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Overview of the potential use of fluvoxamine for COVID-19 and long COVID. 氟伏沙明用于 COVID-19 和长 COVID 的可能性概述。
Pub Date : 2023-01-01 Epub Date: 2023-03-21 DOI: 10.1007/s44192-023-00036-3
Kenji Hashimoto

Coronavirus disease 2019 (COVID-19) has presented a serious worldwide threat to public health since its emergence in late 2019. From a safety point of view, drug repurposing has received particular attention. Several clinical studies have demonstrated that the use of fluvoxamine, a selective serotonin reuptake inhibitor with potent sigma-1 receptor agonism, in the early-stage of infection might be associated with the prevention of clinical deterioration in individuals with SARS-CoV-2 infection, although several reports have shown that a low dose of fluvoxamine may be ineffective. There is increasing evidence that SARS-CoV-2 can cross the blood-brain barrier, resulting in a number of psychiatric and neurologic symptoms in COVID-19 survivors. Importantly, about half of COVID-19 survivors experience a variety of long-term sequelae, including psychiatric and neurologic symptoms, known as long COVID. In this priority review, the author presents an overview of the potential use of fluvoxamine in the treatment of COVID-19 and long COVID.

冠状病毒病 2019(COVID-19)自 2019 年底出现以来,已对全球公共卫生构成严重威胁。从安全性角度来看,药物再利用受到特别关注。多项临床研究表明,在感染早期使用氟伏沙明(一种具有强效sigma-1受体激动作用的选择性5-羟色胺再摄取抑制剂)可能与预防SARS-CoV-2感染者的临床病情恶化有关,但也有一些报告显示,低剂量的氟伏沙明可能无效。越来越多的证据表明,SARS-CoV-2 可以穿过血脑屏障,导致 COVID-19 幸存者出现一系列精神和神经症状。重要的是,约有一半的 COVID-19 幸存者会出现各种长期后遗症,包括精神和神经症状,即所谓的长期 COVID。在这篇重点综述中,作者概述了氟伏沙明治疗 COVID-19 和长期 COVID 的潜在用途。
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引用次数: 0
Interaction of the pre- and postnatal environment in the maternal immune activation model. 母体免疫激活模型中产前和产后环境的相互作用。
Pub Date : 2023-01-01 Epub Date: 2023-08-22 DOI: 10.1007/s44192-023-00042-5
Anna Gundacker, Laura Cuenca Rico, Peter Stoehrmann, Katharina E Tillmann, Ulrike Weber-Stadlbauer, Daniela D Pollak

Adverse influences during pregnancy are associated with a range of unfavorable outcomes for the developing offspring. Maternal psychosocial stress, exposure to infections and nutritional imbalances are known risk factors for neurodevelopmental derangements and according psychiatric and neurological manifestations later in offspring life. In this context, the maternal immune activation (MIA) model has been extensively used in preclinical research to study how stimulation of the maternal immune system during gestation derails the tightly coordinated sequence of fetal neurodevelopment. The ensuing consequence of MIA for offspring brain structure and function are majorly manifested in behavioral and cognitive abnormalities, phenotypically presenting during the periods of adolescence and adulthood. These observations have been interpreted within the framework of the "double-hit-hypothesis" suggesting that an elevated risk for neurodevelopmental disorders results from an individual being subjected to two adverse environmental influences at distinct periods of life, jointly leading to the emergence of pathology. The early postnatal period, during which the caregiving parent is the major determinant of the newborn´s environment, constitutes a window of vulnerability to external stimuli. Considering that MIA not only affects the developing fetus, but also impinges on the mother´s brain, which is in a state of heightened malleability during pregnancy, the impact of MIA on maternal brain function and behavior postpartum may importantly contribute to the detrimental consequences for her progeny. Here we review current information on the interaction between the prenatal and postnatal maternal environments in the modulation of offspring development and their relevance for the pathophysiology of the MIA model.

