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Effectiveness of a package of community-based mental healthcare services to address perinatal mental disorders in Bangladesh: A cluster-randomized controlled trial 以社区为基础的一揽子精神保健服务对解决孟加拉国围产期精神障碍的有效性:分组随机对照试验
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-25 DOI: 10.1016/j.ajp.2024.104290
Goutam Kumar Dutta , Helal Uddin Ahmed , Md. Quiume Talukder , Dipika Shankar Bhattacharyya , M. Shamim Reza , Md. Musfikur Rahman , Ratna Majumdar , Fahmida Tofail , Henry B. Perry , Taposh Kumar Biswas

Background

Perinatal mental disorders of women have an impact on their pregnancy and their child’s brain development across low and middle-income countries. However, to address this issue, there are no specific guidelines for community-level service providers in Bangladesh. Therefore, we aimed to develop a community-based mental healthcare (CBMHC) service package and test its effectiveness in reducing depression, anxiety, and stress among mothers during the perinatal period.

Methods

A cluster-randomized controlled trial (cRCT) was applied to test the CBMHC package in 2017 and 2018. It was provided to one group of mothers along with routine maternal care while another group received only routine maternal care. Paired sample t-test was applied to assess mean changes at baseline and endline in the Depression, Anxiety, and Stress Scales-21 (DASS-21) and EuroQol-5 Dimension and 3 Level (EQ5D3L) scales. A linear mixed-effects model was used to assess the relationship between the DASS-21 score and EQ5D3L.

Results

1215 participants were enrolled, including 605 in the intervention group and 610 in the control group. Measures of depression, anxiety, and stress were significantly decreased in both groups. Reduction in the levels of stress, as measured by changes in the stress score, were significantly greater in the intervention than in the control group (diff: 1.2, 95 % CI: 0.1, 2.2). The EQ5D3L index improved significantly, 0.02 units more at endline in the intervention group than in the control group (diff: 0.02, 95 % CI: 0.007, 0.03). The levels of mobility, usual activities, pain or discomfort, depression, and anxiety improved by 1.4 %, 7.6 %, 4.4 %, 2.6 %, and 0.4 % more, respectively, in the intervention group compared to the control groups. These improvements were statistically significant. The DASS-21 score was negatively and significantly correlated with both the EQ-5D3L index and the Visual Analogue Scale (VAS) score for the intervention group as well as for the usual care group, indicating that EQ5D3L improved when common mental disorders decreased.

Conclusion

Although the improvements were modest, a CBMHC service package was effective in reducing perinatal levels of stress among Bangladeshi rural women.

