Showing papers in "Journal of Nervous and Mental Disease in 2018"

ICD-11 Prevalence Rates of Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in a German Nationwide Sample.

Abstract: Prevalence rates are still lacking for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) diagnoses based on the new ICD-11 criteria In a nationwide representative German sample (N = 2524; 14-99 years), exposure to traumatic events and symptoms of PTSD or CPTSD were assessed with the International Trauma Questionnaire A clinical variant of CPTSD with a lower threshold for core PTSD symptoms was also calculated, in addition to conditional prevalence rates dependent on trauma type and differential predictors One-month prevalence rates were as follows: PTSD, 15%; CPTSD, 05%; and CPTSD variant, 07% For PTSD, the highest conditional prevalence was associated with kidnapping or rape, and the highest CPTSD rates were associated with sexual childhood abuse or rape PTSD and CPTSD were best differentiated by sexual violence Combined PTSD and CPTSD (ICD-11) rates were in the range of previously reported prevalences for unified PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; ICD-10) Evidence on differential predictors of PTSD and CPTSD is still preliminary

The Emerging Imperative for a Consensus Approach Toward the Rating and Clinical Recommendation of Mental Health Apps.

Abstract: With over 10,000 mental health- and psychiatry-related smartphone apps available today and expanding, there is a need for reliable and valid evaluation of these digital tools. However, the updating and nonstatic nature of smartphone apps, expanding privacy concerns, varying degrees of usability, and evolving interoperability standards, among other factors, present serious challenges for app evaluation. In this article, we provide a narrative review of various schemes toward app evaluations, including commercial app store metrics, government initiatives, patient-centric approaches, point-based scoring, academic platforms, and expert review systems. We demonstrate that these different approaches toward app evaluation each offer unique benefits but often do not agree to each other and produce varied conclusions as to which apps are useful or not. Although there are no simple solutions, we briefly introduce a new initiative that aims to unify the current controversies in app elevation called CHART (Collaborative Health App Rating Teams), which will be further discussed in a second article in this series.

Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters: The Mediating Role of Anxiety Sensitivity.

Abstract: Posttraumatic stress disorder (PTSD) symptoms are positively related to suicide risk among firefighters. One mechanism that may account for this relationship is anxiety sensitivity (AS) cognitive concerns-the fear that cognitive symptoms of anxiety will have catastrophic consequences. We sought to replicate the mediating effect of AS cognitive concerns on the relationship between PTSD symptoms and suicide risk among 214 trauma-exposed male firefighters with non-zero suicide risk. Bootstrap mediation analyses tested AS cognitive concerns as a statistical mediator of PTSD symptoms (total and symptoms clusters scores) and suicide risk, controlling for depression symptoms and relevant demographic variables. AS cognitive concerns statistically mediated the relationship between PTSD symptoms (total score, as well as intrusion, avoidance, and arousal-reactivity symptoms clusters) and suicide risk; however, the reverse was also true. AS cognitive concerns may confer risk for suicide among trauma-exposed firefighters. Firefighters may benefit from AS-specific interventions, which are shown to reduce PTSD symptoms and suicidality.

A Survey of American Psychiatrists' Attitudes Toward Classic Hallucinogens.

Abstract: Recent years have seen renewed interest and research about the use of hallucinogens as possible agents in the treatment of psychiatric disorders. However, we are unaware of studies assessing the current attitudes of American psychiatrists regarding hallucinogens. Therefore, we e-mailed surveys to 1000 members of the American Psychiatric Association-250 resident-fellows and 750 attending psychiatrists. The response rate was 32.4%. Respondents tended to perceive hallucinogens as potentially hazardous and appropriately illegal for recreational purposes. However, a large minority expressed optimism about the potential use of hallucinogens for psychiatric treatment. Male and trainee respondents, as compared with female and attending respondents, reported less concern about the risks of hallucinogens and greater optimism about their therapeutic potential. Younger psychiatrists also seemed more optimistic. Optimism among trainees and younger psychiatrists may possibly reflect greater exposure to recent positive publications about hallucinogens and less awareness of more negative past reports.

The Relationships Between Weight Bias, Perceived Weight Stigma, Eating Behavior, and Psychological Distress Among Undergraduate Students in Hong Kong.

