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The ability of peripheral neurophysiological biomarkers to predict future psychological conditions among geriatric populations 外周神经生理生物标志物预测老年群体未来心理状况的能力
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-16 DOI: 10.1016/j.jpsychores.2024.111936

Objective

Though the association between peripheral neurophysiological biomarkers and psychological conditions is widely discussed, there is still limited evidence about the ability of peripheral biomarkers to predict psychological outcomes, especially among geriatric populations.

Methods

The study is designed as a prospective cohort study. We collected information from participants aged over 55 years. The participants were evaluated at the start of the study (T0) and 6–9 months later (T1). Information about demographic profiles, peripheral neurophysiological biomarker recordings (including heart rate variability, finger temperature, skin conductance, and electromyogram), and psychological measurements (including Brief Symptom Rating Scale-5, Chinese Happiness Inventory, and Short Portable Mental Status Questionnaire) were collected at T0. At T1, participants reported self-rated questionnaires for psychological outcomes (Patient Health Questionnaire-15, health anxiety questionnaire, Beck Depression Inventory-II, and Beck Anxiety Inventory) and were evaluated with Mini-Mental State Examination by the staff. The association between the peripheral biomarkers and psychological outcomes was evaluated via multiple regression models.

Results

A total of 385 participants were included in the study and the average age was 74.49 ± 7.34 years. Both stepwise multiple linear and logistic models showed a significant association between decreased skin conductance and increased/presence of depression at T1. The receiver operating characteristic (ROC) curve analysis of skin conductance for depression was fair (area under curve = 0.812).

Conclusions

The ability of skin conductance to predict depression among geriatric populations may facilitate the detection of geriatric depression and future research on the pathophysiology.

尽管外周神经电生理生物标志物与心理状况之间的关联已被广泛讨论,但有关外周生物标志物预测心理结果的能力的证据仍然有限,尤其是在老年人群中。我们收集了 55 岁以上参与者的信息。在研究开始时(T0)和 6-9 个月后(T1)对参与者进行评估。在 T0 阶段,我们收集了有关人口统计学特征、外周神经电生理生物标记物记录(包括心率变异性、指温、皮肤电导和肌电图)和心理测量(包括简易症状评定量表-5、中国幸福感量表和便携式精神状态简易问卷)的信息。在 T1,参与者报告心理结果自评量表(患者健康问卷-15、健康焦虑问卷、贝克抑郁量表-II 和贝克焦虑量表),并由工作人员进行迷你精神状态检查评估。研究通过多元回归模型评估了外周生物标志物与心理结果之间的关联。逐步多元线性模型和逻辑模型均显示,皮肤电导率下降与 T1 抑郁症增加/存在之间存在显著关联。结论 皮肤电导预测老年抑郁症的能力有助于老年抑郁症的检测和未来的病理生理学研究。
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引用次数: 0
Poor stress resilience in adolescence predicts higher risk of severe COVID-19 and other respiratory infections: A prospective cohort study of 1.4 million Swedish men 青春期抗压能力差预示着罹患严重 COVID-19 和其他呼吸道感染的风险较高:对 140 万瑞典男性的前瞻性队列研究
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-14 DOI: 10.1016/j.jpsychores.2024.111935

Objectives

To investigate the associations between stress resilience in late adolescence and later risk of severe COVID-19 and other lower respiratory infections. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection.

Methods

We conducted a registry-based cohort study of 1.4 million Swedish men, undergoing military conscription between 1968 and 2005. All were assessed by a psychologist for stress resilience, receiving a score between 1 and 9. The outcomes were hospitalization or death due to COVID-19 from March 2020 to September 2021 and hospitalization due to bacterial or viral pneumonia from conscription until January 2020. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection.

Results

Poor stress resilience in late adolescence is associated with later risk of severe lower respiratory infections. Using a high resilience score as the reference, the hazard ratio (95 % CI) for death due to COVID-19 for the lowest scores was 1.49 (1.01–2.18) adjusted for CRF and other confounders. The corresponding adjusted hazard ratios for hospitalization due to bacterial pneumonia were 2.28 (2.03–2.57) and for viral pneumonia 1.92 (1.33–2.79). No significant interaction was seen between stress resilience and CRF in the analysis.

Conclusions

Poor stress resilience is a prospective factor for severe COVID-19 as well as for bacterial and viral respiratory pneumonia endpoints, independent of CRF. These findings imply an effect of late adolescent stress resilience on the immune system later in life.

