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Psychiatry 2024Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect...
OBJECTIVE
Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect and emotion dysregulation, poor sleep and insomnia can contribute to the initiation and maintenance of mental disorders. The aim of this cross-sectional study was to investigate the relationship between insomnia severity and overall psychiatric symptoms (anxiety, depression, obsessive-compulsive symptoms, somatization, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism), and the mediational roles of worry and rumination in this relationship.
METHOD
The data was collected from a community sample of 1444 participants (females 69.39%, M = 27.95, SD = 9.37) who completed self-report measures of insomnia severity, worry, rumination, and psychiatric symptoms. The mediational roles of worry and rumination were tested with mediation analysis using the PROCESS Macro.
RESULTS
It was found that insomnia severity (β = 0.20, < .001) significantly predicted psychiatric symptoms directly and via worry and rumination (β = 0.33, < .001), meaning that worry and rumination partially mediated the relationship between insomnia severity and psychiatric symptoms. The findings were similar after controlling for smoking status, daily screen time, coffee consumption in the evening, weekly exercise frequency, and pre-sleep screen time.
CONCLUSIONS
Interventions targeting the reduction of insomnia severity and maladaptive emotion regulation strategies (e.g., worry and rumination), as well as the enhancement of adaptive emotion regulation strategies (e.g., positive refocusing and mindfulness), may alleviate the adverse effects of insomnia on psychiatric symptoms.
Topics: Humans; Female; Male; Sleep Initiation and Maintenance Disorders; Cross-Sectional Studies; Adult; Rumination, Cognitive; Anxiety; Young Adult; Severity of Illness Index; Middle Aged; Depression; Adolescent; Mediation Analysis; Mental Disorders
PubMed: 38758524
DOI: 10.1080/00332747.2024.2347100 -
Frontiers in Psychiatry 2024Studies have consistently demonstrated increased stress sensitivity in individuals with psychosis. Since stress sensitivity may play a role in the onset and maintenance...
INTRODUCTION
Studies have consistently demonstrated increased stress sensitivity in individuals with psychosis. Since stress sensitivity may play a role in the onset and maintenance of psychosis, this could potentially be a promising target for treatment. The current study was the first to investigate whether reactivity to and recovery from daily-life stressors in psychosis change in response to treatment, namely virtual-reality-based cognitive behavioral therapy (VR-CBT).
METHODS
116 patients were randomized to either VR-CBT or the waiting list control group (WL). Pre-treatment and post-treatment participants completed a diary ten times a day during six to ten days. Multilevel analyses were used to model the time-lagged effects of daily stressful events on negative affect (NA) and paranoia symptoms to examine reactivity and recovery.
RESULTS
There was a significant difference in NA reactivity. VR-CBT showed higher NA at post-treatment compared to pre-treatment than WL (b=0.14; b=0.19 vs b=0.18; b=0.14). There was a significant difference in NA recovery and paranoia recovery between the groups at lag 1: VR-CBT showed relatively lower negative affect (b=0.07; b=-0.06) and paranoia (b= 0.08; b=-0.10) at post-treatment compared to pre-treatment than WL (b=0.08; b=0.08; b=0.04; b=0.03).
CONCLUSION
Negative affect and paranoia recovery improved in response to treatment. Increased NA reactivity may be explained by a decrease in safety behavior in the VR-CBT group. The discrepancy between reactivity and recovery findings may be explained by the inhibitory learning theory that suggests that an original threat reaction may not erase but can be inhibited as a consequence of exposure therapy.
PubMed: 38745779
DOI: 10.3389/fpsyt.2024.1360165 -
Spanish Journal of Psychiatry and... 2024Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian...
INTRODUCTION
Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample.
MATERIAL AND METHODS
We used a random representative sample previously identified via standard stratification procedures. Thus, a final sample of 4507 participants were included (response rate 83.7%). Interviewees were thoroughly assessed on sociodemographic, clinical and psychosocial factors, including: exposures to threatening life events (TLEs), childhood abuse, personality disorder and traits (neuroticism, impulsivity, paranoia), global functioning, physical health and toxics consumption. SAD diagnosis was ascertained using the Mini International Neuropsychiatric Interview. Both, pooled prevalences (with 95% confidence intervals) and risk correlates for SAD were estimated using binary logistic regression.
