Showing papers in "Journal of Nervous and Mental Disease in 2019"
TL;DR: Serum cortisol was able to accurately distinguish between patients with depression and those without depression, and there was a significant positive correlation between serum cortisol levels and Hamilton Depression Rating Scale scores.
Abstract: This cross-sectional study aimed at measuring the correlation and association between serum levels of cortisol, inflammatory cytokines, and depression and to measure the detection accuracy of serum levels of cortisol in serum samples. In total, 89 male participants were recruited into this study from June 15, 2017, to September 31, 2017. The Hamilton Depression Rating Scale, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index were used to investigate the mental health status of the participants. Serum concentrations of cortisol and inflammatory cytokines were determined. The serum cortisol concentration, anxiety level, and sleep quality were included in the final logistic regression model. Serum cortisol was able to accurately distinguish between patients with depression and those without depression. There was a significant positive correlation between serum cortisol levels and Hamilton Depression Rating Scale scores.
62 citations
TL;DR: Evaluating the association between depression, anxiety, social anxiety and fear, impulsivity, and aggression and Internet addiction among Lebanese adolescents found that uncontrolled use of the Internet can be associated with addiction and other psychological comorbidities.
Abstract: The study objective was to evaluate the association between depression, anxiety, social anxiety and fear, impulsivity, and aggression and Internet addiction (IA) among Lebanese adolescents. This cross-sectional study, conducted between October 2017 and April 2018, enrolled 1103 young adolescents aged between 13 and 17 years. The Internet Addiction Test (IAT) was used to screen for IA. The results also showed that 56.4% of the participants were average Internet users (IAT score ≤49), 40.0% had occasional/frequent problems (IAT scores between 50 and 79), and 3.6% had significant problems (IAT scores ≥80) because of Internet use. The results of a stepwise regression showed that higher levels of aggression (β = 0.185), depression (Multiscore Depression Inventory for Children) (β = 0.219), impulsivity (β = 0.344), and social fear (β = 0.084) were associated with higher IA, whereas an increased number of siblings (β = -0.779) and a higher socioeconomic status (β = -1.707) were associated with lower IA. Uncontrolled use of the Internet can be associated with addiction and other psychological comorbidities.
52 citations
TL;DR: The present data suggest that the use of passive wearable sensors to inform healthcare decisions holds considerable promise and should be considered for use in clinical practice.
Abstract: Development of digital biomarkers holds promise for enabling scalable, time-sensitive, and cost-effective strategies to monitor symptom severity among those with major depressive disorder (MDD). The current study examined the use of passive movement and light data from wearable devices to assess depression severity in 15 patients with MDD. Using over 1 week of movement data, we were able to significantly assess depression severity with high precision for self-reported (r = 0.855; 95% confidence interval [CI], 0.610-0.950; p = 4.95 × 10) and clinician-rated (r = 0.604; 95% CI, 0.133-0.894; p = 0.017) symptom severity. Pending replication, the present data suggest that the use of passive wearable sensors to inform healthcare decisions holds considerable promise.
51 citations
TL;DR: Higher levels of burnout were found to be associated with multiple psychological factors in the Lebanese population, and multiple validated scales used to measure burnout and other characteristics were performed.
Abstract: Our aim was to assess the relationship between personality and psychological traits, and burnout among the Lebanese population. A questionnaire-based cross-sectional study was conducted with multiple validated scales used to measure burnout and other characteristics. A cluster analysis was then performed to split the population into mutually exclusive groups with different profiles according to the burnout scales using the K-mean method. A multivariate analysis of covariance was carried out to compare multiple measures between the cluster groups under comparison. The study, conducted between November 2017 and March 2018, enrolled 789 participants. The results showed that 100 (14.0%) had high emotional work fatigue, whereas 443 (62.5%) and 680 (95.4%) had high mental and physical work fatigue, respectively. People with high physical work fatigue (cluster 1) had lower alcohol dependence (β = -2.78), alexithymia (β = -3.16), depression (β = -7.20), anxiety (β = -6.99), perceived stress (β = -2.53), social phobia (β = -11.49), suicidal ideation (β = -0.35), emotional awareness (β = -4.54), emotional managament (β = -1.71), social emotional awareness (β = -9.27), and relationship management (β = -9.12). People with high emotional work fatigue (cluster 2) had higher alcohol dependence (β = 2.11), alexithymia (β = 6.51), depression (β = 2.48), anxiety (β = 4.11), perceived stress (β = 4.30), and lower emotional awareness (β = -6.68), emotional management (β = -7.80), social emotional awareness (β = -3.71), and relationship management (β = -3.05). Higher levels of burnout were found to be associated with multiple psychological factors. The results would help understand the burnout dimensions and their correlated factors in the Lebanese population.