目的研究青春期后期的抗压能力与日后罹患严重 COVID-19 和其他下呼吸道感染风险之间的关系。方法我们对 140 万瑞典男性进行了一项基于登记的队列研究,这些男性在 1968 年至 2005 年期间应征入伍。所有人都接受了心理学家的抗压能力评估,得分在 1 到 9 分之间。研究结果为2020年3月至2021年9月期间因COVID-19导致的住院或死亡,以及应征入伍至2020年1月期间因细菌性或病毒性肺炎导致的住院。次要目的是研究低心肺功能(CRF)与压力恢复能力之间在呼吸道感染方面的潜在混杂因素。以抗压能力得分高者为参照,经 CRF 和其他混杂因素调整后,得分最低者因 COVID-19 死亡的危险比(95 % CI)为 1.49(1.01-2.18)。相应的调整后细菌性肺炎住院危险比为 2.28(2.03-2.57),病毒性肺炎为 1.92(1.33-2.79)。结论抗压能力差是导致严重 COVID-19 以及细菌性和病毒性呼吸道肺炎终点的前瞻性因素,与 CRF 无关。这些研究结果表明,青少年晚期的抗压能力会对日后的免疫系统产生影响。
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引用次数: 0
The bowel function instrument for rectal cancer survivors with anastomosis and ostomy 吻合术和造口术直肠癌幸存者肠道功能检测仪
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-14 DOI: 10.1016/j.jpsychores.2024.111931

Objective

Rectal cancer is often treated with surgery such as ostomy or anastomosis. The Bowel Function Instrument (BFI) is a valid and reliable 18-item measure of physical bowel symptoms. Some items on the BFI do not apply to those with ostomies. We reanalyzed data from a previous validation study to inform the best method for scoring the BFI for both people with ostomies and anastomosis.

Methods

People (n = 575) with rectal cancer treated with ostomy (n = 181, 31 %) or anastomosis (n = 394, 69 %) completed the BFI and Short Form 12 (SF12) measure on a mailed survey. The full BFI has three subscales and a total score based on 14 items: soilage/urgency (4 items); frequency of bowel movements (6 items); and dietary changes (4 items). We used confirmatory factor analysis (CFA) to examine two versions (8-item, 11-item) of the BFI adapted for use with both ostomy and anastomosis. We also examined reliability and validity of the version supported by the CFA.

Results

CFA results supported the 8-item BFI that included only the soilage/urgency items and dietary changes items but not the frequency items. The 8-item BFI was reliable (Cronbach's alpha of 0.788). The 8-item BFI score significantly correlated with all SF12 subscales with Pearson correlations ranging from 0.115 (Vitality) to 0.318 (social function).

Conclusions

The 8-item version of the BFI was valid and reliable as a total score for people with ostomy or anastomosis. The 8-item BFI may be useful for monitoring bowel function during and after treatment for rectal cancer.
目的:直肠癌通常采用手术治疗,如造口术或吻合术。肠道功能量表(Bowel Function Instrument,BFI)是一种有效可靠的 18 项肠道症状量表。BFI 的某些项目不适用于造口患者。我们重新分析了之前一项验证研究的数据,以确定为造口术和吻合术患者进行 BFI 评分的最佳方法。方法接受造口术(181 人,31%)或吻合术(394 人,69%)治疗的直肠癌患者(575 人)通过邮寄调查完成 BFI 和简表 12 (SF12) 测量。完整的 BFI 有三个分量表和基于 14 个项目的总分:排便不畅/急迫(4 个项目);排便频率(6 个项目);饮食改变(4 个项目)。我们使用确证因子分析 (CFA) 对 BFI 的两个版本(8 个条目和 11 个条目)进行了检查,这两个版本同时适用于造口术和吻合术。我们还检查了 CFA 支持的版本的信度和效度。结果CFA 结果支持 8 个项目的 BFI,该 BFI 仅包括土壤/紧急程度项目和饮食变化项目,但不包括频率项目。8 个项目的 BFI 是可靠的(Cronbach's alpha 为 0.788)。8个项目的BFI得分与SF12的所有分量表都有明显的相关性,Pearson相关性从0.115(活力)到0.318(社会功能)不等。8 项 BFI 可能有助于在直肠癌治疗期间和治疗后监测肠道功能。
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引用次数: 0
Adverse childhood experiences and psychiatric comorbidity in multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis in the Canadian longitudinal study on aging 加拿大老龄问题纵向研究中多发性硬化症、炎症性肠病和类风湿性关节炎患者的童年不良经历和精神病合并症
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-13 DOI: 10.1016/j.jpsychores.2024.111893

