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1.
Psychol Med ; 54(8): 1580-1588, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38173121

RESUMO

BACKGROUND: This systematic review and individual participant data meta-analysis (IPDMA) examined the overall effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing posttraumatic stress disorder (PTSD) symptoms, achieving response and remission, and reducing treatment dropout among adults with PTSD compared to other psychological treatments. Additionally, we examined available participant-level moderators of the efficacy of EMDR. METHODS: This study included randomized controlled trials. Eligible studies were identified by a systematic search in PubMed, Embase, PsyclNFO, PTSDpubs, and CENTRAL. The target population was adults with above-threshold baseline PTSD symptoms. Trials were eligible if at least 70% of study participants had been diagnosed with PTSD using a structured clinical interview. Primary outcomes included PTSD symptom severity, treatment response, and PTSD remission. Treatment dropout was a secondary outcome. The systematic search retrieved 15 eligible randomized controlled trials (RCTs); 8 of these 15 were able to be included in this IPDMA (346 patients). Comparator treatments included relaxation therapy, emotional freedom technique, trauma-focused cognitive behavioral psychotherapies, and REM-desensitization. RESULTS: One-stage IPDMA found no significant difference between EMDR and other psychological treatments in reducing PTSD symptom severity (ß = -0.24), achieving response (ß = 0.86), attaining remission (ß = 1.05), or reducing treatment dropout rates (ß = -0.25). Moderator analyses found unemployed participants receiving EMDR had higher PTSD symptom severity at the post-test, and males were more likely to drop out of EMDR treatment than females. CONCLUSION: The current study found no significant difference between EMDR and other psychological treatments. We found some indication of the moderating effects of gender and employment status.


Assuntos
Dessensibilização e Reprocessamento através dos Movimentos Oculares , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , Dessensibilização e Reprocessamento através dos Movimentos Oculares/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto , Masculino , Psicoterapia/métodos , Feminino , Terapia Cognitivo-Comportamental/métodos , Resultado do Tratamento
2.
Mult Scler ; 30(6): 747-750, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38372030

RESUMO

BACKGROUND: Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS. OBJECTIVE: to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS. METHODS: We conducted a process-outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function. RESULTS: The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found. CONCLUSION: for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being.


Assuntos
Depressão , Dessensibilização e Reprocessamento através dos Movimentos Oculares , Esclerose Múltipla , Humanos , Projetos Piloto , Dessensibilização e Reprocessamento através dos Movimentos Oculares/métodos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Esclerose Múltipla/terapia , Esclerose Múltipla/complicações , Esclerose Múltipla/fisiopatologia , Depressão/terapia , Depressão/etiologia , Imageamento por Ressonância Magnética , Resultado do Tratamento , Transtorno Depressivo/terapia
3.
BMC Public Health ; 22(1): 333, 2022 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-35172782

RESUMO

BACKGROUND: Social restrictions due to COVID-19 might have had a significant impact on mental health. The aim of this study was to assess the prevalence of four emotional domains (nervousness, anger, numbness, physiological arousal) in a sample of citizens during the first pandemic wave in 2020, and their association with sociodemographic characteristics, housing conditions and lifestyle modifications. METHODS: A cross-sectional study based on a self-administered online questionnaire was set up to investigate emotions. Respondents were recruited through a non-probabilistic snowball sampling approach. The SPAN questionnaire was used to measure emotions in the interviewed population. The association between emotions and independent variables (gender, age, marital status, educational level, working condition, housing condition, COVID-19 positivity, sleep disturbance, increase in alcohol consumption and decrease in physical activity) was assessed through the multivariate Poisson regression. RESULTS: A total of 6,675 subjects were included in the analysis. Almost half of respondents (48.9%) experienced nervousness, 41.3% anger, 15.6% numbness and 18.8% physiological arousal. Females were more likely to face nervousness, anger and physiological arousal. For all the outcomes a decreasing trend was observed from younger to older. Singles were more likely to experience numbness compared to married people. Increase in alcohol consumption was associated with nervousness, anger and numbness. Decrease in physical activity was associated with nervousness, anger and physiological arousal. Restless sleep was the variable most associated with all emotional domains. CONCLUSIONS: The first COVID-19 pandemic wave had a significant emotional impact on this sample, especially among younger people, singles and females. Even without reaching clinical relevance, these emotions could represent a form of psychological distress, which requires the implementation of preventive strategies, in particular regarding lifestyle care.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Estudos Transversais , Emoções , Feminino , Humanos , Pandemias , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários
4.
Psychosom Med ; 82(6): 600-613, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32541543

