BMC Psychiatry最新文献

Background: Working in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran.

Methods: This study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis.

Results: The findings showed that the average job fatigue reached 16.78[Formula: see text] 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue.

Conclusion: Treatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel's mental health and the quality of services provided to patients.

Clinical trial number: Not applicable.

Background: Schizophrenia is a complex neuropsychiatric disorder. Growing evidence indicates that the activation of the inflammatory response system with interleukin (IL)-2, IL-4, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α) plays an important role in the pathogenesis of schizophrenia,. However, clinical data on cytokine levels in patients with schizophrenia treated with antipsychotics are inconsistent or inconclusive. In this study, we have examined inflammatory factors' alterations and their relationship to changes in clinical symptoms before and after olanzapine treatment of drug-naive patients with first-episode schizophrenia.

Methods: We recruited 142 hospitalized patients with first-episode schizophrenia as a study group; blood samples were collected, and the patients were assessed for clinical symptoms at baseline and after 6 weeks of olanzapine treatment. One hundred individuals with no history of mental illness were also recruited as healthy controls. Blood samples were collected, and the serum levels of IL-2, IL-4, IL-8, IL-10, and TNF-α were determined using an enzyme cycling assay. The severity of clinical symptoms was assessed according to the Positive and Negative Syndrome Scale (PANSS).

Results: Individuals with schizophrenia had lower IL-8 levels and higher IL-10 levels than healthy controls (P < 0.001). Positive correlations were detected between serum IL-2 and IL-10 concentrations and each subscale of the PANSS (all P < 0.05). Moreover, a negative correlation existed between the serum IL-8 concentration and the PANSS negative score (r = - 0.172, P = 0.040). After 6 weeks of treatment, serum IL-8 levels in the patient group were lower than at baseline (P < 0.001), whereas serum IL-10 and TNF-α levels were higher than at baseline (all P < 0.05). Therefore, serum IL-10 can be determined as an independent risk factor for outcome in patients with first-episode schizophrenia (P = 0.02, OR = 2.327). Furthermore, serum IL-2, IL-10, and TNF-α levels were significantly lower, whereas the serum IL-8 level was significantly higher (P < 0.001) in the healthy control group than in the "response" and "no-response" treatment groups respectively.

Conclusions: Our results indicate that serum IL-2, IL-8, IL-10, and TNF-α levels may be involved in the pathophysiological mechanisms of schizophrenia and correlate with the effects of olanzapine.

Background: In Ghana, the use of illegal drugs and alcohol has been classified as endemic. To manage this menace, the Therapeutic Community model for Substance Use Disorders (SUD) was introduced in Ghana about a decade ago as an alternative to other existing strategies. However, the effectiveness of this treatment modality for substance use disorders in Pantang Mental Hospital and Accra Psychiatric Hospital has not been scientifically studied.

Objective: This study, therefore, sought to explore the experiences of substance users or residents enrolled in the Therapeutic Community programme toward recovery from substance use disorders.

Method: This research employed an explorative-descriptive design. Participants (N = 20) were enrolled purposively sampled and recruited into the study. Face-to-face interviews were conducted using a semi-structured guide and data were analyzed using Colaizzi's descriptive phenomenology data analysis process.

Results: Two main themes emerged from the data: "Why I stayed" (Motivation), and "All things are new" (Life transformation). The study pointed out that residents or participants mainly expressed positive experiences in the programme, including experiencing a sense of belongingness, enhanced self-esteem/self-worth, and most importantly, developing hope of a life free of addiction.

Conclusion: In conclusion, the study found that participants in the Therapeutic Community (TC) program generally had positive experiences and believed in its effectiveness for recovery. Factors such as a relaxed environment, supportive staff, and interactions with other residents contributed to their positive experience. The study discovered that motivation, a conducive environment for care, structured program activities, and relationships among residents were key factors that motivated participants to stay and actively participate in the therapeutic community program. These factors fostered hope and a sense of belonging, ultimately contributing to their recovery journey. However, participants expressed the need for self-actualization, which they hoped to achieve after completing the program and reintegrating into the community.

Background: Mental healthcare provision is undergoing substantial reconfiguration in many regions of the world. Such changes require a broad, evidence-based approach incorporating epidemiological data and information on local needs. The objective of this study was to estimate the prevalence of schizophrenia spectrum disorders (SSD) in the Lazio region and its geographical distribution using regional administrative healthcare databases.

Methods: Cases of SSD (15-64 years old) were identified using an algorithm based on data from the hospital discharge registry (ICD IX CM: 295, 297, 298 [excl. 298.0], 299) and the ticket exemption database [code 044], between 2006 and 2019. We calculated crude, age- and gender-specific prevalence estimates on December 31, 2019. We also calculated age- and gender-adjusted prevalence to compare prevalence in different regional areas.

