Incidence and influencing factors of aggressive behavior in adolescent inpatients with mental disorders / 新乡医学院学报

Objective To investigate the incidence and influencing factors of aggressive behavior in adolescent inpatients with mental disorders.Methods A total of 372 patients with mental disorders admitted to the Department of Child and Adolescent Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University from January to December 2022 were selected as research subjects.The occurrence of aggressive behavior and its influencing factors were analyzed.Results Among the 372 patients,38(10.2％)cases had aggressive behavior during hospitalization.Univariate and multivariate logistic regression results showed that the history of aggressive behavior,only child,and high irritation factor scores were the risk factors of aggressive behavior in hospitalized adolescents with mental disorders(P＜0.05).Mild,outgoing,insecure and isolated personalities before the onset were protective factors of aggressive behavior in hospitalized adolescents with mental disorders(P＜0.05).Conclusion Adolescent inpatients with mental disorders are likely to have aggressive behavior.Those who have aggressive behavior before,are the only child in their family and get a high score of irritant factors need more attention.Corresponding nursing interventions should be taken in time through nursing assessment to reduce the occurrence of aggressive behavior.

Risk prediction models of dangerous behaviors among patients with severe mental disorder in community / 四川精神卫生

BackgroundThe occurrence rate of dangerous behaviors in patients with severe mental disorders is higher than that of the general population. In China， there is limited research on the prediction of dangerous behaviors in community-dwelling patients with severe mental disorders， particularly in terms of predicting models using data mining techniques other than traditional methods. ObjectiveTo explore the influencing factors of dangerous behaviors in community-dwelling patients with severe mental disorders and testing whether the classification decision tree model is superior to the Logistic regression model. MethodsA total of 11 484 community-dwelling patients with severe mental disorders who had complete follow-up records from 2013 to 2022 were selected on December 2023. The data were divided into a training set （n=9 186） and a testing set （n=2 298） in an 8∶2 ratio. Logistic regression and classification decision trees were separately used to establish predictive models in the training set. Model discrimination and calibration were evaluated in the testing set. ResultsDuring the follow-up period， 1 115 cases （9.71%） exhibited dangerous behaviors. Logistic regression results showed that urban residence， poverty， guardianship， intellectual disability， history of dangerous behaviors， impaired insight and positive symptoms were risk factors for dangerous behaviors （OR=1.778， 1.459， 2.719， 1.483， 3.890， 1.423， 2.528， 2.124， P<0.01）. Being aged ≥60 years， educated， not requiring prescribed medication and having normal social functioning were protective factors for dangerous behaviors （OR=0.594， 0.824， 0.422， 0.719， P<0.05 or 0.01）. The predictive effect in the testing set showed an area under curve （AUC） of 0.729 （95% CI： 0.692~0.766）， accuracy of 70.97%， sensitivity of 59.71%， and specificity of 72.05%. The classification decision tree results showed that past dangerous situations， positive symptoms， overall social functioning score， economic status， insight， household registration， disability status and age were the influencing factors for dangerous behaviors. The predictive effect in the testing set showed an AUC of 0.721 （95% CI： 0.705~0.737）， accuracy of 68.28%， sensitivity of 64.46%， and specificity of 68.60%. ConclusionThe classification decision tree does not have a greater advantage over the logistic regression model in predicting the risk of dangerous behaviors in patients with severe mental disorders in the community. ［Funded by Chengdu Medical Research Project （number， 2020052）］

Research progress in psychopharmacology based on approach-avoidance conflict behavior / 中国药理学与毒理学杂志

Approach-avoidance conflict(AAC)refers to the internal conflict that individuals experi-ence when faced with conflicting approach or avoidance thoughts.It reveals some characteristics of mental disorders,such as anxiety,depression,and addiction represented by excessive tendencies of approach or avoidance.The function of the cortico-limbic-striatal system influences behavioral choices at the neural level during the onset of AAC,and the development of related behavioral paradigms that can better represent AAC behaviors is critical to evaluating the efficacy of drugs and guiding the development of new drugs.This paper summarizes the neural mechanisms,behavioral paradigms,and applications in behavioral pharmacology related to AAC behaviors from the perspective of psychopharmacology with a view to providing new perspectives and methods for the diagnosis and treatment of related neuro-psychiatric disorders.