RESUMO

OBJECTIVE: The study aims to meta-analytically review studies about the effects of mindfulness-based interventions (MBIs) on well-being of people with multiple sclerosis (MS). METHODS: Seven electronic databases were searched from June 2018 to September 2018. A systematic review and a meta-analysis were conducted. RESULTS: Twenty-one studies were included in qualitative synthesis, and 10 studies were included in meta-analysis. MBIs are effective with an overall moderate effect size (Hedges' g = 0.70) in improving well-being in people with MS, with lasting effects at the follow-up (g = 0.55). In particular, MBIs demonstrated to highly reduce stress (g = 1.07) and to improve depression and anxiety symptoms with a moderate to large effect at postintervention (g = 0.77 and g = 0.63, respectively). CONCLUSIONS: MBIs represent a valid and effective mind-body intervention to improve the well-being of patients with MS. Further studies should investigate which components of MBIs could be more beneficial for patients with progressive MS. PROSPERO REGISTRATION: CRD42018099704.


Assuntos
Ansiedade/reabilitação , Depressão/reabilitação , Atenção Plena , Esclerose Múltipla/reabilitação , Satisfação Pessoal , Ansiedade/etiologia , Depressão/etiologia , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia
5.
BMC Psychiatry ; 20(1): 93, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122315

RESUMO

BACKGROUND: Depressive symptoms are common in individuals suffering from severe somatic conditions. There is a lack of interventions and evidence-based interventions aiming to reduce depressive symptoms in patients with severe somatic conditions. The aim of the NEVERMIND project is to address these issues and provide evidence by testing the NEVERMIND system, designed to reduce and prevent depressive symptoms in comparison to treatment as usual. METHODS: The NEVERMIND study is a parallel-groups, pragmatic randomised controlled trial to assess the effectiveness of the NEVERMIND system in reducing depressive symptoms among individuals with severe somatic conditions. The NEVERMIND system comprises a smart shirt and a user interface, in the form of a mobile application. The system is a real-time decision support system, aiming to predict the severity and onset of depressive symptoms by modelling the well-being condition of patients based on physiological data, body movement, and the recurrence of social interactions. The study includes 330 patients who have a diagnosis of myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants are randomised in blocks of ten to either the NEVERMIND intervention or treatment as usual as the control group. Clinical interviews and structured questionnaires are administered at baseline, at 12 weeks, and 24 weeks to assess whether the NEVERMIND system is superior to treatment as usual. The endpoint of primary interest is Beck Depression Inventory II (BDI-II) at 12 weeks defined as (i) the severity of depressive symptoms as measured by the BDI-II. Secondary outcomes include prevention of the onset of depressive symptoms, changes in quality of life, perceived stigma, and self-efficacy. DISCUSSION: There is a lack of evidence-based interventions aiming to reduce and prevent depressive symptoms in patients with severe somatic conditions. If the NEVERMIND system is effective, it will provide healthcare systems with a novel and innovative method to attend to depressive symptoms in patients with severe somatic conditions. TRIAL REGISTRATION: DRKS00013391. Registered 23 November 2017.


Assuntos
Depressão , Qualidade de Vida , Análise Custo-Benefício , Depressão/complicações , Depressão/prevenção & controle , Serviços de Saúde , Humanos , Masculino , Resultado do Tratamento
6.
BMC Pregnancy Childbirth ; 20(1): 703, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208115

