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Frontiers in Psychiatry 2024Short and intensive trauma treatment programs seem promising in treating post-traumatic stress disorder (PTSD). However, little is known about the effects performing...
INTRODUCTION
Short and intensive trauma treatment programs seem promising in treating post-traumatic stress disorder (PTSD). However, little is known about the effects performing these types of intensive treatment programs online.
METHOD
At the Altrecht Academic Anxiety Centre, an in person intensive trauma focused treatment of six days (three consecutive days in two weeks) was altered into a fully online treatment. A treatment day consisted of 90 minutes of prolonged exposure, 60 minutes of exercise, 90 minutes of Eye Movement Desensitization and Reprocessing (EMDR) 2.0 and 60 minutes of psychoeducation. Mary, a patient diagnosed with chronic and severe PTSD, chronic depressive disorder (single episode, moderate to severe), a panic disorder, and an other specified personality disorder was the first patient to take part in this intensive online trauma treatment.
RESULTS
Mary reached full remission of PTSD. The PTSD symptoms (measured on both the clinician-administered PTSD scale for DSM-5, CAPS-5 and The PTSD Checklist for DSM-5, PCL-5) showed maximum improvement and were completely absent during one month and six month follow-up. Moreover, she no longer suffered from severe depressive symptoms and did not report any general psychiatric symptoms (measured with the Beck Depression Inventory version 2, BDI-II and the Brief Symptom Inventory, BSI).
CONCLUSION
In conclusion, the case-report demonstrates that intensive trauma treatment online was successful in this specific case, thereby being a 'proof of concept' that intensive trauma treatment online is feasible. It might be promising for patients with severe and chronic PTSD and comorbid psychiatric disorders. However, further research must show if the results of this specific case can be translated to other patients with severe and chronic PTSD and comorbid psychiatric disorders.
PubMed: 38711872
DOI: 10.3389/fpsyt.2024.1370358 -
Archives of Public Health = Archives... May 2024The fear, panic, and uncertainties arising during the Covid-19 period have caused many questions about breastfeeding. This study was conducted to investigate...
BACKGROUND
The fear, panic, and uncertainties arising during the Covid-19 period have caused many questions about breastfeeding. This study was conducted to investigate breastfeeding and anxiety in mothers with Covid-19.
METHODS
The phenomenological research type study was conducted in Istanbul between August and November 2021. The sample of the research consists of women who breastfeed after birth and who had Covid-19. Both content and descriptive analysis were used to analyze the data.
RESULTS
The data were analyzed under three main themes. Under the theme of the impact of Covid-19 on breastfeeding, mothers experienced situations like decreased or increased breastfeeding frequency, cessation of breastfeeding, isolation, anxiety about transmission, and expression of milk. They reported that their anxiety in the breastfeeding process was related to the health of the baby, baby care, decreased milk or not breastfeeding, and the Covid-19 period. They used practices such as receiving spousal and professional support, paying attention to isolation, effective communication with the baby, and praying as methods of coping with anxiety.
CONCLUSION
The study demonstrated that factors like transmission anxiety, decreased breastfeeding frequency, and isolation affected breastfeeding, and mothers were most concerned about the baby's health. In situations such as pandemics, protecting mother and baby health is important and a priority area. More quantitative and qualitative studies on the subject are needed.
PubMed: 38711105
DOI: 10.1186/s13690-024-01285-6 -
Journal of Affective Disorders Aug 2024Psoriasis is a chronic skin disease associated with lower quality of life and higher risk of anxiety and depression in adults. We investigate whether adolescents with...
BACKGROUND
Psoriasis is a chronic skin disease associated with lower quality of life and higher risk of anxiety and depression in adults. We investigate whether adolescents with psoriasis also experience poorer mental health than their peers.
METHODS
In this cross-sectional study, we included questionnaire data on psoriasis and mental health from the 18-year follow-up of the Danish National Birth Cohort. We estimated odds ratios (OR) and 95 % confidence intervals (CI) using a logistic regression with inverse probability weighting to account for potential selection bias, adjusted for potential confounders identified a priori. We estimated associations between self-reported psoriasis and multiple aspects of mental health (self-rated health, life satisfaction, mental well-being, loneliness, overall and internalizing behavioral difficulties, depressive symptoms, and anxiety symptoms). In sensitivity analyses, we examined doctor-diagnosed psoriasis and psoriasis with and without joint pain.
RESULTS
Of the 44,838 included in this study, 1147 (2.6 %) reported psoriasis. Adolescents with psoriasis had a higher risk of nearly all outcomes, including depressive symptoms (OR 1.38; 1.19-1.58) and panic/agoraphobia among both males (OR 1.72; 1.33-2.19) and females (OR 1.60; 1.33-1.92). Associations attenuated when restricted to doctor-diagnosed psoriasis. Associations with poor mental health were mainly observed for adolescents with psoriasis also reporting joint pain.