Trial Registration

ClinicalTrials.gov ID: NCT03678415
背景在中低收入国家,妇女的产前精神障碍会影响她们的妊娠和孩子的大脑发育。然而,为了解决这一问题,孟加拉国还没有针对社区一级服务提供者的具体指导原则。因此,我们旨在开发基于社区的心理保健(CBMHC)服务包,并测试其在减少围产期母亲抑郁、焦虑和压力方面的有效性。方法在 2017 年和 2018 年采用分组随机对照试验(cRCT)来测试 CBMHC 服务包。一组母亲在接受常规孕产妇护理的同时还接受了该套餐,而另一组母亲仅接受常规孕产妇护理。采用配对样本t检验来评估抑郁、焦虑和压力量表-21(DASS-21)和EuroQol-5 Dimension and 3 Level(EQ5D3L)量表在基线和终点的平均变化。采用线性混合效应模型评估 DASS-21 评分与 EQ5D3L 之间的关系。结果1215 名参与者参加了干预组,其中 605 人,对照组 610 人。干预组和对照组的抑郁、焦虑和压力测量值均显著下降。以压力评分的变化来衡量,干预组压力水平的降低幅度明显高于对照组(差值:1.2,95 % CI:0.1,2.2)。干预组的 EQ5D3L 指数明显改善,在终点线时比对照组多 0.02 个单位(差异:0.02,95 % CI:0.007,0.03)。与对照组相比,干预组的行动能力、日常活动、疼痛或不适、抑郁和焦虑水平分别提高了 1.4%、7.6%、4.4%、2.6% 和 0.4%。这些改善在统计学上具有重要意义。干预组和常规护理组的 DASS-21 评分与 EQ-5D3L 指数和视觉模拟量表 (VAS) 评分均呈显著负相关,这表明当常见精神障碍减少时,EQ5D3L 也随之改善:NCT03678415
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引用次数: 0
Human-fecal microbiota transplantation in relation to gut microbiome signatures in animal models for schizophrenia: A scoping review 人类粪便微生物群移植与精神分裂症动物模型中肠道微生物群特征的关系:范围综述
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-24 DOI: 10.1016/j.ajp.2024.104285
Raghunath Singh , Kristoffer Panganiban , Emily Au , Rekha Ravikumar , Sandra Pereira , Thomas D. Prevot , Daniel J. Mueller , Gary Remington , Sri Mahavir Agarwal , Elena F. Verdu , Premysl Bercik , Giada De Palma , Margaret K. Hahn
More recently, attention has turned to the putative role of gut microbiome (GMB) in pathogenesis, symptomatology, treatment response and/or resistance in schizophrenia (SCZ). It is foreseeable that fecal microbiota transplantation (FMT) from SCZ patients (SCZ-FMT) to germ-free mice could represent a suitable experimental framework for a better understanding of the relationship between GMB and SCZ. Thus, we set out to identify literature (i) characterizing the GMB in animal models of SCZ, and (ii) employing SCZ-FMT into rodents to model SCZ in relation to behavioral and molecular phenotypes. Five studies examining animal models of SCZ suggest distinct GMB composition compared to respective control groups, which was correlated with SCZ-like behavioral phenotypes. Four additional studies investigated SCZ-FMT into rodents in relation to behavioral phenotypes, including spontaneous hyperlocomotion, social deficits, exaggerated startle response, and cognitive impairments, resembling those observed in SCZ patients. Mice receiving SCZ-FMT showed altered neurochemical and metabolic pathways in the brain. Animal models of SCZ have shown altered GMB composition, whereas reported behavioral and neurochemical alterations following FMT from patients into rodents suggest early face and construct validity for SCZ-FMT animal models. However, the predictive validity of these models remains to be validated.
最近,人们开始关注肠道微生物组(GMB)在精神分裂症(SCZ)的发病机制、症状、治疗反应和/或抗药性中的作用。可以预见,将精神分裂症(SCZ)患者的粪便微生物群(FMT)移植到无菌小鼠体内,是更好地了解肠道微生物群与精神分裂症(SCZ)之间关系的合适实验框架。因此,我们开始寻找以下文献:(i) 描述 SCZ 动物模型中 GMB 特征的文献;(ii) 将 SCZ-FMT 移植到啮齿类动物体内以建立 SCZ 行为和分子表型模型的文献。五项关于 SCZ 动物模型的研究表明,与各自的对照组相比,GMB 的组成与 SCZ 类行为表型相关。另有四项研究调查了啮齿类动物的SCZ-FMT与行为表型的关系,包括自发性运动过度、社交障碍、夸张的惊吓反应和认知障碍,这些都与在SCZ患者身上观察到的表型相似。接受SCZ-FMT治疗的小鼠表现出大脑神经化学和代谢途径的改变。SCZ动物模型显示了GMB组成的改变,而据报道,从患者到啮齿类动物的FMT后的行为和神经化学改变表明了SCZ-FMT动物模型的早期面貌和构造的有效性。然而,这些模型的预测有效性仍有待验证。
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引用次数: 0
Default at fault? Exploring neural correlates of default mode network in children with ADHD, their unaffected siblings versus neurotypical controls: A quantitative EEG study 默认模式有问题?探索多动症儿童及其未受影响的兄弟姐妹与神经典型对照组默认模式网络的神经相关性:脑电图定量研究。
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-24 DOI: 10.1016/j.ajp.2024.104291
Chaithanya Leon , Simran Kaur , Rajesh Sagar , Prashant Tayade , Ratna Sharma

Background

Sustained activation of default mode network has been implicated for momentary lapses of attention and higher errors during performance of cognitive tasks in attention deficit hyperactive disorder (ADHD) children. Despite emerging evidence indicating the genetic basis of ADHD, there is paucity of literature investigating the alteration of DMN in children with ADHD and their unaffected siblings.

Aim

To study the cortical sources of DMN in children with ADHD compared to their siblings and neurotypical controls.

Methods

Eighty-six participants (35 ADHD (12.4(±2.7) years), 16 unaffected siblings (11.8(±4.3) years) and 35 matched neurotypical controls (12.6 (±3.6) years) participated in the study. 128 channel EEG data was acquired during rest and Stroop cognitive task and analyzed for cortical source estimation using LORETA software.