RESULTS
Estimated prevalence for SAD was 1.1% (95% CI=0.8-1.4). Having a SAD diagnosis was independently and significantly associated with younger age, poorer global functioning, higher neuroticism and paranoia personality traits, having suffered childhood abuse and exposure to previous TLEs. Furthermore, SAD was significantly associated with comorbid personality disorder, major depression, panic disorder and alcohol abuse.
CONCLUSIONS
Among this large Andalusian population sample, the prevalence of SAD and its associated factors are relatively similar to previously reported international studies, although no population study had previously reported such a strong association with paranoia.
Topics: Humans; Phobia, Social; Female; Male; Adult; Middle Aged; Spain; Prevalence; Young Adult; Adolescent; Comorbidity; Aged; Personality Disorders
PubMed: 38720187
DOI: 10.1016/j.rpsm.2021.09.006 -
Clinical Practice and Epidemiology in... 2024Wegener's disease is an autoimmune condition affecting the respiratory tract and kidneys. Mental health assessment is crucial due to the impact of psychological...
BACKGROUND
Wegener's disease is an autoimmune condition affecting the respiratory tract and kidneys. Mental health assessment is crucial due to the impact of psychological disorders on the immune system. Despite this, there is limited community-based research on psychiatric disorders and personality traits among patients with Wegener's disease.
OBJECTIVE
This study aimed to investigate the prevalence of psychiatric disorders and examine the predictive role of personality traits among patients with Wegener's disease.
METHODS
A total of 100 patients met the inclusion and exclusion criteria, and all of them were selected to participate in the study. Out of them, 75 individuals completed the questionnaires. The instruments included the SCL-90 questionnaire and the NEO Big Five personality traits. The data were analysed using Stata software, and the prevalence of psychiatric disorders in different patient groups was determined using the chi-square method. The predictive role of personality traits in mental disorders was examined using multivariate regression.
RESULTS
The results revealed that paranoia (53.3%) and depression (44%) had the highest prevalence in terms of psychiatric disorders, while psychosis (17.3%) and hostility (25.33%) had the lowest prevalence. Additionally, the findings demonstrated a positive correlation between most psychiatric disorders and the neuroticism personality trait.
CONCLUSION
Given the influence of mental disorders on the immune system in Wegener's disease, it is essential to provide psychological care for these patients.
PubMed: 38715951
DOI: 10.2174/0117450179276345240117043037 -
Molecular Psychiatry May 2024Effective prevention of severe mental disorders (SMD), including non-psychotic unipolar mood disorders (UMD), non-psychotic bipolar mood disorders (BMD), and psychotic...
Effective prevention of severe mental disorders (SMD), including non-psychotic unipolar mood disorders (UMD), non-psychotic bipolar mood disorders (BMD), and psychotic disorders (PSY), rely on accurate knowledge of the duration, first presentation, time course and transdiagnosticity of their prodromal stages. Here we present a retrospective, real-world, cohort study using electronic health records, adhering to RECORD guidelines. Natural language processing algorithms were used to extract monthly occurrences of 65 prodromal features (symptoms and substance use), grouped into eight prodromal clusters. The duration, first presentation, and transdiagnosticity of the prodrome were compared between SMD groups with one-way ANOVA, Cohen's f and d. The time course (mean occurrences) of prodromal clusters was compared between SMD groups with linear mixed-effects models. 26,975 individuals diagnosed with ICD-10 SMD were followed up for up to 12 years (UMD = 13,422; BMD = 2506; PSY = 11,047; median[IQR] age 39.8[23.7] years; 55% female; 52% white). The duration of the UMD prodrome (18[36] months) was shorter than BMD (26[35], d = 0.21) and PSY (24[38], d = 0.18). Most individuals presented with multiple first prodromal clusters, with the most common being non-specific ('other'; 88% UMD, 85% BMD, 78% PSY). The only first prodromal cluster that showed a medium-sized difference between the three SMD groups was positive symptoms (f = 0.30). Time course analysis showed an increase in prodromal cluster occurrences approaching SMD onset. Feature occurrence across the prodromal period showed small/negligible differences between SMD groups, suggesting that most features are transdiagnostic, except for positive symptoms (e.g. paranoia, f = 0.40). Taken together, our findings show minimal differences in the duration and first presentation of the SMD prodromes as recorded in secondary mental health care. All the prodromal clusters intensified as individuals approached SMD onset, and all the prodromal features other than positive symptoms are transdiagnostic. These results support proposals to develop transdiagnostic preventive services for affective and psychotic disorders detected in secondary mental healthcare.