Abstract: Weight bias issues are rarely discussed in Asian. Therefore, we examined the relationships between weight bias, perceived weight stigma (PWS), eating behavior, and psychological distress among Hong Kong people. Using cross-sectional design, 400 undergraduate students (175 men) completed questionnaires and were assigned into a self-reported overweight (n = 61) or nonoverweight group (n = 339) using body mass index, and a self-perceived overweight (n = 84) or nonoverweight group (n = 316) based on self-perception. For self-reported and self-perceived overweight groups, more weight bias was related to higher depression (β = -0.403; p = 0.004). Self-perceived group additionally showed that weight bias was related to PWS and inappropriate eating behaviors; PWS related to inappropriate eating behaviors. For self-reported and self-perceived nonoverweight groups, weight bias was related to PWS, inappropriate eating behaviors, anxiety, and depression (β = -0.228 to -0.148; p's < 0.05); PWS was associated with inappropriate eating behaviors, anxiety, and depression. Thus, weight bias issues should not be ignored for both overweight and nonoverweight people.

Mental Health Impact of Homecoming Experience Among 1730 Formerly Deployed Veterans From the Vietnam War to Current Conflicts: Results From the Veterans' Health Study.

Abstract: We examined the effects of homecoming support on current mental health among 1730 deployed veterans from Vietnam, Iraq/Afghanistan, Persian Gulf, and other conflicts. The prevalence of current posttraumatic stress disorder (PTSD) was 5.4%, current depression was 8.3%, and 5.4% had suicidal thoughts in the past month. Overall, 26% of veterans had low homecoming support, which was more prevalent among Vietnam veterans (44.3%, p < 0.001). In multivariable logistic regressions, controlling for demographics, combat exposure, number of deployments, trauma history, and operational theater, low postdeployment support was associated with PTSD (odds ratio, 2.13; p = 0.032) and suicidality (odds ratio, 1.91; p < 0.030), but not depression. For suicidality, an interaction was detected for homecoming by theater status, whereby Iraq/Afghanistan veterans with lower homecoming support had a higher probability of suicidal thoughts (p = 0.002). Thus, years after deployment, lower homecoming support was associated with current PTSD and suicidality, regardless of theater and warzone exposures. For suicidality, lower support had a greater impact on Iraq/Afghanistan veterans.

Effects of Mind-Body Exercise on Cognitive Function in Older Adults With Cognitive Impairment: A Systematic Review and Meta-analysis

Abstract: To quantify the effects of mind-body exercise on cognitive function in older adults with cognitive impairment, we systematically searched five databases. Findings were analyzed according to the mean change of global cognition, memory, and executive function. Subgroup analyses were conducted based on the level of cognitive impairment and types of exercise. Thirteen studies were included. Analyses revealed that mind-body exercise was effective in promoting global cognition in individuals with cognitive impairment (standardized mean difference [SMD] = 0.61; 95% confidence interval, 0.21-1.00; p = 0.003), as well as in individuals with mild cognitive impairment (SMD = 0.46; 95% confidence interval, 0.06-0.85; p = 0.02) or dementia; dance was effective in promoting global cognition (SMD = 0.84; 95% confidence interval, 0.23-1.46; p = 0.007) and memory (SMD = 0.27; 95% confidence interval, 0.02-0.52; p = 0.04) in individuals with cognitive impairment, but tai chi was not. Nevertheless, additional well-designed randomized clinical trials are further needed.

Clinical and Serological Predictors of Suicide in Schizophrenia and Major Mood Disorders.

Abstract: Persons with serious mental illness are at high risk for suicide, but this outcome is difficult to predict. Serological markers may help to identify suicide risk. We prospectively assessed 733 persons with a schizophrenia spectrum disorder, 483 with bipolar disorder, and 76 with major depressive disorder for an average of 8.15 years. The initial evaluation consisted of clinical and demographic data as well as a blood samples from which immunoglobulin G antibodies to herpes viruses and Toxoplasma gondii were measured. Suicide was determined using data from the National Death Index. Cox proportional hazard regression models examined the role of baseline variables on suicide outcomes. Suicide was associated with male sex, divorced/separated status, Caucasian race, and elevated levels of antibodies to Cytomegalovirus (CMV). Increasing levels of CMV antibodies were associated with increasing hazard ratios for suicide. The identification of serological variables associated with suicide might provide more personalized methods for suicide prevention.