30 citations
TL;DR: It is suggested that measures of demoralization can help identify cancer patients at high suicide risk and that such patients require further attention and measures targeting demoralization for suicide prevention.
Abstract: Demoralization is a form of psychological distress that may cause suicidal ideation. Demoralization syndrome is common among cancer patients, but there has been little empirical study on the association of suicidal ideation with demoralization, depression, and anxiety in this population. This study aims to investigate the prevalence of high demoralization among cancer patients in mainland China and the contribution of high demoralization to suicidal ideation beyond the impact of self-report depression and anxiety. In this cross-sectional study, 303 patients with cancer were invited to complete questionnaires. In total, 14.5% participants reported suicidal ideation and 49.50% high demoralization. Logistic regression analysis identified high demoralization as an independent risk factor for suicidal ideation. Only depression (odds ratio [OR], 6.68) had a stronger influence on suicidal ideation than demoralization (OR, 5.85), and patients with both depression and high demoralization were most likely to experience suicidal ideation. These findings suggest that measures of demoralization can help identify cancer patients at high suicide risk and that such patients require further attention and measures targeting demoralization for suicide prevention.
28 citations
TL;DR: This integrative review analyses and synthesizes specialized literature of 20 years up to 2017 studying barriers/obstacles to employment for people with severe mental illnesses to enable employment specialists to better support their clients in overcoming them, thus facilitating their work integration.
Abstract: This integrative review analyses and synthesizes specialized literature of 20 years up to 2017 studying barriers/obstacles to employment for people with severe mental illnesses. The inclusion and exclusion criteria led to 35 experimental and nonexperimental studies. Results of the prospective studies were analyzed with the evidence synthesis method to isolate the most salient obstacles. Six main themes emerged from the findings, grouped into personal and environmental barriers. Environmental barriers were related to disability benefits and other physical resources, to stigma and social support, and to vocational services. Individual barriers included those related to illness, to work experience and skills, and to self-perception, fears, and motivation. The most prominent obstacles are lack of work experience and lack of use of effective strategies toward employment. Systematically identifying barriers to employment for people with severe mental illnesses will enable employment specialists to better support their clients in overcoming them, thus facilitating their work integration.
28 citations
TL;DR: The capacity to seek out other people, to share experiences with them, and to accept comfort from them may offer a means for SLS to better deal with their tragedy.
Abstract: Losing a loved one to suicide may have detrimental effects, one of them being suffering from complicated grief (CG). To date, no studies have fully examined the psychological processes that delineate the risk and resilience factors that contribute to CG among suicide-loss survivors (SLSs). We hypothesized that social support and self-disclosure would moderate the relationship between attachment styles and CG for SLS. Questionnaires assessing attachment style, self-disclosure, social support, and CG were completed by 156 SLS participants. A regression model revealed that secure attachment negatively predicted CG, but self-disclosure moderated this association. Secure attachment seems to be a resilient factor for CG. However, SLS with low secure attachment but high in self-disclosure ability use this behavior as a way to impede CG. The capacity to seek out other people, to share experiences with them, and to accept comfort from them may offer a means for SLS to better deal with their tragedy.
27 citations
TL;DR: The results suggest that rumination parsimoniously explains the tendency of stress and affective distress to contribute to poor sleep quality, and together with poor sleep, it may also contribute to worse fatigue in some individuals.
