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Journal of Women's Health (2002) Jul 2024Military sexual trauma (MST) is more common among post-9/11 Veterans and women versus older Veterans and men. Despite mandatory screening, the concordance of electronic...
Electronic Health Record Concordance with Survey-Reported Military Sexual Trauma Among Younger Veterans: Associations with Health Care Utilization and Mental Health Diagnoses.
Military sexual trauma (MST) is more common among post-9/11 Veterans and women versus older Veterans and men. Despite mandatory screening, the concordance of electronic health record (EHR) documentation and survey-reported MST, and associations with health care utilization and mental health diagnoses, are unknown for this younger group. Veterans' Health Administration (VHA) EHR (2001-2021) were merged with data from the observational, nationwide WomenVeterans Cohort Study (collected 2016-2020, = 1058; 51% women). Experiencing MST was defined as positive endorsement of sexual harassment and/or assault. From the EHR, we derived Veterans' number of primary care and mental health visits in the initial two years of VHA care and diagnoses of posttraumatic stress disorder (PTSD), depression, and anxiety. First, the concordance of EHR MST screening and survey-reported MST was compared. Next, multivariate analyses tested the cross-sectional associations of EHR screening and survey-reported MST with Veterans' health care utilization, and compared the likelihood of PTSD, depression, and anxiety diagnoses by MST group, while covarying demographics and service-related characteristics. With few MST cases among men, multivariate analyses were only pursued for women. Overall, 29% of women and 2% of men screened positive for MST in the EHR, but 64% of women and 9% of men had survey-reported MST. Primary care utilization was similar between women with concordant, positive MST reports in the EHR and survey versus those with survey-reported MST only. Women with survey-reported MST only were less likely to have a PTSD or depression diagnosis than those with concordant, positive MST reports. There was no group difference in women's likelihood of anxiety. EHR MST documentation is discordant for many post-9/11 Veterans-both for men and women. Improving MST screening and better supporting MST disclosure are each critical to provide appropriate and timely care for younger Veterans, particularly women.
PubMed: 38946553
DOI: 10.1089/jwh.2023.0993 -
Revue Des Maladies Respiratoires Jun 2024COPD has become more prevalent among women, revealing a specific feminine phenotype. Women experience greater dyspnea and a more impaired quality of life. The main...
INTRODUCTION
COPD has become more prevalent among women, revealing a specific feminine phenotype. Women experience greater dyspnea and a more impaired quality of life. The main objective of this study was to assess the effect of gender on dyspnea during a pulmonary rehabilitation program (PRP).
METHODS
Retrospective study including COPD patients having participated in PRPs. The following data were analyzed according to gender before and after a PRP: dyspnea, quality of life, anxiety and depression, exercise capacity, muscle function (quadriceps and inspiratory muscles).
RESULTS
More than 500 patients (252 men and 252 women) were included. We did not find a significant effect of gender on the evolution of dyspnea, anxiety or depressive disorders, exercise capacity, inspiratory muscle strength, or overall quality of life score. That said, we found a possible effect on the sub-scores of the quality of life questionnaire, and regarding quadriceps strength. All criteria improved during the program in both groups.
CONCLUSIONS
During a PRP, gender does not impact the evolution of dyspnea. While women may nonetheless benefit to a greater extent in terms of quality of life sub-scores (impact, activities, symptoms) and quadriceps strength, these results still require confirmation.
PubMed: 38945799
DOI: 10.1016/j.rmr.2024.06.007 -
Behavioural Brain Research Jun 2024Major depressive disorder (MDD) affects millions of people worldwide, with women at a higher risk during the childbearing age. Vortioxetine (VOX) and Vilazodone (VLZ)...