Results

Higher activation of DMN and DMN associated areas were observed during encoding of the color-word stimuli in children with ADHD. Sustained activation of core DMN areas namely medial frontal gyrus, posterior cingulate gyrus, parahippocampal gyrus and inferior parietal lobule was observed across all groups. Among the three groups, distinct cortical source activation differences were identified solely in the DMN and its associated areas among children with ADHD during the task encoding phase compared to baseline. In contrast, both siblings and neurotypical controls displayed activation in fronto-parieto-temporal areas subserving executive function were also observed.

Conclusion

Sustained activity of DMN areas with minimal activity in executive network in ADHD children and unaffected siblings during encoding of stimulus implies potential endophenotypic marker in children with ADHD compared to neurotypical controls.
背景:默认模式网络的持续激活被认为与注意力缺陷多动障碍(ADHD)儿童在完成认知任务过程中的瞬间注意力缺失和较高错误率有关。尽管有新的证据表明ADHD有遗传基础,但研究ADHD儿童及其未受影响的兄弟姐妹的DMN改变的文献却很少。目的:研究ADHD儿童与他们的兄弟姐妹和神经典型对照组相比的DMN皮层来源:86名参与者(35名多动症儿童(12.4(±2.7)岁)、16名未受影响的兄弟姐妹(11.8(±4.3)岁)和35名匹配的神经典型对照组儿童(12.6(±3.6)岁)参加了研究。研究人员采集了128个通道的静息和Stroop认知任务时的脑电图数据,并使用LORETA软件进行皮层源估算分析:结果:在对颜色-文字刺激进行编码时,观察到多动症儿童的DMN和DMN相关区域的激活程度较高。在所有组别中都观察到了DMN核心区域(即额叶内侧回、扣带回后部、海马旁回和顶叶下部)的持续激活。在三个组别中,与基线相比,多动症儿童在任务编码阶段仅在 DMN 及其相关区域发现了明显的皮质源激活差异。相比之下,同胞兄弟姐妹和神经典型对照组的前颞区辅助执行功能的区域也出现了激活:结论:与神经典型对照组相比,多动症儿童和未受影响的兄弟姐妹在刺激编码期间DMN区域持续活跃,而执行网络的活动极少,这意味着多动症儿童存在潜在的内表型标记。
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引用次数: 0
The ban on alcohol consumption and the tragedy of death by alcohol poisoning in Iran 伊朗的禁酒令与酒精中毒死亡悲剧
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-22 DOI: 10.1016/j.ajp.2024.104286
Bijan Pirnia, Alireza Ellieen
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引用次数: 0
Spiritual integration in counseling for student suicide prevention in higher education in Indonesia 印尼高校预防学生自杀辅导中的精神整合
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-22 DOI: 10.1016/j.ajp.2024.104287
Rizky Andana Pohan, Aidir Husni, Mustika Delima, Putri Bunga Aisyah Pohan, Ririn Dwi Astuti, Marhaban Marhaban
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引用次数: 0
Depressive symptoms among Chinese adolescents from single parent families present a downward trend in the past 25 years: A cross-temporal meta-analysis 中国单亲家庭青少年的抑郁症状在过去25年中呈下降趋势:跨时空荟萃分析
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-22 DOI: 10.1016/j.ajp.2024.104288
Xiaohan Liu , Sijia Guo , Mingyu Zhang , Ning Huang , Yongqi Huang , La Mang , Siying Zhu , Jing Guo

Background

In recent decades, depressive symptoms have intensified among Chinese adolescents, particularly those from single-parent homes, who are presumed to face heightened mental health risks. Nonetheless, economic growth, fertility policy reforms, and cultural openness have enhanced the adaptability of these adolescents, enabling them to better manage depressive symptom risks.

Aim and method

This study aims to scrutinize the evolving trends of depressive symptoms and explore the related social factors among Chinese adolescents from single-parent families. We involved 109 studies by a Cross-temporal meta-analysis.

Results

Over the past 25 years, the prevalence of depressive symptoms in adolescents from single-parent homes has annually declined. Economic status negatively correlates with depressive symptoms in the current year and 5 years prior. Birth rate, household size negatively impact symptoms, while urbanization level inversely correlates in the present and 5 years ago. Unemployment rate shows negative correlations 5 years apart but positive in the current year. Divorce rates exhibit similar patterns, negative before and now.