Results: We identified 18,371 cases. The overall prevalence was 5.03 per 1000 population (95% CI 4.96-5.10). Age-adjusted prevalence estimates were 4.18 (95% CI 4.09-4.27) per 1000 for women and 5.92 (95% CI 5.81-6.04) per 1000 for men. The prevalence was higher among older age groups, in both genders. There were differences in prevalence within the region, ranging from 4.25/1000 in the province of Viterbo to 5.42/1000 in Rome and 6.02/1000 in the province of Frosinone. When we analysed the subcategories of SSD, the three most frequent conditions were schizophrenia, schizoaffective disorder, and psychosis NOS. In general, the prevalence was higher in men for all the conditions but delusional disorders and brief psychosis.

Conclusions: Our results show that the overall prevalence of SSD among adults in the Lazio region is similar to those published in previous reviews, but an uneven regional distribution was observed. While possible underestimation must be considered, administrative databases represent a valuable source of information for epidemiological surveillance and healthcare planning.

Background: Non-suicidal self-injury (NSSI) behaviors pose a significant threat to the physical and psychological well-being of adolescents. Recent research suggests that persistent, uncontrollable and repetitive NSSI can be conceptualized as a behavioral addiction. The addictive feature of NSSI behavior can be assessed using Ottawa self-injury inventory (OSI), the higher addiction score indicates the more serious NSSI behavior. This study aims to explore the relationship of impulsivity and decision-making on the addictive features of NSSI in adolescents with depressive disorder, to explore the influencing factors of behavioral addictive features of NSSI and to predict the addictive features of NSSI.

Methods: Using a cross-sectional design, a total of 126 adolescent outpatients and inpatients with a mean age of 15.49 years old (M = 15.49, SD = 1.56), male students (n = 28, 22.2%) and female students (n = 98, 77.8%) diagnosed with depressive disorders were recruited according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and clinical interviews were completed by two psychiatrists. NSSI addictive features according to the OSI's addictive features items. The final group was categorized into three groups: depression without NSSI (n = 42), depression with NSSI without addictive features (n = 44), and depression with NSSI and addictive features (n = 40). The present study employed the Hamilton Depression Scale (HAMD-24), Chinese Revised Barratt Impulsiveness Scale Version 11 (BIS-11), OSI, and the Adolescent Non-Suicidal Self-Injury Questionnaire (ANSSIQ). Cognitive decision-making abilities were assessed using the Iowa Gambling Task (IGT).

Results: The depression with NSSI addictive features group had significantly lower total net scores and net scores of block3, block4, and block5 in the IGT than the depression without NSSI group, whereas there was no statistically significant difference between the two in net scores of block1 and block2. Lower scores mean more unfavorable decisions and strategy adjustments. The addictive features of NSSI behaviors were significantly and positively correlated with the severity of NSSI behaviors, depression, and cognitive impulsiveness, and significantly and negatively correlated with the total net score of the IGT. The severity of NSSI behaviors, severity of depression, cognitive impulsiveness positively predicts the addictive features of NSSI behaviors, the total net score of the IGT negatively predicted the addictive features of NSSI behaviors.

Conclusion: Adolescents with depressive disorders with NSSI behavioral addictive features had higher severity of depression, exhibited higher cognitive impulsivity, and made more unfavorable decisions when making choices.

Background: Research suggests that individuals with obsessive-compulsive disorder (OCD) frequently experience insomnia. Some previous studies have suggested that insomnia may predict treatment outcomes, but the evidence is limited, especially for adolescents. This study examined the prevalence of insomnia in an adolescent OCD patient sample, explored the correlation between OCD and insomnia, and tested whether levels of insomnia at baseline predict outcomes for adolescent patients receiving the Bergen 4-Day Treatment (B4DT) for OCD.

Methods: Forty-three adolescent OCD patients who received B4DT were selected for this study. Treatment outcome was quantified as change in Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores across time from pre- to posttreatment and 3-month follow-up. Insomnia symptoms were measured by the Bergen Insomnia Scale (BIS). Linear mixed models were used to examine the relationship between the BIS and changes in CY-BOCS scores. We controlled for symptoms of general anxiety disorder measured by the GAD-7 and depression symptoms measured by the PHQ-9.

Results: In this sample, 68.4% of the patients scored above the cutoff for insomnia on the BIS. There was a moderate correlation between baseline CY-BOCS and BIS that did not reach statistical significance (r = .32, p = .051). High BIS scores before treatment were significantly associated with poorer treatment outcomes, as measured by changes in CY-BOCS over time (p = .002). The association between baseline insomnia and change in OCD symptoms remained significant (p = .033) while controlling for GAD-7 and PHQ-9.

Conclusion: Insomnia is common among adolescents with OCD, and these data suggest that these patients may be at increased risk for poor treatment outcomes. Future research to explore mechanisms and adjunctive treatments is warranted.

Trial registration: The study was approved by the Regional Committee for Medical and Health Research Ethics of Northern Norway (REK Nord: 2023/606482).

Background: Identifying the factors affecting emotional divorce due to the negative consequences of this social problem in women can play an important role in preventing its occurrence. Therefore, the present study aimed to investigate the relationship between internet addiction, domestic violence, and emotional divorce among married women in Tehran.