LIMITATIONS
We could not establish temporality and lacked data on joint pain in referents.
CONCLUSION
Psoriasis is associated with poor mental health in adolescents. This appears to be driven by adolescents with psoriasis also reporting joint pain and is less evident in those with a doctor-confirmed diagnosis.
Topics: Humans; Adolescent; Male; Female; Denmark; Psoriasis; Cross-Sectional Studies; Depression; Anxiety; Mental Health; Cohort Studies; Surveys and Questionnaires; Quality of Life; Loneliness; Personal Satisfaction
PubMed: 38703911
DOI: 10.1016/j.jad.2024.05.009 -
Physiological Reports May 2024We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds...
We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.
Topics: Humans; Adolescent; Male; Female; Cognition; Blood Pressure; Pulse Wave Analysis; Memory, Short-Term; Sedentary Behavior; Heart Rate; Carotid Intima-Media Thickness; Attention; Exercise; Carotid Arteries
PubMed: 38697946
DOI: 10.14814/phy2.16024 -
Annals of Medicine and Surgery (2012) May 2024Increased COVID-19 transmission among the populace may be caused by healthcare workers (HCWs) who lack knowledge, awareness, and good preventive practices. Additionally,...
BACKGROUND
Increased COVID-19 transmission among the populace may be caused by healthcare workers (HCWs) who lack knowledge, awareness, and good preventive practices. Additionally, it may cause elevated stress levels, anxiety, poor medical judgement, and situational overestimation.
OBJECTIVES
The present survey aimed to assess knowledge and risk perception regarding COVID-19 among HCWs in Khyber Pakhtunkhwa (KP), Pakistan.
METHODOLOGY
A web-based online, pre-tested questionnaire comprising 26 items was circulated via social media in April 2020 amongst HCWs in major tertiary care facilities in KP.
RESULTS
The study's results, revealing both the commendable knowledge levels among HCWs about COVID-19 and their heightened risk perception, highlight the critical need for targeted interventions to address the potential impact on self-protective behaviour and mental health within this vital workforce. This insight is important for designing strategies that not only enhance HCWs' well-being but also ensure the continued effectiveness of healthcare delivery during pandemics. The percentage mean score (PMS) of COVID-19 knowledge was 85.14±10.82. Male HCWs and those with an age older than or equal to 32 years demonstrated a higher knowledge score (85.62±11.08; =0.032 and 87.59±7.33, =0.021, respectively). About 76% of HCWs feared contracting COVID-19. Nearly 82% of respondents were mentally preoccupied with the pandemic and also terrified of it. 'Of these, 81% were nurses, 87% had a job experience of 6-8 years and 54.45% were frontline workers. Feelings of panic and concern about the pandemic were found to be more in HCWs who were physicians above the age of 32, and who had 3-5 years of work experience. HCWs' overall risk perception was found to be significantly different between males (7.04±2.26) and females (8.01±1.97), job experience of 6-10 years (8.04±177) with 3-5 years and younger than or equal to 2 years job experience (7.18±2.43,6.93±2.22), respectively, and between frontline HCWs (7.50±2.10) and non-frontline HCWs (6.84±2.40).
CONCLUSION
HCWs demonstrated good knowledge about COVID-19. As the risk perception of COVID-19 among HCWs is high, it can raise concerns about their self-protective behaviour, and mental health. These issues need to be addressed.
PubMed: 38694302
DOI: 10.1097/MS9.0000000000001916 -
Cureus Mar 2024Introduction Nomophobia is an emerging phobia resulting from people's excessive interaction with mobile phones. This phobia is rapidly increasing due to significant...
Introduction Nomophobia is an emerging phobia resulting from people's excessive interaction with mobile phones. This phobia is rapidly increasing due to significant technological innovations and widespread acceptance and usage of mobile phones worldwide. Nomophobia is often associated with complications such as panic attacks, irritability, and anxiety. Smartphone usage is particularly high among the younger population, raising concerns as it generates distress and leads to various problems. This study aims to determine the prevalence of nomophobia among undergraduates. Method The study utilized the Nomophobia Questionnaire (NMP-Q) with a minimum sample size of 136. A total of 300 Google Forms (Google, Mountain View, California) were circulated, out of which 172 responses were received. A Google Form comprising 20 questions related to smartphone use and nomophobia was designed and distributed to all undergraduate students, who were requested to complete the form. The data based on their responses were subsequently analyzed. Results In this study, approximately 31.40% of students disagreed with experiencing panic when running out of credits or hitting monthly data limits. Additionally, 24.42% of students agreed that not having smartphones made them worried, as their family and friends could not contact them. About 16.86% of students strongly disagreed with feeling uneasy because they could not stay updated without their phones. Furthermore, 16.28% strongly agreed that they felt anxious due to the inability to contact their family and friends when not having smartphones. Conclusion It can be concluded from this study that nomophobia is present among undergraduate students. The overall usage of smartphones has increased in this population, highlighting the emergence of a serious disorder that warrants attention. Consequently, the usage of smartphones should be reduced through structured training programs, as this proves to be an effective method for enhancing undergraduates' understanding of the prevention and treatment of nomophobia.
