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Journal of Psychiatric Research Jun 2024All definitions of treatment-resistant depression (TRD) require that patients have experienced insufficient benefit from one or more adequate antidepressant trials.... (Review)
Review
All definitions of treatment-resistant depression (TRD) require that patients have experienced insufficient benefit from one or more adequate antidepressant trials. Thus, identifying "failed, adequate trials" is key to the assessment of TRD. The Antidepressant Treatment History Form (ATHF) was one of the first and most widely used instruments that provided objective criteria in making these assessments. The original ATHF was updated in 2018 to the ATHF-SF, changing to a checklist format for scoring, and including specific pharmacotherapy, brain stimulation, and psychotherapy interventions as potentially adequate antidepressant treatments. The ATHF-SF2, presented here, is based on the consensus of the ATHF workgroup about the novel interventions introduced since the last revision and which should/should not be considered effective treatments for major depressive episodes. This document describes the rationale for these choices and, for each intervention, the minimal criteria for determining the adequacy of treatment administration. The Supplementary Material that accompanies this article provide the Scoring Checklist, Data Collection Forms (current episode and composite of previous episodes), and Instruction Manual for the ATHF-SF2.
PubMed: 38917723
DOI: 10.1016/j.jpsychires.2024.05.046 -
AIDS Education and Prevention :... Jun 2024Employment linked with social venues has long been described as permissive environments for excessive drinking, disruptive/aggressive behaviors, and overt sexual...
Between a Rock and a Hard Place: "I Decided to Keep Quiet": A Qualitative Inquiry Into the Coping Experiences of Young People (15-24) Working at High-Risk Venues for HIV in Uganda.
Employment linked with social venues has long been described as permissive environments for excessive drinking, disruptive/aggressive behaviors, and overt sexual behaviors, which are known risk factors for HIV. Yet, our understanding of the extent to which workers in such high-risk work settings cope with the various risks therein is still limited. This study explored the coping strategies employed by workers at social venues. We interviewed 47 workers at 22 social venues through small group discussions (15) and in-depth interviews (10) in 2021 in Rakai district, Uganda. All discussions were audiorecorded and transcribed verbatim before analysis. Data were analyzed using thematic content analysis. We found two main categories of coping strategies used by workers: acceptance of sexual risks and keeping safe. Acceptance of risks such as transactional sex was the most used strategy, hence highlighting negative coping. This calls for interventions for improving workers' coping efficiency and adjustment as well as interventions ameliorating the conditions underpinning increased risk of HIV at the venues.
Topics: Humans; Adaptation, Psychological; Uganda; HIV Infections; Female; Male; Qualitative Research; Young Adult; Adolescent; Sexual Behavior; Interviews as Topic; Risk Factors; Risk-Taking; Employment; Adult
PubMed: 38917301
DOI: 10.1521/aeap.2024.36.3.198 -
BMC Public Health Jun 2024Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to...
BACKGROUND
Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to assess physical, psychological and social status of older adults. This study is conducted to explore the association between them in a large Indian community-dwelling population.
METHODS
Data were based on the wave 1 survey of the Longitudinal Ageing Study in India (LASI). People aged 60 and above with complete information were included. The elderly met five standards including absence of chronic diseases, freedom from disability, high cognitive ability, free from depressive symptoms and active social engagement, were classified into successful agers. The assessment of falls, fall-related injuries and multiple falls depended on interview. Multivariate logistic regression was conducted to find the associations between falls, fall-injury, multiple falls and successful ageing after adjusting both socio-demographic and biological covariates. The log-likelihood ratio test was calculated interactions in subgroups.
RESULTS
31,345 participants in LASI were finally included in our study. Of them, 20.25% reported fall, and 25% were classified into successful agers. After full adjustment, successful ageing was negatively associated with falls (OR 0.70; 95%CI 0.65-0.76) and multiple falls (OR 0.70; 95%CI 0.63-0.78). And the association did not show the significance in older adults with fall-related injuries (OR 0.86; 95%CI 0.72-1.04).
