The Mini-International Neuropsychiatric Interview (MINI) is a widely used structured diagnostic interview that assesses common mental health disorders in the DSM-5 and ICD-10. Using data from the 2004 Pelotas Birth Cohort Study, we highlight that the criteria for manic episodes in the MINI is not coded according to DSM-5 or ICD-10 criteria. The implications of this are discussed
Ninety percent of people with depression also report suffering from additional cognitive disorders. However, despite the high prevalence, the effectiveness of cognitive training methods for mental illnesses has not yet been extensively researched.
In our study, ninety-six adult patients with depressive symptoms were randomly assigned to one of two intervention groups or a passive control group. Ultimately, 48 patients successfully completed the training and assessments. The first intervention group completed computer-based cognitive training (three times a week for 20 min). The second intervention group practiced different memory strategies three times a week, in addition to completing the same computer-based cognitive training as the first intervention group.
All groups demonstrated several improvements in cognitive performance and experienced benefits in everyday life over time. However, we found neither a significant group effect nor a significant time × group interaction effect for any of the measures. Despite this, on a descriptive level, the intervention groups showed improvements across all five cognitive test performance outcomes (especially attention and working memory) and displayed better scores in the post intervention assessment of the self-reported personal variables (well-being, emotional regulation and depressive symptoms). Approximately 50 % of the subjects in each group did not complete the training or the post intervention assessment and were excluded. We worked closely with healthcare professionals, therapists and doctors and were thus able to gather not only research results but also valuable experience in dealing with patients with depressive symptoms who are undergoing cognitive training. Our findings and experiences may have implications for optimizing the reintegration of people with depressive symptoms.
Repetitive transcranial magnetic stimulation (TMS) is now widely accepted as an effective non-pharmacologic treatment for treatment-resistant depression. However, whether repeated acute TMS courses can recapture the antidepressant effects of the initial acute course is still an open question, especially in the Veteran population. We present here a retrospective analysis of a specialty clinic within the Veteran Affairs Hospital System to help address this question.
Following an acute treatment course of TMS, we sought to determine the treatment response of a subsequent TMS course. We hypothesized that those who responded to an initial acute TMS course would respond in a similar manner to a subsequent treatment course.
116 cases referred for evaluation for TMS between September 2017 to April 2021 were reviewed. 63 Veterans completed at least one acute course of TMS and 12 completed at least two courses and met inclusion criteria for this review. 6 met criteria for treatment response in the first course, while the other 6 were initial treatment nonresponders. Symptoms were evaluated via self-reported scales at baseline and weekly throughout treatment. Clinical response to subsequent treatment (>50% symptom reduction as measured by the PHQ-9) was compared to initial treatment response.
Of the initial treatment responders (n = 6), all six responded to a second acute course, with an 85.3% symptom reduction. Of the initial treatment nonresponders (n = 6), three responded to a second acute course. No adverse events were reported in those who completed a second course, and the Veterans tolerated the treatment well.
Our findings support the growing understanding that a second acute TMS treatment course for treatment-resistant depression is safe, well-tolerated, and effective in initial responders and some non-responders. Despite multiple confounders in a naturalistic setting, robust initial treatment response was sustained in a second acute course. Low power limits generalizability, and larger powered, prospective studies are needed.
Intimate partner violence (IPV) is one of the most common forms of violence against women. Gender-based violence is a major issue for women throughout their lifespan and comorbid mental health complaints are documented. The estimated worldwide prevalence is nearly 1 in 3, with female survivors reporting physical and/or sexual assault by an intimate partner at some time in their life. Scientific panels are currently addressing interest in both understanding risk factors and improving support services for this population. Up to now, previous research made poor efforts to explore the effectiveness of psychological interventions, in particular psychotherapy, in addressing mental health problems among women survivors of intimate partner violence. Our search aimed to summarize the available literature about psychological treatments for post-traumatic stress disorder (PTSD) in female survivors with a focus on the effectiveness of cognitive-behavioral therapy in addressing those symptoms. Twenty-six studies providing cognitive-behavioral therapies, psychodrama, interpersonal therapy, and active psychological intervention were included in a systematic review. Meta-analysis was restricted to thirteen studies that implemented cognitive behavioral therapies with similar treatment components. A strong reduction of PTSD severity was found (g = 1.52; 95 %-CI = 1.33, 1.71; p < 0.01) with moderate to large heterogeneity between studies (I2= 64 %; Q = 80.81). Evidence for publication bias was observed (Egger's test; t = 2.396; p = 0.02). Results suggest cognitive behavioral therapy is effective for PTSD symptoms improvement in women survivors of intimate partner violence. The core interventions’ components included psychoeducation, relaxation with diaphragmatic breathing, trauma exposure, imagery, and problem-solving.
