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Frontiers in Psychiatry 2024Emerging adulthood is considered a peak age for the onset of mental health difficulties with approximately 75% of mental health disorders being diagnosed during this...
INTRODUCTION
Emerging adulthood is considered a peak age for the onset of mental health difficulties with approximately 75% of mental health disorders being diagnosed during this developmental period. Companion animals confer both risk and benefits to mental health yet the potential underpinning mechanisms which explain such impacts are not fully understood. This study aimed to gather an in-depth understanding of young adults' lived experience of how their companion dogs and cats may impact their mental health symptoms and the perceived mechanisms which explain their effects.
METHODS
Semi-structured interviews were carried out with 16 young adults aged 18-26 years, from the United Kingdom, who either had a companion dog, cat, or both. All participants had difficulties with anxiety and or depression, and 12 had received a formal diagnosis of an affective disorder.
RESULTS
Five overarching themes and one subtheme were identified through reflexive thematic analysis using an inductive approach: Theme 1: Pet impact on generalized anxiety and panic, Subtheme 1A: Pet impact on social anxiety and loneliness; Theme 2: Pet impact on low mood, depression, and stress; Theme 3: Pet impact on severe mental health and suicide prevention; Theme 4: Staying well; Theme 5: Positive outlook and successful futures. Several perceived mechanisms underpinning the impacts of pets for mental health were also identified.
DISCUSSION
These findings have relevance for the development and evaluation of mental health interventions and treatment protocols aimed at young adults with mental health difficulties, where companion animals may prove to be effective for symptom management and improvements in positive wellbeing.
PubMed: 38425998
DOI: 10.3389/fpsyt.2024.1355317 -
Cureus Feb 2024This investigation centered on the hypnagogic and hypnopompic wake-sleep/sleep-wake transition states and the associated exploration of hypnagogic and hypnopompic... (Review)
Review
This investigation centered on the hypnagogic and hypnopompic wake-sleep/sleep-wake transition states and the associated exploration of hypnagogic and hypnopompic experiences (HHEs), and sleep paralysis (SP) on psychiatric exacerbation and paradoxical masking. The study aims to discern causality by examining how these sleep-related experiences may contribute to the emergence or exacerbation of psychiatric and neurodegenerative conditions, particularly, pertaining to the clinical or sub-clinical demographic of Schizotypal Personality Disorder (STPD), Mood Disorders, Schizophrenia, Post-Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), Narcolepsy, Panic Disorder, specific phobias, or heightened psychotic sensitivity. Methodologically, this study employed a comprehensive literature review, drawing from a range of studies across sleep medicine, psychiatry, and psychology, utilizing PubMed-indexed peer-reviewed scientific literature, sourcing from academic institutions, Google Scholar, and open-access publications. This interdisciplinary approach allowed for a nuanced and systematic understanding of the potential links between specific sleep-wake/wake-sleep aberrations and their masking or exacerbation of clinical/sub-clinical psychiatric symptomatology in this particular demographic. Insights gained from the outcome of this study hold promise for advancing understanding of the interrelationship between sleep neurobiology and psychiatric disorders. Additionally, the findings may inform targeted therapeutic interventions tailored to mitigate the impact of sleep-wake disruptions on vulnerable populations. The overarching objective is to bridge current gaps in knowledge, cultivating a more profound understanding with direct implications for both clinical practice and ongoing research endeavors. The study outcomes provide an intriguing understanding of the complex relationship between sleep neurobiology and psychiatric disorders, paving the way for targeted therapeutic interventions to alleviate the effects of sleep-wake disruptions, and addressing critical gaps in knowledge with direct implications for clinical practice and ongoing research.
PubMed: 38425327
DOI: 10.7759/cureus.55262 -
JMIR Formative Research Feb 2024Cognitive behavioral therapy (CBT) is effective in treating anxiety disorders. Accessibility to CBT has been limited in Japan due to the shortage of therapists. While an...