PubMed: 38710907
DOI: 10.1038/s41380-024-02533-5 -
Journal of Psychiatric Research Apr 2024The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has... (Review)
Review
The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has been recognized as a useful tool for understanding the characteristics, dynamics, and underlying mechanisms of prodromal symptoms of psychosis. The present systematic review aimed to provide a qualitative synthesis of findings provided by the ESM studies conducted in people with psychosis risk states. A systematic review of the MEDLINE, ERIC, Academic Search Ultimate, and Health Source: Nursing/Academic Edition databases, utilizing search terms related to the ESM and the risk of psychosis was conducted. Out of 1069 publication records identified, 77 studies met the inclusion criteria for the review. Data were synthesized around the following topics: 1) assessment of symptoms dynamics and social functioning; 2) assessment of the mechanisms contributing to the emergence of psychotic experiences and 3) assessment of stress sensitivity. The studies have shown that negative emotions are associated with subsequent development of paranoia. The tendency to draw hasty conclusions, aberrant salience, self-esteem, and emotion regulation were the most frequently reported mechanisms associated with the emergence of psychotic experiences. Studies using the ESM also provided evidence for the role of stress sensitivity, in the development of psychotic symptoms. The ESM has widely been applied to studies investigating psychosis risk states, using a variety of protocols. Findings from this systematic review might inform future studies and indicate potential targets for interventions.
PubMed: 38704979
DOI: 10.1016/j.jpsychires.2024.04.050 -
Schizophrenia Bulletin May 2024Exposure to childhood maltreatment-a risk factor for psychosis is associated with paranoia-may impact one's beliefs about the world and how beliefs are updated. We...
BACKGROUND AND HYPOTHESIS
Exposure to childhood maltreatment-a risk factor for psychosis is associated with paranoia-may impact one's beliefs about the world and how beliefs are updated. We hypothesized that increased exposure to childhood maltreatment is related to volatility-related belief updating, specifically higher expectations of volatility, and that these relationships are strongest for threat-related maltreatment. Additionally, we tested whether belief updating mediates the relationship between maltreatment and paranoia.
STUDY DESIGN
Belief updating was measured in 75 patients with schizophrenia-spectrum disorders and 76 nonpsychiatric controls using a 3-option probabilistic reversal learning (3PRL) task. A Hierarchical Gaussian Filter (HGF) was used to estimate computational parameters of belief updating, including prior expectations of volatility (μ03). The Childhood Trauma Questionnaire (CTQ) was used to assess cumulative maltreatment, threat, and deprivation exposure. Paranoia was measured using the Positive and Negative Syndrome Scale (PANSS) and the revised Green et al. Paranoid Thoughts Scale (R-GPTS).
RESULTS
Greater exposure to childhood maltreatment is associated with higher prior expectations of volatility in the whole sample and in individuals with schizophrenia-spectrum disorders. This was specific to threat-related maltreatment, rather than deprivation, in schizophrenia-spectrum disorders. Paranoia was associated with both exposure to childhood maltreatment and volatility priors, but we did not observe a significant indirect effect of volatility priors on the relationship between maltreatment and paranoia.
CONCLUSIONS
Our study suggests that individuals with schizophrenia-spectrum disorders who were exposed to threatening experiences during childhood expect their environment to be more volatile, potentially facilitating aberrant belief updating and conferring risk for paranoia.
PubMed: 38701234
DOI: 10.1093/schbul/sbae057 -
Frontiers in Psychiatry 2024Impaired function of brain morphogenic genes is considered one of the predisposing factors for the manifestation of psychiatric and cognitive disorders, such as paranoid...
