-
Revista de La Facultad de Ciencias... Jun 2024Introducción: La fiebre es común en la niñez y existe un alto nivel de preocupación por parte de los cuidadores para manejarla, a esto se le denomina "fiebrefobia".... (Observational Study)
Observational Study
Introducción: La fiebre es común en la niñez y existe un alto nivel de preocupación por parte de los cuidadores para manejarla, a esto se le denomina "fiebrefobia". El objetivo fue evaluar la presencia de fiebrefobia y factores asociados en la población de estudio. Materiales y método: estudio observacional, transversal, con recolección prospectiva y analítico durante el 2021 a 2022, a través de una encuesta ad hoc auto administrada a los padres y/o cuidadores de pacientes menores de 6 años que consultaron a la emergencia del Hospital de Niños Dr. Roberto del Río en Santiago de Chile. Se analizó la asociación entre las variables sociodemográficas, conocimientos, actitudes y temores frente al niño febril mediante Chi cuadrado, Fisher además de análisis de regresión logística univariante. Resultados: Se realizaron 381 encuestas. El 98% presentó algún grado de fiebrefobia. El 40,6% definió fiebre bajo los 38°C. El 56 % de los cuidadores utilizaba medidas físicas. La principal secuela temida por los tutores fueron las convulsiones (82 %) y un 42,7% refirió que podía ser letal. La mayoría (92%) utilizó fuentes de información no confiables y dos tercios (66%) nunca recibieron información sobre el tema por parte del personal de salud. La regresión logística evidenció que el hecho de ser progenitor, el nivel de escolaridad básica o media y un umbral térmico menor a 38°C fueron las variables mayormente asociadas a la fiebrefobia. Conclusiones. La fiebrefobia es un fenómeno vigente en nuestra población y la entrega de información adecuada y oportuna pudiese prevenirlo.
Topics: Humans; Cross-Sectional Studies; Male; Female; Fever; Prospective Studies; Child, Preschool; Health Knowledge, Attitudes, Practice; Caregivers; Socioeconomic Factors; Infant; Parents; Adult; Phobic Disorders; Surveys and Questionnaires; Chile; Child
PubMed: 38941223
DOI: 10.31053/1853.0605.v81.n2.42845 -
The Journal of Clinical Endocrinology... Jun 2024Selye described stress as a unified neurohormonal mechanism maintaining homeostasis. Acute stress system activation is adaptive through neurocognitive,...
Selye described stress as a unified neurohormonal mechanism maintaining homeostasis. Acute stress system activation is adaptive through neurocognitive, catecholaminergic, and immunomodulation mechanisms, followed by a reset via cortisol. Stress system components, the sympathoadrenomedullary system, hypothalamic-pituitary-adrenal axis, and limbic structures are implicated in many chronic diseases by establishing an altered homeostatic state, allostasis. Consequent "primary stress system disorders" were popularly accepted, with phenotypes based on conditions such as Cushing syndrome, pheochromocytoma, and adrenal insufficiency. Cardiometabolic and major depressive disorders are candidates for hypercortisolemic etiology, contrasting the "hypocortisolemic symptom triad" of stress sensitivity, chronic fatigue, and pain. However, acceptance of chronic stress etiology requires cause-and-effect associations, and practical utility such as therapeutics altering stress system function. Inherent predispositions to stress system perturbations may be relevant. Glucocorticoid receptor (GR) variants have been associated with metabolic/neuropsychological states. The SERPINA6 gene encoding corticosteroid-binding globulin (CBG), was the sole genetic factor in a single-nucleotide variation-genome-wide association study linkage study of morning plasma cortisol, a risk factor for cardiovascular disease, with alterations in tissue-specific GR-related gene expression. Studies showed genetically predicted high cortisol concentrations are associated with hypertension and anxiety, and low CBG concentrations/binding affinity, with the hypocortisolemic triad. Acquired CBG deficiency in septic shock results in 3-fold higher mortality when hydrocortisone administration produces equivocal results, consistent with CBG's role in spatiotemporal cortisol delivery. We propose some stress system disorders result from constitutional stress system variants rather than stressors themselves. Altered CBG:cortisol buffering may influence interstitial cortisol ultradian surges leading to pathological tissue effects, an example of stress system variants contributing to stress-related disorders.
PubMed: 38941154
DOI: 10.1210/clinem/dgae412 -
Molecular and Cellular Biochemistry Jun 2024Bisphenol A (BPA), a common endocrine-disrupting chemical, is found in a wide range of home plastics. Early-life BPA exposure has been linked to neurodevelopmental...
Early-life bisphenol A exposure causes neuronal pyroptosis in juvenile and adult male rats through the NF-κB/IL-1β/NLRP3/caspase-1 signaling pathway: exploration of age and dose as effective covariates using an in vivo and in silico modeling approach.