Objectives

Adverse childhood experiences (ACE) are associated with immune-mediated inflammatory diseases (IMID). We evaluated whether: (i) ACE associate with psychiatric comorbidity among individuals with IMID, including rheumatoid arthritis (RA), multiple sclerosis (MS), and inflammatory bowel disease (IBD); (ii) whether psychiatric disorders mediate the relationship between ACE and IMID; and (iii) whether these findings differ from those in individuals with other chronic physical disorders.

Methods

Using data from the Canadian Longitudinal Study on Aging (CLSA) we performed a retrospective case-control study of participants aged 45–85 years recruited between 2010 and 2015. ACE were queried using questions derived from the Childhood Experiences of Violence Questionnaire-Short Form and the National Longitudinal Study of Adolescent to Adult Health Wave III questionnaire. We used multivariable logistic regression and causal mediation analysis to address our objectives.

Results

We included 13,977 CLSA participants. Among the 31 % of IMID participants who reported a comorbid psychiatric disorder, 79 % reported a history of ACE. ACE associated with increased odds (OR [95 % CI]) of a psychiatric disorder (2.55 [1.02–6.35]) among participants with IMID; this did not differ across IMID. The total effect (OR [95 % CI]) of ACE on IMID was 1.11 (1.07–1.16), of which 10.60 % (8.04–17.47) was mediated by psychiatric disorders. We found similar associations among participants with other chronic physical disorders.

Conclusion

Our findings suggest that psychiatric disorders partially mediate the association between ACE and IMID. Most participants with IMID and comorbid psychiatric disorders report a history of ACE and may benefit from trauma-informed mental health care.

目的 儿童时期的不良经历(ACE)与免疫介导的炎症性疾病(IMID)有关。我们评估了:(i) ACE 是否与 IMID(包括类风湿性关节炎 (RA)、多发性硬化症 (MS) 和炎症性肠病 (IBD))患者的精神疾病合并症有关;(ii) 精神疾病是否介导 ACE 与 IMID 之间的关系;(iii) 这些研究结果是否与其他慢性身体疾病患者的研究结果不同。方法利用加拿大老龄化纵向研究(CLSA)的数据,我们对 2010 年至 2015 年间招募的 45-85 岁参与者进行了一项回顾性病例对照研究。我们使用源自童年暴力经历问卷-简表和全国青少年到成人健康纵向研究第三波问卷的问题对ACE进行了询问。我们使用多变量逻辑回归和因果中介分析来实现我们的目标。在31%报告合并有精神障碍的IMID参与者中,79%报告有ACE病史。在 IMID 参与者中,ACE 与精神障碍的几率(OR [95 % CI])增加有关(2.55 [1.02-6.35] );这在不同 IMID 中并无差异。ACE对IMID的总效应(OR [95 % CI])为1.11(1.07-1.16),其中10.60 %(8.04-17.47)由精神障碍介导。结论我们的研究结果表明,精神疾病在一定程度上介导了 ACE 与 IMID 之间的关系。大多数患有 IMID 且合并有精神障碍的参与者都报告了 ACE 病史,他们可能会受益于以创伤为基础的心理健康护理。
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引用次数: 0
Connecting the dots: Network structures of internalizing and functional symptoms in a population-based cohort 连接点:基于人群的队列中内化症状和功能性症状的网络结构
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-13 DOI: 10.1016/j.jpsychores.2024.111932

Objective

Comorbidities between internalizing disorders (IDs) and functional disorders (FDs) are well-documented, indicating shared pathways. However, their symptom-level relationships have been largely unexplored. This exploratory study employs a network approach to investigate symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS) to identify bridge symptoms explaining comorbidity between the two domains.

Methods

We used cross-sectional data on 72,919 adult subjects from the Lifelines Cohort Study, a Dutch general population sample. A total of 38 symptoms representing diagnostic criteria of IDs and FDs were assessed with validated questionnaires. Network models were estimated using eLasso, based on the Ising model, to identify bridge symptoms. The Network Comparison Test (NCT) was used to test whether there were differences in network structure and strength across sex and age.

