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Journal of Anesthesia, Analgesia and... Jun 2024Burnout is a maladaptive response to chronic stress, particularly prevalent among clinicians. Anesthesiologists are at risk of burnout, but the role of maladaptive...
BACKGROUND
Burnout is a maladaptive response to chronic stress, particularly prevalent among clinicians. Anesthesiologists are at risk of burnout, but the role of maladaptive traits in their vulnerability to burnout remains understudied.
METHODS
A secondary analysis was performed on data from the Italian Association of Hospital Anesthesiologists, Pain Medicine Specialists, Critical Care, and Emergency (AAROI-EMAC) physicians. The survey included demographic data, burnout assessment using the Maslach Burnout Inventory (MBI) and subscales (emotional exhaustion, MBI-EE; depersonalization, MBI-DP; personal accomplishment, MBI-PA), and evaluation of personality disorders (PDs) based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition) criteria using the assessment of DSM-IV PDs (ADP-IV). We investigated the aggregated scores of maladaptive personality traits as predictor variables of burnout. Subsequently, the components of personality traits were individually assessed.
RESULTS
Out of 310 respondents, 300 (96.77%) provided complete information. The maladaptive personality traits global score was associated with the MBI-EE and MBI-DP components. There was a significant negative correlation with the MBI-PA component. Significant positive correlations were found between the MBI-EE subscale and the paranoid (r = 0.42), borderline (r = 0.39), and dependent (r = 0.39) maladaptive personality traits. MBI-DP was significantly associated with the passive-aggressive (r = 0.35), borderline (r = 0.33), and avoidant (r = 0.32) traits. Moreover, MBI-PA was negatively associated with dependent (r = - 0.26) and avoidant (r = - 0.25) maladaptive personality features.
CONCLUSIONS
There is a significant association between different maladaptive personality traits and the risk of experiencing burnout among anesthesiologists. This underscores the importance of understanding and addressing personality traits in healthcare professionals to promote their well-being and prevent this serious emotional, mental, and physical exhaustion state.
PubMed: 38907360
DOI: 10.1186/s44158-024-00171-5 -
Frontiers in Public Health 2024The wellbeing of retired teachers is often easily overlooked. This study aims to explore the mental health status and influencing factors of retired teachers.
INTRODUCTION
The wellbeing of retired teachers is often easily overlooked. This study aims to explore the mental health status and influencing factors of retired teachers.
METHOD
From October to December 2022, a convenient sampling survey was conducted on retired teachers using the Symptom Checklist 90 (SCL-90), mainly using the χ-test and logistic regression analysis.
RESULTS
A sampling survey was conducted on 353 retired teachers, with an overall positive detection rate of 16.1%. The five factors with the highest positive detection rate were found to be obsessive-compulsive disorder (30.3%), interpersonal sensitivity (21.5%), paranoia (20.1%), anxiety (19.3%), and others (19.3%). The detection rates for the five factors, namely psychosis, depression, hostility, terror, and somatization, are all below 19%. The data on sex (χ = 4.626, = 0.043), professional title (χ = 17.670, = 0.003), income (χ = 9.960, = 0.041), life satisfaction (χ = 27.348, = 0.000), family relationships (χ = 51.451, = 0.000), and physical health status (χ = 50.361, = 0.000) show that the difference in mental health among retired teachers is statistically significant. The multivariate binary logistic regression analysis revealed that family relationships, life satisfaction, and physical health were important factors leading to mental health problems among retired teachers.
DISCUSSION
Retired teachers should cultivate a wide range of interests and hobbies, engage in regular physical exercise, develop healthy living habits, foster a positive family atmosphere, establish harmonious family relationships, promote community cultural construction, strengthen psychological intervention, and prevent psychological diseases.
Topics: Humans; Male; Female; Middle Aged; Retirement; Mental Health; School Teachers; Surveys and Questionnaires; Health Status; Adult; Aged; China; Mental Disorders; Logistic Models
PubMed: 38903565
DOI: 10.3389/fpubh.2024.1358285 -
Cell Reports Jun 2024Beliefs-attitudes toward some state of the environment-guide action selection and should be robust to variability but sensitive to meaningful change. Beliefs about...
Beliefs-attitudes toward some state of the environment-guide action selection and should be robust to variability but sensitive to meaningful change. Beliefs about volatility (expectation of change) are associated with paranoia in humans, but the brain regions responsible for volatility beliefs remain unknown. The orbitofrontal cortex (OFC) is central to adaptive behavior, whereas the magnocellular mediodorsal thalamus (MDmc) is essential for arbitrating between perceptions and action policies. We assessed belief updating in a three-choice probabilistic reversal learning task following excitotoxic lesions of the MDmc (n = 3) or OFC (n = 3) and compared performance with that of unoperated monkeys (n = 14). Computational analyses indicated a double dissociation: MDmc, but not OFC, lesions were associated with erratic switching behavior and heightened volatility belief (as in paranoia in humans), whereas OFC, but not MDmc, lesions were associated with increased lose-stay behavior and reward learning rates. Given the consilience across species and models, these results have implications for understanding paranoia.