CONCLUSIONS
Successful ageing was negatively associated with falls and multiple falls, but not fall-related injuries in older people in India. Future studies are demanded to explore the causal relationship and to reveal the underlying mechanism.
Topics: Humans; Accidental Falls; India; Male; Female; Aged; Middle Aged; Cross-Sectional Studies; Longitudinal Studies; Aged, 80 and over; Aging; Risk Factors
PubMed: 38914970
DOI: 10.1186/s12889-024-19181-7 -
International Journal of Palliative... Jun 2024Providing supportive care to patients with cancer and improving their comfort levels can promote their adjustment to the disease, compliance with treatment and improve...
BACKGROUND
Providing supportive care to patients with cancer and improving their comfort levels can promote their adjustment to the disease, compliance with treatment and improve their quality of life.
AIM
The aim of this cross-sectional, descriptive study was to identify the effects of the supportive care needs of cancer patients on their comfort levels.
METHODS
The study was performed in the oncology department of a university hospital. A total of 153 cancer patients undergoing chemotherapy constituted the sample. The data collection procedure included the Supportive Care Needs Survey (SCNS) and the General Comfort Questionnaire (GCQ).
RESULTS
The SCNS scores of the patients were low (Mean±SD: 75.13±27.93). The socio-cultural dimension of the GCQ was the most adversely influenced area of comfort. There was a negative relationship between needs and comfort levels (rs=-0.69, p<0.01). Lower scores of comfort were associated with higher scores of SCNS (ß=-0.487; ß=-0.316; ß=-0.958, respectively).
CONCLUSIONS
Cancer patients undergoing chemotherapy were supported in meeting their physical and psychological needs and performing their activities of daily living and care during their hospital stay. Patients with higher support needs had lower comfort levels.
Topics: Humans; Neoplasms; Female; Male; Cross-Sectional Studies; Middle Aged; Aged; Surveys and Questionnaires; Adult; Patient Comfort; Needs Assessment; Quality of Life; Palliative Care; Aged, 80 and over
PubMed: 38913641
DOI: 10.12968/ijpn.2024.30.6.295 -
Psychology Research and Behavior... 2024Intergenerational solidarity between parents and emerging adult offspring requires more substantial attention at the present time. Changing demographic structures and...
BACKGROUND
Intergenerational solidarity between parents and emerging adult offspring requires more substantial attention at the present time. Changing demographic structures and transformations in family dynamics over recent decades have increased both opportunities and the need for parent-child interactions and exchanges of support and affection during emerging adulthood.
PURPOSE
The study had two aims: first, to explore patterns in intergenerational solidarity in accordance with different sociodemographic characteristics of emerging adults; and second, to analyse associations between intergenerational solidarity and emerging adults' psychological distress and satisfaction with life.
METHODS
Participants were 644 emerging adult university students from Southern Europe (Spain and Portugal), aged between 18 and 29 years, who completed a self-report questionnaire designed to assess variables linked to sociodemographic aspects (gender, country of residence, sexual orientation, living status, family income), intergenerational solidarity, psychological distress and satisfaction with life.
RESULTS
The results indicated some differences in intergenerational solidarity patterns in accordance with a range of sociodemographic characteristics. They also revealed significant associations between intergenerational solidarity dimensions and emerging adults' satisfaction with life and psychological distress. Moreover, affective solidarity was found to fully mediate the relationship between associational, functional and normative solidarity and emerging adults' adjustment. In the case of conflictual solidarity, affective solidarity was found to partially mediate the relationship between this dimension of intergenerational solidarity and emerging adults' distress and to fully mediate the relationship between this same dimension and emerging adults' satisfaction with life.
CONCLUSION
The results indicate that it is important to take sociodemographic diversity into account when exploring relationships between emerging adults and their parents. They also suggest that affective solidarity acts as a protective factor in promoting emerging adults' adjustment.
PubMed: 38912157
DOI: 10.2147/PRBM.S451905 -
Midwifery Jun 2024To explore the underlying beliefs of preventive health behaviours among women with a history of GDM who had low levels of preventive health behaviours during their...