PubMed: 38681298
DOI: 10.7759/cureus.57056 -
Journal of Public Health Research Apr 2024A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating...
A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating habits, and social interactions, before the lockdown period, was a determinant for depressive episodes during the lockdown; (2) In tighter lockdowns, DBR triggered depressive episodes in bipolar patients; (3) DBR in healthcare workers under pressure was a determinant of burnout; (4) DBR influenced the course of chronic diseases by altering immune responses. In addition, it was found that scoring positive on the Mood Disorder Questionnaire (MDQ) was closely associated with the dysregulation of sleep rhythms. MDQ is a screening tool for bipolar disorder (BD), criticized for detecting too many false positives. Studies showed that positivity to the MDQ implied a severe impairment of quality of life even in people without psychiatric diagnoses. According to this evidence, three different hyperactivation levels could be proposed (from normality to pathology): firstly, an adaptive increase in energy (e.g. athletes performing well); secondly, a DBR determined from the continuous stimulation of stress hormones, with possible positive scores on the MDQ without a diagnosis of bipolar disorder, like in burnout syndromes and, thirdly, hyperactivity during manic episodes. The Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS), the second level of the scale, is proposed as a working hypothesis. DYMERS is also seen as a vulnerable condition that may evolve in other disorders (including BD) according to the individual susceptibility (including genetic predisposition) and the specific nature/level of the stressor.
PubMed: 38680762
DOI: 10.1177/22799036241248022 -
International Journal of Environmental... Apr 2024Technological addiction refers to behavior characterized by excessive and prolonged use of technological devices; reactions of anger, frustration, or panic when unable...
Technological addiction refers to behavior characterized by excessive and prolonged use of technological devices; reactions of anger, frustration, or panic when unable to use them; and unsuccessful attempts to reduce the time spent on them [...].
Topics: Humans; Smartphone; Behavior, Addictive; Internet Addiction Disorder; Internet
PubMed: 38673347
DOI: 10.3390/ijerph21040436 -
The Lancet. Psychiatry Jun 2024Globally, mental health conditions pose a substantial burden of disease. Despite the availability of evidence-based pharmacological and psychological treatments, the... (Randomized Controlled Trial)
Randomized Controlled Trial
A transdiagnostic group exercise intervention for mental health outpatients in Germany (ImPuls): results of a pragmatic, multisite, block-randomised, phase 3 controlled trial.
BACKGROUND
Globally, mental health conditions pose a substantial burden of disease. Despite the availability of evidence-based pharmacological and psychological treatments, the symptoms of a substantial subgroup of patients do not respond to these interventions, and only a minority of patients have access to them. This study aimed to assess the efficacy of ImPuls, a 6-month transdiagnostic group exercise intervention, plus treatment-as-usual, compared with treatment-as-usual alone in outpatients with various mental disorders.
METHODS
In this pragmatic, two-arm, multisite, randomised controlled trial in Germany, ten outpatient rehabilitative and medical care facilities were involved as study sites. Participants were outpatients diagnosed according to ICD-10 with one or more of the following disorders based on structured clinical interviews: moderate or severe depression, primary insomnia, post-traumatic stress disorder (PTSD), panic disorder, or agoraphobia. Participants were required to be aged between 18 years and 65 years, insured by the health insurers Allgemeine Ortskrankenkasse Baden-Württemberg or Techniker Krankenkasse, fluent in German, and without medical contraindications for exercise. Blocks of six participants were randomly allocated to ImPuls plus treatment-as-usual or treatment-as-usual alone (allocation ratio: 1:1), stratified by study site. The randomisation sequence was generated by an external data manager. The team responsible for data collection and management was masked to the randomisation sequence. The ImPuls intervention comprised evidence-based outdoor exercises lasting 30 min, and aimed at achieving at least moderate intensity. It also incorporated behavioural change techniques targeting motivational and volitional determinants of exercise behaviour. Treatment-as-usual was representative of typical outpatient health care in Germany, allowing patients access to any standard treatments. The primary outcome was global symptom severity at 6 months after randomisation, measured using self-report on the Brief Symptom Inventory (BSI-18) and analysed in the intention-to-treat sample. No individuals with lived experience of mental illness were involved in conducting the study or writing the final publication. Safety was assessed in all participants. The trial was registered with the German Clinical Trials Register (DRKS00024152) with a completion date of June 30, 2024.