Abstract: Stress and affective distress have previously been shown to predict sleep quality, and all the factors have been shown to predict fatigue severity. However, few prior studies have examined the likely indirect mediational relationships between stress, affective distress, and sleep quality in predicting fatigue severity, and the potential role played by ruminative thinking. A short questionnaire asked 229 participants about their recent experiences of stress, affective distress, rumination, sleep, and fatigue in a community sample. High stress, anxiety, and depression were related to more ruminative thinking, which in turn was related to poor sleep quality (composed of subjective sleep quality, daytime dysfunction, sleep latency, and sleep disturbance) and poor sleep quality predicted worse fatigue. The results suggest that rumination parsimoniously explains the tendency of stress and affective distress to contribute to poor sleep quality, and together with poor sleep, it may also contribute to worse fatigue in some individuals.
27 citations
TL;DR: This is a review of 32 empirical articles on health-related quality of life (HRQoL) published in peer-reviewed journals over the past 37 years and it is of importance to assess patients with narcolepsy carefully in terms of depressive symptoms because they may have a major impact on HRZoL with important clinical implications.
Abstract: Narcolepsy is a chronic disorder characterized by symptoms of excessive daytime sleepiness, irresistible sleep attacks that may be accompanied by cataplexy brought on by emotions, sleep paralysis, and hypnagogic hallucinations. This is a review of 32 empirical articles on health-related qual
25 citations
TL;DR: Those having a higher level of weight-related self-stigma presented with more mental health problems compared with non-OW children; BSRS-5 was significantly associated with the WBIS.
Abstract: This study aimed to test the differences of weight-related self-stigma and mental health conditions between overweight (OW) and non-OW children in Hong Kong. The correlations between weight-related self-stigma and mental health conditions were also investigated. Children aged 8 to 12 years (n = 367; 198 boys) completed questionnaires on weight-related self-stigma (Weight Bias Internalization Scale [WBIS] and Weight Self-Stigma Questionnaire [WSSQ]) and mental health conditions (Brief Symptom Rating Scale-5 [BSRS-5]). Compared with non-OW children (n = 241; 143 boys), OW children (n = 114; 55 boys) had higher weight-related self-stigma in the WBIS (26.49 ± 8.68 vs. 21.58 ± 7.54; p < 0.001) and WSSQ scores (26.36 ± 8.98 vs. 21.91 ± 8.71; p < 0.001). No significant difference was found between OW and non-OW children in mental health conditions as reflected by the BSRS-5 score (4.29 ± 4.35 vs. 4.44 ± 4.16; p = 0.761). BSRS-5 was significantly associated with the WBIS. OW children tended to have a higher level of self-stigma; those having a higher level of weight-related self-stigma presented with more mental health problems.
25 citations
TL;DR: RAPID-PFA was more effective in lowering negative affect scores postintervention, and significantly increasing positive affect scores at 30-minute delay, which support the two primary goals of PFA, mitigating acute distress and instilling hope.
Abstract: A randomized controlled trial assessed the efficacy of group psychological first aid (PFA) by comparing the Johns Hopkins RAPID-PFA model with a group conversation condition in 119 participants using the state version of State Trait Anxiety Scale and the Positive and Negative Affect Schedules. Both groups showed similar baseline scores, and after watching a distressing 5-minute video, both groups showed similar significant increases in state anxiety scores and negative affect scores, as well as similar decreases in positive affect scores. However, compared with the group conversation condition, the RAPID-PFA group evidenced significantly lower state anxiety scores at postintervention and at 30-minute delay. RAPID-PFA, compared with the group conversation condition, was also more effective in lowering negative affect scores postintervention, and significantly increasing positive affect scores at 30-minute delay. These results support the two primary goals of PFA, which are mitigating acute distress and instilling hope.
TL;DR: A focused review identified the following characteristic pattern: AVHs in BPD cannot be distinguished phenomenologically from AVH in schizophrenia, often meet the criteria for First-Rank Symptoms (FRSs), are highly stress related, and are strongly associated with dissociative experiences and childhood trauma.