怀孕期间的不良影响与一系列对发育中的后代不利的结果有关。母亲的心理社会压力、感染和营养失衡是神经发育紊乱的已知风险因素,也是后代后期的精神和神经表现。在这种情况下,母体免疫激活(MIA)模型已被广泛用于临床前研究,以研究妊娠期间对母体免疫系统的刺激如何破坏胎儿神经发育的紧密协调序列。MIA对后代大脑结构和功能的影响主要表现在行为和认知异常上,表现在青春期和成年期。这些观察结果是在“双重打击假说”的框架内解释的,该假说表明,神经发育障碍的风险增加是由于个体在不同时期受到两种不利的环境影响,共同导致病理学的出现。产后早期,在这段时间里,照顾孩子的父母是新生儿环境的主要决定因素,构成了易受外部刺激的窗口。考虑到MIA不仅影响发育中的胎儿,还影响母亲的大脑,母亲的大脑在怀孕期间处于可塑性增强的状态,MIA对母亲大脑功能和产后行为的影响可能会对其后代产生重要影响。在这里,我们回顾了产前和产后母体环境在调节后代发育中的相互作用及其与MIA模型病理生理学的相关性的最新信息。
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引用次数: 0
Disease-specific differences in gene expression, mitochondrial function and mitochondria-endoplasmic reticulum interactions in iPSC-derived cerebral organoids and cortical neurons in schizophrenia and bipolar disorder. 精神分裂症和双相情感障碍患者ipsc衍生的脑类器官和皮质神经元中基因表达、线粒体功能和线粒体-内质网相互作用的疾病特异性差异
Pub Date : 2023-01-01 DOI: 10.1007/s44192-023-00031-8
Annie Kathuria, Kara Lopez-Lengowski, Donna McPhie, Bruce M Cohen, Rakesh Karmacharya

We compared transcriptomic profiles of cerebral organoids differentiated from induced pluripotent stem cells of eight schizophrenia and eight bipolar disorder patients to identify genes that were differentially expressed in cerebral organoids between two disorders. Gene ontology analysis showed relative up-regulation in schizophrenia organoids of genes related to response to cytokines, antigen binding and clathrin-coated vesicles, while showing up-regulation in bipolar disorder of genes involved in calcium binding. Gene set enrichment analysis revealed enrichment in schizophrenia of genes involved in mitochondrial and oxidative phosphorylation while showing enrichment in bipolar disorder of genes involved in long term potentiation and neuro-transporters. We compared mitochondrial function in cerebral organoids from schizophrenia and bipolar disorder subjects and found that while schizophrenia organoids showed deficits in basal oxygen consumption rate and ATP production when compared to healthy control organoids, while bipolar disorder organoids did not show these deficits. Gene ontology analyses also revealed enrichment in bipolar disorder of genes in ion binding and regulation of transport. Experiments examining the interaction between mitochondria and endoplasmic reticulum in cortical neurons from bipolar disorder subjects showed a significantly lower number of contact sites between mitochondria and endoplasmic reticulum when compared to cortical neurons from schizophrenia patients. These results point to disease-specific deficits in mitochondrial respiration in schizophrenia and in mitochondrial-endoplasmic reticulum interactions in bipolar disorder.

Supplementary information: The online version contains supplementary material available at 10.1007/s44192-023-00031-8.

我们比较了8名精神分裂症和8名双相情感障碍患者诱导多能干细胞分化的脑类器官的转录组学特征,以确定两种疾病之间脑类器官中差异表达的基因。基因本体分析显示,在精神分裂症类器官中,与细胞因子应答、抗原结合和网格蛋白包被囊泡相关的基因相对上调,而在双相情感障碍中,与钙结合相关的基因相对上调。基因集富集分析显示,精神分裂症中线粒体和氧化磷酸化相关基因富集,而双相情感障碍中长时程增强和神经转运相关基因富集。我们比较了精神分裂症和双相情感障碍受试者脑类器官的线粒体功能,发现与健康对照类器官相比,精神分裂症类器官在基础耗氧量和ATP产生方面存在缺陷,而双相情感障碍类器官则没有这些缺陷。基因本体分析也揭示了双相情感障碍中离子结合和转运调控基因的富集。研究双相情感障碍受试者皮质神经元线粒体和内质网相互作用的实验显示,与精神分裂症患者皮质神经元相比,线粒体和内质网之间的接触位点数量明显减少。这些结果指出了精神分裂症的线粒体呼吸和双相情感障碍的线粒体-内质网相互作用的疾病特异性缺陷。补充资料:在线版本提供补充资料,网址为10.1007/s44192-023-00031-8。
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引用次数: 4
Whole Person Modeling: a transdisciplinary approach to mental health research. 全人建模:心理健康研究的跨学科方法。
Pub Date : 2023-01-01 Epub Date: 2023-08-24 DOI: 10.1007/s44192-023-00041-6
Daniel Felsky, Alyssa Cannitelli, Jon Pipitone