Results

Symptoms were moderately connected, with a network density of 52.7%. ID and FD symptoms clustered in their respective domains, but were connected through the bridge symptoms, fatigue, difficulty concentrating, trouble sleeping, and unrefreshing sleep. Fatigue and difficulty concentrating had the most connections, associated with 86.6% and 78.9% of the other symptoms, respectively. NCTs indicated no differences in network connectivity between females versus males or younger versus older adults (>50 years).

Conclusions

ID and FD symptoms are moderately interconnected. Bridge symptoms displaying strong connections to multiple disorders may play a central role in the mechanisms underpinning the comorbidity between IDs and FDs.

目标内化障碍(IDs)和功能性障碍(FDs)之间的共病性已得到充分证实,这表明它们之间存在共同的发病途径。然而,它们在症状层面上的关系在很大程度上尚未被研究。这项探索性研究采用网络方法调查了重性抑郁症(MDD)、广泛性焦虑症(GAD)、肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)、纤维肌痛(FM)和肠易激综合征(IBS)的症状,以确定解释这两个领域之间共病性的桥梁症状。我们使用有效问卷对代表 ID 和 FD 诊断标准的 38 种症状进行了评估。使用基于 Ising 模型的 eLasso 估算了网络模型,以确定桥接症状。网络比较测试(NCT)用于检验不同性别和年龄的网络结构和强度是否存在差异。ID和FD症状聚集在各自的领域中,但通过疲劳、注意力难以集中、睡眠困难和睡眠不清爽等桥接症状连接在一起。疲劳和难以集中注意力的关联度最高,分别与 86.6% 和 78.9% 的其他症状相关联。NCT表明,女性与男性、年轻人与老年人(50岁)之间的网络连接没有差异。与多种疾病有密切联系的桥接症状可能在 ID 和 FD 的合并症机制中发挥核心作用。
{"title":"Connecting the dots: Network structures of internalizing and functional symptoms in a population-based cohort","authors":"","doi":"10.1016/j.jpsychores.2024.111932","DOIUrl":"10.1016/j.jpsychores.2024.111932","url":null,"abstract":"<div><h3>Objective</h3><p>Comorbidities between internalizing disorders (IDs) and functional disorders (FDs) are well-documented, indicating shared pathways. However, their symptom-level relationships have been largely unexplored. This exploratory study employs a network approach to investigate symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS) to identify bridge symptoms explaining comorbidity between the two domains.</p></div><div><h3>Methods</h3><p>We used cross-sectional data on 72,919 adult subjects from the Lifelines Cohort Study, a Dutch general population sample. A total of 38 symptoms representing diagnostic criteria of IDs and FDs were assessed with validated questionnaires. Network models were estimated using eLasso, based on the Ising model, to identify bridge symptoms. The Network Comparison Test (NCT) was used to test whether there were differences in network structure and strength across sex and age.</p></div><div><h3>Results</h3><p>Symptoms were moderately connected, with a network density of 52.7%. ID and FD symptoms clustered in their respective domains, but were connected through the bridge symptoms, fatigue, difficulty concentrating, trouble sleeping, and unrefreshing sleep. Fatigue and difficulty concentrating had the most connections, associated with 86.6% and 78.9% of the other symptoms, respectively. NCTs indicated no differences in network connectivity between females versus males or younger versus older adults (&gt;50 years).</p></div><div><h3>Conclusions</h3><p>ID and FD symptoms are moderately interconnected. Bridge symptoms displaying strong connections to multiple disorders may play a central role in the mechanisms underpinning the comorbidity between IDs and FDs.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924003441/pdfft?md5=eec1874c88390a039d4d3ffb8d888913&pid=1-s2.0-S0022399924003441-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond physical healing: The essential role of integrated care in trauma recovery 超越身体康复:综合护理在创伤康复中的重要作用
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-12 DOI: 10.1016/j.jpsychores.2024.111934
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引用次数: 0
Randomised controlled pilot trial of the EndoSMS supportive text message intervention for individuals with endometriosis: Feasibility and acceptability results 针对子宫内膜异位症患者的 EndoSMS 支持性短信干预随机对照试验:可行性和可接受性结果
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-12 DOI: 10.1016/j.jpsychores.2024.111929

Objective

Diminished quality of life, inadequate support and social isolation are commonly experienced by individuals living with the chronic pain condition, endometriosis. We aimed to determine the feasibility and acceptability of EndoSMS, a psychologically-focused text message intervention designed to support individuals living with endometriosis.