Is Tapping on Acupuncture Points an Active Ingredient in Emotional Freedom Techniques? A Systematic Review and Meta-analysis of Comparative Studies.

Abstract: We published a meta-analysis of component trials of emotional freedom techniques (EFT) in this journal. EFT is an evidence-based method, validated in over 100 clinical trials, that uses fingertip tapping on acupressure points in conjunction with techniques from exposure and cognitive therapy. The meta-analysis examined six studies in which an active control, such as diaphragmatic breathing or sham acupoints, was used in place of tapping on actual acupoints. The purpose of the meta-analysis was to determine whether tapping was an inert or an active ingredient in EFTs observed treatment effects. Subsequent to publication, errors in the statistical analysis were identified, primarily incorrect standard deviation values, and our methodological approach was questioned by others. We therefore had the meta-analysis rerun by an independent senior statistician who compared pre- to follow-up results to determine the sustained effects of treatment. The cumulative fixed effects Hedge's g-value was found to be 0.73 (95% confidence interval = 0.42-1.04, p < 0.0001). The corresponding random effects Hedge's g-value is 0.74 (95% confidence interval = 0.34-1.13, p < 0.0001). We also reviewed and clarified our methodology. In conclusion, despite computational errors in our original publication, the present revised analysis supports the original conclusion that the acupressure component of the EFT protocol is an active ingredient that contributes to the method's favorable health effects.

Metacognitive Interpersonal Therapy for Personality Disorders Featuring Emotional Inhibition: A Multiple Baseline Case Series.

Abstract: Metacognitive interpersonal therapy (MIT) is an integrative psychotherapeutic approach targeting personality disorders (PDs) featuring inhibition and avoidance. The current case series reports the outcome of a time-limited, 12-month MIT intervention for people with PDs featuring emotional inhibition. Seven participants were diagnosed with a PD on the basis of a structured clinical interview. The study followed a multiple baseline design, with baseline measures taken for 3 weeks before intervention. Participants underwent 12 months of weekly MIT sessions, with outcome measures taken every 3 months. Outcome variables were diagnostic recovery, symptom severity, and alexithymia. All participants improved over the course of the 12-month intervention across most measures. For six of the participants, the intervention was a likely driver of change. The current study contributes to a growing evidence base regarding the effectiveness of MIT for the treatment of PDs.

Attitudes Toward Disclosing a Mental Health Problem and Reemployment: A Longitudinal Study

Abstract: Despite low unemployment rates, individuals with mental health problems often struggle to gain reemployment. Many face the decision whether to disclose their mental illness to employers. This study therefore examined the role of disclosure attitudes for reemployment over time. Clinical and job search variables as well as attitudes toward disclosing a mental health issue to an employer were assessed among 301 unemployed individuals with mental health problems. Predictors of reemployment at 6-month follow-up were assessed using multiple regression, adjusted for sociodemographic variables, unemployment length, and depressive symptoms. Greater reluctance to disclose mental health problems at baseline predicted reemployment after 6 months. Reemployment was also associated with male sex, better education, lower disability levels, and more job offers at baseline. Therefore, a cautious approach toward disclosing a mental health problem may facilitate short-term reemployment. It is unclear whether this is a successful long-term strategy in employment settings.

A Positive Psychology Intervention to Promote Health Behaviors in Heart Failure: A Proof-of-Concept Trial.

Abstract: Patients with heart failure (HF) frequently struggle to adhere to health behaviors, and psychological factors may contribute to nonadherence. We examined the feasibility and acceptability of a 10-week, positive psychology (PP)-based intervention to promote health behavior adherence in patients (N = 10) with mild to moderate HF and suboptimal health behavior adherence. Participants engaged in weekly phone sessions, completed PP exercises (e.g., writing a gratitude letter, using a personal strength), and set goals related to diet, medication adherence, and physical activity. Feasibility was assessed by the number of sessions completed, and acceptability by participant ratings of ease and utility. Preliminary efficacy was measured by changes in psychological and adherence outcomes. The intervention was feasible (87% of exercises completed) and acceptable. Furthermore, in exploratory analyses, the intervention was associated with improvements in psychological and health behavior adherence outcomes. Larger, randomized trials are needed to further investigate the utility of this intervention. Trial registration ClinicalTrials.gov identifier: NCT02938052.