The growing global burden of mental illness has prompted calls for innovative research strategies. Theoretical models of mental health include complex contributions of biological, psychosocial, experiential, and other environmental influences. Accordingly, neuropsychiatric research has self-organized into largely isolated disciplines working to decode each individual contribution. However, research directly modeling objective biological measurements in combination with cognitive, psychological, demographic, or other environmental measurements is only now beginning to proliferate. This review aims to (1) to describe the landscape of modern mental health research and current movement towards integrative study, (2) to provide a concrete framework for quantitative integrative research, which we call Whole Person Modeling, (3) to explore existing and emerging techniques and methods used in Whole Person Modeling, and (4) to discuss our observations about the scarcity, potential value, and untested aspects of highly transdisciplinary research in general. Whole Person Modeling studies have the potential to provide a better understanding of multilevel phenomena, deliver more accurate diagnostic and prognostic tests to aid in clinical decision making, and test long standing theoretical models of mental illness. Some current barriers to progress include challenges with interdisciplinary communication and collaboration, systemic cultural barriers to transdisciplinary career paths, technical challenges in model specification, bias, and data harmonization, and gaps in transdisciplinary educational programs. We hope to ease anxiety in the field surrounding the often mysterious and intimidating world of transdisciplinary, data-driven mental health research and provide a useful orientation for students or highly specialized researchers who are new to this area.

全球日益加重的精神疾病负担促使人们呼吁采取创新的研究策略。心理健康的理论模型包括生物学、心理社会、经验和其他环境影响的复杂贡献。因此,神经心理学研究已经自我组织成基本上孤立的学科,努力解码每个人的贡献。然而,将客观生物学测量与认知、心理、人口统计学或其他环境测量相结合进行直接建模的研究现在才开始激增。本综述旨在(1)描述现代心理健康研究的前景和当前向综合研究的趋势,(2)为定量综合研究提供一个具体的框架,我们称之为全人建模,(3)探索全人建模中使用的现有和新兴技术和方法,以及(4)讨论我们对稀缺性的观察,潜在价值,以及高度跨学科研究的未经测试的方面。全人建模研究有可能更好地理解多层次现象,提供更准确的诊断和预后测试以帮助临床决策,并测试长期存在的精神疾病理论模型。目前阻碍进步的一些障碍包括跨学科沟通和合作的挑战、跨学科职业道路的系统性文化障碍、模型规范、偏见和数据协调方面的技术挑战,以及跨学科教育计划中的差距。我们希望缓解该领域围绕着跨学科、数据驱动的心理健康研究这个往往神秘而令人生畏的世界的焦虑,并为新进入该领域的学生或高度专业化的研究人员提供有用的指导。
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引用次数: 0
A qualitative assessment of mental health literacy and help-seeking behaviors among male college students. 男大学生心理健康素养与求助行为的定性评价
Pub Date : 2022-12-29 DOI: 10.1007/s44192-022-00028-9
Rita DeBate, Amy Gatto, Gregor Rafal, Jennifer Bleck

Although the number of students receiving care from college counseling centers has increased, engaging male college students to seek help presents a unique challenge. This qualitative study explored mental health literacy and help-seeking behaviors among undergraduate college men. Semi-structured interviews (n = 26) based on three vignettes (anxiety, depression, stress) were employed to assess mental health literacy. Analysis revealed three general themes and associated sub-themes: (a) knowledge of signs and symptoms (physiological, behavioral, and emotional); (b) recommended help-seeking behaviors (do nothing, self-care, seek help); and (c) barriers to help-seeking (social stigma, self-stigma, masculinity). Findings present a triadic interplay between the person, help-seeking behavior, and environment. Future research should explore this dynamic relationship to inform interventions aimed at improving college male mental health help-seeking behavior.