The GAD-7 is a widely used screening tool for the measurement and diagnosis of symptoms of generalized anxiety disorder. It has been translated and validated across more than 20 cultural contexts. However, no study to date examined its psychometric properties in a Slovak sample, despite the fact that a Slovak translation exists. The purpose of the present study was to test psychometric properties and factor structure of GAD-7 in a general sample of Slovak helping professionals. It was hypothesized that a one-dimensional factor structure would be supported by the data, and that construct validity would be demonstrated. A total of 2239 participants (Mage = 42.20, SD = 14.30) from different helping professions (e.g., psychologists, teachers, special educators, medical doctors, nurses, speech-language pathologists) completed an online survey. A confirmatory factor analysis yielded satisfactory factor loadings and acceptable model fit of the tested one-dimensional model. This evidence was invariant by sex. Internal consistency coefficients indicated good reliability. Significant correlations were found between the GAD-7 and both negative and positive adjustment constructs, thus demonstrating convergent and discriminant validity, respectively. The results of this study add to the evidence on the GAD-7 and its applicability across cultures and support the use of a Slovak translation of the instrument.
Depression is linked to more frequent experiences of ostracism (being excluded and ignored). Here, we examine attributions of everyday ostracism that may play an important role in individuals’ experience of and reactions to ostracism. Based on interpersonal and attribution theories of depression, we hypothesize that internal (compared to external) attributions of ostracism and attributions to being burdensome are particularly frequent among depressed individuals.
We use an experience sampling approach including retrospective reports of ostracism (N = 490) and event-contingent reports of ostracism (n = 323, k = 1107 experiences in 14 days) to analyze the frequency of everyday ostracism experiences, subsequent need threat, and attributions of ostracism by depressed individuals (i.e., individuals with stronger current depressive symptoms and those who had been diagnosed with depression before).
Depressed individuals report more frequent retrospective ostracism, and more frequent everyday ostracism, as well as higher need threat following everyday ostracism. Depressed individuals do not attribute ostracism more internally, but they attribute being ostracized more frequently to being burdensome, as well as to hostile intent of the ostracizer(s).
This research used a non-clinical sample and self-reports of current depressive symptoms and previous diagnoses of depression. Future research in patient populations and longitudinal designs will fruitfully complement the present findings.
Maladaptive attributions of everyday ostracism may perpetuate the cycle between ostracism experiences and depression. This warrants attention from clinical practitioners, specifically in interventions against cognitive biases in depression.
General practitioners play a pivotal role in the diagnosis attention-deficit/hyperactivity disorder (ADHD) in adults. This systematic review aims to determine the effectivity and feasibility of screening tools for ADHD in adults in primary care.
A literature search was performed in PubMed, Cochrane Library, Ovid, ERIC, PsycInfo, PSYNDEX and Embase in November 2022. Sensitivity and specificity were considered as primary outcomes. Further psychometric properties, feasibility in general practice as well as digital practicability were evaluated as secondary outcomes. Risk of bias was assessed via QUADAS-2/C. A narrative data synthesis and meta-analysis was performed (PROSPERO: CRD42022374597).
A total of fifty-eight studies were included in data analysis. These studies referred to eighty-four various screening tools. ASRS-6 (DSM-V), WURS-25, CAARS-s:sV and TRAQ10 are suitable instruments for screening of ADHD in adults in primary care. The highest test accuracy was shown by ASRS 6 (DSM-V) (Sensitivity=0.83 [0.67–0.92], Specificity=0.87 [0.93–0.8], AUC=0.92, I2=8.6–12.3 %).
Included studies used rating scales as reference standard. Some studies compared study groups to control groups with an unknown ADHD status and there is a large degree of heterogeneity between the populations. Some studies referred to the best-balanced results of sensitivity and specificity under a certain cut-off, that has not been determined before.