RESUMO

BACKGROUND: Trauma, natural and man-made catastrophic events can be predictors of postpartum psychological distress. In a public health response due to coronavirus disease 2019 outbreak, the Italian government imposed a lockdown from March 9 to May 3. This extraordinary situation may have been challenging for maternal psychological health. The aim of this study was to investigate the prevalence of depressive and post-traumatic stress symptoms in women giving birth during the Covid-19 pandemic and its associations with quarantine measures, obstetrical factors, and relational attachment style. METHODS: Women who gave birth in a high-volume obstetric/gynaecological medical centre located in an epidemic area during the Covid-19 pandemic (March 8 to June 15) were asked to complete an online survey about their childbirth experience and the perceived effect of the pandemic. The Edinburgh Postnatal Depression Scale (EPDS), the Impact of Event Scale-Revised (IES-R), and the Relationship Questionnaire (RQ) were administered to assess levels of postpartum depressive and post-traumatic stress symptoms (PTSS) and relational style of attachment, respectively. Multivariate analysis was applied to identify associations between quarantine measures, childbirth experience, attachment style, and EPDS and IES-R scores. RESULTS: The survey was completed by 163 women (response rate 60.8%). The prevalence of depressive symptoms was 44.2% (EPDS cut-off score ≥ 11) and the PTSS rate was 42.9% (IES-R cut-off score ≥ 24). Dismissive and fearful avoidant attachment styles were significantly associated with the risk of depression and PTSS, respectively. Perceived pain during birth was a risk factor for postpartum depression. Perceived support provided by healthcare staff was a protective factor against depression and PTSS. Another protective factor against PTSS was quiet on the ward due to the absence of hospital visitors. CONCLUSION: This study reports a high prevalence of postpartum depressive and PTSS in women who gave birth during the Covid-19 pandemic. Postnatal psychological distress seemed to be associated more with the prenatal experience and other individual factors than with the pandemic hospital restrictions. Early detection during pregnancy of an insecure attachment style is fundamental to provide targeted preventive and therapeutic psychological interventions.


Assuntos
Infecções por Coronavirus/psicologia , Depressão Pós-Parto , Pneumonia Viral/psicologia , Período Pós-Parto/psicologia , Gestantes/psicologia , Angústia Psicológica , Quarentena/psicologia , Adulto , Betacoronavirus , COVID-19 , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/etiologia , Depressão Pós-Parto/prevenção & controle , Feminino , Humanos , Itália/epidemiologia , Pandemias/prevenção & controle , Parto/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Gravidez , Prevalência , Psicologia , Sistemas de Apoio Psicossocial , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle
7.
J Nerv Ment Dis ; 206(2): 149-151, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29373457

RESUMO

Chronic and life-threatening illnesses, such as multiple sclerosis (MS), have been identified as significant stressors potentially triggering posttraumatic stress disorder (PTSD). The study aims to investigate the prevalence of PTSD according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria in a large sample of patients with MS. A total of 988 patients with MS were screened with the Impact of Event Scale-Revised, and then assessed with the PTSD module of the Structured Clinical Interview for DSM-IV and with the Clinician-Administered PTSD Scale to confirm PTSD diagnosis. Posttraumatic symptoms were reported by 25.5% of the sample. A confirmed diagnosis of PTSD was found in 5.7% of patients, but prevalence could reach 8.5%, including also dropout patients. Further studies are needed to evaluate if adjustment disorder could better encompass the frequently encountered subthreshold posttraumatic stress symptoms and how clinicians can deal with these symptoms with appropriate interventions.


Assuntos
Esclerose Múltipla/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Esclerose Múltipla/complicações , Prevalência , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia
8.
Eur Addict Res ; 24(4): 163-172, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30016803

RESUMO

BACKGROUND/AIMS: The aim of this prospective study was to estimate gender differences in anxiety, depression, and alcohol use severity among patients with alcohol use disorder (AUD) before and after detoxification program and within 12 months after discharge. METHODS: AUD severity, state and trait anxiety, and depression were assessed in 187 patients entering an inpatient alcohol detoxification program. Follow-up assessments were performed at 6 and 12 months after discharge. A between- and within-subjects analyses explored gender differences. The predictive value of anxiety and depression for alcohol relapse was analyzed by logistic and linear regression in both genders. RESULTS: Females had higher levels of anxiety and depression than males both at admission and after discharge. Trait anxiety and depression significantly increased 6 months after discharge in males and females respectively. Both state and trait anxiety levels at the 6-month follow-up predicted alcohol relapse at the 12-month follow-up in males. Conversely, in females, depression level at the 6-month follow-up was a predictor of relapse at the 12-month follow-up. CONCLUSIONS: In both genders, the psychopathological dimension that showed the most significant worsening at 6-month follow-up (i.e., anxiety in males and depression in females) was found to be a significant predictor of relapse at the 12-month follow-up.