PubMed: 38870010
DOI: 10.1016/j.celrep.2024.114355 -
Actas Espanolas de Psiquiatria Jun 2024The neurobiological basis of delusional disorder is less explored through neuroimaging techniques than in other psychotic disorders. This study aims to provide...
BACKGROUND
The neurobiological basis of delusional disorder is less explored through neuroimaging techniques than in other psychotic disorders. This study aims to provide information about the neural origins of delusional disorder (DD) by examining the neuroanatomical features of some basal nuclei with magnetic resonance imaging (MRI) texture analysis.
MATERIALS AND METHODS
Twenty DD patients and 20 healthy individuals were included in the study. Globus pallidus, putamen, and caudate nuclei were selected individually with a region of interest (ROI) on the axial MRI images. The entire texture analysis algorithm applied to all selected ROIs was done with an in-house software. Nuclei on both sides were taken as separate samples.
RESULTS
There were no significant differences between groups in terms of age and gender. The average "mean, median and maximum" values of all three nuclei were decreased in DD patients. The small putamen area and the differences detected in different tissue parameters for all three nuclei in delusional disorder patients indicate that they differ in delusional disorder from normal controls (p < 0.05).
CONCLUSION
The differences detected in the texture parameters for all three nuclei indicate that there is something different in the DD from in the normal controls. Neuroimaging studies with larger samples and different techniques in the future may shed light on the etiology of delusional disorder.
Topics: Humans; Female; Putamen; Male; Globus Pallidus; Magnetic Resonance Imaging; Caudate Nucleus; Middle Aged; Schizophrenia, Paranoid; Adult; Case-Control Studies; Neuroimaging
PubMed: 38863052
DOI: 10.62641/aep.v52i3.1604 -
The Mental Health Clinician Jun 2024Catatonia is a syndrome characterized by psychomotor and behavioral disturbances and is associated with a substantially increased mortality risk in adolescent patients....
INTRODUCTION
Catatonia is a syndrome characterized by psychomotor and behavioral disturbances and is associated with a substantially increased mortality risk in adolescent patients. There is a dearth of published literature describing treatment strategies for pediatric patients with catatonia. This dual-case series will describe the treatment course of 2 adolescent patients with catatonia at our pediatric inpatient psychiatric facility.
CASE SERIES
This case series presents 2 adolescent patients (a 17-year-old male and a 16-year-old female) who initially presented with worsening agitation and paranoia, later developing catatonia. Both patients required long durations of hospitalization and were treated with high-dose lorazepam before requiring the addition of electroconvulsive therapy (ECT).
DISCUSSION
Treatment of pediatric patients with catatonia creates a significant burden on patients, families, and the healthcare system. Treatment with high-dose benzodiazepines is high risk, while ECT is both difficult to access and comes with its own risks. Both patients discussed are transitional age, meaning they will soon be young adults who will continue to require high-level psychiatric care. Psychiatric pharmacists have a large role to play in ensuring safe medication management for these complex patients.
CONCLUSIONS
This case series of 2 adolescent patients with catatonia demonstrates marginal reduction in symptoms with high-dose lorazepam in conjunction with ECT, with minimal side effects. This case series adds to the limited available literature regarding treatment of catatonia in pediatric patients and highlights the need for further study into effective treatment alternatives.
PubMed: 38835818
DOI: 10.9740/mhc.2024.06.215 -
Translational Psychiatry Jun 2024There is a lack of knowledge regarding the relationship between proneness to dimensional psychopathological syndromes and the underlying pathogenesis across major...
There is a lack of knowledge regarding the relationship between proneness to dimensional psychopathological syndromes and the underlying pathogenesis across major psychiatric disorders, i.e., Major Depressive Disorder (MDD), Bipolar Disorder (BD), Schizoaffective Disorder (SZA), and Schizophrenia (SZ). Lifetime psychopathology was assessed using the OPerational CRITeria (OPCRIT) system in 1,038 patients meeting DSM-IV-TR criteria for MDD, BD, SZ, or SZA. The cohort was split into two samples for exploratory and confirmatory factor analyses. All patients were scanned with 3-T MRI, and data was analyzed with the CAT-12 toolbox in SPM12. Psychopathological factor scores were correlated with gray matter volume (GMV) and cortical thickness (CT). Finally, factor scores were used for exploratory genetic analyses including genome-wide association studies (GWAS) and polygenic risk score (PRS) association analyses. Three factors (paranoid-hallucinatory syndrome, PHS; mania, MA; depression, DEP) were identified and cross-validated. PHS was negatively correlated with four GMV clusters comprising parts of the hippocampus, amygdala, angular, middle occipital, and middle frontal gyri. PHS was also negatively associated with the bilateral superior temporal, left parietal operculum, and right angular gyrus CT. No significant brain correlates were observed for the two other psychopathological factors. We identified genome-wide significant associations for MA and DEP. PRS for MDD and SZ showed a positive effect on PHS, while PRS for BD showed a positive effect on all three factors. This study investigated the relationship of lifetime psychopathological factors and brain morphometric and genetic markers. Results highlight the need for dimensional approaches, overcoming the limitations of the current psychiatric nosology.