Abstract: Misdiagnosis is common for patients with a primary diagnosis of borderline personality disorder (BPD) who experience auditory verbal hallucinations (AVHs). AVHs in BPD are associated with severe BPD and high levels of suicidality. Wrongly treating these patients as though they are suffering from schizophrenia or other primary psychotic disorder and not treating BPD can cause significant iatrogenic damage. We outline a specific pattern of symptoms and phenomenology that will assist diagnostic accuracy in these cases. A focused review identified the following characteristic pattern: AVHs in BPD cannot be distinguished phenomenologically from AVH in schizophrenia, often meet the criteria for First-Rank Symptoms (FRSs), are highly stress related, and are strongly associated with dissociative experiences and childhood trauma. Formal thought disorder is uncommon, negative symptoms are usually absent, bizarre delusions are absent, affect remains reactive, and sociability is usually retained. Diagnostic accuracy can be improved by examining the overall clinical presentation and is essential to improving the prognosis for these patients.
TL;DR: In the overall sample, a significant negative correlation between general intellectual abilities and emotional awareness was found and a border cognitive functioning influences mentalization processes as ability to discriminate and monitor emotions, as well as higher domains of cognition.
Abstract: According to DSM-5 and ICD-10, borderline intellectual functioning (BIF) should not be classified properly as a disorder However, BIF people may present relevant problems of adaptive functioning in several areas of daily activities, and they seem to be more vulnerable to mental diseases Young adolescence may be considered a particular period for emotional information processing The "own and others' emotions" awareness can play a crucial role in many daily life situations, such as decision making, interpersonal relationships, and decoding of facial expressions On this background, a BIF young adolescents group underwent a neuropsychological assessment including emotional and cognitive domains, and was compared with a healthy young adolescents control group (HC) In the overall sample, a significant negative correlation between general intellectual abilities and emotional awareness was found The BIF group showed a significantly greater level of alexithymia and a poorer performance in higher cognitive tasks than HC group As hypothesized, a border cognitive functioning influences mentalization processes as ability to discriminate and monitor emotions, as well as higher domains of cognition
TL;DR: Investigating the role of social support among adolescents after the Yancheng tornado showed a nonsignificant relationship between intrusive rumination and PTG, whereas a positive relationship was found between deliberate ruminationand PTG.
Abstract: Posttraumatic growth (PTG) may exist in trauma survivors, especially adolescents, whereas rumination is a typical cognitive characteristic among traumatized individuals. However, there were mixed relationships between rumination (intrusive rumination, deliberate rumination) and PTG. The study aimed to increase understanding of the relationships between them by investigating the role of social support among adolescents after the Yancheng tornado. Four hundred forty-three middle school students in the core area of the tornado were administered a revised social support scale based on Furman and Buhrmester's Network of Relationships Inventory, Event-Related Rumination Inventory, and Posttraumatic Growth Inventory. Results showed a nonsignificant relationship between intrusive rumination and PTG, whereas a positive relationship was found between deliberate rumination and PTG. Moreover, social support did not moderate the relationship between intrusive rumination and PTG, but it significantly mediated the relationship between deliberate rumination and PTG. Clinical implications on trauma intervention and limitations as well as future research directions were discussed.
TL;DR: The results of the structural equation model verify that meaning in life mediates the association between dispositional mindfulness and perceived stress and psychological symptoms, and suggest that psychological symptoms may be reduced by addressing the impact of mean in life.
Abstract: This research examined the degree to which meaning in life explained the association between dispositional mindfulness and psychological symptoms. This was a survey research study with 292 patients with gastrointestinal cancer. Meaning in Life, dispositional mindfulness, psychological symptoms, and perceived stress were assessed. Results showed that consistent with theory and prior research, greater dispositional mindfulness was associated with less psychological symptoms and perceived stress. In addition, the results of the structural equation model verify that meaning in life mediates the association between dispositional mindfulness and perceived stress and psychological symptoms. Findings are consistent with logotheory and suggest that psychological symptoms may be reduced by addressing the impact of meaning in life.
TL;DR: Clinical features that best discriminate melancholia from nonmelancholic depressive conditions were identified and Psychomotor retardation and mood nonreactivity were the most relevant clinical features for the identification of melancholic depressions.