Tattoo Recognition in Screening for Victims of Human Trafficking.

Abstract: There is little information on the secondary prevention of human trafficking and how medical professionals can screen for victims. There is a paucity of validated screening tools for use in clinical settings to identify adult trafficked patients, although one for use in pediatric populations exists. Many victims withhold information about their trafficked status. Because traffickers may mark victims, identification of tattoos provides a useful method for screening patients, which complements history taking, especially when victims are unable to disclose that information. We searched existing medical literature, PsycINFO, PubMed, Google, and JSTOR using keywords "human," "trafficking," and "tattoos." Because there is scant literature on this topic, we also searched the gray literature that enabled preliminary identification of several themes used in trafficking tattoos. We also discussed tattoo placement and quality. Tattoo recognition is a critical factor in identifying victims and setting them on a pathway to freedom and recovery.

Cutting Words: A Commentary on Language and Stigma in the Context of Nonsuicidal Self-Injury.

Abstract: O ver the last 15 years, nonsuicidal self-injury (NSSI) has received increased attention in the research literature and popular media. Inclusion of NSSI disorder as a condition for further study in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) (2013) further prompted discussion of NSSI. However, despite efforts to discuss other mental health issues in a humanistic way, this shift in language has not been applied to NSSI. Specifically, although a behavior, the discourse surrounding discussion of NSSI is fundamentally grounded in language stemming frommodels of infectious disease. Language positioning NSSI as a disease, and one that may spread through “contagion,” increases stigma of both NSSI and peoplewho engage in the behavior. In this commentary, we argue that conversations about NSSI must be respectful of people who self-injure, and offer alternate language that fosters a better understanding of NSSI, reduces stigma, and facilitates help-seeking for peoplewishing to reduce their self-injury.

Moral Injury and Religiosity in US Veterans With Posttraumatic Stress Disorder Symptoms.

Abstract: Moral injury (MI) involves feelings of shame, grief, meaninglessness, and remorse from having violated core moral beliefs related to traumatic experiences. This multisite cross-sectional study examined the association between religious involvement (RI) and MI symptoms, mediators of the relationship, and the modifying effects of posttraumatic stress disorder (PTSD) severity in 373 US veterans with PTSD symptoms who served in a combat theater. Assessed were demographic, military, religious, physical, social, behavioral, and psychological characteristics using standard measures of RI, MI symptoms, PTSD, depression, and anxiety. MI was widespread, with over 90% reporting high levels of at least one MI symptom and the majority reporting at least five symptoms or more. In the overall sample, religiosity was inversely related to MI in bivariate analyses (r = -0.25, p < 0.0001) and multivariate analyses (B = -0.40, p = 0.001); however, this relationship was present only among veterans with severe PTSD (B = -0.65, p = 0.0003). These findings have relevance for the care of veterans with PTSD.

The Influence of Trauma Type and Timing on PTSD Symptoms.

Abstract: Although it is well known that different trauma histories can uniquely affect subsequent trauma-related symptoms, this is the first study to evaluate individual posttraumatic stress symptoms (PTSSs) in relation to trauma type and timing. This cross-sectional study surveyed a consecutive sample of mental health outpatients (n = 602), using regression to estimate associations between DSM-5 PTSSs and demographics, several trauma types, and age at first trauma in those with trauma (n = 367). Combat and sexual trauma were associated with worse total PTSS severity. Combat was significantly associated with arousal and intrusions (especially physical symptoms), sexual trauma with conscious avoidance and negative cognitions/mood (especially amnesia, an unconscious avoidance symptom), and physical assault with blame. Interpersonal traumas were the most common first traumas experienced, but age at first trauma was not significantly associated with PTSS severity. We discuss potential explanations and implications of these findings.

Assessing Severity of Psychological Distress Among Refugees With the Refugee Health Screener, 13-Item Version.

Abstract: The recent inflow of refugees to Sweden has put pressure on health care as well as revealing a need for methods regarding assessment of refugees' mental health status. The present study investigate ...