Recomendaciones clínicas para la solicitud de evaluación de neurocirugía en el trastorno obsesivo compulsivo / Clinical recommendations for requesting neurosurgical evaluation in obsessive-compulsive disorder

Estas recomendaciones clínicas delinean los criterios utilizados por el Equipo de Cirugía de los Trastornos Psiquiátricos del Hospital de Clínicas para la selección de candidatos a neurocirugía en pacientes con trastorno obsesivo compulsivo grave y refractario al tratamiento convencional. Los criterios de inclusión se enfocan en la cronicidad, la gravedad y la resistencia, considerando procedimientos ablativos o de neuromodulación. La gravedad se evalúa mediante la Escala Yale-Brown Obsessive Compulsive, junto con una evaluación integral del desempeño y la discapacidad. La refractariedad se define como la falta de respuesta, según criterios consensuados, a diversos tratamientos farmacológicos y no farmacológicos respaldados por evidencia científica significativa para el trastorno obsesivo compulsivo. Es esencial realizar una evaluación dimensional del desempeño global y estimar el pronóstico sin intervención quirúrgica. Los criterios de exclusión abarcan comorbilidades graves, trastornos de personalidad específicos y discapacidad intelectual. Además, se especifican pruebas paraclínicas necesarias, incluyendo evaluaciones sanguíneas, serológicas, cardíacas y neurológicas. Se detallan las tablas utilizadas para el registro de información necesaria para la evaluación. Todas las evaluaciones de neurocirugía culminan en un ateneo clínico conjunto entre el Equipo de Cirugía de los Trastornos Psiquiátricos del Hospital de Clínicas y la Unidad Académica de Psiquiatría de la Facultad de Medicina en donde se determinan las estrategias terapéuticas posibles.

These clinical recommendations outline the criteria used by the Psychiatric Disorders Surgery Team for selecting neurosurgery candidates among patients with severe Obsessive Compulsive Disorder refractory to conventional treatment. Inclusion criteria focus on chronicity, severity, and resistance. Ablative procedures or neuromodulation are taken into consideration. Severity is assessed by means of Yale-Brown Obsessive Compulsive Scale, and a comprehensive evaluation of performance and disability. Refractoriness is defined as lack of response, according to consensus criteria, to various pharmacological and non-pharmacological treatments for Obsessive Compulsive Disorder supported by significant scientific evidence. It is essential to conduct a dimensional assessment of overall performance and estimate prognosis without surgical intervention. Exclusion criteria encompass serious comorbidities, specific personality disorders, and intellectual disability. Furthermore, necessary paraclinical tests are specified, including blood, serological, cardiac, and neurological evaluations. Tables used for recording essential information for assessment are detailed. All neurosurgical assessments culminate in a joint clinical discussion of possible therapeutic strategies between the Psychiatric Disorders Surgery Team and the Psychiatry Academic Department (Facultad de Medicina) at the Hospital de Clínicas.

Inclusión social de persona con trastorno mental en situación de calle: una intervención comunitaria

Introducción: Experiencia de una comunidad de barrio capitalino (Asunción-Paraguay), movilizada por la grabación de un corto documental a cargo de estudiantes de cinematografía, que inician un proceso de participación para mejorar la calidad de vida de una persona con trastornos mentales y discapacidad psicosocial en situación de calle, logrando su inclusión social. Objetivo : Identificar los elementos claves que favorecieron la participación comunitaria, derivando en el proceso de reinserción social de una persona con trastorno mental y discapacidad psicosocial para contribuir con estrategias innovadoras de modelos de atención basados en la comunidad con enfoque de derechos humanos. Materiales y métodos: Estudio cualitativo de diseño narrativo, utilizando datos de la historia de una persona y la experiencia de una comunidad para describir, analizar e identificar elementos que se consideran claves para los resultados logrados. La experiencia comunitaria fue observada y registrada de cerca durante más de 4 años. Resultado: Participación comunitaria activa en torno a un objetivo colectivo impulsado por un proyecto cinematográfico logrando la reinserción social de una persona con trastorno mental o discapacidad psicosocial que se encontraba en situación de calle. Conclusión : El cine o arte generan un impacto emocional y sensibilizador que acompañados con estrategias sostenibles; facilitación, tecnología, recursos económicos, lugares de residencia o acogida, acompañamiento; permiten aprovechar y movilizar recursos comunitarios, con participación y enfoque de derechos humanos. El resultado en este caso es la inclusión social de una persona con trastornos mentales y discapacidad psicosocial, que se encontraba en el extremo de exclusión social: vida en calle por más de 20 años.