Abstract: We sought to identify clinical features that best discriminate melancholia from nonmelancholic depressive conditions. An extensive review of studies using latent factor models that identified a melancholic depression dimension/factor was undertaken. Clinical variables extracted from these studies were analyzed in terms of their contribution to a diagnosis of melancholia and their consistency across studies. Psychomotor retardation and mood nonreactivity were the most relevant clinical features for the identification of melancholic depressions. Other clinical features commonly described as weighted to melancholia, such as anhedonia, psychomotor agitation, late insomnia, or appetite/weight loss, seemed less useful in distinguishing these subtypes of depression. Study results are considered in relation to the potential limitations of current operational definitions of melancholia, and how symptom sets could be modified.
TL;DR: The DSM-5 revision envisioned a paradigm shift away from traditional diagnostic categories as discussed by the authors, and plans for a major move from descriptive to etiologic diagnoses were quickly abandoned as infeasible.
Abstract: The initial plans for the DSM-5 revision envisioned a paradigm shift away from traditional diagnostic categories. However, plans for a major move from descriptive to etiologic diagnoses were quickly abandoned as infeasible. Support was much broader for adding dimensional/spectrum constructs to the categorical diagnoses, although this was interpreted in various ways. Delegation of substantial autonomy to work groups with modest central coordination was seen as problematic by some work groups and positively by others. Controversies emerged around the standards for diagnostic change, and the degree to which the same standards should be used across diagnostic groups. The Summit Group was given the final task of trying to forge a consensus among the various review groups. We conclude with thoughts about the difficulty of trying to revise an entire manual all at once and the desirability of developing clear rules for change at the outset of such a diagnostic project.
TL;DR: Class membership had prognostic value as evidenced by associations with PCBD severity and functional impairment assessed 3 years later, and deaths of partners/children, unexpectedness of the loss, and maladaptive cognitions and avoidance behaviors were also associated with membership of the pervasive symptom classes.
Abstract: Persistent complex bereavement disorder (PCBD) entered DSM-5. No studies have yet examined the nature, prevalence, prognostic validity, and underlying mechanisms of PCBD symptom-patterns in recently bereaved people. Knowledge on these issues could improve the early identification and treatment of disturbed grief. Latent class analysis was used to identify subgroups characterized by different PCBD symptompatterns among recently (≤6 months) bereaved adults (N = 476). In a subgroup (N = 251) we assessed associations of class-membership with PCBD-severity and functional impairment assessed three years later. Associations between classmembership and socio-demographic and cognitive-behavioral variables were also examined. We identified a Resilient (50.0%), Separation Distress (36.1%), and High PCBD Symptoms (13.9%) Class. Class-membership had prognostic value as evidenced by associations with PCBD-severity and functional impairment assessed three years later. Deaths of partners/children, unexpectedness of the loss, and maladaptive cognitions and avoidance behaviors were also associated with membership of the pervasive symptom classes.
TL;DR: It is demonstrated that all PTSD symptom clusters significantly positively predicted suicide risk, although none of these clusters interacted with alcohol use problems to predict suicide risk; theoretical and clinical implications are discussed as they relate to the importance of screening for PTSD and alcohol use disorder among firefighter populations.
Abstract: Alcohol use problems are associated with suicidal desire and may provide an avenue to suicidal ideation and behavior. However, the influence of posttraumatic stress disorder (PTSD) on the nature of the relationship between alcohol use problems and suicide risk is not well understood. In particular, the potential for PTSD to moderate the association between alcohol use problems and suicide risk remains unexplored. The present study investigated the main and interactive effects of alcohol use problems (Alcohol Use Disorders Identification Test) and PTSD symptoms (PTSD Checklist for DSM-5) on suicide risk (Suicide Behaviors Questionnaire-Revised) in a sample of 632 trauma-exposed firefighters (93.5% men; Mage = 38.44 years, SD = 8.59). Hierarchical logistic regression analyses evaluated whether the main and interactive effects of PTSD symptom severity and alcohol use disorders were significantly related to suicide risk, above and beyond age and cumulative trauma. The main effects of PTSD symptom severity (odds ratio, 1.76; p 0.05). A secondary, exploratory aim demonstrated that all PTSD symptom clusters significantly positively predicted suicide risk (p's 0.05). Theoretical and clinical implications are discussed as they relate to the importance of screening for PTSD and alcohol use disorder among firefighter populations.