Social Anxiety and Benign and Toxic Online Self-Disclosures: An Investigation Into the Role of Rejection Sensitivity, Self-Regulation, and Internet Addiction in College Students

Abstract: This work aimed to explore the relationship between social anxiety with benign and toxic online self-disclosures with the mediating role of rejection sensitivity, self-regulation, and Internet addiction. In this study, 358 students who were active members of social networks at the Mohaghegh Ardabili University, Iran were evaluated in the form of a structural equation model. The results substantiated that social anxiety could explain 47% of the variance in benign online self-disclosure and 27% of toxic online self-disclosure with the mediating role of rejection sensitivity, self-regulation, and Internet addiction. It was found that people with high social anxiety had higher rejection sensitivity and lower self-regulation. Also, people with higher social anxiety had directly higher benign and toxic online self-disclosures. The results indicated that self-regulation did not have a direct impact on benign online self-disclosure; however, it had a direct negative impact on toxic online self-disclosure.

Certified Peer Specialists and Older Adults With Serious Mental Illness' Perspectives of the Impact of a Peer-Delivered and Technology-Supported Self-Management Intervention.

Abstract: We explored the perspectives of certified peer specialists and older adults with serious mental illness on the impact of a peer-delivered medical and psychiatric self-management intervention, "PeerTECH." Transcripts from interviews with consumers with serious mental illness and a focus group with certified peer specialists who were engaged in PeerTECH were analyzed. Consumer participants (n = 8) had a mean age of 68.8 years (SD = 4.9) and included individuals diagnosed with major depressive disorder (five people), schizophrenia spectrum disorders (two people), and bipolar disorder (one person). Certified peer specialists (n = 3) were aged 55 years or more. Themes included internal and external forces of accountability, confidence, internal and external locus of hope, human bonding, and peer support. This exploratory qualitative study found that human support from peers can potentially influence health behavioral change in a combined peer and technology-based medical and psychiatric illness self-management intervention.

Natural Medicines for Psychotic Disorders: A Systematic Review

Abstract: Patients with psychotic disorders regularly use natural medicines, although it is unclear whether these are effective and safe. The aim of this study was to provide an overview of evidence for improved outcomes by natural medicines. A systematic literature search was performed through Medline, PsycINFO, CINAHL, and Cochrane until May 2015. In 110 randomized controlled trials, evidence was found for glycine, sarcosine, N-acetylcysteine, some Chinese and ayurvedic herbs, ginkgo biloba, estradiol, and vitamin B6 to improve psychotic symptoms when added to antipsychotics. Ginkgo biloba and vitamin B6 seemed to reduce tardive dyskinesia and akathisia. Results on other compounds were negative or inconclusive. All natural agents, except reserpine, were well tolerated. Most study samples were small, study periods were generally short, and most results need replication. However, there is some evidence for beneficial effects of certain natural medicines.

A Lonely Search?: Risk for Depression When Spirituality Exceeds Religiosity.

Abstract: This study clarified longitudinal relations of spirituality and religiosity with depression. Spirituality's potential emphasis on internal (e.g., intrapsychic search for meaning) versus religiosity's potential emphasis on external (e.g., engagement in socially-sanctioned belief systems) processes may parallel depression-linked cognitive-behavioral phenomena (e.g., rumination and loneliness) conceptually. Thus, this study tested the hypothesis that greater spirituality than religiosity, separate from the overall level of spirituality and religiosity, predicts longitudinal increases in depression. A national sample of midlife adults completed diagnostic interviews and questionnaires of spiritual and religious intensity up to three times over 18 years. In time-lagged multilevel models, overall spirituality plus religiosity did not predict depression. However, in support of the hypothesis, greater spirituality than religiosity significantly predicted subsequent increases in depressive symptoms and risk for major depressive disorder (odds ratio = 1.34). If replicated, the relative balance of spirituality and religiosity may inform depression assessment and prevention efforts.

Decreases in Suicide Cognitions After Cognitive Processing Therapy Among Veterans With Posttraumatic Stress Disorder Due to Military Sexual Trauma: A Preliminary Examination.

Abstract: Posttraumatic stress disorder (PTSD) is associated with suicidal ideation (SI) and suicidal self-directed violence (SDV). Military sexual trauma (MST) is a common precursor to PTSD among veterans. Survivors of MST are more likely to be diagnosed with PTSD and are at greater risk for SI than survivors of other forms of trauma. Suicide-specific beliefs (e.g., unlovability, unbearability, unsolvability) have been shown to be strong predictors of SI and future suicidal SDV. Suicide-specific beliefs were examined over the course of treatment and follow-up in 32 veterans (23 women, 9 men) who received cognitive processing therapy (CPT) for MST-related PTSD. Hierarchical linear models revealed that veterans who received CPT had significant reductions in suicide-specific cognitions regarding unbearability, unlovability, and unsolvability. These preliminary findings warrant replication in a randomized controlled trial with a larger sample that includes participants with more acute suicidal intent.