Assuntos
Alcoolismo/psicologia , Ansiedade/psicologia , Depressão/psicologia , Alta do Paciente/tendências , Caracteres Sexuais , Centros de Tratamento de Abuso de Substâncias/tendências , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/terapia , Alcoolismo/epidemiologia , Alcoolismo/terapia , Ansiedade/epidemiologia , Ansiedade/terapia , Depressão/epidemiologia , Depressão/terapia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recidiva
9.
BMC Neurol ; 16: 7, 2016 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-26757728

RESUMO

BACKGROUND: Multiple Sclerosis has a great impact on psychological functioning of patients and can be associated with various mental health disorders and symptoms. The most prevalent one is depression, which ranges from 15 to 47%. Mindfulness Based Interventions are a relatively brief and cost-effective program that has been studied in patients with several chronic diseases and recently also in patients with Multiple Sclerosis. Mindfulness Based Interventions are based on the assumption that a non-judgmental awareness and acceptance of one's moment-to-moment experience can have a positive effect on the adaptation to the disease, reducing the psychological burden and improving patients' quality of life. Several studies concluded that Mindfulness Based Interventions can be beneficial in terms of improving both psychological and psychical aspects of Multiple Sclerosis, but none of them compared the intervention with an active control group. The primary objective of the study is to evaluate the efficacy of a group-based Mindfulness Based Intervention on depressive symptoms in patients with Multiple Sclerosis, as compared with an active control group. METHODS: The study design is a randomized controlled clinical trial. Eighty-eight patients with Multiple Sclerosis and depressive symptoms will be recruited and randomized to either Mindfulness Based Intervention or an active control group. The latter is designed to control for non-specific elements of the intervention and it comprises psycho-education and relaxation techniques. The primary outcome is the reduction of depressive symptoms as measured via the Beck Depressive Inventory-II. Secondary outcome measures are level of quality of life, anxiety, perceived stress, illness perception, fatigue and quality of interpersonal relationship. Outcomes will be assessed at baseline, after treatment and 6 months after the end of the treatment. Caregivers will participate in groups together with patients. DISCUSSION: As far as we know this trial will be the first randomized controlled trial testing the efficacy of group-based Mindfulness Based Intervention for patients with Multiple Sclerosis with a comparison with an active control group with a specific focus on depressive symptoms. TRIAL REGISTRATION: NCT02611401.


Assuntos
Cuidadores/psicologia , Protocolos Clínicos , Depressão/terapia , Atenção Plena/métodos , Esclerose Múltipla/psicologia , Avaliação de Resultados em Cuidados de Saúde/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
J Nerv Ment Dis ; 204(1): 43-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26558501

RESUMO

To estimate the relationship between type D personality and essential hypertension among patients visiting their GPs for any health problem, 101 hypertensive and 138 nonhypertensive patients were consecutively recruited and assessed using the Type D Personality Scale (DS14). The predictive value of type D personality was determined using a logistic regression model, taking into account the differences in recognized confounders between groups. Type D personality in the hypertension group was twice as frequent as in the no hypertension group and hypertension was more frequent among type D than non-type D patients. Logistic regression showed a significant predictive value of type D personality for hypertension, adjusting for sex, age, body mass index, family history of hypertension, living condition, education, and employment. Therefore, type D personality was strongly related to hypertension and it was a noteworthy predictor of hypertension in a real-world cohort of primary care patients.


Assuntos
Hipertensão/epidemiologia , Personalidade Tipo D , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Hipertensão Essencial , Feminino , Medicina Geral/estatística & dados numéricos , Humanos , Hipertensão/diagnóstico , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/estatística & dados numéricos
12.
Qual Life Res ; 23(10): 2757-67, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24929832