TL;DR: Investigating the relationship between the two variables by considering the role of patient's anxiety and depression indicated that family caregiver's burden influenced patient's QoL negatively, and this relationship was partially mediated by patient's Anxiety and depression.
Abstract: Previous research showed that family caregiver's perception of burden can influence patient's report on their quality of life (QoL). The present study investigated the relationship between the two variables by considering the role of patient's anxiety and depression. A total of 382 dyads of Chinese breast cancer patients and their family caregivers participated in this study. The results showed that the mediation model fitted the data well (χ = 49.859; df = 16; χ/df = 3.116; RMSEA = 0.05; TLI = 0.928; CFI = 0.959). It indicated that family caregiver's burden influenced patient's QoL negatively, and this relationship was partially mediated by patient's anxiety and depression.
TL;DR: Findings indicate that ELS can be considered as a risk factor for the comorbidity between depression and chronic pain.
Abstract: It is estimated that comorbidity between depression and chronic pain reaches more than half of the depressed adult patients around the world. Evidence indicates that some stressors, such as early-life stress (ELS), mediate the co-occurrence of depression and chronic pain. This study aimed to assess whether ELS or any of its subtypes could be considered as risk factors for comorbidity between depression and chronic pain. For this purpose, 44 patients in depressive episode were evaluated, in which 22 were diagnosed with depression and chronic pain, and the other 22 patients were diagnosed with depression but without chronic pain. Results had shown that ELS occurrence is more significant among depressive patients with chronic pain compared with those without pain. When subtypes of ELS were evaluated, the group of depressive patients with pain showed significantly higher prevalence of emotional neglect than those depressive participants without pain. Data analysis has shown that severity of the depressive symptoms has a significant impact on the total score of childhood trauma, emotional abuse, physical abuse, emotional neglect, and physical neglect, and that emotional abuse, sexual abuse, and physical neglect have significant impact on the severity of depression. In conclusion, our findings indicate that ELS can be considered as a risk factor for the comorbidity between depression and chronic pain.
TL;DR: Evidence is added to the evidence that insomnia, along with other factors (including sociodemographic and psychological factors), can have a detrimental impact on both physical and mental QOL of participants.
Abstract: The study objective was to assess if insomnia, along with other factors, can impact the physical and mental quality of life (QOL) of the Lebanese general population. This cross-sectional study, conducted between November 2017 and March 2018, enrolled 756 community-dwelling participants. A first linear regression, using the SF-12 PCS score as the dependent variable, showed that having a family history of insomnia problems (β = 1.107, p = 0.026) was significantly associated with higher physical QOL (higher SF-12 PCS score), whereas increased stress (β = 0.048, p = 0.015) was significantly associated with lower physical QOL. A second linear regression, using the SF-12 MCS score as dependent variable, showed that having increased age (β = -0.079, p < 0.001) was significantly associated with lower mental QOL. Despite its cross-sectional design and the modest sample size, this study adds to the evidence that insomnia, along with other factors (including sociodemographic and psychological factors), can have a detrimental impact on both physical and mental QOL of participants.
TL;DR: Female sex, physical illness, and greater number of potentially traumatic events predicted both PTSD and depression, and lower economic status predicted depression among men, but not among women.
Abstract: Although most of the 3.6 million Syrian refugees in Turkey live outside refugee camps, most mental health research is on camp residents and few are on those living in cities. We aimed to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and depression in Syrian refugees living in an urban area in Turkey. A total of 420 adult Syrians living in Ankara were assessed using the Harvard Trauma Questionnaire and the Beck Depression Inventory. Probable PTSD and depression rates were 36.5% and 47.7%, respectively. Female sex, physical illness, and greater number of potentially traumatic events predicted both PTSD and depression. PTSD was additionally predicted by past psychiatric illness, and depression was predicted by lower economic status. Interestingly, lower economic status predicted depression among men, but not among women. Studies on refugees should be sensitive to factors that could have a significant effect on mental health such as sex or residence.