BACKGROUND
Cognitive behavioral therapy (CBT) is effective in treating anxiety disorders. Accessibility to CBT has been limited in Japan due to the shortage of therapists. While an open-source e-learning system can be used to create a simple internet-based cognitive behavioral therapy (ICBT) program, the safety and outpatient acceptance of this treatment approach have not been explored in Japan.
OBJECTIVE
The aim of this study was to investigate whether outpatients with anxiety disorders could accept and successfully complete the ICBT program with guidance by CBT therapists when implementing therapeutic modules and CBT tasks. Due to being in the initial phase of a novel treatment in Japan, this study was intended for verification with a small sample size.
METHODS
In total, 6 adults, including 4 male participants and 2 female participants, were enrolled in a single-arm trial. The intervention involved guided ICBT comprising 12 sessions, including CBT text, comprehension confirmation tests, and explanatory videos about cognitive behavioral models, accessible through a website. The therapist guided the participants in accessing the ICBT program and answering their questions using a chat tool. The primary outcome was anxiety severity assessed using the State-Trait Anxiety Inventory-Trait. Secondary outcomes included the Panic Disorder Severity Scale, Liebowitz Social Anxiety Scale (LSAS), Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Working Alliance Inventory-Short Form (WAI-SF). Statistical analyses were performed using paired 2-tailed t tests to assess the changes in clinical symptoms. The total WAI-SF score at the final session was used to evaluate the therapeutic alliance. For statistical analyses, mean changes for total State-Trait Anxiety Inventory-Trait, BAI, Panic Disorder Severity Scale, LSAS, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 scores were analyzed using the paired 2-tailed t test. The 2-sided significance level for hypothesis testing was set at 5%, and 2-sided 95% CIs were calculated.
RESULTS
Most participants diligently engaged with the ICBT program. No adverse events were reported. The mean total scores for the primary outcome decreased by 11.0 (SD 9.6) points (95% CI -22.2 to 0.20; Hedges g=0.95), but it was not statistically significant. The mean total scores for the secondary outcomes that assess clinical symptoms decreased, with a significant reduction observed in the BAI of 15.7 (SD 12.1) points (95% CI -28.4 to -3.0; P=.03; Hedges g=1.24). The mean total scores for PDSS and LSAS decreased significantly, by 12.0 (SD 4.24) points (95% CI -50.1 to 26.1; P=.16; Hedges g=1.79) and 32.4 (SD 11.1) points (95% CI -59.7 to -4.3; P=.04; Hedges g=1.38), respectively. Of the participants, 67% (n=4) showed treatment response, and 50% (n=3) achieved remission after the intervention. The therapeutic alliance, measured using the WAI-SF, was moderate.
CONCLUSIONS
Guided ICBT may be feasible for the treatment of outpatients with panic disorder and social anxiety disorder in Japan.
TRIAL REGISTRATION
University Hospital Medical Information Network Clinical Trials Registry UMIN0000038118; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043439.
PubMed: 38421717
DOI: 10.2196/53659 -
Comprehensive Psychoneuroendocrinology Feb 2024Patients with panic disorder (PD) show alterations of the immune reactivity to acute stress, which could serve as a marker for effective treatment. Nevertheless, the...
BACKGROUND
Patients with panic disorder (PD) show alterations of the immune reactivity to acute stress, which could serve as a marker for effective treatment. Nevertheless, the effect of immune reactivity under acute stress before treatment on therapy outcome remains unclear.
METHODS
A total of = 16 PD patients performed the Trier Social Test. Blood sample collection of anti-inflammatory cytokine IL-10 accompanied the TSST. The Mobility Inventory was handed out for the assessment of avoidance behavior before and after treatment. Area under the curve with respect to the ground (AUC) and increase (AUC) were calculated for assessed cytokine levels and were used as predictors for therapy outcome in regression analyses.
RESULTS
AUC significantly predicts avoidance behavior in company after treatment ( = -0.007, = .033) but not avoidance behavior alone ( = -0.003, = .264). AUC does not significantly predict therapy outcome.
CONCLUSION
Higher concentrations of anti-inflammatory cytokine IL-10 under acute stress before treatment predicts less avoidance behavior in company after therapy. Immune markers seem to play a crucial role in the maintenance of mental disorders such as PD. Underlying mechanisms and IL-10 as a marker for individualized treatments should be investigated in future studies.