尽管接受大学咨询中心护理的学生人数有所增加,但让男大学生寻求帮助是一项独特的挑战。这项定性研究探讨了大学生男性的心理健康素养和求助行为。半结构化访谈(n = 26)基于三个小插曲(焦虑、抑郁、压力)来评估心理健康素养。分析揭示了三个一般主题和相关的子主题:(a)对体征和症状(生理、行为和情绪)的了解;(b) 推荐的求助行为(无所事事、自我照顾、寻求帮助);以及(c)寻求帮助的障碍(社会污名、自我污名、男子气概)。研究结果表明,求助者、求助行为和环境之间存在三元相互作用。未来的研究应该探索这种动态关系,为旨在改善大学男性心理健康求助行为的干预措施提供信息。
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引用次数: 0
A novel set of volatile urinary biomarkers for late-life major depressive and anxiety disorders upon the progression of frailty: a pilot study. 一套新的易挥发性尿液生物标志物对老年抑郁症和焦虑症的进展脆弱:一项试点研究
Pub Date : 2022-10-27 DOI: 10.1007/s44192-022-00023-0
Akiko Fujita, Kazushige Ihara, Hisashi Kawai, Shuichi Obuchi, Yutaka Watanabe, Hirohiko Hirano, Yoshinori Fujiwara, Yoichi Takeda, Masashi Tanaka, Keiko Kato

Mood and anxiety disorders are frequent in the elderly and increase the risk of frailty. This study aimed to identify novel biomarkers of major depressive disorder (MDD) and anxiety in the elderly. We examined 639 participants in the community-dwelling Otassha Study (518 individuals considered healthy control, 77 with depression, anxiety, etc.), mean age 75 years, 58.4% of female. After exclusion criteria, we analyzed VOCs from 18 individuals (9 healthy control, 9 of MDD/agoraphobia case). Urinary volatile and semi-volatile organic compounds (VOCs) were profiled using solid-phase microextraction and gas chromatography-mass spectrometry. Six urinary VOCs differed in the absolute area of the base peak between participants with MDD and/or agoraphobia and controls. High area under the receiver-operating characteristic curve (AUC) values were found for phenethyl isothiocyanate (AUC: 0.86, p = 0.009), hexanoic acid (AUC: 0.85, p = 0.012), texanol (AUC: 0.99, p = 0.0005), and texanol isomer (AUC: 0.89, p = 0.005). The combined indices of dimethyl sulfone, phenethyl isothiocyanate, and hexanoic acid, and texanol and texanol isomer showed AUCs of 0.91 (p = 0.003) and 0.99 (p = 0.0005) and correlated with the GRID-HAMD and the Kihon Checklist (CL score), respectively. These VOCs may be valuable biomarkers for evaluating MDD and/or agoraphobia in the elderly.

情绪和焦虑障碍在老年人中很常见,并增加了虚弱的风险。本研究旨在确定老年人重度抑郁障碍(MDD)和焦虑的新生物标志物。我们调查了639名居住在社区的Otassha研究参与者(518人被认为是健康对照,77人患有抑郁症、焦虑症等),平均年龄75岁,女性58.4%。在排除标准之后,我们分析了18名个体的挥发性有机物(9名健康对照,9名MDD/广场恐惧症患者)。采用固相微萃取和气相色谱-质谱法对尿液中挥发性和半挥发性有机化合物(VOCs)进行了分析。患有MDD和/或广场恐惧症的参与者与对照组之间,6种尿液VOC的基峰绝对面积不同。异硫氰酸苯乙酯的受试者工作特性曲线下面积(AUC)值较高(AUC:0.86,p = 0.009),己酸(AUC:0.85,p = 0.012),texanol(AUC:0.99,p = 0.0005)和texanol异构体(AUC:0.89,p = 0.005)。二甲基砜、异硫氰酸苯乙酯和己酸以及特烷醇和特烷醇异构体的组合指数显示AUCs为0.91(p = 0.003)和0.99(p = 0.0005)并分别与GRID-HAMD和Kihon检查表(CL评分)相关。这些挥发性有机物可能是评估老年人MDD和/或广场恐惧症的有价值的生物标志物。
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引用次数: 1
Effects of cannabidiol on weight and fasting blood sugar with chronic and subchronic haloperidol administration. 大麻二酚对慢性和亚慢性氟哌啶醇给药时体重和空腹血糖的影响
Pub Date : 2022-07-14 DOI: 10.1007/s44192-022-00021-2
Jaiyeola Abiola Kajero, Soraya Seedat, Jude U Ohaeri, Abidemi Akindele, Oluwagbemiga Aina