TL;DR: It is suggested that loneliness plays a major role in the development of complex PTSD and in the preservation of its symptoms, and therapies for complex PTSD should include interventions that address loneliness.
Abstract: Loneliness impacts both physical and psychological health and is associated with increases of all-cause mortality and suicidal behavior. Because loneliness may result from a variety of developmental, interpersonal, and intrapersonal factors, distinguishing its components, origins, and sustaining factors as it manifests in various psychopathological states are important steps in formulating interventions to alleviate these conditions. To date, loneliness has not been widely studied in relation to complex posttraumatic stress disorder (PTSD), which is newly delineated in the International Classification of Diseases, characterized by PTSD symptoms in the context of significant early trauma, as well as "disturbances in self-organization" marked by affective dysregulation, negative self-concept, and disturbances in relationships. In this article, illustrating with case material, we suggest that loneliness plays a major role in the development of complex PTSD and in the preservation of its symptoms. Consequently, therapies for complex PTSD should include interventions that address loneliness.
TL;DR: Disclosure in one's private environment may improve quality of life among unemployed individuals with mental health problems and, at a trend level, less self-stigma at baseline.
Abstract: Unemployment and mental disorders are associated with impaired quality of life. Because of the stigma associated with mental illness, unemployed individuals with mental health problems face the difficult decision whether to disclose their condition to others. Disclosure has both risks and benefits, and it is unclear how it affects quality of life. We therefore examined disclosure attitudes at baseline as predictors of quality of life after 6 months and also assessed social support, depressive symptoms, self-stigma, and perceived discrimination among 301 unemployed individuals with mental health problems. Better quality of life at follow-up was predicted by better attitudes toward disclosure among family and friends, shorter length of unemployment, less symptoms, and, at a trend level, less self-stigma at baseline. Thus disclosure in one's private environment may improve quality of life among unemployed individuals with mental health problems.
TL;DR: The study underlines the importance of assessing anhedonia and related psychosocial factors in patients with serious mental illness.
Abstract: This study sought to evaluate predischarge anhedonia level and its predictors in 125 inpatients with schizophrenia and schizoaffective disorders. Consecutively admitted inpatients were assessed before discharge from the hospital using the Specific Loss of Interest and Pleasure Scale (SLIPS) and a battery of measures for clinical and psychosocial variables. When symptoms, distress, and social anhedonia scores were controlled, the SLIPS score inversely correlated with self-constructs, social support, quality of life, recovery, and unmet needs. Using two cutoff points of the data set of SLIPS, we identified three groups: 19 (15.2%) patients reported "no loss of pleasure"; 46 (36.8%), "some loss of pleasure"; and 60 (48.0%), "marked diminishment of pleasure." The SLIPS score is predicted by sensitivity, unmet needs, deficient interpersonal pleasure, poor quality of life, and friend support. The study underlines the importance of assessing anhedonia and related psychosocial factors in patients with serious mental illness.
TL;DR: This article retraces the development of pseudoneurotic (or "borderline") schizophrenia in modern psychiatry, finding it a pioneering concept in psychopathology and demonstrating that recent findings about the positive syndrome, good-outcome, type I "distress" subtype of schizophrenia show surprising consistency with the clinical concept of pseud oneurotic schizophrenia.
Abstract: The term "pseudoneurotic schizophrenia" was introduced in 1949 by Hoch and Polatin to describe apparently neurotic patients showing formal thought disorders, emotional dysregulation, and transient psychotic symptoms. Even if this diagnostic entity is no longer included in modern diagnostic systems, its evolution is intertwined with the history of schizophrenia in the 20th century. This article retraces the development of pseudoneurotic (or "borderline") schizophrenia in modern psychiatry, finding it a pioneering concept in psychopathology. In particular, we demonstrate that recent findings about the positive syndrome, good-outcome, type I "distress" subtype of schizophrenia (associated with high emotionality, including anxiety, depression, and sensitivity to stress) show surprising consistency with the clinical concept of pseudoneurotic schizophrenia. Finally, we discuss the historical development of pseudoneurotic schizophrenia in modern psychiatry as a meaningful example of the difficulty of confining severe psychological disturbances lying at the edge of full-blown schizophrenia within a widely accepted diagnostic category.
