Journal of Affective Disorders Reports最新文献

Background

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.

Aims

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.

Methods

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.

Results

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.

Conclusions

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.

Background

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.

Methods

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).

Results

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).

Limitations

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.

Conclusions

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.

Background

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.

Method

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).

Results

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 %).

Limitations

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.

Conclusion

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.

Introduction

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.

Methods

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.

Results

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.

Conclusions

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.

Background

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.

Methods

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.

Results

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.

Limitations

The main limitations relate to the operationalization of religiousness based on demographic variables at baseline.

Conclusions

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.

Introduction

Lithium has demonstrated significant antisuicidal effects: it significantly reduces the high excess overall mortality of patients with affective disorders.

Methods

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.

Results

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.

Conclusions

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.

Limitations

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.

Objective

This study aimed to measure the rate of depression, anxiety and stress among ethnic minority adolescents and identify relationships between demographic characteristics, behaviours and adverse childhood experiences (ACEs) factors with different mental disorders.

Methods

A cross-sectional study was conducted in Lang Son province, Vietnam, among adolescents in boarding schools for ethnic minorities. The Depression-Anxiety-Stress Scale–21 (DASS-21) and the ACEs Questionnaire were used. Information on age, gender, ethnicity, frequency of home visits, frequency of parental visits, number of people living together, quality of friendship, physical activity, and frequency of Internet use was also collected. Multivariate Logistic and Tobit regression were employed.

Results

Among 845 students, the rates of stress, anxiety and depression were 24.7 %, 54.4 % and 59.0 %, respectively. There were 48.9 % experiencing at least one ACEs, and the mean number of ACEs was 1.1 (SD = 1.8, range = 0–6). The number of ACEs was positively associated with anxiety score (Coef. = 0.28), stress score (Coef. = 0.28), and depression score (Coef. = 0.16). Having fair or poor friendships was positively associated with anxiety, stress and depression scores. Adolescents using the Internet daily or not using the Internet had a significantly lower anxiety score than those using the Internet at the weekend. Finally, information sources such as friends or television were negatively associated with stress and anxiety scores.

Conclusion

This study revealed the high prevalence of mental health problems and ACEs among ethnic minority adolescents in current sample. The present study illustrates an immediate demand for interventions to address ACEs and cognitive issues to improve adolescents’ well-being.

Introduction

Engagement in self-harm is common among youth in psychiatric inpatient units, however the nature of self-harm may be different in psychiatric care due to the increased supervision and theoretically decreased access to typical means of self-harm. This study aims to describe daily reports of self-harm experienced during psychiatric inpatient stays among adolescents and compare these inpatient self-harm experiences based on neurodevelopmental diagnoses (NDDs, including autism) given that self-harm methods differ across NDD diagnostic groups outside of the inpatient unit.

Methods

Data were derived from a larger study of risk factors among a sample of 119 suicidal adolescent inpatients, recruited from a large, urban adolescent inpatient psychiatric unit. Participants answered a daily series of self-report questions, including items about self-harm engagement, frequency, and methods used since the last survey.

Results

There was no difference in the number of participants who reported any engagement in self-harm based on diagnostic group (χ² = 0.08, p = .96). There were also no differences in the frequency of self-harm across diagnostic groups (F = 2.40, p = .12). There were no differences in the use of any method across diagnostic groups (ps > 0.05).

Conclusions

Findings revealed that in an inpatient unit where patients are presenting for self-harm risk, there are no significant differences in engagement, frequency, or methods used for self-harm based on autism and NDD status. These analyses provide valuable clinical information regarding a lack of differences in self-harm by these diagnostic subgroups. Future research should seek to further explore functional purposes of self-harm on inpatient unit and how this differs by diagnoses.