RESUMO

PURPOSE: To estimate variations in Overall Quality Of Life (OQOL) within 12 months following alcohol detoxification and to evaluate the predictive value of OQOL for relapse and alcohol use severity. METHODS: Alcohol use disorders and four OQOL domains (physical health, psychological health, social relationships and environment) were assessed in 199 patients entering in-patient alcohol detoxification. Follow-up assessments were performed at 6 and 12 months after discharge. Cross-sectional and longitudinal analyses explored the relationship between OQOL and alcohol use severity, examining differences between abstinent and relapsed patients. The predictive value of OQOL was analyzed by logistic and linear regression. RESULTS: Correlation between OQOL and Alcohol Use Disorders Identification Test scores was confirmed at all stages of observation. Abstinent patients showed a significant improvement in all OQOL domains at 6 months after discharge, whereas OQOL domains did not undergo any significant change in relapsed patients. Baseline OQOL did not prove to be predictive of either relapse or alcohol use severity. CONCLUSIONS: Overall quality of life changed in parallel with alcohol use severity throughout the duration of the study, confirming it to be a useful and sensitive measure of secondary outcome for alcohol detoxification. Conversely, none of the OQOL baseline scores functioned as predictors of relapse within 12 months following discharge or alcohol use severity in relapsed patients.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/tratamento farmacológico , Alcoolismo/psicologia , Qualidade de Vida/psicologia , Adulto , Doença Crônica , Estudos Transversais , Feminino , Humanos , Inativação Metabólica , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Recidiva , Centros de Tratamento de Abuso de Substâncias , Inquéritos e Questionários
13.
J Health Psychol ; : 13591053241253046, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38738922

RESUMO

The significance of spirituality in navigating the meaning of illness and death has been well-established. However, healthcare professionals working with palliation also grapple with their own spiritual dimensions when confronted with these circumstances. This study aimed to explore spirituality from a subjective standpoint among a sample of palliative care professionals, investigating its role and associated needs. For the first time, the FICA Spiritual History Tool was applied in a focus group setting. The meetings were transcribed, and thematic analysis was performed. The findings underscore how spirituality is perceived as more relational than transcendent, potentially fostering connections between the self, patients, and colleagues, thereby enhancing resilience. Simultaneously, spirituality needs to be considered as a potential source of suffering that could impact both the quality of life and work of healthcare workers involved. This issue should be addressed through dedicated moments of shared reprocessing, with beneficial implications for public health.

14.
Neurocase ; 19(6): 542-52, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22823908

RESUMO

Alzheimer's disease (AD) is a neurodegenerative condition characterized by significant impairment in multiple cognitive domains. In recent years, the development of cognitive trainings in AD has received significant attention. In the present case study we designed a cognitive training program (GEO, Geographical Exercises for cognitive Optimization) based on an errorless paradigm and tailored to the patient's cultural interests. The aim of this training was to investigate the potential for acquiring and possibly retaining both procedural and verbal knowledge in early-stage AD. This study involved an 80-year-old female patient diagnosed with early-stage AD, and 10 matched healthy subjects. Participants were asked to perform the two GEO training tasks: a "puzzle-like" task for procedural memory, and an "association" task for verbal memory. Both the patient and the healthy controls were subsequently trained with GEO using the same two tasks for 2 months. Although the patient's performance before training in both tasks was poor compared to healthy controls, after the training these differences disappeared. Our results showed that the patient was able to acquire new procedural abilities and verbal knowledge, and that her achievements were stable at the follow-up testing scheduled 3 months after the end of the intervention. This case study suggests a potentially useful strategy for cognitive training in AD.


Assuntos
Doença de Alzheimer/reabilitação , Atenção/fisiologia , Transtornos Cognitivos/reabilitação , Cognição/fisiologia , Memória/fisiologia , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Transtornos Cognitivos/psicologia , Feminino , Humanos , Testes Neuropsicológicos , Índice de Gravidade de Doença , Resultado do Tratamento
15.
J Clin Psychol Med Settings ; 20(2): 240-6, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23053829

RESUMO

Chronic and life-threatening neurodegenerative diseases may be associated with post-traumatic stress disorder (PTSD). Therefore, the current study was an investigation of the prevalence of PTSD in multiple sclerosis (MS) patients, and identification of significant determinants of PTSD. Two hundred thirty-two MS patients were consecutively recruited and screened for the presence of PTSD with the Impact of Event Scale-Revised, corroborated by the Structured Clinical Interview for DSM-IV. Furthermore, participants were administered the Hospital Anxiety and Depression Scale and the Fatigue Severity Scale. Twelve patients (12/232, i.e. 5.17 %) were diagnosed as suffering from PTSD. Levels of education, anxiety and depression were significant determinants of the presence of PTSD. The role played by the levels of education, anxiety and depression in determining the presence of PTSD has been discussed. Further research on the psychological features of neurodegenerative diseases is urgently needed in order to plan appropriate treatments and improve patients' quality of life.