AIMS
To explore the underlying beliefs of preventive health behaviours among women with a history of GDM who had low levels of preventive health behaviours during their postpartum period in Singapore.
METHODS
This paper reports on the qualitative arm of a mixed method study. The qualitative descriptive design was adopted. Individual interviews were conducted between 7th September 2020 and 25th September 2020 using a semi-structured interview guide. Data collected were analysed using thematic analysis.
RESULTS
A total of 18 women completed the interview. The participants' ages ranged from 26 to 40 years with a mean age of 33.17 years (SD= 4.09). The duration since childbirth was 8.78 months (SD = 1.35). Through thematic analysis, five themes were developed: lifestyle adjustment, self-motivation, supportive environment, barriers to practising a healthy lifestyle, and risk perception. A total of 14 subthemes emerged from the five main themes. The beliefs of women with a history of GDM were described according to the Theory of Planned Behaviour.
CONCLUSIONS
Having a newborn brings changes to the lifestyle of a woman and her family, which can affect the health behaviours in the postpartum period. This study revealed several novel findings relating to the unmet needs of women who had GDM, specifically to the need for information and emotional support to safely resume healthy behaviours after childbirth, for which participants have provided suggestions on how to enhance the continuity of care in the postpartum period.
PubMed: 38909554
DOI: 10.1016/j.midw.2024.104068 -
Multiple Sclerosis and Related Disorders Jun 2024Adherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason...
BACKGROUND
Adherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence.
OBJECTIVES
To investigate prevalence of and barriers to adherence, including for people with MS-related cognitive problems, and to identify adherence-related strategies.
METHODS
Recruited via the UK MS Register and MS Society groups, participants completed a Medication Adherence Questionnaire and the Perceived Deficits Questionnaire. A subset were interviewed.
RESULTS
Of 257 participants, 94 % reported being adherent, although 59 % missed ≥1 dose, and 25 % reported cognitive problems. Adherence was lower amongst those with cognitive problems, who experienced more barriers: memory problems; negative feelings about taking medication; and not wanting medication to interfere with activities. Such barriers, along with mood, cognition, and method of DMT administration, explained 17 % of variance in adherence, with intravenous treatment a significant predictor. Cognitive problems explained a unique proportion of variance; however, was non-significant when anxiety was factored in. Interviews highlighted how anxiety about side-effects and injections, and difficulties accepting the diagnosis, hindered use of reminders.
CONCLUSION
Interventions for cognition and mood problems, minimising treatment burden and supporting adjustment to diagnosis, may improve adherence.
PubMed: 38905992
DOI: 10.1016/j.msard.2024.105727 -
Tobacco Prevention & Cessation 2024Individuals with behavioral health conditions smoke at significantly higher rates and have been resistant to existing smoking cessation efforts. A clearer understanding...
INTRODUCTION
Individuals with behavioral health conditions smoke at significantly higher rates and have been resistant to existing smoking cessation efforts. A clearer understanding of associations between vaping and daily cigarette consumption in this vulnerable population is warranted.
METHODS
We analyzed data from the 2014-2018 National Health Interview Survey (NHIS) to examine whether vaping was associated with differences in number of cigarettes smoked per day (CPD) among adults who smoke daily and have varying levels of psychological distress.
RESULTS
After adjustment for sociodemographic covariates, individuals who vaped every day smoked on average 1.48 fewer cigarettes per day than individuals who never vaped (p<0.01), while individuals who vaped some days and individuals who ever but no longer vaped smoked 0.77 and 1.48 more CPD, respectively, than individuals who never vaped. Differences between those who vaped every day and those who never vaped were even greater among those with moderate psychological distress (-2.21 CPD, p<0.01).
CONCLUSIONS
Our findings suggest that use of vaping devices may be associated with lower daily cigarette use among individuals with psychological distress, potentially supporting smoking harm reduction efforts.