Methods

As part of a two-arm parallel pilot randomised controlled trial with waitlist control, the feasibility and acceptability of a brief (3-month) version of EndoSMS was assessed using a mixed methods approach. Feasibility data (uptake, attrition, text message delivery analytics) and user acceptability (via self-report survey items and written feedback) were assessed. Qualitative data were thematically analysed using the template approach. Primary trial outcomes are not reported in this paper.

Results

Feasibility was indicated by: high conversion rate (99.1 %), low attrition (14.2 %), few opt-outs (0.02 %) and a high message delivery rate (99.8 %). Most intervention participants indicated user acceptability (mean = 4.02/5) across self-report questions. Most rated the length of the program (65.5 %), and the number (80.9 %) and language (94.5 %) of the text messages to be ‘just right’. Thematic analysis created four themes: A shared “battle”: Feeling less isolated and alone; “Be kind to yourself”: A focus on self-care, self-compassion and active coping; Keeping endometriosis at the forefront: Helpful or stressful?; Mixed perceptions surrounding the provision of general endometriosis information; and, Tailoring of text messages.

Conclusion

EndoSMS supportive text message program was feasible and acceptable for individuals with endometriosis. Future developments of the program should consider greater tailoring of content to user needs.

Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12621001642875).

目的 患有慢性疼痛--子宫内膜异位症的患者通常会经历生活质量下降、支持不足和社会隔离等问题。我们旨在确定EndoSMS的可行性和可接受性,这是一种以心理为重点的短信干预措施,旨在为子宫内膜异位症患者提供支持。方法作为双臂平行试验随机对照试验的一部分,我们采用混合方法评估了简短版(3个月)EndoSMS的可行性和可接受性。对可行性数据(接受率、流失率、短信发送分析)和用户接受度(通过自我报告调查项目和书面反馈)进行了评估。采用模板法对定性数据进行了专题分析。本文未报告主要试验结果。结果可行性表现在:转换率高(99.1%)、流失率低(14.2%)、退出率低(0.02%)和短信发送率高(99.8%)。大多数干预参与者在自我报告问题中表示用户可接受(平均 = 4.02/5)。大多数人认为计划的长度(65.5%)、短信的数量(80.9%)和语言(94.5%)"恰到好处"。专题分析产生了四个主题:共同的 "战斗":感觉不再孤立和孤单;"善待自己":结论EndoSMS 支持性短信项目对于子宫内膜异位症患者来说是可行的,也是可以接受的。该项目在未来的发展中应考虑根据用户需求进一步调整内容:试验注册:澳大利亚-新西兰临床试验注册中心(ACTRN12621001642875)。
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引用次数: 0
Validation of the German Purpose in Life Questionnaire (PLQ) in a healthy population and patients with cardiovascular disease 在健康人群和心血管疾病患者中验证德国生活目的问卷 (PLQ)
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-12 DOI: 10.1016/j.jpsychores.2024.111928

In this cross-sectional study, a German translation of the subscale “Purpose in Life” (PLQ) from the Scales of Psychological Well-being (SPWB) was validated in a representative sample of participants from healthy and cardiovascular populations. The main objectives were to assess the reliability, convergent, and discriminant validity using a large and representative sample (N = 466 healthy sample, N = 247 patients with an implanted cardioverter-defibrillator (ICD), N = 70 patients with a cardiovascular disease (CVD)).

The findings indicated that the German PLQ is a reliable and valid measure of positive psychological well-being, showing a positive correlation with health-related quality of life, optimism, and positive affect. In turn, the PLQ score was significantly and negatively correlated with depressive symptom severity, anxiety, pessimism, and negative affect, while being distinct from these constructs. The comparability of the measurement properties of the German PLQ with the original English version further supports the validity of the translation. Additionally, the unidimensional structure of the German version mirrored that of the English PLQ.

As this study used a large and representative sample, it provides the most up-to-date normative population value for the subscale of the SPWB. Moreover, this study represents the first known exploration of the questionnaire in a cardiovascular sample, revealing relationships between health-related quality of life, optimism, positive affect, and the German PLQ. However, in patients with ICD, the positive correlation between the PLQ and the physical component of the SF-12 did not reach significance. Despite these valuable findings, future research to enhance the understanding of the PLQ and its implications is warranted.