Introduction : Experience of a community from a neighborhood of the Capital City (Asunción-Paraguay), mobilized by the recording of a Short Documentary by cinematography students, who begin a process of participation to improve the quality of life of a person with mental disorders and psychosocial disabilities who are homeless, achieving their social inclusion. Objective : Identify the key elements that allowed community participation and the social reintegration process of a person with a mental disorder or psychosocial disability to contribute with innovative strategies of community-based care models with a human rights approach. Materials and Methods : A qualitative type study of narrative design, using data from a person's story and the experience of a community to describe, analyze and identify the key elements to the results achieved. The community experience was closely observed and recorded for more than 4 years. Results : active community participation around a collective objective driven by a film project, achieving the reintegration and social rehabilitation of a person with mental disorder who was in street situation. Conclusion : Cinema or art generates an emotional and sensitizing impact that, accompanied by sustainable strategies; facilitation, technology, economic resources, places of residence or reception, support; allows taking advantage of and mobilizing community resources, with participation and a human rights approach. The result in this case is the social inclusion of a person with mental disorders or psychosocial disabilities who was at the extreme of social exclusion; street life for more than 20 years.

Autolesión no suicida en población general: frecuencia y factores asociados en Paraguay

Introducción: La investigación sobre la autolesión no suicida permite aumentar la conciencia sobre este fenómeno, posibilita su detección temprana y la implementación de estrategias más eficaces en prevención y tratamiento. Esto conlleva a una reducción del sufrimiento individual, los costos económicos y el impacto en la sociedad en su totalidad. Objetivo: Determinar la frecuencia y factores asociados a autolesión no suicida en una muestra de población adulta de Paraguay. Metodología: Estudio descriptivo de asociación cruzada, de corte transversal y prospectivo. Una encuesta en línea fue difundida a través de redes sociales y aplicaciones de mensajería. Esta incluía preguntas sobre datos sociodemográficos y clínicos. La presencia de autolesiones se determinó a través de la versión en español de la escala Self-Harm Questionnaire. Se utilizó estadística descriptiva para todas las variables. Para buscar asociaciones se utilizó la prueba chi cuadrado. Resultados: Participaron 241 personas (media de edad=32±12 años, 74,7% mujeres). Se encontró una frecuencia de autolesiones de 24,5% (n=59). De estos, el 91,5% había tenido ideación suicida al menos una vez. Se encontró asociación entre el nivel de ingresos y la frecuencia de autolesiones (χ

Introduction: Research on non-suicidal self-injury raises awareness of this phenomenon, enabling the early detection and implementation of more effective strategies in prevention and treatment. This leads to a reduction in individual suffering, economic costs, and impact on society. Objective: To determine the frequency and associated factors of non-suicidal self-injury in a sample of the adult population of Paraguay. Methodology: This was a descriptive, cross-sectional, and prospective study. An online survey was disseminated through social networks and messaging applications. The survey included questions on sociodemographic and clinical data. The presence of self-injury was determined by using the Spanish version of the Self-Harm Questionnaire. Descriptive statistics were used for all the variables. The chi-square test was used to examine associations. Results: There were 241 participants (mean age=32±12 years, 74.7%female). A non-suicidal self-injury frequency of 24.5% (n=59) was observed. Of these, 91.5% reported suicidal ideation at least once. An association was found between income level and the frequency of non-suicidal self-injury (χ

The impact of inclusion practices on the identity of people diagnosed with severe mental illness: Radio Nikosia / O impacto das práticas de inclusão na identidade de pessoas diagnosticadas com doença mental grave: Radio Nikosia

Abstract This article examines the discursive approach adopted by Radio Nikosia, highlighting its crucial role in the recovery of people diagnosed with severe mental illness. It examines how putting social representations aside has enabled Radio Nikosia to render agency to these social actors, acknowledging their capacity to construct, reconstruct and change their own identities. The geographic scope of the study comprises the Autonomous Community of Catalonia while the methodology followed is qualitative in nature, analysing programme audio and transcription, reports, academic articles, theses, and a participant interview. The aim of the analysis is to examine the significance of discursive practices in Radio Nikosia in modifying the permanence of identities anchored in severe mental illness. The results illustrate the practical use of radio as a powerful tool that both promotes social inclusion and impacts mental illness identity.

Resumo Este artigo examina a abordagem discursiva adotada pela Rádio Nikosia, destacando seu papel crucial na recuperação de pessoas diagnosticadas com doença mental grave. Examina como deixar de lado as representações sociais permitiu à Rádio Nikosia dar agência a esses atores sociais, reconhecendo sua capacidade de construir, reconstruir e mudar suas próprias identidades. O escopo geográfico do estudo compreende a Comunidade Autônoma da Catalunha, enquanto a metodologia seguida é de natureza qualitativa, analisando áudio e transcrição do programa, relatórios, artigos acadêmicos, teses e entrevista participante. O objetivo da análise é examinar o significado das práticas discursivas da Rádio Nikosia na modificação da permanência de identidades ancoradas na doença mental grave. Os resultados ilustram o uso prático do rádio como uma ferramenta poderosa que promove a inclusão social e impacta a identidade da doença mental.