Feasibility studies are needed to provide more evidence for WURS-25 and CAARS-s:sV. The determination of sufficient cut-offs is important, to improve the identification of ADHD in adults by general physicians.
Nativity/birthplace and neighborhood cohesion are potential contributing factors to psychological distress. This study explores the impact of nativity/birthplace and neighborhood cohesion on moderate-severe psychological distress among United States (US) adults, considering the duration lived in a neighborhood.
Using the 2013–2018 National Health Interview Survey data, we conducted a stratified analysis based on years lived in the neighborhood (≤10 years [n = 96,175] and >10 years [n = 68,187]). Bivariate chi-square tests and multivariable logistic regression models were used to assess the statistical differences and associations between moderate-severe psychological distress and nativity/birthplace, and neighborhood cohesion, while adjusting for other covariates.
Individuals with 10 years or less of residence reported higher levels of moderate-severe psychological distress than those with more than 10 years (22.3 % vs. 18.1 %). Low or medium neighborhood cohesion, regardless of duration of residence, was associated with significantly higher odds of moderate-severe psychological distress compared to high cohesion. Foreign-born individuals had higher odds of psychological distress after more than 10 years in a neighborhood, although this difference was not statistically significant. However, they had lower odds of psychological distress after 10 years or less in the neighborhood compared to US-born individuals. Similarly, the interaction of foreign-born status and 10 years or less of residence in a neighborhood showed decreased odds of psychological distress.
These findings underscore the importance of strong social cohesion in neighborhoods for positive mental well-being. Establishing community initiatives to enhance neighborhood social cohesion is crucial.
Religion can be an important aspect in life for people and may therefore be important to consider in anxiety disorders. However, there has been limited research into the longitudinal relationship between religiousness and the prevalence of anxiety disorders or anxiety severity and no such research up to date looking at specific anxiety disorders.
We made use of data from the Netherlands Study of Depression and Anxiety (NESDA), a large clinical cohort study, including 2981 participants at baseline. Based on religious affiliation, commitment to affiliation and religious attendance at baseline as demographic variables, three groups (non-affiliated; affiliated, low commitment/attendance; affiliated, higher commitment/attendance) were compared regarding the prevalence of specific anxiety disorders and anxiety severity at baseline and at two, four, six, and nine years follow-up. For the analyses, we used graphs and Linear Mixed Models.
Overall, no differences were found for the prevalence of specific anxiety disorders and of comorbidity between anxiety disorders or comorbidity with depressive disorders. Furthermore, results showed no differences between the groups regarding the anxiety severity over time.
The main limitations relate to the operationalization of religiousness based on demographic variables at baseline.
On a population level, being religiously affiliated with more or less commitment/attendance does not seem to protect against specific anxiety disorders or more anxiety symptoms, nor is it a risk factor. Further research should focus on more internal religious aspects, and more specifically on anxiety in specific groups of religious people or people with specific religion related anxiety.
Lithium has demonstrated significant antisuicidal effects: it significantly reduces the high excess overall mortality of patients with affective disorders.
Public drinking water samples were collected in 53 Lithuanian municipalities during a two-month period. Linear models used lithium level in public drinking water as predictor and ratio of suicide attempts to suicide mortality as outcomes across the municipalities.
Lithium in drinking water predicted the ratio of attempted to completed suicides (A/S) nonlinearly, described by a U-shaped curve. The curves for visualization of the association of incidence of affective disorders and suicide standard mortality rate with lithium level displayed significant suicide curve decrements and invers direction in affective disorders curve. Multivariate regression model for ratio A/S in high lithium exposure group (> 7 µg/L, N = 26) suggests that the lithium level can explain 54.3 % of variance of ratio A/S in municipalities with exposure of lithium above median and with high incidence of affective disorders.
The findings provide confirmatory evidence that in municipalities with high incidence of affective disorders higher lithium levels in the public drinking water are associated with higher ratio A/S due to an unchanging number of suicide attempts and due to decreasing suicide lethal outcomes.
Nevertheless, the methods employed detected several factors with well-established associations with suicide. Finally, cohort, prospective or intervention studies are needed to verify the causal inverse relationship of these variables and to speculate the mechanism for this relationship.
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