Psychiatry research communications最新文献

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.

The COVID-19 pandemic brought about unique challenges, leading to a simultaneous decline in global mental well-being and an increase in perceived social threats. The present study explores the interplay between COVID-19 beliefs and mental health symptoms in a multinational sample of 1523 individuals primarily from Canada, the US and Mexico. Between May 2020 and February 2021, participants completed an online survey assessing somatic symptoms, anxiety, depression, alexithymia, and psychotic-like symptoms, along with the newly developed COVID-19 beliefs questionnaire (CBQ). The CBQ consisted of a series of statements corresponding to different beliefs about the origins and consequences of the virus and it revealed two dimensions through Exploratory Factor Analysis: Fear of contagion of COVID-19 (FC) and COVID-19 denial/conspiratorial ideation (CI).

Correlation analyses and linear regressions revealed a negative correlation between these two belief patterns as well their distinct associations with mental health symptoms. Fear of contagion was positively predicted by somatic symptoms and anxiety. In contrast, COVID-19 denial/conspiratorial ideation was positively predicted by positive psychotic-like experiences, alexithymia, and depression, and negatively predicted by negative psychotic-like symptoms. Furthermore, the relationship between positive psychotic-like symptoms and CI was mediated negatively by negative psychotic-like symptoms, suggesting that individuals with higher self-reported delusional ideation and bizarre experiences but lower avolition during the pandemic were the most likely to endorse COVID-19 related conspiracy theories.

We provide an interpretation of these results according to which these two profiles represent distinct doxastic threat responses, shaped by the interaction between the non-specific pandemic distress response and individual proneness to mental health symptomatology.

There is accumulating evidence that mukbang (i.e., eating broadcasts) watching may be another emerging online behaviour that has the potential to become uncontrolled and harmful among a small number of individuals. However, there is still a large gap in the literature regarding the psychological and mental health predictors of problematic mukbang watching. Due to the paucity of research, the present study investigated the emotional and psychological correlates of problematic mukbang watching (PMW) including emotion regulation difficulties (ERDs), impulsivity facets (i.e., negative urgency, positive urgency, sensation seeking, lack of premeditation, lack of perseverance), and psychological distress (i.e., depression, anxiety, stress). A total of 513 adults (54% female; M_age = 32.05 years, SD = 11.14) who watched mukbang in the past seven days completed a survey including psychometric assessment tools for the aforementioned variables. ERDs were directly and indirectly related to PMW via anxiety and positive urgency. Daily time spent watching mukbang was also moderately positively associated with PMW. Consequently, the present study suggests that individuals with emotional and psychological impairments may use PMW as a maladaptive coping strategy.