Objectives: The duration of administration (e.g., subchronic or chronic) of haloperidol may influence its adverse effects. We studied the effects of duration of administration of haloperidol on body weight and fasting blood sugar (FBS). In addition, we examined whether orally administered cannabidiol (CBD) had any putative mitigating influence on haloperidol-induced body weight changes and FBS elevation.

Methods: Haloperidol (5 mg/kg/day) was administered for 21 days (subchronic administration), via the intraperitoneal (IP) route, or monthly (50 mg/kg monthly) for 3 months (chronic administration), via the intramuscular (IM) route, either alone or before CBD (5 mg/kg/day). Oral CBD (5 mg/kg/day) alone and distilled water alone were administered for 21 days. Weight and FBS were measured before administration of pharmacological agents (distilled water in the control group) and post-administration.

Results: Group differences in average weight across time were significant. Pairwise comparisons showed that mean weight of the subchronic (IP) haloperidol alone group (Group A) and the chronic (IM) haloperidol before CBD group (Group F) increased significantly over time. Post medications, there was a significant increase in mean FBS in the subchronic (IP) haloperidol group compared to the subchronic (IP) haloperidol before CBD group. There was also a significant reduction in mean FBS from the baseline for the control group only.

Conclusion: We demonstrated that the duration of administration of haloperidol influenced weight and FBS in rats, suggesting that metabolic side effects, may be influenced by duration of administration. CBD ameliorated the increase in weight and FBS observed in the subchronic (IP) haloperidol groups.

目的:氟哌啶醇的给药时间(如亚慢性或慢性)可能会影响其不良反应。我们研究了氟哌啶醇给药时间对体重和空腹血糖(FBS)的影响。此外,我们还研究了口服大麻二酚(CBD)是否对氟哌啶醇诱导的体重变化和FBS升高有任何公认的缓解作用。方法:氟哌啶醇(5 mg/kg/天)通过腹膜内(IP)途径给药21天(亚慢性给药),或通过肌内(IM)途径每月(50 mg/kg每月)给药3个月(慢性给药,单独给药或在CBD(5 mg/kg/天)之前给药。单独口服CBD(5mg/kg/天)和单独蒸馏水给药21天。在给药前(对照组为蒸馏水)和给药后测量体重和FBS。结果:不同时间组的平均体重差异显著。成对比较显示,单独亚慢性(IP)氟哌啶醇组(A组)和CBD前慢性(IM)氟哌啶酮组(F组)的平均重量随时间显著增加。用药后,亚慢性(IP)氟哌啶醇组的平均FBS与CBD前的亚慢性(IP)氟哌啶醇组相比显著增加。仅对照组的平均FBS也比基线显著降低。结论:我们证明氟哌啶醇的给药时间会影响大鼠的体重和FBS,这表明代谢副作用可能受到给药时间的影响。CBD改善了亚慢性(IP)氟哌啶醇组中观察到的体重和FBS的增加。
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引用次数: 0
Length of stay of hospitalized patients at tertiary psychiatry facilities in Uganda: the role of caregiver's presence. 乌干达三级精神病院住院病人的住院时间:护理人员在场的作用
Pub Date : 2022-07-04 DOI: 10.1007/s44192-022-00018-x
Mark Mohan Kaggwa, Maria Sarah Najjuka, Claire Kesande, Novatus Nyemara, Moses Kule, Mohammed A Mamum, Felix Bongomin, Scholastic Ashaba

Background: Whether the presence of caregivers during the hospital stay of patients with mental illness affects the length of hospital stay (LoS) remains inconclusive.