Major depressive disorder (MDD) affects millions of people worldwide, with women at a higher risk during the childbearing age. Vortioxetine (VOX) and Vilazodone (VLZ) are newer antidepressants with improved therapeutic profile commonly used, but their safety during pregnancy and long-term effects on offspring are poorly understood due to paucity of literature in preclinical and clinical studies. This study aimed to investigate whether prenatal exposure to VOX and VLZ impacts depressive- and anxiety-like neurobehavioral alterations in offspring, focusing on neurotransmitter-mediated mechanisms. Pregnant Wistar dams received either VOX or VLZ, 1mg/day and 2mg/day of the drug orally from gestation day (GD) 6 to 21. The dams naturally delivered their offspring and reared until they reached postnatal day (PND) 21. Offspring of both sexes were tested for display of depressive-and anxiety-like behaviors from PND 56 to 70. After PND 70, offspring were sacrificed, and their brains were collected to estimate neurotransmitter levels. As per protocol, controls were maintained simultaneously for each experimental design. Prenatal exposure to VOX or VLZ induced an increased state of depressive- and anxiety-like behaviors in both male and female offspring. Additionally, neurotransmitter (serotonin, dopamine, and nor-epinephrine) levels in the prefrontal cortex region of the brain were substantially reduced in exposed offspring. No sex specific neurobehavioral and neurochemical implications were observed in the present study. Our findings suggest that prenatal exposure to VOX and VLZ disrupts neurochemical balance in the fetal brain, leading to long-lasting neurobehavioral impairments in offspring of both sexes.
PubMed: 38945303
DOI: 10.1016/j.bbr.2024.115128 -
The Science of the Total Environment Jun 2024Climate change is affecting both the frequency and scale of wildfires, as well as the increase in the number of days with Saharan dust intrusions. Traditionally, studies...
Short-term effects of fine particulate matter from biomass combustion and Saharan dust intrusions on emergency hospital admissions due to mental and behavioural disorders, anxiety and depression in Spain.
Climate change is affecting both the frequency and scale of wildfires, as well as the increase in the number of days with Saharan dust intrusions. Traditionally, studies have focused on the extent to which the increase in fine particulate matter (PM) has had an impact on cardio-respiratory diseases, but (apart from PM) not on how the meteorological and pollution conditions in these situations affect other diseases, such as those linked to mental health. This study therefore sought to ascertain how daily mean PM, PM , NO, O concentrations and daily maximum temperature in heat waves influence daily emergency hospital admissions in Spain caused by mental and behavioural disorders, depression and anxiety on days with PM from biomass combustion and/or Saharan dust intrusions, as compared to days without such conditions, across the period 2009-2018. Our results indicate that on days on which there is biomass combustion, PM concentrations have a statistically significant effect on emergency admissions due to mental disorders, probably related with the toxicity of these particles. Yet on days with intrusions of Saharan dust rather than PM, it is the other variables considered in the analysis that are most closely linked to these types of admissions. The results of this study thus point to the need to implement public health prevention plans which take into account the joint effect of various environmental risk factors that act synergistically in given situations.
PubMed: 38945243
DOI: 10.1016/j.scitotenv.2024.174316 -
Archives of Suicide Research : Official... Jun 2024Nearly 50,000 Americans die each year from suicide, despite suicide death being a rare event in the context of health risk assessment and modeling. Prior research has...
OBJECTIVE
Nearly 50,000 Americans die each year from suicide, despite suicide death being a rare event in the context of health risk assessment and modeling. Prior research has underscored the need for contextualizing suicide risk models in terms of their potential uses and generalizability. This sensitivity analysis makes use of the Maryland Suicide Data Warehouse (MSDW) and illustrates how results inform clinical decision support.
METHOD
A cohort of 1 million living control patients were extracted from the MSDW in addition to 1,667 patients who had died by suicide between the years 2016 and 2019 according to the Maryland Office of the Medical Examiner (OCME). Data were extracted and aggregated as part of a 4-year retrospective design. Binary logistic and two penalized regression models were deployed in a repeated fivefold cross-validation. Model performances were evaluated using sensitivity, positive predictive value (PPV), and F1, and model coefficients were ranked according to coefficient size.