FINDINGS
600 patients provided informed consent, were recruited to the study, and underwent a diagnostic interview between Jan 1, 2021, and May 31, 2022. Following this, 199 were excluded on the basis of inclusion and exclusion criteria and one withdrew consent during the baseline assessment. Of the 400 eligible participants, 284 (71%) self-identified as female, 106 (27%) self-identified as male, and nine (2%) self-identified as other. The mean age was 42·20 years (SD 13·23; range 19-65). Ethnicity data were not assessed. 287 (72%) participants met the criteria for moderate or severe depression, 81 (20%) for primary insomnia, 37 (9%) for agoraphobia, 46 (12%) for panic disorder, and 72 (18%) for PTSD. 199 participants were allocated to the intervention group of ImPuls plus treatment-as-usual and 201 to the control group of treatment-as-usual alone. 38 (19%) participants did not receive the minimum ImPuls intervention dose. ImPuls plus treatment-as-usual demonstrated superior efficacy to treatment-as-usual alone in reducing global symptom severity, with an adjusted difference on BSI-18 of 4·11 (95% CI 1·74-6·48; d=0·35 [95% CI 0·14-0·56]; p=0·0007) at 6 months. There were no significant differences in the total number of adverse events or serious adverse events between the two groups. There was one serious adverse event (male, torn ligament) related to the intervention.
INTERPRETATION
ImPuls is an efficacious transdiagnostic adjunctive treatment in outpatient mental health care. Our findings suggest that exercise therapy should be implemented in outpatient mental health care as an adjunctive transdiagnostic treatment for mental disorders such as depression, insomnia, panic disorder, agoraphobia, and PTSD. Transdiagnostic group exercise interventions might ameliorate the existing disparity in care provision between the many individuals in need of evidence-based treatment and the few who are receiving it.
FUNDING
The German Innovation Fund of the Federal Joint Committee of Germany.
Topics: Humans; Male; Female; Germany; Middle Aged; Adult; Mental Disorders; Exercise Therapy; Outpatients; Treatment Outcome; Psychotherapy, Group; Ambulatory Care; Aged
PubMed: 38670127
DOI: 10.1016/S2215-0366(24)00069-5 -
Medicine Apr 2024People have difficulty in eating and speaking when they are suffering from mouth ulcers. Some studies suggest that estradiol is associated with the development and...
People have difficulty in eating and speaking when they are suffering from mouth ulcers. Some studies suggest that estradiol is associated with the development and treatment of mouth ulcers, while some do not. To clarify the effect of estradiol on mouth ulcers, we performed 2-sample Mendelian randomization and multivariable Mendelian randomization (MVMR) analysis to evaluate their relationship. Data were obtained from the IEU OpenGWAS project and UK biobank, including male estradiol dataset (case/controls = 13,367/134,323), female estradiol dataset (case/controls = 37,461/126,524), mouth ulcers dataset (case/controls = 47,102/414,011). The causal associations were estimated by MR-Egger, weighted median, inverse-variance weighted (IVW) method, simple mode, and weighted mode. Cochran Q test, MR-Egger intercept test, MR-PRESSO tests, and leave-one-out analysis were used to examine sensitivity analyses. The MVMR controlling for depression, anxiety or panic attacks, severe stress and adjustment disorders was used to assess the effect of estradiol on mouth ulcers. Through screening, 13 single nucleotide polymorphisms (SNPs) of males and 2 SNPs of females in estradiol were used for harmonizing and MR analysis. The 2-sample MR analysis showed no causal association between estradiol of males and mouth ulcers (IVW, OR: 0.998, 95% confidence interval [95% CI]: 0.995-1.001, P = .18). Similar results were obtained between estradiol of females and mouth ulcers (IVW, OR: 1.000, 95% CI: 0.988-1.012, P = .97). No pleiotropy and heterogeneity were found and the results were robust (P > .05). After adjusting for the potential effects of confounders, estradiol of males and mouth ulcers still showed no causal association through MVMR analysis (P = .081). While MVMR analysis showed that the causal relationship between estradiol and mouth ulcers in women could not be statistical for the small number of SNPs. There was no evidence of a causal relationship between estradiol and mouth ulcers. The strategy of treating mouth ulcers with estradiol still needs to be confirmed by more studies.
Topics: Humans; Mendelian Randomization Analysis; Estradiol; Female; Male; Polymorphism, Single Nucleotide; Oral Ulcer; Case-Control Studies
PubMed: 38669373
DOI: 10.1097/MD.0000000000037989