Bisphenol A (BPA), a common endocrine-disrupting chemical, is found in a wide range of home plastics. Early-life BPA exposure has been linked to neurodevelopmental disorders; however, the link between neuroinflammation, pyroptosis, and the development of psychiatric disorders is rarely studied. The current study attempted to investigate the toxic effect of BPA on inflammatory and microglial activation markers, as well as behavioral responses, in the brains of male rats in a dose- and age-dependent manner. Early BPA exposure began on postnatal day (PND) 18 at dosages of 50 and 125 mg/kg/day. We started with a battery of behavioral activities, including open field, elevated plus- and Y-maze tests, performed on young PND 60 rats and adult PND 95 rats. BPA causes anxiogenic-related behaviors, as well as cognitive and memory deficits. The in vivo and in silico analyses revealed for the first time that BPA is a substantial activator of nuclear factor kappa B (NF-κB), interleukin (IL)-1β, -2, -12, cyclooxygenase-2, and the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, with higher beclin-1 and LC3B levels in BPA rats' PFC and hippocampus. Furthermore, BPA increased the co-localization of caspase-1 immunoreactive neurons, as well as unique neurodegenerative histopathological hallmarks. In conclusion, our results support the hypothesis that neuroinflammation and microglial activation are involved with changes in the brain after postnatal BPA exposure and that these alterations may be linked to the development of psychiatric conditions later in life. Collectively, our findings indicate that BPA triggers anxiety-like behaviors and pyroptotic death of nerve cells via the NF-κB/IL-1β/NLRP3/Caspase-1 pathway.
PubMed: 38941031
DOI: 10.1007/s11010-024-05039-4 -
Community Mental Health Journal Jun 2024Home treatment (HT) treats patients in an acute crisis through an interdisciplinary team with daily appointments for a short treatment period. The effectiveness of HT...
Home treatment (HT) treats patients in an acute crisis through an interdisciplinary team with daily appointments for a short treatment period. The effectiveness of HT has already been confirmed. However, only few studies addressed specific patient characteristics associated outcome of treatment. This study aimed to identify patient characteristics associated with successful outcomes of HT. A systematic literature search was conducted according to the PRISMA guidelines. A total of 13 studies were included in the systematic review. Being employed, having a regular income, having an anxiety disorder and family involvement were associated with a successful treatment outcome in HT. High symptom severity and former hospital admissions were associated with unsuccessful treatment outcome in HT in the selected studies. HT seems to be especially beneficial for patients with paid employment or regular income, patients with anxiety disorders, and patients with familial or other social support.
PubMed: 38940978
DOI: 10.1007/s10597-024-01297-0 -
Archives of Women's Mental Health Jun 2024Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of...
PURPOSE
Postpartum mood disorders affect many women following childbirth. Prescribing medication for depression and anxiety is one strategy for the effective treatment of postpartum mood disorders. Left untreated, mothers experiencing these disorders and their infants face increased risks of adverse health outcomes. Little is known about how diagnosis and treatment of postpartum mood disorders changed during COVID-19.
METHODS
We used a retrospective pooled cross-sectional design in a sample of privately-insured postpartum women in U.S. claims data from January 1, 2016 to December 31, 2020. We measured changes in diagnoses of anxiety and depression and changes in prescription fills and days supplied of classes of medications used to treat these conditions (antidepressants, benzodiazepines, and z-drugs). We used ordinary least squares (OLS) regression for each outcome variable during the pre-pandemic period and forecast expected outcomes the observation period. Forecasted and actual values of the outcomes were then compared.
RESULTS
Following the onset of the COVID-19 pandemic in March 2020, diagnoses of depression and anxiety were not significantly higher among privately insured postpartum women in the United States. The proportion of privately-insured postpartum women filling a benzodiazepine prescription increased by 15.2%.
CONCLUSIONS
We find diagnosis of postpartum mood disorders did not increase after the onset of the COVID-19 pandemic, however, fills of benzodiazepines increased among privately-insured postpartum women. Given prior evidence of increased depressive and anxiety symptoms among postpartum women during COVID-19, this suggests increased barriers to appropriate diagnoses and treatment for depression during this period.
PubMed: 38940966
DOI: 10.1007/s00737-024-01488-4 -
Alternative Therapies in Health and... Jun 2024The research aims to investigate the impact of narrative nursing on the psychological well-being of nursing personnel in the context of the normalization of epidemic.
OBJECTIVE
The research aims to investigate the impact of narrative nursing on the psychological well-being of nursing personnel in the context of the normalization of epidemic.