Topics: Humans; Male; Female; Adult; Magnetic Resonance Imaging; Bipolar Disorder; Depressive Disorder, Major; Schizophrenia; Psychotic Disorders; Gray Matter; Middle Aged; Genome-Wide Association Study; Factor Analysis, Statistical; Brain; Psychopathology; Multifactorial Inheritance; Cerebral Cortex
PubMed: 38830892
DOI: 10.1038/s41398-024-02936-6 -
Alpha Psychiatry Jan 2024Schizophrenia patients often have personality disorders; schizophrenia patients with personality disorders are more difficult to treat and have a worse prognosis. Early...
OBJECTIVE
Schizophrenia patients often have personality disorders; schizophrenia patients with personality disorders are more difficult to treat and have a worse prognosis. Early identification of this group of patients and early intervention can achieve better prognosis. Therefore, it is very important to explore effective biomarkers and early diagnosis for the prognosis of schizophrenia. The primary purpose of this paper is to explore the relationship between plasma miRNA expression level and personality disorder with schizophrenia.
METHODS
Gene microarrays in miRNA files were employed, and the plasma of peripheral blood of 82 schizophrenic patients and 43 healthy control subjects were examined. Real-time reverse transcription polymerase chain reaction detection were performed to explore the results. Spearman correlation analysis was used to analyze the correlation between expression level of miRNAs and Personality Diagnosis Questionnaire-4 score.
RESULTS
The results showed that miR-1273d, miR-1303, miR-3064-5p, miR-3131, miR-3687, miR-4428, miR-4725-3p, and miR-5096 were up-regulated in schizophrenic patients. Compared to healthy control subjects, the difference was statistically significant ( < .05). Schizophrenic patients with schizoid, paranoid, schizotypal, and obsessive compulsive traits had negative correlation with miR-1303, miR-3131, miR-4428, and miR-5096 expression level ( = -0.40 to -0.62, < .05); there were no significant differences in the other miRNAs. Correlation with other personality traits was not significant ( > .05). The stepwise regression analysis indicated that miR-5096, miR-3131, and miR-1273d have a significant predictive effect on the schizoid trait ( < .01). MiR-4428 and miR-1303 had a significant predictive effect on the schizotypal trait ( < .01). MiR-5096, miR-4428, and miR-4725-3P had a significant predictive effect on the paranoid trait ( < .05). MiR-4428, miR-1303, and miR-5096 had a significant predictive effect on the obsessive compulsive trait ( < .05).
CONCLUSION
The expression levels of miR-1273d, miR-1303, miR-3064-5p, miR-3131, miR-3687, miR-4428, miR-4725-3p, and miR-5096 were up-regulated in the peripheral blood of patients with schizophrenia, and these miRNAs are expected to be diagnostic biomarkers for accurate diagnosis of schizophrenia. The expression levels of miR-1303, miR-3131, miR-1273d, miR-4428, miR-4725-3p, and miR-5096 have significant predictive effects on personality disorder in schizophrenia.
PubMed: 38799488
DOI: 10.5152/alphapsychiatry.2024.231216 -
Computational Psychiatry (Cambridge,... 2024Paranoid delusions or unfounded beliefs that others intend to deliberately cause harm are a frequent and burdensome symptom in early psychosis, but their emergence and...
Paranoid delusions or unfounded beliefs that others intend to deliberately cause harm are a frequent and burdensome symptom in early psychosis, but their emergence and consolidation still remains opaque. Recent theories suggest that overly precise prediction errors lead to an unstable model of the world providing a breeding ground for delusions. Here, we employ a Bayesian approach to test for such an unstable model of the world and investigate the computational mechanisms underlying emerging paranoia. We modelled behaviour of 18 first-episode psychosis patients (FEP), 19 individuals at clinical high risk for psychosis (CHR-P), and 19 healthy controls (HC) during an advice-taking task designed to probe learning about others' changing intentions. We formulated competing hypotheses comparing the standard Hierarchical Gaussian Filter (HGF), a Bayesian belief updating scheme, with a mean-reverting HGF to model an altered perception of volatility. There was a significant group-by-volatility interaction on advice-taking suggesting that CHR-P and FEP displayed reduced adaptability to environmental volatility. Model comparison favored the standard HGF in HC, but the mean-reverting HGF in CHR-P and FEP in line with perceiving increased volatility, although model attributions in CHR-P were heterogeneous. We observed correlations between perceiving increased volatility and positive symptoms generally as well as with frequency of paranoid delusions specifically. Our results suggest that FEP are characterised by a different computational mechanism - perceiving the environment as increasingly volatile - in line with Bayesian accounts of psychosis. This approach may prove useful to investigate heterogeneity in CHR-P and identify vulnerability for transition to psychosis.
PubMed: 38774429
DOI: 10.5334/cpsy.95 -
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