger sample cohorts and incorporating biological validation through molecular biology methods.

Objective: There is growing concern about the occurrence of burnout syndrome in university students worldwide. This systematic review aimed to estimate the prevalence of burnout syndrome and its associated factors among health sciences students (HSS) in Spain.

Methods: Five databases (MEDLINE/PubMed, PsycINFO, EMBASE, Dialnet and MEDES) were searched up to January 5, 2023, adhering to PRISMA guidelines. Quantitative studies reporting the prevalence of burnout syndrome among HSS in Spanish universities were considered. The reference lists of the selected studies were hand searched. Data were extracted from peer-reviewed articles.

Results: Twenty-six studies were included with a total of 14,437 HSS. Most studies included nursing students (k = 11), followed by medicine students (k = 8), psychology students (k = 5), dental students (k = 2), physiotherapy students (k = 1) and pharmacy students (k = 1). Overall, study quality was fair. The most widely used instrument was the Maslach Burnout Inventory. The mean prevalence of burnout was 35.3% (k = 11 studies). However, rates varied widely between studies, which may be due to methodological differences. Inconsistent associations were found with gender and year of study. The relationship of burnout with academic and mental-health related variables was consistent across studies. Personal attributes, such as higher resilience, are likely protective against burnout.

Conclusion: Burnout appears to be prevalent among HSS in Spain, and may be affected by academic, mental health and personality factors. Identifying risk and protective factors for burnout could help to develop preventive and management strategies to ultimately reduce its negative consequences in this population.

Systematic review registration: PROSPERO (CRD42023387460).

Objective: Neutrophil-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelets-lymphocyte ratio (PLR) are biomarkers easy-to-obtain and could be used in clinical practice to verify an inflammatory status and are associated with alcohol use disorder (AUD) and cocaine use disorder (CUD). Our aim was to compare NLR, MLR, and PLR among men with AUD and CUD and to assess the relationship between these biomarkers and addiction-related outcomes.

Methods: This is a cross-sectional study comprising 979 inpatient men diagnosed with substance use disorder (391 with AUD and 588 with CUD) under hospital treatment for drug addiction.

Results: Individuals with AUD had higher NLR and MLR (p = 0.041, p < 0.001 respectively) compared to individuals with CUD. In the AUD group, positive correlations between age and MLR (r = 0.111; p = 0.029), NLR and liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST) (r = 0.103, p = 0.043; r = 0.155, p = 0.002; respectively), and MLR and ALT, AST and gamma-glutamyl transferase (GGT) levels were observed (r = 0.173, p = 0.001; r = 0.242, p < 0.001; r = 0.167, p = 0.001, respectively). Individuals with CUD showed a positive correlation between age and NLR (r = 0.113; p = 0.006). The presence of clinical comorbidities, human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis were not associated with NLR, MLR, and PLR (p > 0.05).

Conclusion: These biomarkers are a rapid and inexpensive way to assess the effects of substance use on the inflammatory profile. Our findings contribute with valuable insights into the distinctive inflammatory profiles associated with AUD and CUD. These insights could guide further research and the development of more studies, which could include control groups, in order to refine the clinical applicability of these biomarkers.

Objective: Children grow up spending most of their time within the family social environment, where they can experience stressful situations such as marital conflict, a non-cohesive environment, parental alcohol use disorder, parental depression, and other parental mental health issues. All these factors are associated with children's developmental delays. We aimed to conduct a scoping review on associations between family stress and family resilience and child development delays to examine familial conditions associated with child development.

Methods: We conducted a scoping review of observational studies published from January 2000 to July 2023 and indexed in the MEDLINE and LILACS databases. We included observational studies that assessed history of exposure to violence and behavioral or emotional symptoms or mental health problems among children aged 4-12. Data were independently extracted using a structured form.

Results: Database searches identified 12,990 unique records. A total of 43 articles were included in the review. Three main findings emerged: (1) parental mental health problems, especially depressive symptoms in mothers, were associated with child developmental delays and mental health problems; (2) better parenting practices and a cohesive home environment were positively associated with child development; and (3) vulnerable social environments (e.g., poverty and housing insecurity) may be linked to child mental health problems.

Conclusion: The studies reviewed show that promoting better family dynamics and increasing family cohesion, as well as improving parenting abilities, are beneficial to children's socioemotional development and prevention of child mental health problems. Moreover, increasing family and children's resilience improves the quality of life within family units.