METHODS
A cohort of 170 frontline nursing staff at our institution was selected for this clinical study from January 1st to October 31st of 2023. The Symptom Checklist-90 (SCL-90) was employed to evaluate the psychological health of these frontline nursing personnel, compared to the standard norms for nurses in mainland China. Employing a randomized selection method, the cohort was divided into two groups: a control group (85 cases) receiving conventional nursing care and a research group (85 cases) receiving narrative nursing care. The duration of nursing intervention in both groups was set at 12 weeks. Various aspects of psychological well-being, work-related stress, psychological resilience, post-traumatic stress disorder, occupational burnout, job satisfaction, and coping strategies were assessed both before and after the nursing intervention.
RESULTS
Among the positive projects of 170 frontline nursing personnel, 32 exhibited positive symptoms, resulting in a positive rate of 18.82%. With the exception of the paranoia dimension score, the scores for other dimensions in the SCL-90 scale within the clinical group were notably higher than those observed in the norm group (P < .05). Among the ten items with the highest frequency of positive symptoms, anxiety, obsessive-compulsive symptoms, and hostility were identified as the most prevalent psychological health issues among frontline nursing personnel. Post-nursing intervention, the research group exhibited lower scores in dimensions other than paranoia in the SCL-90 scale compared to the control group (P < .05). The research group also displayed lower scores in SAS, SDS, SRQ, PCL-C, MBI-HSS and higher scores in CD-RISC and JWS post-intervention (P < .05). In the post-nursing intervention phase, the research group demonstrated lower scores in negative coping and higher scores in positive coping as per the SCSQ scale in comparison to the control group (P < .05).
CONCLUSIONS
Amidst the ongoing normalization of the epidemic, the psychological well-being of frontline nursing staff was lower than the established norms for nurses in mainland China. Notably, somatization, anxiety, and depression emerged as predominant manifestations. Narrative nursing was identified as an effective intervention to enhance nursing personnel's psychological well-being and coping strategies, ultimately regulating negative emotions, reducing post-traumatic stress disorder and occupational burnout, reducing stress levels, and enhancing job satisfaction and psychological resilience.
PubMed: 38940786
DOI: No ID Found -
Journal of the European Academy of... Jun 2024Alopecia areata (AA) carries a psychological burden for patients beyond hair loss. However, quality-of-life measurement tools such as EQ-5D used in clinical trials may...
IMPORTANCE
Alopecia areata (AA) carries a psychological burden for patients beyond hair loss. However, quality-of-life measurement tools such as EQ-5D used in clinical trials may not adequately capture the burden of AA, the perceived stigmatization or the psychosocial impact of AA.
OBJECTIVE
To investigate the potential association between disease severity and the degree of social isolation, perceived stigmatization, anxiety and depression, alcohol consumption and work absenteeism using multiple PRO measures in patients with AA.
DESIGN, SETTING AND PARTICIPANTS
Using the Danish Skin Cohort, the study included adult patients diagnosed with AA. The study included multiple PRO measures, including Skindex-16, EQ-5D-5L, Work Productivity and Activity Impairment (WPAI), Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and the Alopecia Areata Symptom Impact Scale (AASIS). The questionnaires were dispatched to the patients in January 2023. The severity of AA was determined based on scalp involvement using a modified Alopecia Areata Scale. Multiple multivariate linear regressions were conducted using Skindex-16, AASIS and WPAI, while multivariate logistic regressions were applied to HADS, AUDIT-C and EQ-5D-5L.
RESULTS
A total of 376 patients were included, of which 177 (47%) had severe disease, 41 (11%) had moderate disease, 94 (25%) had mild disease, and 64 (17%) were in remission. The median age of patients was 55 (IQR, 47-66 years) and most were female (70%). Skindex-16 and AASIS were the only PRO measures able to distinguish between severity. For these scores, moderate and severe diseases, female sex, and involvement of eyebrows increased the score and negatively impacted patient quality of life.
CONCLUSION AND RELEVANCE
The results indicate the importance of using the proper tool for the intended measurement of quality of life and that factors such as the severity of AA, as well as female sex and involvement of the eyebrows, may potentially increase the psychosocial burden of AA.
PubMed: 38940661
DOI: 10.1111/jdv.20211 -
Psychology and Psychotherapy Jun 2024Intrusive mental imagery is associated with anxiety in bipolar disorder (BD) and presents a novel treatment target. Imagery-based treatments show promise in targeting...
Experiences of imagery-based treatment for anxiety in bipolar disorder: A qualitative study embedded within the image based emotion regulation feasibility randomised controlled trial.
OBJECTIVES
Intrusive mental imagery is associated with anxiety in bipolar disorder (BD) and presents a novel treatment target. Imagery-based treatments show promise in targeting anxiety and improving mood instability. This qualitative study explored experiences of receiving up to 12 sessions of a brief structured psychological intervention: Image-Based Emotion Regulation (IBER), which targets maladaptive mental imagery in the context of BD with an aim to modify the emotional impact of these images.