在这项横断面研究中,对心理健康量表(SPWB)中 "生活目的"(PLQ)分量表的德语译本进行了验证,验证对象为健康人群和心血管疾病人群中的代表性样本。主要目的是通过大量代表性样本(466 名健康样本、247 名植入式心律转复除颤器(ICD)患者、70 名心血管疾病(CVD)患者)来评估该量表的可靠性、收敛性和区分性。研究结果表明,德文版 PLQ 是一种可靠有效的积极心理健康测量方法,与健康相关的生活质量、乐观情绪和积极情绪呈正相关。反过来,PLQ 分数与抑郁症状严重程度、焦虑、悲观和消极情绪呈显著负相关,同时又有别于这些结构。德文 PLQ 的测量属性与英文原版具有可比性,这进一步证明了翻译的有效性。此外,德文版 PLQ 的单维度结构与英文版 PLQ 的单维度结构如出一辙。由于本研究使用了大量具有代表性的样本,因此为 SPWB 的子量表提供了最新的人群常模值。此外,这项研究也是首次在心血管样本中对该问卷进行探讨,揭示了健康相关生活质量、乐观情绪、积极情绪和德文 PLQ 之间的关系。然而,在 ICD 患者中,PLQ 与 SF-12 的身体部分之间的正相关性并不显著。尽管这些研究结果很有价值,但未来的研究仍有必要加深对 PLQ 及其影响的理解。
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引用次数: 0
Acceptance and commitment therapy for people with depressive and anxiety symptoms following acquired brain injury: Results of the BrainACT randomized controlled trial 后天性脑损伤后抑郁和焦虑症状患者的接纳与承诺疗法:BrainACT随机对照试验的结果
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-12 DOI: 10.1016/j.jpsychores.2024.111933

Objective

This study aimed to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people who experience anxiety and/or depressive symptoms following acquired brain injury.

Methods

The study is a multicentre randomized controlled two-arm parallel trial. In total, 72 people who survived a stroke or traumatic brain injury were randomized into an eight-session ACT or control (i.e. psycho-education and relaxation) intervention. The primary outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Depression Anxiety and Stress Scale (DASS). Secondary outcomes were ACT process measures, participation, and quality of life. Outcome assessments were performed by trained assessors, blinded to treatment condition, pre-treatment, during treatment, post-treatment, and at 7 and 12 months follow-up.

Results

There were no differences between groups on any outcome measure. Participants in both groups significantly improved on all outcome measures, except for participation frequency. More clinically relevant long-term improvements (i.e. recovered or reliable changes on the HADS) were found in favour of ACT for depressive and anxiety symptoms.

Conclusion

The study was negative on the primary outcome measures. On an individual level, this study showed that especially on the long term ACT seems to show a more clinically relevant decrease in anxiety and depressive symptoms compared to an active control intervention. However, ACT was not superior in improving ACT-related processes such as psychological flexibility, cognitive defusion, and valued living nor in increasing participation or quality of life. Further large-scale group studies are warranted.

Trial registration

The study was originally registered in the Dutch Trial Register (now Clinical Trial Registry Platform), NL-OMON50203. Registered on 18/07/2018 and now to be found under https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON50203.

目的本研究旨在调查经调整的 ACT 干预(BrainACT)对后天性脑损伤后出现焦虑和/或抑郁症状的患者的有效性。方法本研究是一项多中心随机对照双臂平行试验。共有 72 名中风或脑外伤幸存者被随机分配到为期八节的 ACT 或对照组(即心理教育和放松)干预中。主要结果指标为医院焦虑抑郁量表(HADS)和抑郁焦虑压力量表(DASS)。次要结果为 ACT 过程测量、参与度和生活质量。在治疗前、治疗期间、治疗后以及 7 个月和 12 个月的随访中,由训练有素的评估人员进行结果评估,评估人员对治疗条件保密。除参与频率外,两组参与者在所有结果指标上都有明显改善。在抑郁症状和焦虑症状方面,临床相关的长期改善(即 HADS 的恢复或可靠变化)更倾向于 ACT。就个体而言,这项研究表明,与积极的对照干预相比,特别是在长期治疗方面,ACT 似乎更能在临床上减少焦虑和抑郁症状。然而,ACT 在改善 ACT 相关过程(如心理灵活性、认知化解和有价值的生活)以及提高参与度或生活质量方面并不占优势。该研究最初在荷兰试验注册中心(现为临床试验注册平台)注册,编号为NL-OMON50203。注册时间为2018年7月18日,现在可在https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON50203。
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引用次数: 0
Longitudinal relationships among number of chronic diseases, depression, and anxiety: A cross-lagged model analyses 慢性病数量、抑郁和焦虑之间的纵向关系:交叉滞后模型分析
IF 3.5 2区 医学 Q2 PSYCHIATRY Pub Date : 2024-09-10 DOI: 10.1016/j.jpsychores.2024.111930