Conclusion

The above results indicate that depressive symptoms among Chinese adolescents from single-parent families present a downward trend over time with social development. Macro-level factors such as economic instability, policy dynamics, and shifting attitudes towards marriage had a correlation with depression among adolescents from single-parent families. Future studies can dig into the details of the impact on the mental health of adolescents from single-parent families.
背景:近几十年来,中国青少年抑郁症状加剧,尤其是来自单亲家庭的青少年,他们被认为面临着更高的心理健康风险。然而,经济增长、生育政策改革和文化开放提高了这些青少年的适应能力,使他们能够更好地控制抑郁症状风险:本研究旨在观察中国单亲家庭青少年抑郁症状的演变趋势,并探讨与之相关的社会因素。我们通过跨时空荟萃分析法对109项研究进行了分析:结果:在过去的 25 年中,单亲家庭青少年抑郁症状的发生率逐年下降。经济状况与当年及五年前的抑郁症状呈负相关。出生率和家庭规模对抑郁症状有负面影响,而城市化水平与当年和 5 年前的抑郁症状呈反向关系。失业率在 5 年前呈负相关,但在当年呈正相关。离婚率表现出类似的模式,以前和现在均为负相关:上述结果表明,随着社会的发展,中国单亲家庭青少年的抑郁症状呈下降趋势。经济不稳定、政策动态、婚姻观念转变等宏观因素与单亲家庭青少年抑郁有一定的相关性。未来的研究可以深入探讨单亲家庭青少年心理健康的影响细节。
{"title":"Depressive symptoms among Chinese adolescents from single parent families present a downward trend in the past 25 years: A cross-temporal meta-analysis","authors":"Xiaohan Liu ,&nbsp;Sijia Guo ,&nbsp;Mingyu Zhang ,&nbsp;Ning Huang ,&nbsp;Yongqi Huang ,&nbsp;La Mang ,&nbsp;Siying Zhu ,&nbsp;Jing Guo","doi":"10.1016/j.ajp.2024.104288","DOIUrl":"10.1016/j.ajp.2024.104288","url":null,"abstract":"<div><h3>Background</h3><div>In recent decades, depressive symptoms have intensified among Chinese adolescents, particularly those from single-parent homes, who are presumed to face heightened mental health risks. Nonetheless, economic growth, fertility policy reforms, and cultural openness have enhanced the adaptability of these adolescents, enabling them to better manage depressive symptom risks.</div></div><div><h3>Aim and method</h3><div>This study aims to scrutinize the evolving trends of depressive symptoms and explore the related social factors among Chinese adolescents from single-parent families. We involved 109 studies by a Cross-temporal meta-analysis.</div></div><div><h3>Results</h3><div>Over the past 25 years, the prevalence of depressive symptoms in adolescents from single-parent homes has annually declined. Economic status negatively correlates with depressive symptoms in the current year and 5 years prior. Birth rate, household size negatively impact symptoms, while urbanization level inversely correlates in the present and 5 years ago. Unemployment rate shows negative correlations 5 years apart but positive in the current year. Divorce rates exhibit similar patterns, negative before and now.</div></div><div><h3>Conclusion</h3><div>The above results indicate that depressive symptoms among Chinese adolescents from single-parent families present a downward trend over time with social development. Macro-level factors such as economic instability, policy dynamics, and shifting attitudes towards marriage had a correlation with depression among adolescents from single-parent families. Future studies can dig into the details of the impact on the mental health of adolescents from single-parent families.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"102 ","pages":"Article 104288"},"PeriodicalIF":3.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New paradigm for mental health in the Middle East: Integrating digital innovations and cultural models to reduce stigma and improve access to services 中东心理健康的新模式:整合数字创新和文化模式,减少耻辱感并改善服务获取途径
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-22 DOI: 10.1016/j.ajp.2024.104289
Mahdi Naeim
The following study proposes a new framework for mental health care in the Middle East that incorporates digital innovation along with culturally sensitive models to reduce stigma and improve access to mental health services. This framework will make use of technology and community-based strategies to overcome the region-specific problems in creating a more inclusive and effective mental health system.
以下研究为中东地区的心理保健提出了一个新框架,该框架将数字创新与文化敏感模式相结合,以减少耻辱感并改善心理保健服务的获取。该框架将利用技术和基于社区的战略,克服该地区在创建更具包容性和更有效的心理健康系统方面存在的具体问题。
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引用次数: 0
Validity and reliability of the new NIMHANS intellectual disability screening instrument (NID-Screener) for children and adolescents in India 印度儿童和青少年新的 NIMHANS 智力残疾筛查工具(NID-Screener)的有效性和可靠性。
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-22 DOI: 10.1016/j.ajp.2024.104282
Aaheli Roy , Gautham M. Sukumar , Rajendra Kiragasur Madegowda , Gayatri Tamuli , Banandur S. Pradeep

Introduction

There is a gap in tools specifically designed for assessing Intellectual Disability (ID) in Indian settings. To address this, the NIMHANS intellectual disability screening instrument (NID-Screener) was developed by the Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences.