Aims: (1) To determine the average LoS and the associated factors, and (2) to determine the role of caregivers' presences during inpatient stay on LoS.

Methods: We conducted a cross-sectional study in two hospitals in Uganda; one with caregivers and the other without caregivers between July to November 2020. Mann-Whitney U test was used to compare LoS in the two selected hospitals and linear regression was used to determine factors associated with LoS.

Results: A total of 222 participants were enrolled, the majority were males (62.4%). Mean age was 36.3 (standard deviation (SD) = 13.1) years. The average LoS was 18.3 (SD = 22.3) days, with patients in a hospital without caregivers having a longer median LoS (i.e., (30 (interquartile range (IQR) = 30) vs. 7 (7) days; χ2 = 68.95, p < 0.001). The factors significantly associated a longer LoS among our study participants included; being admitted in a hospital without caregivers (adjusted coefficient [aCoef]: 14.88, 95% CI 7.98-21.79, p < 0.001), a diagnosis of schizophrenia (aCoef: 10.68, 95 %CI 5.53-15.83, p < 0.001), being separated or divorced (aCoef: 7.68, 95% CI 1.09-14.27, p = 0.023), and increase in money spent during the admission (aCoef: 0.14, 95% CI 0.09-0.18, p < 0.001).

Conclusion: Patients with mental illness in southwestern Uganda have a short LoS (below 28 days), and the stay was much shorter for patients with fulltime caregivers. We recommend caregivers presence during patient's hospital stay to reduce the LoS and minimize healthcare expenditure.

背景:精神疾病患者住院期间护理人员的存在是否会影响住院时间(LoS)仍不确定。目的:(1)确定平均LoS及其相关因素,(2)确定护理人员在住院期间的作用。方法:我们在乌干达的两家医院进行了一项横断面研究;在2020年7月至11月期间,一个有照顾者,另一个没有照顾者。Mann-Whitney U检验用于比较所选两家医院的LoS,线性回归用于确定与LoS相关的因素。结果:共有222名参与者入选,其中大多数是男性(62.4%)。平均年龄为36.3(标准差(SD) = 13.1)年。平均LoS为18.3(SD = 22.3)天,在没有护理人员的医院中,患者的LoS中位数较长(即(30(四分位间距(IQR) = 30)对7(7)天;χ2 = 68.95,p 结论:乌干达西南部的精神疾病患者的LoS较短(低于28天),有全职护理人员的患者住院时间要短得多。我们建议护理人员在患者住院期间在场,以减少LoS并最大限度地减少医疗支出。
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引用次数: 6
Child, adolescent, and parent mental health in general population during a year of COVID-19 pandemic in belgium: a cross-sectional study. 比利时2019冠状病毒病大流行期间普通人群的儿童、青少年和父母心理健康:一项横断面研究
Pub Date : 2022-07-04 DOI: 10.1007/s44192-022-00019-w
Amélyne Wauters, Julien Tiete, Joana Reis, Isabelle Lambotte, Simone Marchini, Véronique Delvenne

Background: This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium.

Method: Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021.

Results: Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores.

Conclusion: The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.

背景:本研究旨在评估新冠肺炎大流行第一年比利时儿童、青少年及其父母的心理健康状况。方法:分析2020年11月2日开始的第二次全国封锁前后的结果。2020年5月至2021年4月期间进行了一项横断面在线调查。结果:218名成年人和273名儿童完全完成了调查。几乎五分之一的儿童(17.9%)表现出中度至重度抑郁症。青少年的抑郁程度高于儿童(p = 中度至重度抑郁症的发生率(10.8%-21%,p = 0.007),并且在第二次封锁期间内化症状增加(p 结论:第二次封锁似乎加剧了疫情对儿童和父母心理健康的影响。有必要针对儿童/青少年及其父母实施具体干预措施,在封锁期间为他们提供支持,并改善心理健康状况。
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引用次数: 2
Narratives and mental health in the Covid-19 Pandemic Covid-19大流行中的叙事与心理健康
Pub Date : 2022-04-19 DOI: 10.1007/s44192-022-00013-2
M. Mendes
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引用次数: 1
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Discover mental health
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