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Using Multivariate Statistics

The self-medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self-medication factors occur in a context of self-regulation vulnerabilities--primarily difficulties in regulating affects, self-esteem, relationships, and self-care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self-medication hypothesis of addictive disorders. The cause-consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self-medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.

The Self-medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications

Background-The diagnostic performance of the latest 64-slice CT scanner, with increased temporal(165 ms) and spatial(0.4 mm3) resolution, to detect significant stenoses in the clinically relevant coronary tree is unknown. Methods and Results -We studied 52 patients(34 men; mean age, 59.6± 12.1 years)with atypical chest pain, stable or unstable angina pectoris, or non-ST-segment elevation myocardial infarction scheduled for diagnostic conventional coronary angiography. All patients had stable sinus rhythm. Patients with initial heart rates ≥ 70 bpm received β -blockers. Mean scan time was 13.3± 0.9 seconds. The CT scans were analyzed by 2 observers unaware of the results of invasive coronary angiography, which was used as the standard of reference. All available coronary segments, regardless of size, were included in the evaluation. Lesions with ≥ 50 luminal narrowing were considered significant stenoses. Invasive coronary angiography demonstrated the absence of significant disease in 25% (13 of 52), single-vessel disease in 31% (16 of 52), and multivessel disease in 45% (23 of 52) of patients. One unsuccessful CT scan was classified as inconclusive. Ninety-four significant stenoses were present in the remaining 51 patients. Sensitivity, specificity, and positive and negative predictive values of CT for detecting significant stenoses on a segment-by-segment analysis were 99% (93 of 94; 95% CI, 94 to 99), 95% (601 of 631; 95% CI, 93 to 96), 76% (93 of 123; 95% CI, 67 to 89), and 99% (601 of 602; 95% CI, 99 to 100), respectively. Conclusions -Noninvasive 64-slice CT coronary angiography accurately detects coronary stenoses in patients in sinus rhythm and presenting with atypical chest pain, stable or unstable angina, or non-ST-segment elevation myocardial infarction.

High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography

Objective: Although the proven link between parenting stress, postnatal depression and anxiety, no study has investigated such relationship among fathers and mothers. The specific aims of this study were: 1) to investigate whether there were any differences between first-time fathers’ and mothers’ postnatal parenting stress, anxiety and depression symptoms and to see their evolution between 3 and 6 months after the child’s birth; 2) to explore how one’s own parenting stress and anxiety levels and the anxiety-depressive symptoms of the partner contribute to parental postnatal depression. Method: The sample was composed by 362 parents – 181 couples - (mothers’ MAge = 35.03, SD = 4.7; fathers’ MAge = 37.9, SD = 5.6) of a healthy baby. At three (T1) and six months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory. Results: Analyses showed that, compared to fathers, mothers reported higher scores on postpartum anxiety, depression and parenting stress. Scores on all measures for both mothers and fathers decreased from T1 to T2. However, path analyses suggested that the persistence of both maternal and paternal postnatal depression were influenced directly by one’s own levels of anxiety and parenting stress as well as by the presence of partner’s depression. Discussion: The study pointed out the relevant impact and effects of both maternal and paternal stress, anxiety and depression symptoms during the transition to parenthood. Therefore, in order to provide efficacious, targeted, early interventions, perinatal screening should always be directed to both parents.

/pdf/perinatal-parenting-stress-anxiety-and-depression-outcomes-1cb02nxg2l.pdf

Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study.

Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.

/pdf/the-economic-case-for-the-prevention-of-mental-illness-2j51y9s3jt.pdf

The Economic Case for the Prevention of Mental Illness

Transition to parenthood represents an important life event increasing vulnerability to psychological disorders. Postpartum depression and parenting distress are the most common psychological disturbances and a growing scientific evidence suggests that both mothers and fathers are involved in this developmental crisis. This paper aims to explore maternal and paternal experience of transition to parenthood in terms of parenting distress and risk of postpartum depression. Seventy-five couples of first-time parents were invited to compile the Edinburgh Postnatal Depression Scale and the Parenting Stress Index-Short Form in the first month of children life. Study sample reported very high levels of parenting distress and a risk of postpartum depression in 20.8% of mothers and 5.7% of fathers. No significant correlation between parenting distress and the risk of postpartum depression emerged, both in mothers than in fathers group while maternal distress levels are related to paternal one. The first month after partum represents a critical phase of parents life and it could be considered a developmental crisis characterized by anxiety, stress and mood alterations that could have important repercussions on the child psycho-physical development.

/pdf/paternal-and-maternal-transition-to-parenthood-the-risk-of-4wfffb0ige.pdf

Paternal and Maternal Transition to Parenthood: The Risk of Postpartum Depression and Parenting Stress.