TL;DR: The symptoms, common course, proposed causes, and common treatments for neurasthenia are reviewed; similarities are seen in several familiar diagnoses, including depression, chronic fatigue syndrome, and fibromyalgia.
Abstract: Neurasthenia was a popular diagnosis from 1869 through 1930. Despite being discarded, the core symptoms of neurasthenia can still be found throughout modern society. The present article reviews the symptoms, common course, proposed causes, and common treatments for neurasthenia. Similarities are seen in several familiar diagnoses, including depression, chronic fatigue syndrome, and fibromyalgia. Through reviewing the trends of neurasthenia, modern doctors may learn more about the subtleties of the diagnostic process, as well as the patient-physician relationship. The goal is to learn from the past as it relates to current problems that may be related to the stress of modern living. The history of neurasthenia is presented as it relates to problems that may remain today.
TL;DR: In conclusion, few studies examined the effects of cerebellar modulation in schizophrenia but yielded promising results, and this approach may hold therapeutic potential, pending further methodologically robust replication.
Abstract: Structural and functional abnormalities of the cerebellum have been observed in schizophrenia since the first neuroimaging studies. More recently, the functions of the cerebellum have been extended beyond sensorimotor control to include participation in higher-level cognition and affective regulation. Consistently, the "cognitive dysmetria" theory posits that dysfunctions of cortical-subcortical-cerebellar circuitry may be crucial for the pathogenesis of different clinical features of schizophrenia. This conceptual framework offers a set of testable hypotheses, now that various tools to exert direct modulation of cerebellar activity are available. We conducted a systematic review of studies examining the effects of cerebellar modulation in schizophrenia. Two independent authors conducted a search within PubMed for articles published up to April 2019 and identified 10 studies (three randomized controlled trials, two open-label studies, two case reports, one preclinical study) describing the effects of cerebellar circuitry modulation in patients with schizophrenia or animal models. The majority of interventions were uncontrolled and used stimulation of the cerebellar vermis, using transcranial magnetic stimulation or transcranial direct-current stimulation. Most studies detected improvements after cerebellar modulation. Clinical changes mostly pertained the domains of negative symptoms, depressive symptoms and cognitive functions. In conclusion, few studies examined the effects of cerebellar modulation in schizophrenia but yielded promising results. This approach may hold therapeutic potential, pending further methodologically robust replication.
TL;DR: Acupuncture can be used as an alternative treatment to improve cognitive function and QoL of patients with ITN and showed significant improvement when compared with the end of treatment.
Abstract: To estimate the effect of acupuncture on idiopathic trigeminal neuralgia (ITN), we recruited 116 patients with ITN from December 2016 to April 2018 and further divided into them into two groups: acupuncture intervention group (n = 62) and sham control group (n = 54). Clinical pain, cognitive function, and quality of life (QoL) assessed with the 36-Item Short Form Health Survey (SF-36) were evaluated at the initial time of treatment, at the end of treatment, and 6 weeks after the treatment. Pain intensity, headache, and generalized body pain showed significant decrease both at the end of treatment and after 6 weeks of treatment when compared with initial time. The scores of the cognitive tests (Mini-Mental State Examination, Trail Making Test, Verbal Fluency Test, tracing score, and memory score) and five aspects of the SF-36 assessment (role emotional, general health, body pain, role physical, and mental health scores) showed significant improvement at the end of treatment compared with the initial time. Whereas after 6 weeks of treatment, the Mini-Mental State Examination, memory score, and Trail Making Test-A score and four aspects of the SF-36 assessment (vitality, bodily pain, mental health, and role physical) showed significant improvement when compared with the end of treatment. Acupuncture can be used as an alternative treatment to improve cognitive function and QoL of patients with ITN.