RESULTS
Several features were significantly associated with patients having died by suicide, including male sex, depressive and anxiety disorder diagnoses, social needs, and prior suicidal ideation and suicide attempt. Cross-validated binary logistic regression outperformed either ridge or LASSO (least absolute shrinkage and selection operator) models but generally achieved low-to-moderate PPV and sensitivity across most thresholds and a peak F1 of 0.323.
CONCLUSIONS
Suicide death prediction is constrained by the context of use, which determines the best balance of precision and recall. Predictive models must be evaluated close to the level of intervention. They may not hold up to different needs at different levels of care.
PubMed: 38945167
DOI: 10.1080/13811118.2024.2363227 -
Psychiatry Research Jun 2024On October 7, 2023, a war erupted in Israel following a mass terror attack including mass shootings, violent events, civilian abductions, and numerous fatalities,...
Mental Health Outcomes of Arab and Jewish Populations in Israel a Month after the Mass Trauma Events of October 7, 2023: A Cross-Sectional Survey of a Representative Sample.
On October 7, 2023, a war erupted in Israel following a mass terror attack including mass shootings, violent events, civilian abductions, and numerous fatalities, ranking as the third most deadliest terror attack. This cross-sectional, population-based study evaluated the impact on the mental health and utilization of mental health services in the Arab and Jewish populations. Conducted through a virtual platform, the study compared demographic factors, exposure to war-related events, anxiety, and post-traumatic stress symptoms among 517 participants in a representative sample of the adult population in Israel (79.1% Jewish, 20.9% Arab). Jews reported higher exposure to war-related events, but a majority expressed a lack of interest in mental help. In contrast, more Arabs desired mental help but faced barriers like stigma and scarce resources. Arabs showed a greater preference for group therapy and medical treatment. Trust in official bodies was consistently higher among Jews. Both populations exhibited similar levels (12-15.4%) of probable post-traumatic stress disorder (PTSD). This study equips clinicians, researchers and policymakers with real-time insights into improving mental health support for the culturally diverse needs of Jewish and Arab communities following exposure to mass trauma.
PubMed: 38945101
DOI: 10.1016/j.psychres.2024.116042 -
Pediatric Neurology May 2024Despite research demonstrating sleep disturbance in children with Tourette syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two...
BACKGROUND
Despite research demonstrating sleep disturbance in children with Tourette syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two important sleep health dimensions. Therefore, this study examined bedtime regularity and sleep sufficiency in children with TS relative to matched healthy control subjects, and its associated demographic, clinical, and behavioral factors.
METHODS
Participants were 384 parents or caregivers of children aged three to 17 years, including 192 with current TS and 192 matched healthy control subjects drawn from the 2020-2021 cycle of the National Survey of Children's Health. Parents completed questions assessing demographic (i.e., age, race, sex), clinical (i.e., attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder, anxiety, depression, tic severity, behavioral or conduct problems, ADHD medication, health condition-related impairment), and behavioral (i.e., screen time) characteristics. Mann-Whitney U test and chi-square test of independence were performed to compare groups on bedtime regularity and sleep sufficiency, respectively. Ordinal regression and binary logistic regression without and with backward elimination were performed to evaluate indicators of bedtime regularity and sleep sufficiency, respectively, in children with TS.
RESULTS
Children with current TS had significantly poorer bedtime regularity, but not sleep sufficiency, relative to matched healthy control subjects. In children with TS, anxiety and two or more hours of daily screen time were associated with higher likelihood of poor bedtime regularity. Autism was associated with lower likelihood of insufficient sleep, and depression was associated with increased likelihood of insufficient sleep.
CONCLUSIONS
Findings put forth screen time, anxiety, and depression as intervention targets to optimize sleep health in children with TS.
PubMed: 38945036
DOI: 10.1016/j.pediatrneurol.2024.05.001 -
Advances in Gerontology = Uspekhi... 2024Metabolic syndrome is a group of disorders that are closely related to both the risk of developing type 2 diabetes mellitus and cardiovascular diseases, and generally... (Review)
Review
[Markers of inflammation with decreased functionality in the cognitive and psychological domains of individual vitality in middle-aged and elderly patients with metabolic syndrome.].