DESIGN
A qualitative study embedded within the Image Based Emotion Regulation (IBER) feasibility randomised controlled trial.
METHODS
Semi-structured interviews were conducted with 12 participants in the treatment arm of the trial who received IBER + treatment as usual. Data were analysed using thematic analysis.
RESULTS
Despite some initial scepticism about imagery-focused treatment, all participants expressed broadly positive accounts of treatment experiences. High levels of engagement with imagery modification techniques, beneficial use of techniques post treatment and improvements in anxiety management and agency were described by some. Three sub-groups were identified: those who reported a powerful transformative impact of treatment; those who embedded some new techniques into their daily lives, and those who felt they had techniques to use when needed. No participants reported overall negative experiences of the IBER treatment.
CONCLUSIONS
Findings from this study highlight the value for treatment recipients of modifying the underlying meanings associated with maladaptive imagery, and the personalised skills development to manage anxiety within bipolar disorders. Findings can inform treatment refinements and further trial-based evaluations.
PubMed: 38940581
DOI: 10.1111/papt.12538 -
Nutrition Bulletin Jun 2024The prevalence of mental health issues among UK undergraduate students is growing, and poor diet quality appears to be a risk factor for poor mental health although with...
The prevalence of mental health issues among UK undergraduate students is growing, and poor diet quality appears to be a risk factor for poor mental health although with limited research in this area. Therefore, the objective of this study was to examine the cross-sectional associations between diet quality and common mental disorders (CMD) such as depression and anxiety in UK undergraduate students. A cross-sectional survey consisting of demographic information and validated questionnaires (the Short-Form Food Frequency Questionnaire [SFFFQ] and the Hospital Anxiety and Depression Scale [HADS]) was conducted to measure diet quality and anxiety and depression in young adults in 44 UK-based universities. Multiple regression analysis adjusting for confounding factors was used to assess the associations between them. Undergraduate university students (n = 202, 67% female) with a mean age of 20.9 ± 3.6 years and a mean body mass index (n = 170) of 22.6 ± 3.2 kg/m took part in the study. Prevalence of anxiety was high, with 40% of the sample having an anxiety score in the severe range (≥12 points) while the prevalence of depression was lower, with 6% of the population having a depression score in the severe range (≥12 points). Diet quality was significantly higher for females than males (p = 0.034) and was poor for 38% of the sample, being more common in males compared to females, although not significantly so (43% and 36%, respectively). Diet quality was inversely associated with anxiety (β = -0.427; p = 0.029) and was more likely to be associated with anxiety in females than males (β = 0.743; p = 0.043). No significant relationship between diet quality and depression was found. Better self-reported health, father's qualification and smoking status were also associated with less anxiety and depression. This research supports other research suggesting that UK universities should explore whether the implementation of dietary interventions and improving the food environment would be a cost-effective option to reduce the high prevalence of anxiety among students.
PubMed: 38940391
DOI: 10.1111/nbu.12694 -
Muscle & Nerve Jun 2024The impact of treatment expectations on active treatment outcomes has not been specifically investigated in neuromuscular disorders. We thus explored in myasthenia...
INTRODUCTION/AIMS
The impact of treatment expectations on active treatment outcomes has not been specifically investigated in neuromuscular disorders. We thus explored in myasthenia gravis (MG) the contribution of patients' pre-treatment expectations combined with an immunosuppressant drug on treatment outcomes.
METHODS
This pilot correlational study involved 17 patients with generalized MG, scheduled to start immunosuppressant azathioprine. At baseline, a healthcare professional administered: (i) the Stanford Expectations of Treatment Scale; (ii) a structured checklist paper form asking patients which side-effects they expected to develop after starting azathioprine, coupled with a standardized framing of statements. Quantitative Myasthenia Gravis (QMG) score and daily dose of concomitant drugs were assessed by neurologists as clinical outcomes. Clinical outcomes and side-effects were re-assessed at 3 and 6 months, and clinical outcomes were monitored at 18 months.
RESULTS
Clinically significant improvement in the QMG scores was achieved at 3 or 6 months. The level of state anxiety appeared to act as moderator of pre-treatment negative expectations (strong, positive, indicative correlation, rs = .733, p = .001). The latter were, in turn, associated with the fulfillment of side-effects that patients expected to develop with the new treatment (moderate, positive, indicative correlation, rs = .699, p = .002). No significant correlation emerged between positive and negative expectations.
DISCUSSION
Our findings show a very quick clinical response and also suggest that patients' expectations and anxiety contributed to treatment outcomes, highlighting the importance of promoting safety messages and education strategies around newly introduced treatments. Future goals include evaluating a larger cohort that includes a matched control group.
PubMed: 38940302
DOI: 10.1002/mus.28189