INTRODUCTION
Impaired function of brain morphogenic genes is considered one of the predisposing factors for the manifestation of psychiatric and cognitive disorders, such as paranoid schizophrenia (SCZ) and major depressive disorder (MDD). Identification of such genes (genes of neurotrophic factors and guidance molecules among them) and their deleterious genetic variants serves as a key to diagnosis, prevention, and possibly treatment of such disorders. In this study, we have examined the prevalence of genomic variants in brain morphogenic genes in individuals with SCZ and MDD within a Russian population.
METHODS
We have performed whole-exome sequencing of 21 DNA samples: 11 from individuals with SCZ and 10 with MDD, followed by ARMS (Amplification-Refractory Mutation System) based screening of detected single nucleotide variants (SNVs) in larger groups: 102 for individuals with SCZ, 79 for those with MDD and 103 for healthy donors.
RESULTS
Whole-exome sequencing has revealed 226 missense mutations in 79 genes (out of 140 studied), some of which occur in patients with psychiatric disorders significantly more frequently than in healthy donors. We have identified previously undescribed genomic variants in brain morphogenic genes: (rs1944294-T and rs17445840-T), (rs11935573-G and rs12500437-G/T) and (rs1227051-G/A), significantly associated with the incidence of SCZ and MDD in the Russian population. For some SNVs (rs6265-T, rs1944294-T, rs11935573-G, rs4760-G) sex-biased differences in their prevalence between SCZ/MDD patients and healthy donors was detected.
DISCUSSION
However, the functional significance of the SNVs identified has still to be confirmed in cellular and animal models. Once it is fulfilled, these SNVs have the potential to complement the diagnostic toolbox for assessing susceptibility to mental disorders. The data obtained indirectly confirm the importance of adequate brain structure formation for its correct functioning and preservation of mental health.
PubMed: 38699454
DOI: 10.3389/fpsyt.2024.1338168 -
MedRxiv : the Preprint Server For... Apr 2024Adolescent self-reported psychotic experiences are associated with mental illness and could help guide prevention strategies. The Community Assessment of Psychic...
BACKGROUND
Adolescent self-reported psychotic experiences are associated with mental illness and could help guide prevention strategies. The Community Assessment of Psychic Experiences (CAPE) was developed over 20 years ago. In a rapidly changing society, where new generations of adolescents are growing up in an increasingly digital world, it is crucial to ensure high reliability and validity of the questionnaire.
METHODS
In this observational validation study, we used unique transgenerational questionnaire and health registry data from the Norwegian Mother, Father, and Child Cohort, a population-based pregnancy cohort. Adolescents, aged ~14 years, responded to the CAPE-16 ( = 18,835) and fathers to the CAPE-9 questionnaire ( = 28,793). We investigated the psychometric properties of CAPE-16 through factor analyses, measurement invariance testing across biological sex, response before/ during the COVID-19 pandemic, and generations (comparison with fathers), and examined associations with later psychiatric diagnoses.
OUTCOMES
One third (33·4%) of adolescents reported lifetime psychotic experiences. We confirmed a three-factor structure (paranoia, bizarre thoughts, and hallucinations) of CAPE-16, and observed good scale reliability of the distress and frequency subscales (ω = ·86 and ·90). CAPE-16 measured psychotic experiences were invariant to biological sex and pandemic status. CAPE-9 was non-invariant across generations, with items related to understanding of the digital world () prone to bias. CAPE-16 sum scores were associated with a subsequent psychiatric diagnosis, particularly psychotic disorders ( OR = 2·06; 97·5% CI = 1·70-2·46; OR = 1·93; 97·5% CI = 1·63-2·26).
INTERPRETATION
CAPE-16 showed robust psychometric properties across sex and pandemic status, and sum scores were associated with subsequent psychiatric diagnoses, particularly psychotic disorders. These findings suggest that with certain adjustments, CAPE-16 could have value as a screening tool for adolescents in the modern, digital world.
FUNDING
European Union's Horizon 2020 Programme, Research Council of Norway, South-Eastern Norway Regional Health Authority, NIMH, and the KG Jebsen Stiftelsen.
PubMed: 38699352
DOI: 10.1101/2024.04.18.24306017