The COVID-19 pandemic that has hit the world in the year 2020 has put a strain on our ability to cope with events and revolutionized our daily habits. On 9 March, Italy was forced to lockdown to prevent the spread of the infection, with measures including the mandatory closure of schools and nonessential activities, travel restrictions, and the obligation to spend entire weeks in the same physical space. The aim of this study was to assess the impact of the COVID-19 pandemic and lockdown measures on quality of life (QoL) in a large Italian sample, in order to investigate possible differences in QoL levels related to both demographic and pandemic-specific variables. A total of 2251 Italian adults (1665 women, mainly young and middle adults) were recruited via a snowball sampling strategy. Participants were requested to answer to an online survey, which included demographic and COVID-related information items, and the World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF). The results showed statistically significant differences in QoL depending on a number of variables, including sex, area of residence in Italy, and being diagnosed with a medical/psychiatric condition. To our knowledge, this is the first study to assess QoL during COVID-19 pandemic in Italy, therefore the present findings can offer guidelines regarding which social groups are more vulnerable of a decline in QoL and would benefit of psychological interventions.

https://www.mdpi.com/2077-0383/10/2/289/pdf

The Impact of COVID-19 Pandemic and Lockdown Measures on Quality of Life among Italian General Population.

Background
Self-image is the subjective perception about one's own self, body, mental functioning, social attitudes, and adjustment in different aspects of life. Research has linked negative self-image with a number of problem behaviors and psychiatric symptoms in adolescence; however, studies of the relationship between self-image and anxiety disorders are still scarce.

Method
This study involved a community sample of 1305 high-school students (51.4% female) who ranged in age from 14 to 19 years old. They completed self-report measures of self-image and social anxiety disorder (SAD).

Results
A quarter of the students reported high levels of social anxiety. Statistical analyses showed significant differences between these students and the other students in all the self-image subscales. Several dimensions of impaired self-image (emotional tone, social attitudes, vocational and educational goals, family relationships, external mastery, and psychological health) were associated with high levels of social anxiety, with some gender differences underpinning these relationships.

Conclusions
Clinicians treating SAD in youth may wish to consider that a negative self-image may play a critical role in the onset and retention of social anxiety symptoms.

The relationship between self-Image and social anxiety in adolescence.

Coeliac disease (CD) is a chronic disease which could stress patients and their family. Although, poor attention has been paid to the quality of life in CD children and to the functioning of families with CD children. The study aims to evaluate the parenting perception of the CD impact and the parenting distress level. A group of 74 parents of CD children compiled the Impact Childhood Illness Scale and the Parenting Stress Index which is also compiled by 74 parents of health children. The assessment does not reveal a significant impact of CD on patient’s personal life although some critical areas emerged. Results evidenced an higher level of parenting stress in parents of CD children than parents of healthy children. CD, if suitably managed, has not a critical impact on parenting perception. Although, CD certainly put parents through an higher risk of a distress related to parenting role than parents with health children. A early identification of parenting distress in a pediatric chronic illness could facilitate the adjustment to pathology.

/pdf/parenting-stress-and-impact-of-illness-in-parents-of-4f501g7uyn.pdf

Parenting stress and impact of illness in parents of children with coeliac disease

Background

Respiratory allergic symptoms impact on social life and school activities, influencing the patient's mood states. We evaluated the relationships between allergic respiratory diseases and depressive/anxious mood in a large sample of Italian middle school students, using the partial directed acyclic graph (P-DAG).



Methods

We studied 1283 subjects aged 10–13. A health respiratory questionnaire including questions relevant to socioeconomic status (HCI) and a test for depression and anxiety were administered. All subjects performed spirometry and skin prick tests.



Results

A causal role of rhinitis on depression was found: the likelihood of being depressed increased from 11.2 to 17.7%, when rhinitis was present. Moreover, a direct effect of low HCI on depressive mood was shown (p < 0.0001) as well as the correlation between anxiety and depression (p < 0.0001). Gender was not a direct causal factor for depressive mood, but their relation was mediated through anxious mood. Anxiety appeared to have a stronger association with depression than gender. Allergic sensitization was significantly related to both asthma and rhinitis (p < 0.0001, respectively). Asthma and rhinitis were also directly associated (p < 0.0001). Conversely, asthma was not directly associated with depressive mood, but their relation was mediated through rhinitis. Body mass index (BMI) and impaired lung function (IPF) were not associated with the other variables.



Conclusions

The use of this novel approach to analyzing the dynamic relationships allowed us to find a causal role of rhinitis on depressive state. Moreover, anxious condition and low socioeconomic status contributed to induce depressive mood.

/pdf/rhinitis-as-a-risk-factor-for-depressive-mood-in-pre-25zayqoyh0.pdf

Sabina La Grutta

Papers

Paternal and Maternal Transition to Parenthood: The Risk of Postpartum Depression and Parenting Stress.

The Impact of COVID-19 Pandemic and Lockdown Measures on Quality of Life among Italian General Population.

The relationship between self-Image and social anxiety in adolescence.

Parenting stress and impact of illness in parents of children with coeliac disease

Rhinitis as a risk factor for depressive mood in pre-adolescents: a new approach to this relationship.