Methods: A cross-sectional survey was conducted among married women in Tehran, Iran. Sampling was conducted first through a multi-stage cluster method and then continued using a random method. Tehran was divided into five parts: central, northern, southern, eastern, and western. The sample size was divided by 5, resulting in 80 participants selected from each part. In each part, two regions were selected, and in each region, 40 houses were randomly selected. Researchers visited the selected houses, and the questionnaires were filled out at home by the women. Tools such as Gottman's Emotional Divorce Test, Young's Internet Addiction Test, and the Domestic Violence against Women Survey were used to collect data. Descriptive and inferential statistics were used to analyze the data in SPSS (version 24) software.

Results: A total of 400 women participated in the study. 46% of all married women suffered emotional divorce. The analysis of these tests showed that are positive and significant relationships between emotional divorce and internet addiction (r = 0.626, p < 0.0001), emotional divorce and domestic violence (r = 0.632, p < 0.0001), and internet addiction and domestic violence (r = 0.455, p < 0.0001). It was also found that there are significant negative relationships between emotional divorce and both the level of education (r=-0.115, p = 0.021) and employment status (r=-0.512, p < 0.0001). Additionally, there are significant negative relationships between internet addiction and age (r=-0.285, p < 0.0001), duration of marriage (r=-0.237, p < 0.0001) and employment status (r=-0.694, p < 0.0001). Furthermore, it was revealed that there are significant negative relationship between domestic violence and age (r=-0.104, p = 0.037) and level of education (r=-0.156, p = 0.002).

Conclusion: Almost half of the married women in this study experienced emotional divorce, internet addiction, and domestic violence. These factors have a direct relationship with emotional divorce. Future studies are needed to understand how internet addiction might be associated with separation, emotional divorce and family problems.

Background: Second-generation antipsychotic drugs are increasingly used to treat depressive disorders with psychotic symptoms. In addition to effectively managing psychotic symptoms, second-generation antipsychotics can also result in adverse drug reactions in patients, which should not be underestimated.

Case presentation: We report the case of 14 years old unmarried female patient with depression. At first, she started with moping and gradually developed into self-injury and whispering. After antidepressant treatment combined with the second-generation antipsychotic drug blonanserin, the patient's psychotic and depressive symptoms improved significantly, while the patient developed lactation, which stopped after the medication was changed.

Conclusions: Although Blonanserin's clinical trials have reported rare adverse reactions like elevated prolactin levels and even lactation, caution is still needed in clinical application of the drug. This case is expected to improve psychiatrists' choice of antidepressant therapy in combination with antipsychotic drugs.

Background: Data on Emotion Dysregulation among youth in Lebanon is scarce. Given that Emotion Dysregulation is associated with psychopathology and has a negative impact on youth outcomes, there is a need to better understand the prevalence, clinical and demographic correlates of Emotion Dysregulation.

Methods: This study is a secondary analysis of the Psychopathology in Children and Adolescents in Lebanon Study which recruited 1517 youth and one parent from a nationally representative sample. Participants completed The Screen for Child Anxiety Related Emotional Disorders, Mood and Feelings Questionnaire, Strengths and Difficulties Questionnaire, Peer Relations Questionnaire, Conflict Behavior Questionnaire (CBQ).Parents completed a sociodemographic questionnaire and the General Health Questionnaire (GHQ). The Strengths and Difficulties Questionnaire-Dysregulation Profile was used to measure Emotion Dysregulation.

Results: The prevalence of Emotion Dysregulation was 11.26% among children aged 5 to < 8 years, 9.40% among children aged 8 to < 12 years and 6.60% among those older than 12 years. Emotion Dysregulation was associated with psychopathology across age groups and a number of correlates were identified. In the final regression models, among children aged 5 to < 8 years; Emotion Dysregulation was associated with lower odds of father employment (OR = 0.235;CI[0.078,0.704]). For those aged 8 to < 12 years old, Emotion Dysregulation was associated with acceptable school performance (OR = 2.246,CI[1.209,4.173]) as opposed to a good school performance, having a chronic physical illness (OR = 2.962; CI [1.495,5.867)], and higher parental GHQ scores (OR = 1.034;CI [1.010,10.58)] indicating worse parental mental health. Adolescents aged 12 years and older who screened positive for Emotion Dysregulation were more likely to be younger (OR = 0.688, CI[0.527,0.899]), be a bully (OR = 2.467;CI[1.036,5.875] and to have higher parental CBQ scores (OR = 1.092;CI [1.011,1.180]), indicating worse parent-child conflict. Youth who screened positive for emotion dysregulation were more likely to seek psychiatric care than their counterparts who screen negative for emotion dysregulation.

Conclusion: Age, school performance, parental mental health, parental conflict, chronic physical illness and bullying emerge as important correlates of Emotion Dysregulation. Findings add to the limited data on Emotion Dysregulation in Lebanon and the region and are a first step towards developing intervention and prevention strategies.