Methods

Ten non experts/language and ten experts rated face and content validity of NID-Screener respectively. Content validity was measured by Content Validity Ratio, Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Construct validity was calculated by performing Exploratory Factor Analysis(EFA) on responses from 275 parent(s)/guardian(s) of children and adolescents (6–17 years). Criterion Validity was tested against Brief Intellectual Disability Scale (BIDS) and Clinical Diagnosis by Child and Adolescent Psychiatrist. Kappa Statistics was used to calculate inter – method and inter-Rater Reliability. Cronbach’s alpha was used to assess Internal Consistency. This study was approved by NIMHANS ethics committee.

Results

Findings revealed that NID-Screener has good face and content validity (S-CVI/Average = 0.917). Criterion Validity was excellent (Kappa Value=0.862, p-value<0.001) when compared with BIDS. Sensitivity and specificity were found to be 84.7 %, 89 % respectively against Clinical Diagnosis. On EFA, only one underlying factor with Eigen value > 1 was identified (55.8 % of total variance). Kappa value was found to be 0.971 and 0.942 for inter- rater and inter –method reliability respectively(p-value<0.001). NID-Screener has good internal consistency [Cronbach’s alpha = 0.841].

Conclusions

NID-Screener is a reliable and valid tool for screening ID among children and adolescents in India, facilitating its early detection through diagnostic assessments and subsequent interventions.
导言:在印度,专门用于评估智力障碍(ID)的工具还很缺乏。为解决这一问题,印度国家精神卫生和神经科学研究所儿童和青少年精神病学部开发了印度国家精神卫生和神经科学研究所智力残疾筛查工具(NID-Screener):方法:10 位非专家/语言专家和 10 位专家分别对 NID-Screener 的表面效度和内容效度进行了评定。内容效度通过内容效度比、内容效度指数(I-CVI、S-CVI)和修正卡帕统计来衡量。结构效度是通过对 275 名儿童和青少年(6-17 岁)的家长/监护人的回答进行探索性因子分析(EFA)来计算的。标准效度根据简明智力障碍量表(BIDS)和儿童及青少年精神科医生的临床诊断进行测试。Kappa 统计法用于计算方法间和评分者间的可靠性。Cronbach's alpha 用于评估内部一致性。这项研究获得了 NIMHANS 伦理委员会的批准:研究结果表明,NID-Screener 具有良好的表面效度和内容效度(S-CVI/Average = 0.917)。标准效度非常好(Kappa 值=0.862,P 值为 1(占总方差的 55.8%)。评分者之间和方法之间的 Kappa 值分别为 0.971 和 0.942(p 值):NID筛查器是筛查印度儿童和青少年智障的可靠有效工具,有助于通过诊断评估和后续干预措施及早发现智障。
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引用次数: 0
The role of gender and SES in exacerbating ACEs in children and adolescents 性别和社会经济地位在加剧儿童和青少年 ACE 中的作用。
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-21 DOI: 10.1016/j.ajp.2024.104281
Syafrida Selfiardy , Mint Husen Raya Aditama , Meisie Lenny Mangantes , Julduz Ruland Paus
{"title":"The role of gender and SES in exacerbating ACEs in children and adolescents","authors":"Syafrida Selfiardy ,&nbsp;Mint Husen Raya Aditama ,&nbsp;Meisie Lenny Mangantes ,&nbsp;Julduz Ruland Paus","doi":"10.1016/j.ajp.2024.104281","DOIUrl":"10.1016/j.ajp.2024.104281","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"102 ","pages":"Article 104281"},"PeriodicalIF":3.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Addressing the misuse and abuse of trihexyphenidyl 解决三苯氧胺的误用和滥用问题。
IF 3.8 4区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-20 DOI: 10.1016/j.ajp.2024.104284
Lateef Olabisi Okeleji , Ayodeji Folorunsho Ajayi
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引用次数: 0
期刊
Asian journal of psychiatry
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