Psychiatry research communications最新文献

This study aimed to establish evidence of the psychometric properties of the Centre for Epidemiologic Studies Depression Scale Revised – Vietnamese Version (CESDR-V) for use among adolescents in Vietnam. We selected 1084 Grade-10 students in Hanoi using a multiple-stage sampling method. The factorial structure of the CESDR-V was evaluated using exploratory factor analysis. Internal consistency was tested using Cronbach's alpha coefficient. Measurement invariance between male and female participants was tested using multiple group confirmatory factor analysis. Convergent and divergent validity were tested using Pearson's correlation coefficients between CESDR-V and the Depression Anxiety and Stress Subscales of Depression (DASS21-D), Anxiety (DASS21-A), and Stress (DASS21-S) and a measure of mental well-being, Mental Health Continuum Short Form (MHC-SF). The CESDR-V was found to be unidimensional. Cronbach's alpha coefficient of CESDR-V was 0.92. All levels of measurement invariance between male and female participants for the CESDR-V were supported well. The CESDR-V was positively correlated with DASS21-D at stronger levels (convergent pattern) than with DASS21-A/DASS21-S (discriminant pattern). The CESDR-V was negatively correlated with MHC-SF at a lower level than with the DASS21 subscales (discriminant pattern). This study strongly supports the use of the CESDR-V to screen for depression in adolescents in Vietnam who are attending school.

Problems with sleep appear a key feature in psychological distress emerging as suicidal thoughts at its worst. As part of a nationwide health examination study on 4387 participants, aged 18–97 years, we analyzed, whether suicidal thoughts during the past 7 days as scored on the Hopkins Symptom Checklist were associated with current sleep disturbances including difficulties in falling or staying asleep, daytime tiredness, loss of sleep over worry, insufficient sleep, and the usage of sleeping pills. In the stepwise regression analysis of the recent suicidal thoughts, the current daytime tiredness showed the significant association most robustly, whereas by adding clinically relevant information to analysis, the current difficulties falling or staying asleep, the use of mental health services during the past 12 months, and the level of education predicted the recent suicidal thoughts significantly. To conclude, recent suicidal thoughts were significantly associated with current sleep disturbances.

The trauma of wildfires leads to one of the most challenging and treatment resistant mental health conditions-namely-post-traumatic stress disorder (PTSD). Research addressing the contribution of pre-existing mental health conditions to the development of PTSD symptoms following traumatization by wildfires is limited. This study examined whether people with pre-existing diagnoses of anxiety, depression, PTSD, insomnia and nightmares, by a mental health professional, are more likely to develop symptoms of PTSD than those with no previous diagnosis following the trauma of wildfires. A total of 126 wildfire survivors from Australia, Canada and the United States of America completed an online survey. An independent sample t-tests revealed that pre-existing diagnosed conditions of depression, an anxiety disorder and PTSD significantly increased the likelihood of developing PTSD symptoms following traumatization by wildfires (t = −2.51, p = 0.014, 95% CI [-18.91 to −2.20], t = −2.61, p = 0.01, 95% CI [-18.91 to −2.57], t = −2.57, p = 0.012, 95% CI [-22.36 to −2.87] respectively). Practitioners working in communities subjected to wildfires need to run a thorough screening of their patients’ pre-existing mental health conditions to provide the right treatment and referral pathways to those affected by the trauma of wildfires.

This study aims to determine the most common reasons for emergency department (ED) visits of pediatric patients with major depressive disorder (MDD). We abstracted data from the Nationwide Emergency Department Sample. A total of 380,095 ED visits for patients aged <18 years with “any” diagnosis of MDD in 2018. Mental disorders and injuries and poisoning were the most common reasons for presentation to the ED. Among these, 166,055 had MDD as the “principal” diagnosis. MDD, suicidal ideation, anxiety, and intentional self-harm were the most common specific reasons for presentation to the ED among pediatric patients with MDD.

Background

Having failed at least two pharmacotherapies, treatment-resistant depression (TRD) constitutes a major burden to healthcare in the US and globally, affecting close to a third of people diagnosed with depression in the US. Several studies have demonstrated the higher economic burden associated with TRD. This study sought to investigate changes in the availability of TRD somatic treatment options (Electroconvulsive therapy [ECT], Ketamine infusion therapy (KIT), and Transcranial Magnetic Stimulation [TMS]) in the US between 2014 and 2020 and the geographic variations in availability of TRD treatment options in the US as of 2020.

Method

This study is a cross-sectional study of US mental health facilities providing TRD treatment options between 2014 and 2020. We used the 2014 to 2020 National Mental Health Services Survey (N-MHSS) data from the Substance Abuse and Mental Health Service Administration (SAMHSA). We estimated service availability per 100,000 US adults, both nationally and regionally, and computed a random-effect logistic regression to calculate the changes in the availability of the services over the study period.