Shame and Defectiveness Beliefs in Treatment Seeking Patients With Body Dysmorphic Disorder.

Abstract: Shame is a distressing emotion experienced when individuals judge themselves in a broadly negative and critical manner. Clinical descriptions of body dysmorphic disorder (BDD) emphasize the centrality of shame, yet research on shame in BDD remains scarce. This study is the largest investigation of shame in clinically diagnosed individuals with BDD, and it is the first to examine whether shame changes with treatment. Eighty-three adults with BDD were treated with 14 weeks of open-label escitalopram. Shame was measured using the Young Schema Questionnaire-Short Form. Shame was significantly higher in individuals with BDD than in previously reported healthy control and psychiatric outpatient samples. Shame was significantly, moderately correlated with greater suicidal thoughts and hopelessness and marginally significantly correlated with greater BDD severity. Shame decreased significantly with treatment. Reductions in shame with escitalopram were significantly associated with reductions in suicidal thoughts and hopelessness, even when accounting for reductions in BDD and depression severity.

Smoking and Risk for Alzheimer Disease: A Meta-Analysis Based on Both Case-Control and Cohort Study.

Abstract: This study was performed to identify the association between smoking and Alzheimer's disease (AD). To perform this meta-analysis based on case-control and cohort studies, PubMed, Google Scholar, and the CNKI electronic databases were searched through April 30, 2017. Our meta-analysis included 27 studies, including 16 that reported odds ratios (ORs) and 11 that reported hazard ratios (HRs) or ratio risks. No significant association was found between smoking and AD among the studies that reported ORs (1.020, 95% confidence interval [CI] = 0.812-1.281, I = 67.9%, random model, p < 0.001). A subgroup analysis revealed no significant difference between different smoking statuses. The pooled HRs revealed a significant association between smoking and AD (HR = 1.520, 95% CI = 1.194-1.934, I = 83.6%, random model, p < 0.001). Cumulative meta-analysis of the HRs revealed that the effect of smoking on AD tended to be stable over time. Smoking may confer an increased risk of AD, and this effect has tended to be stable over time.

Obstetric Phenotypes in the Heterogeneity of Schizophrenia

Abstract: Schizophrenia is a complex mental disorder with genetic and environmental components. Obstetric complications (OCs) are one of the most common environmental risk factors described. However, despite being different in timing and outcome, OCs are usually described as a homogeneous entity. In the present study, we evaluate the presence of different patterns of OCs evaluated with the Lewis-Murray Scale in chronic schizophrenia patients (n = 101) and their association with a crude marker of the intrauterine environment such as weight at birth.OCs related with abnormal fetal growth (p < 0.001) and OCs during gestation (p = 0.003) were associated with lower birth weight. However, difficulties in delivery, complications in pregnancy, and OCs all together (as a set) were not associated with weight at birth.Our results infer that OCs cannot be taken as a homogeneous group. Different patterns of OCs result in different birth weights, which is associated with specific metabolic, cognitive, and brain structure outcomes.

Metabolic Syndrome, Anxiety and Depression in a Sample of Italian Primary Care Patients.

Abstract: This cross-sectional study aimed at measuring the correlation and association of anxiety, depression and comorbid anxiety-depression symptoms with metabolic syndrome (MetS) in a sample of Italian primary care patients who attended their General Practitioner clinics over a 1-month period in 2013. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depressive symptoms. The sample was made up of 129 patients (57% women; mean age, 61 ± 12 years). The prevalence of MetS varied from 40% (Adult Treatment Panel III-Revised criteria) to 48% (International Diabetes Federation criteria). The prevalence of symptoms of anxiety, depression and comorbid anxiety and depression was, respectively, 26%, 2%, and 15%. MetS (defined according to Adult Treatment Panel III-Revised criteria) was associated with comorbid anxiety-depressive symptoms (odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.26-11.71), but not with anxiety or depressive symptoms only. Out of the individual components of MetS, enlarged waist circumference was associated with anxiety symptoms (OR = 4.22, 95% CI = 1.56-11.44).