Assuntos
Esclerose Múltipla/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Comorbidade , Feminino , Humanos , Itália/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/etiologia
16.
Front Med (Lausanne) ; 10: 1280592, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38239607

RESUMO

Despite the increasing body of evidence supporting the use of simulation in medicine, a question remains: when should we introduce it into the medical school's curriculum? We present the experience and future perspectives of the MD program in Medicine and Surgery of University of Turin-MedInTo. Since its launch, MedInTo has been dedicated to integrating innovative teaching approaches at the early stages into the medical curriculum. Herewith, we describe a case-based approach for our activities, which includes the utilization of simulation for emergency medical care training for students and the integration of virtual and augmented reality technology. Dedicated surgical training activities using virtual-augmented reality and life-like simulator for students are also described.

17.
Compr Psychiatry ; 53(4): 355-63, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-21821240

RESUMO

BACKGROUND: Alcohol abuse and dependence are frequently associated with psychiatric disorders and personality disorders (PDs) with differences among gender. However, only few studies investigated gender differences in PDs among alcoholics. The aim of this study was to investigate PDs in a sample of patients accessing inpatient alcohol detoxification treatment and to describe gender differences in prevalence and comorbidity of PDs. METHODS: The study population consisted of 206 patients entering alcohol detoxification treatment in a specialized clinic in Italy. At enrollment, patients filled in the Millon Clinical Multiaxial Inventory-III for the assessment of PDs. RESULTS: The sample consisted of 150 males and 56 females. Twenty-five percent of males vs 12.5% of females had 1 PD; 16% vs 23%, 2 PDs; and 46% vs 48%, more than 3 PDs. A statistically significant higher proportion of females got high scores on avoidant (21.4% vs 9.3%), self-defeating (50.0% vs 24.0%), and borderline scales (42.9% vs 25.3%). Depressive, self-defeating, and borderline PDs were frequently associated both to other PDs and among each other, particularly among females. CONCLUSIONS: Borderline PD is confirmed to be more frequent among females than among males accessing alcohol detoxification treatment. More studies are needed to clarify prevalence and associations of PDs, prognosis, and gender differences in alcoholics patients.


Assuntos
Alcoolismo/epidemiologia , Alcoolismo/terapia , Transtornos da Personalidade/epidemiologia , Adulto , Idoso , Alcoolismo/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Hospitalização , Humanos , Pacientes Internados , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Prevalência , Fatores Sexuais
18.
JMIR Form Res ; 6(6): e33734, 2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35675116

RESUMO

BACKGROUND: eHealth interventions have become a topic of interest in the field of mental health owing to their increased coordination and integration of different elements of care, in treating and preventing mental ill health in patients with somatic illnesses. However, poor usability, learnability, and user engagement might affect the effectiveness of an eHealth intervention. Identifying different sociodemographic characteristics that might be associated with higher perceived usability can help improve the usability of eHealth interventions. OBJECTIVE: This study aimed to identify the sociodemographic characteristics that might be associated with the perceived usability of the NEVERMIND (Neurobehavioural Predictive and Personalised Modelling of Depressive Symptoms During Primary Somatic Diseases) eHealth system, comprising a mobile app and a sensorized shirt, in reducing comorbid depressive symptoms in patients with breast or prostate cancer. METHODS: The study included a total of 129 patients diagnosed with breast (n=80, 62%) or prostate (n=49, 38%) cancer, who received a fully automated mobile app and sensorized shirt (NEVERMIND system). Sociodemographic data on age, sex, marital status, education level, and employment status were collected at baseline. Usability outcomes included the System Usability Scale (SUS), a subjective measure that covers different aspects of system usability; the user version of the Mobile App Rating Scale (uMARS), a user experience questionnaire; and a usage index, an indicator calculated from the number of days patients used the NEVERMIND system during the study period. RESULTS: The analysis was based on 108 patients (n=68, 63%, patients with breast cancer and n=40, 37%, patients with prostate cancer) who used the NEVERMIND system for an average of 12 weeks and completed the study. The overall mean SUS score at 12 weeks was 73.4 (SD 12.5), which indicates that the NEVERMIND system has good usability, with no statistical differences among different sociodemographic characteristics. The global uMARS score was 3.8 (SD 0.3), and women rated the app higher than men (ß=.16; P=.03, 95% CI 0.02-0.3), after adjusting for other covariates. No other sociodemographic characteristics were associated with higher uMARS scores. There was a statistical difference in the use of the NEVERMIND system between women and men. Women had significantly lower use (ß=-0.13; P=.04, 95% CI -0.25 to -0.01), after adjusting for other covariates. CONCLUSIONS: The findings suggest that the NEVERMIND system has good usability according to the SUS and uMARS scores. There was a higher favorability of mobile apps among women than among men. However, men had significantly higher use of the NEVERMIND system. Despite the small sample size and low variability, there is an indication that the NEVERMIND system does not suffer from the digital divide, where certain sociodemographic characteristics are more associated with higher usability. TRIAL REGISTRATION: German Clinical Trials Register RKS00013391; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013391.