Metabolic syndrome is a group of disorders that are closely related to both the risk of developing type 2 diabetes mellitus and cardiovascular diseases, and generally leading to the phenomenon of premature aging of the body. Excessive accumulation of adipose tissue contributes to the development of chronic immune inflammation and oxidative stress, which are both precursors to various disorders, such as insulin resistance, arterial hypertension and dyslipidemia, but also trigger inflammatory processes in patients. An increasing number of studies support the importance of chronic immune inflammation in the pathogenesis of metabolic syndrome, as pro-inflammatory markers such as TNF-α, IL-1β, IL-6, monocyte chemotactic protein-1 and growth of vascular endothelium. Among a wide range of cytokines, monocyte chemotactic protein-1 is considered one of the most important chemokines, which activates monocytes and other immune cells actively involved in inflammation. Another important point of chronic immune inflammation is its impact on the mental health of patients with metabolic syndrome. Increased levels of anxiety and depression are associated with levels of pro-inflammatory cytokines produced by adipose tissue, which ultimately has an adverse effect on the cognitive status of patients.
Topics: Humans; Metabolic Syndrome; Inflammation; Biomarkers; Aged; Cytokines; Middle Aged; Aging; Oxidative Stress
PubMed: 38944784
DOI: No ID Found -
Advances in Gerontology = Uspekhi... 2024A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly...
A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly people. The study included 678 participants of the ESSE-RF3 population study in the Arkhangelsk region in the age of 60-74 years. We used a questionnaire, including the hospital scale of anxiety and depression score (HADS), and the assessment of the ophthalmological status. It was found that all the study participants had diseases of the visual organ. Elevated depression scores were associated with sex, age, marital status (being single), and disability, elevated anxiety scores - with sex. The scores on the anxiety scale were on average 25% higher in participants whose visual acuity decreased to 0,5 units, and showed no independent associations with diagnosed ophthalmological diseases. The scores on the depression scale were on average 33% higher in participants with visual acuity 0,5 units, and 22% higher in the presence of retinopathy. In conclusion, anxiety and depression in the elderly people were more associated with visual deficits rather than with the presence of ophthalmological diseases underlying a decrease in functional status.
Topics: Humans; Male; Female; Aged; Middle Aged; Russia; Anxiety; Visual Acuity; Depression; Eye Diseases; Surveys and Questionnaires; Vision Disorders
PubMed: 38944776
DOI: No ID Found -
Biological Psychiatry. Cognitive... Jun 2024'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH...
BACKGROUND
'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH remain largely unexplored. While auditory perceptual dysfunction is among the abnormalities implicated in schizophrenia VH, whether VH in trauma-D also involves auditory perceptual alterations is unknown.
METHODS
We investigated auditory cortex (AC)-related functional connectivity (FC) in n=65 women with trauma-D related to childhood abuse with varying severities of VH. Using a novel, computationally-driven and individual-specific method of functionally parcellating the brain, we calculated the FC of two distinct AC subregions-Heschl's gyrus (HG, corresponding to primary AC) and lateral superior temporal gyrus (lSTG, in non-primary AC)- with both the cerebrum and cerebellum. We then measured the association between VH severity and FC using leave-one-out cross validation within the cerebrum, and voxel-wise multiple regression analyses in the cerebellum.
RESULTS
We found that VH severity positively correlated with left lSTG-frontoparietal network FC, while it negatively correlated with FC between left lSTG and both cerebral and cerebellar representations of the default mode network. VH severity was not predicted by FC of left HG or right AC subregions.
CONCLUSIONS
Our findings point to altered interactions between auditory perceptual processing and higher-level processes related to self-reference and executive functioning. This is the first study to show alterations in auditory cortical connectivity in trauma-related VH. While VH in trauma-D appears to be mediated by brain networks that are also implicated in schizophrenia VH, the results suggest a unique mechanism that could distinguish VH in trauma-D.
PubMed: 38944384
DOI: 10.1016/j.bpsc.2024.06.009