Physical activity, depression, anxiety, and stress in adults and elderly in the COVID-19 pandemic in Brazil / Atividade física, depressão, ansiedade e estresse em adultos e idosos na pandemia COVID-19 no Brasil

The aim was to verify whether there is a relationship between physical activity habits and the indica-tion of associated risk for depression, anxiety, and stress in adults and the elderly during a period of the COVID-19 pandemic in Brazil. A cross-sectional study, with data collection between October and November 2021, was carried out using an online form, with questions about sociodemographic data, physical activity practice before and during the pandemic, health status, mental health through the Scale of Depression, Anxiety, and Stress (DASS-21), and level of physical activity through the International Physical Activity Questionnaire (IPAQ). Statistical analysis was performed using the chi-square test with a significance level of 5% and multiple correspondence analysis. The were 1044 men and women, aged between 18 and 75, from all over the national territory. Among them, 48.0%, 35.9%, and 61.1% showed an indication of associated risk for depression, anxiety, and stress, respec-tively. Adult participants 93.4%, female 66.8%, educational level up to undergraduate studies 54.2%, and single 57.5%, as well as those with a low level of physical activity 36.1% and who reported wors-ening in practice during the pandemic 53.9%, showed a greater risk indication for depression, anxiety and stress (p<0.05). In summary, physically active people who managed to maintain or improve their practice during the pandemic showed a lower indication of associated risk for problems related to mental health. It is important to consider the planning of public policies from the perspective of equity to help people with greater vulnerability in accessing physical activity

O objetivo foi verificar se há relação entre os níveis de atividade física e a indicação de risco associado para depressão, ansiedade e estresse em adultos e idosos durante um período da pandemia da COVID-19 no Brasil. Estudo transversal, entre outubro e novembro de 2021, foi realizado por meio de um formulário online, com perguntas sobre dados sociodemográficos, prática de atividade física antes e durante a pandemia, estado de saúde, saúde mental - Escala de Depressão, Ansiedade e Estresse (DASS-21) e nível de atividade física - Questionário Internacional de Atividade Física (IPAQ). A análise estatística foi realizada por meio do teste Qui-Quadrado com nível de significância de 5% e análise de correspondência múltipla. Participaram 1044 homens e mulheres, com idade entre 18 e 75 anos, de todo território nacional. Entre os participantes, 48,0%, 35,9% e 61,1% apresentaram indicação de risco associado para depressão, ansiedade e estresse, res-pectivamente. Os participantes adultos 93,4%, do gênero feminino 66,8%, nível de escolaridade até o ensino superior 54,2% e solteiros 57,5%, bem como os com nível baixo de atividade física 36,1% e que relataram piora na prática durante a pandemia 53,9% apresentaram maior indicação de risco para depressão, ansieda-de e estresse (p<0,05). Em síntese, pessoas fisicamente ativas e que conseguiram manter ou melhorar a prática durante a pandemia, apresentaram menor indicação de risco associado para problemas relacionados à saúde mental. É importante considerar o planejamento de políticas públicas sob a ótica da equidade, para auxiliar pessoas com maior vulnerabilidade no acesso à atividade física

Guia da gestão autônoma da medicação como ferramenta educativa do enfermeiro na atenção psicossocial / Guide to the autonomous medication management as an educational tool for nurses in psychosocial care / Guía para la gestión autónoma de medicamentos como herramienta educativa para enfermeros en atención psicossocial

Objetivo: analisar as repercussões da intervenção educativa do enfermeiro com o uso do Guia da Gestão Autônoma da Medicação para usuários de um Centro de Atenção Psicossocial. Métodos: estudo qualitativo, com referencial metodológico na Pesquisa Convergente Assistencial, realizado com 27 usuários de um Centro de Atenção Psicossocial que participaram de grupos de intervenção educativa. Empregou-se o princípio da triangulação dos dados, com quatro diferentes fontes de dados, observação participante, entrevista conversação, grupos e diário de campo. A análise dos dados envolveu processos de apreensão, síntese, teorização e transferência. Resultados: a intervenção educativa propiciou aos usuários mais empoderamento frente ao tratamento, organização de estratégias de enfrentamento dos problemas e cooperou para a cogestão do tratamento. Conclusão: o Guia da Gestão Autônoma da Medicação mostrou-se um instrumento importante no âmbito da educação em saúde para a prática assistencial do enfermeiro, e contribuiu para o compartilhamento de cuidado e de autonomia no processo de reabilitação psicossocial. (AU)