PubMed: 38404508
DOI: 10.1016/j.cpnec.2024.100227 -
Journal of Clinical Medicine Feb 2024The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the...
BACKGROUND
The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults.
METHODS
A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV).
RESULTS
Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of 'agoraphobia' (0.947; 95%CI [0.934, 0.960]), 'anxiety' (0.959; 95%CI [0.946, 0.970]), and 'panic disorder' (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the 'obsessive-compulsive' dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for 'depression' (0.716; 95%CI [642, 798]) and 'alcohol abuse' (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions.
CONCLUSIONS
The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ screening result.
PubMed: 38398481
DOI: 10.3390/jcm13041170 -
Brain and Behavior Feb 2024Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder for which the Bárány Society has established diagnostic criteria. This...
OBJECTIVES
Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder for which the Bárány Society has established diagnostic criteria. This nationwide multicenter study aims to investigate the clinical features of individuals with definite PPPD and clinical variant PPPD who do not fully meet the diagnostic criteria, with a particular focus on visual exaggeration.
METHODS
Between September 2020 and September 2021, a total of 76 individuals with definite PPPD and 109 individuals with clinical variant PPPD who did not meet all three exacerbating factors outlined in Criterion B were recruited from 18 medical centers in South Korea. The study gathered information on demographic factors, clinical manifestations, balance scales, and personality assessments.
RESULTS
Comparative analysis between groups with definite PPPD and clinical variant with visual exacerbation revealed no significant differences in sociodemographic characteristics, clinical course, dizziness impact, and specific precipitants. Only disease duration was significantly longer in definite PPPD compared with variant with visual exacerbation. However, the variant without visual exacerbation displayed significantly reduced rates of panic disorder, diminished space-motion discomfort, lesser impact of dizziness, and decreased prevalence of depression when compared with the definitive PPPD.
CONCLUSION
This is the first comprehensive nationwide study examining clinical features of both definite PPPD patients and its clinical variants, considering visual exacerbating factors. Differences in dizziness and personality traits emerged between definite PPPD and its potential variant without visual issues. Our results highlight the possibility of a distinct clinical variant of PPPD influenced by visual dependency.
Topics: Humans; Dizziness; Cross-Sectional Studies; Vertigo; Vestibular Diseases; Republic of Korea
PubMed: 38391108
DOI: 10.1002/brb3.3389 -
Psychiatry Research Apr 2024Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of...
Health service and psychotropic medication use for mental health conditions among healthcare workers active during the Spain Covid-19 Pandemic - A prospective cohort study using web-based surveys.
Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of Spanish HCW (n = 4,809), recruited shortly after the COVID-19 pandemic onset, and assessed at four timepoints using web-based surveys. Use of health services among HCW with mental health conditions (i.e., those having a positive screen for mental disorders and/or suicidal thoughts and behaviours [STB]) was initially low (i.e., 18.2 %) but increased to 29.6 % at 16-month follow-up. Service use was positively associated with pre-pandemic mental health treatment (OR=1.99), a positive screen for major depressive disorder (OR=1.50), panic attacks (OR=1.74), suicidal thoughts and behaviours (OR=1.22), and experiencing severe role impairment (OR=1.33), and negatively associated with being female (OR = 0.69) and a higher daily number of work hours (OR=0.95). Around 30 % of HCW with mental health conditions used anxiolytics (benzodiazepines), especially medical doctors. Four out of ten HCW (39.0 %) with mental health conditions indicated a need for (additional) help, with most important barriers for service use being too ashamed, long waiting lists, and professional treatment not being available. Our findings delineate a clear mental health treatment gap among Spanish HCW.
Topics: Humans; Female; Male; Mental Health; Pandemics; Suicide, Attempted; Depressive Disorder, Major; Prospective Studies; Spain; COVID-19; Health Services; Health Personnel; Internet
PubMed: 38387166
DOI: 10.1016/j.psychres.2024.115800