19.
Integr Cancer Ther ; 21: 15347354221096808, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35635127

RESUMO

OBJECTIVE: People diagnosed with cancer have to deal with the debilitating psychological implications of this disease. Although the clinical efficacy of psychological interventions is well documented, relatively little has been written on the neural correlates of these treatments in the context of oncology. The present work is the first to provide an overall perspective of the existing literature on this topic. It also considers the potential directions for future research. METHODS: This scoping review was carried out across 5 databases (EMBASE, PsycINFO, OVID MEDLINE, CINAHL, COCHRANE CENTRAL), from conception dates until 3 December 2021. RESULTS: From an initial set of 4172 records, 13 papers were selected for this review. They consisted of 9 randomized controlled studies (RCTs), 1 quasi-experiment, 2 single case studies, and 1 secondary quantitative analysis. The studies were also heterogeneous in terms of the patient and control populations, psychological interventions, and neuroimaging methodologies used. The findings from these few studies suggest that psychological interventions in oncology patients may modulate both cortical and subcortical brain activity, consistent with the brain areas involved in distress reactions in general and to cancer specifically. The implications of this scoping review in terms of future research are also discussed. CONCLUSIONS: The literature on the neural correlates of psychological interventions in cancer patients is very limited, and thus requires further exploration. The provision of psychological interventions offers cancer patients a more integrated approach to care, which may in turn help preserve both the physical and the psychological wellbeing of individuals with cancer.


Assuntos
Neoplasias , Intervenção Psicossocial , Encéfalo , Humanos , Oncologia , Neoplasias/psicologia , Neoplasias/terapia
20.
PLoS One ; 17(12): e0278715, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36459526

RESUMO

Emotional styles concern the ways in which individuals adapt and respond to the world and can be defined using six dimensions: outlook, resilience, social intuition, self-awareness, sensitivity to context and attention. The Emotional Style Questionnaire (ESQ) assesses how people vary across the dimensions and gauges an individual's overall level of emotional health. An Italian version of the ESQ (ESQ-ITA) could favour the understanding of cultural characteristics concerning emotions and personality within the Italian population, with both clinical and social implications. The aim of the present study is to validate the ESQ in the Italian language and to assess its psychometric properties. Two studies were conducted. Study 1 examined construct validity, internal consistency, and test-retest reliability, through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), Cronbach's alpha estimates, and by estimating the Spearman's rank correlation Study 2 examined construct validity and internal consistency through the CFA and Cronbach's alpha estimates and investigated criterion validity by correlating the ESQ-ITA dimensions with the corresponding scales or subscales used for the validation estimating, again, the Spearman's rank correlation coefficient Study 2 also examined the criterion validity of the validated scales and the ESQ-ITA overall score to assess its suitability as an indicator of emotional health. ESQ-ITA was confirmed to be reliable and stable. The correlation between the ESQ-ITA overall score and the other scales and questionnaires supports the use of ESQ-ITA to measure emotional health. The Italian version of the ESQ opens up the possibility to enrich the research landscape with new knowledge that will be useful for advancing the pathogenetic and therapeutic aspects of psychological distress and emotional dysregulation.


Assuntos
Emoções , Idioma , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
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