Background

Research is increasingly highlighting the intricate relationship between mental and physical health. However, longitudinal studies investigating the interplay between chronic diseases (CDs), depression and anxiety are still relatively scarce. This study aimed to delve into the longitudinal connections among these variables.

Methods

This study conducted a 4-year prospective survey involving 486 participants from rural communities in Shandong Province, China. The relationships among these variables were analyzed using multiple linear regression, cross-lagged path analysis, and multiple-group analysis.

Results

Our analysis revealed that the number of CDs reported at wave 1 significantly predicted anxiety levels (β = 0.126, p < .01) at wave 2, while depression symptoms also predicted anxiety (β = 0.220, p < .01) at wave 2. Furthermore, anxiety levels at wave 1 significantly predicted both the number of CDs (β = 0.219, p < .01) and depression symptoms (β = 0.160, p < .05) at wave 2. However, the study did not find support for a relationship between CDs and depression.

Conclusion

The study uncovered a bidirectional association between CDs and anxiety, depression and anxiety, but found no direct longitudinal relationship between CDs and depression. Research has indicated that CDs indirectly affect depression through anxiety.

背景研究越来越多地强调心理健康与身体健康之间错综复杂的关系。然而,调查慢性病、抑郁和焦虑之间相互影响的纵向研究仍然相对较少。本研究旨在深入探讨这些变量之间的纵向联系。方法 本研究进行了一项为期 4 年的前瞻性调查,涉及来自中国山东省农村社区的 486 名参与者。结果我们的分析表明,第 1 次调查时报告的 CD 数量可显著预测第 2 次调查时的焦虑水平(β = 0.126,p < .01),而抑郁症状也可预测第 2 次调查时的焦虑水平(β = 0.220,p < .01)。此外,第 1 波时的焦虑水平可显著预测第 2 波时的光盘数量(β = 0.219,p < .01)和抑郁症状(β = 0.160,p < .05)。研究表明,CD 通过焦虑间接影响抑郁。
{"title":"Longitudinal relationships among number of chronic diseases, depression, and anxiety: A cross-lagged model analyses","authors":"","doi":"10.1016/j.jpsychores.2024.111930","DOIUrl":"10.1016/j.jpsychores.2024.111930","url":null,"abstract":"<div><h3>Background</h3><p>Research is increasingly highlighting the intricate relationship between mental and physical health. However, longitudinal studies investigating the interplay between chronic diseases (CDs), depression and anxiety are still relatively scarce. This study aimed to delve into the longitudinal connections among these variables.</p></div><div><h3>Methods</h3><p>This study conducted a 4-year prospective survey involving 486 participants from rural communities in Shandong Province, China. The relationships among these variables were analyzed using multiple linear regression, cross-lagged path analysis, and multiple-group analysis.</p></div><div><h3>Results</h3><p>Our analysis revealed that the number of CDs reported at wave 1 significantly predicted anxiety levels (β = 0.126, <em>p</em> &lt; .01) at wave 2, while depression symptoms also predicted anxiety (β = 0.220, p &lt; .01) at wave 2. Furthermore, anxiety levels at wave 1 significantly predicted both the number of CDs (β = 0.219, <em>p</em> &lt; .01) and depression symptoms (β = 0.160, <em>p</em> &lt; .05) at wave 2. However, the study did not find support for a relationship between CDs and depression.</p></div><div><h3>Conclusion</h3><p>The study uncovered a bidirectional association between CDs and anxiety, depression and anxiety, but found no direct longitudinal relationship between CDs and depression. Research has indicated that CDs indirectly affect depression through anxiety.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Psychosomatic Research
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