Objective: to analyze the repercussions of the educational intervention of nurses using the Guide to the Autonomous Management of Medication for users of a Psychosocial Care Center. Methods: qualitative study, with a methodological framework in the Convergent Care Research, carried out with 27 users of a Psychosocial Care Center who participated in educational intervention groups. The principle of data triangulation was used, with four different data sources, participant observation, conversational interview, groups and field diary. Data analysis involved processes of apprehension, synthesis, theorization and transfer. Results: the educational intervention provided users with more empowerment regarding the treatment, organization of coping strategies for the problems and cooperated for the co-management of the treatment. Conclusion: The Autonomous Medication Management Guide proved to be an important instrument in the context of health education for the nursing care practice, and contributed to the sharing of care and autonomy in the psychosocial rehabilitation process. (AU)

Objetivo: analizar las repercusiones de la intervención educativa de enfermeros utilizando la Guía para el Manejo Autónomo de Medicamentos para usuarios de un Centro de Atención Psicosocial. Métodos: estudio cualitativo, con marco metodológico en la Investigación de Atención Convergente, realizado con 27 usuarios de un Centro de Atención Psicosocial que participaron en grupos de intervención educativa. Se utilizó el principio de triangulación de datos, con cuatro fuentes de datos diferentes, observación participante, entrevista conversacional, grupos y diario de campo. El análisis de datos involucró procesos de aprehensión, síntesis, teorización y transferencia. Resultados: la intervención educativa proporcionó a los usuarios un mayor empoderamiento con respecto al tratamiento, organización de estrategias de afrontamiento de los problemas y cooperó para el co-manejo del tratamiento. Conclusión: La Guía de Manejo Autónomo de Medicamentos demostró ser un instrumento importante en el contexto de la educación en salud para la práctica del cuidado de enfermería, y contribuyó a la compartición del cuidado y la autonomía en el proceso de rehabilitación psicosocial. (AU)

Factors affecting physical examinations among patients with severe mental disorders in Shaoxing City / 预防医学

Objective@#To investigate the proportion of physical examinations among patients with severe mental disorders and its influencing factors in Shaoxing City, Zhejiang Province, so as to provide the evidence for improving the proportion of physical examinations among patients with severe mental disorders. @*Methods @#The epidemiological and clinical features of patients with severe mental disorders included in community management in Shaoxing City in 2022 were collected from Zhejiang Provincial Severe Mental Disorder Management Information System, including demographics, disease diagnosis and treatment, physical examination, and rescue and assistance. Factors affecting the physical examination were identified among patients with severe mental disorders using a multivariable logistic regression model. @*Results@#A total of 25 468 patients with severe mental disorders were enrolled in Shaoxing City in 2022, including 12 151 males and 13 317 females, with a male to female ratio of 0.91∶1, and the participants had a mean age of (54.34±14.71) years. Schizophrenia was the predominant type of severe mental disorders (15 419 cases, 60.54%), and 21 374 subjects participating in the physical examinations in 2022 (83.92%). Multivariable logistic regression analysis showed that female (OR=0.901, 95%CI: 0.832-0.975), urban areas (OR=0.506, 95%CI: 0.468-0.547), mental disorders due to epilepsy (OR=1.779, 95%CI: 1.104-2.866), hospitalized treatment (6 to 10 times, OR=0.523, 95%CI: 0.401-0.681; 11 times and more, OR=0.177, 95%CI: 0.108-0.288), special diseases in outpatient (OR=1.738, 95%CI: 1.597-1.891), receiving medical assistance (OR=2.851, 95%CI: 2.616-3.107), targets of the community care and assistance groups (OR=1.653, 95%CI: 1.471-1.857) and guardian (spouse, OR=1.777, 95%CI: 1.513-2.086; children, OR=1.277, 95%CI: 1.069-1.526; parents, OR=1.342, 95%CI: 1.143-1.576) were statistically associated with the proportion of physical examinations. @*Conclusions@#The proportion of health examinations was 83.92% among patients with severe mental disorders in Shaoxing City in 2022. Gender, residence, guardian, disease diagnosis, times of hospitalized treatment, medical assistance, special diseases in outpatients and target of community care and assistance groups were factors affecting health examinations among patients with severe mental disorders.