Result

Overall, availability of any one of ECT, KIT, or TMS in US mental health facilities declined between 2014 and 2019 (0.23 vs. 0.18 per 100,000 US adults) but increased to 0.24 in 2020. While availability of ECT consistently declined between 2014 and 2020, ketamine and TMS reportedly became available only in 2020. North Dakota, Wyoming, and Utah had the highest availability per 100,000 US adults (0.86, 0.67, and 0.65) while Nevada, Oregon and Georgia had the lowest availability (0.04, 0.06, and 0.06) regionally.

Conclusion

The US had less than one mental health facility offering somatic treatment options for TRD per 100,000 US adults as of 2020. Also, the observed increase in the availability of somatic treatment options for TRD across the US between 2014 and 2020 did not reflect the increasing need for more treatment options for the treatment of TRD.

Reports on polypharmacy strategies for patients with schizophrenia and major depressive disorder (MDD) are scarce. The nationwide Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project has been used to train psychiatrists on the guidelines for treatment of schizophrenia and MDD. This study aimed to determine whether the EGUIDE program enabled more appropriate evidence-based treatment of outpatients with schizophrenia and MDD. The types and doses of all psychotropics were analyzed in 174 and 147 patients with schizophrenia and MDD, respectively, in 2018 before the EGUIDE program and in 2019 and 2020 after the program. There were no significant differences in the rate of monopharmacy with antipsychotics for schizophrenia; however, the prescriptions of first-generation antipsychotics, anticholinergics, and benzodiazepines for schizophrenia decreased significantly after the program. There were also no significant differences in antidepressant monopharmacy rates for MDD; however, the prescriptions of benzodiazepines in patients with MDD decreased significantly after the program. Significant positive correlations were found between the number of psychotropic prescriptions and dosage of benzodiazepines. In conclusion, the EGUIDE project has improved the prescribing behavior for outpatients with schizophrenia and depression. Therefore, the guideline training program may be useful for regulating the prescribing behavior among physicians.

People may be more likely to exercise if they have self-efficacy for exercise (SEE). We conducted an exploratory analysis of SEE using data from a clinical trial designed to increase physical activity (N = 340). We evaluated correlates of baseline SEE and the relationship between baseline SEE and physical activity. Low SEE at baseline was correlated with lower well-being, physical activity, and higher depression at baseline. Participants with high (vs. low) baseline SEE had higher physical activity (but no differential change in activity) over time. These data highlight the potential role of SEE in psychological health and physical activity.

The objective is to examine how hospital admissions for mental health and eating disorders changed at the beginning of the COVID-19 pandemic and with the return to fully in-person school with increased vaccine availability. Data from a tertiary care children's hospital were examined for admissions to the hospital from March 2018 through March 2022, including children 6–20 years old admitted with ICD-10 codes for mental health and eating disorders. Interrupted time series (ITS) analyses were used to examine for changes at specific time points. In the first year of the pandemic, the ITS analysis showed a significant increase in admissions per month for eating disorders with a slope of 1.2 (95 % CI: 0.2, 2.2) and for other mental health diagnoses, a slope of 1.9 (95 % CI: 1.1, 2.7). In a longer-term ITS analysis, return to fully in-person school was associated with no significant changes. The COVID-19 pandemic had an initial impact on admissions for eating disorders and other mental health that attenuated over time.

Background

Illusory ownership over a rubber limb, as observed in the experimental paradigm the rubber hand illusion (RHI), has been reported to be correlated with self-reported dissociative symptoms in patients with current and remitted borderline personality disorder. The aim of the present study was to assess the association between RHI and dissociative symptoms in women with non-suicidal self-injury (NSSI), a patient group reporting high levels of dissociative symptoms.

Methods

41 women with NSSI and a healthy control group of 40 women were included in the study. The RHI was induced by administering tactile stimulation with a soft brush to the participants’ hand and a rubber hand. One congruent condition (synchronous brushing) and one incongruent condition (asynchronous brushing) was compared. The strength of the illusion was measured with the RHI questionnaire and proprioceptive drift. Trait dissociation was measured with the Dissociative Experience Scale-II.

Results

Both the NSSI group (p < .001) and control group (p < .001) reported illusory ownership during the experiment, but there was no statistically significant difference in illusory ownership (p = .694) or proprioceptive drift (p = .219) between NSSI and controls. Illusory ownership did not correlate with trait dissociation symptoms in the NSSI group.

Discussion

The RHI was induced in both groups but was not more pronounced in NSSI and did not correlate with dissociative symptoms. The results are consistent with some of the previous efforts to establish a relationship between illusory ownership and borderline personality disorder.