PubMed: 38903697
DOI: 10.18332/tpc/189769 -
Prenatal Maternal Psychological Distress During the COVID-19 Pandemic and Newborn Brain Development.JAMA Network Open Jun 2024Elevated maternal psychological distress during pregnancy is associated with altered fetal brain development. During the COVID-19 pandemic, prenatal maternal...
IMPORTANCE
Elevated maternal psychological distress during pregnancy is associated with altered fetal brain development. During the COVID-19 pandemic, prenatal maternal psychological distress more than doubled.
OBJECTIVE
To examine the association of the pandemic and rising maternal psychological distress with brain growth in newborns using quantitative 3-dimensional volumetric magnetic resonance imaging (MRI).
DESIGN, SETTING, AND PARTICIPANTS
This prospective cross-sectional study recruited mother-infant dyads at Children's National Hospital, Washington, DC, during the COVID-19 pandemic (June 1, 2020, to June 30, 2022) into a longitudinal infant brain development study and compared them with an existing normative healthy cohort (recruited March 1, 2014, to December 31, 2019). Exclusion criteria included multiple gestation pregnancy, known or suspected congenital infection, documented chromosomal abnormalities, or any maternal contraindication to MRI, as well as prenatal COVID-19 exposure. Infants with structural brain abnormalities or a postnatal confirmation of a genetic syndrome were excluded.
EXPOSURE
Psychological distress during COVID-19 pandemic.
MAIN OUTCOMES AND MEASURES
Prenatal maternal mental health was evaluated using the Spielberger State-Trait Anxiety Inventory and the Perceived Stress Scale. Neonates underwent nonsedated brain MRI. An ordinary least squares linear regression model was used to measure the differences in regional brain volumes of neonates born before vs during the pandemic with and without exposure to elevated prenatal maternal psychological distress after adjustment for neonatal sex and gestational age at MRI and maternal age and educational level.
RESULTS
A total of 159 mother-infant dyads were included in the analysis: 103 before and 56 during the pandemic (median gestational age of infants, 39.6 [IQR, 38.4-40.4] weeks; median maternal age, 34.5 [IQR, 31.0-37.0] years). Eighty-three infants (52.2%) were female. Among the mothers, 130 (81.8%) had a college degree and 87 (54.7%) had a graduate degree. Forty-four mothers (27.7%) identified as Asian, Hispanic, or multiracial; 27 (17.0%), as Black; and 88 (55.3%), as White. Scores on anxiety and stress measures were significantly increased in the pandemic cohort. Infants of mothers with elevated maternal distress showed median reductions in white matter (-0.36 [95% CI, -0.61 to -0.11] cm3; Q < .001), right hippocampal (-0.35 [95% CI, -0.65 to -0.06] cm3; Q = .04), and left amygdala (-0.49 [95% CI, -0.84 to -0.13] cm3; Q = .03) volumes compared with infants of mothers with low distress levels. After adjusting for the cohort effect of the pandemic, elevated trait anxiety remained significantly associated with decreased left amygdalar volumes (-0.71 [95% CI, -1.12 to -0.29]; Q < .001).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of maternal-infant dyads prior to and during the COVID-19 pandemic, regional neonatal brain volumes were associated with elevated maternal psychological distress.
Topics: Humans; Female; COVID-19; Pregnancy; Infant, Newborn; Brain; Adult; Cross-Sectional Studies; Prospective Studies; Psychological Distress; Magnetic Resonance Imaging; Male; SARS-CoV-2; Mothers; Pandemics; Stress, Psychological; Pregnancy Complications; Prenatal Exposure Delayed Effects; Anxiety
PubMed: 38900424
DOI: 10.1001/jamanetworkopen.2024.17924 -
Frontiers in Public Health 2024Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the...
Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system.
INTRODUCTION
Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect.
OBJECTIVES
To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system.
METHODS AND ANALYSIS
This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed.
DISCUSSION
This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
Topics: Humans; Motivation; Male; Personality; Female; Health Behavior; Qualitative Research; Adult; Social Determinants of Health; Focus Groups; Middle Aged; Health Promotion; Aged
PubMed: 38898892
DOI: 10.3389/fpubh.2024.1387528