Effects of Physical Exercise on Depressive Symptoms in Patients With Cognitive Impairment: A Systematic Review and Meta-Analysis

Abstract: We aimed to evaluate the efficacy of physical exercise in ameliorating depressive symptoms in patients with cognitive impairment. The databases of PubMed, EMBASE, Web of Science, the Cochrane Library, PsycINFO, China National Knowledge Infrastructure, WanFang, and WeiPu (VIP) were searched to identify randomized controlled trials (RCTs) that involved physical exercise for patients with cognitive impairment. A random effects model and a fixed effects model were used to calculate the pooled effect size. Twenty-one studies were identified. The meta-analysis showed that physical exercise significantly ameliorated depressive symptoms (standardized mean difference [SMD] = -0.23; 95% confidence interval [CI], -0.39 to -0.07; p = 0.004). In addition, beneficial improvements in neuropsychiatric symptoms (mean difference, -4.62; 95% CI, -9.07 to -0.16, p = 0.04), quality of life (SMD = 0.23; 95% CI, 0.01-0.46; p = 0.04), and activities of daily living (SMD = 0.27; 95% CI, 0.12-0.43; p = 0.0005) were observed in our study. No significant improvements were found in anxiety or apathy. Nevertheless, further high-quality, multicenter RCTs are needed to identify the clinical value of our results.

Psychological Community Integration of Individuals With Serious Mental Illness.

Abstract: As different facets of community integration as well as psychological and social integration are important dimensions of recovery for individuals with serious mental illness (SMI). The primary aim of the study was to explore psychological integration for individuals with SMI into the mental health and mainstream (i.e., non-mental health) communities and its association with their social integration into both communities. The study used self-report and egocentric social network data from 60 individuals with SMI receiving community-based mental health services. The primary findings indicated that social integration connected to service providers was associated with psychological integration in both mental health and mainstream communities. Our data suggest that in addition to providing services, providers are doing something meaningful to impact their clients' lives well beyond mental health services. The study supports a bifurcated conceptualization of psychological integration and provides a more complex understanding of the community integration concept.

Self Efficacy in Depression: Bridging the Gap Between Competence and Real World Functioning.

Abstract: We investigated the discrepancy between competence and real-world performance in major depressive disorder (MDD) for adaptive and interpersonal behaviors, determining whether self-efficacy significantly predicts this discrepancy, after considering depressive symptoms. Forty-two participants (Mage = 37.64, 66.67% female) with MDD were recruited from mental health clinics. Competence, self-efficacy, and real-world functioning were evaluated in adaptive and interpersonal domains; depressive symptoms were assessed with the Beck Depression Inventory II. Hierarchical regression analysis identified predictors of functional disability and the discrepancy between competence and real-world functioning. Self-efficacy significantly predicted functioning in the adaptive and interpersonal domains over and above depressive symptoms. Interpersonal self-efficacy accounted for significant variance in the discrepancy between interpersonal competence and functioning beyond symptoms. Using a multilevel, multidimensional approach, we provide the first data regarding relationships among competence, functioning, and self-efficacy in MDD. Self-efficacy plays an important role in deployment of functional skills in everyday life for individuals with MDD.

Less Mindful, More Struggle and Growth: Mindfulness, Posttraumatic Stress Symptoms, and Posttraumatic Growth of Breast Cancer Survivors.

Abstract: Treatment of posttraumatic stress symptoms (PTSSs) and facilitation of posttraumatic growth (PTG) are two encouraging areas of research, yet little is understood about the relationships between dispositional mindfulness, PTSSs, and PTG. The aim of the present study was to investigate whether PTSSs is correlated with PTG among breast cancer patients in China and explore the role of mindfulness in this relationship. A sample of 202 Chinese breast cancer patients voluntarily participated in the study by completing a set of questionnaires. The results revealed that PTSSs were significantly positively correlated with PTG. Structural equation modeling showed that mindfulness did not moderate but mediated the relation between PTSSs and PTG. These findings indicate that breast cancer patients with higher mindfulness may recover from PTSSs through a different process. Posttraumatic growth may not be the only positive indicator of posttraumatic individuals.