Risk factors for nonfatal self-harm and suicide among adolescents: two nested case-control studies conducted in the UK Clinical Practice Research Datalink.

BACKGROUND: The characteristics of adolescents who die by suicide have hitherto been examined in uncontrolled study designs, thereby precluding examination of risk factors. The degree to which antecedents of nonfatal self-harm and suicide at young age differ remains unknown. METHOD: We delineated two nested case-control studies of patients aged 10-19 years using the Clinical Practice Research Datalink with interlinked hospital and national mortality records. Cases were adolescents who between 1st January 2003 and 31st December 2018 had died from suicide (N = 324) - study 1; experienced their first self-harm episode (N = 56,008) - study 2. In both studies, cases were matched on sex, age and practice-level deprivation quintile to 25 controls. By fitting conditional logistic regression, we examined how risks varied according to psychiatric diagnoses, prescribed psychotropic medication, patterns of clinical contact and area-level deprivation. RESULTS: Suicides occurred more often among boys (66%), but self-harm was more common in girls (68%). Most individuals who self-harmed or died from suicide presented to their GP at least once in the preceding year (85% and 75% respectively). Only a third of cases had one of the examined diagnostic categories recorded. Depression was most strongly associated with elevated risks for both outcomes (self-harm: OR 7.9; 95% CI 7.8-8.2; suicide: OR 7.4; 95% CI 5.5-9.9). Except for autism spectrum disorder, all other diagnostic categories were linked with similar risk elevations for self-harm as for suicide. Whilst self-harm risk rose incrementally with increasing levels of area-level deprivation, suicide risks did not. CONCLUSIONS: We observed few marked differences in risk factor profiles for nonfatal self-harm versus suicide. As most adolescents who had harmed themselves or died by suicide were known to services in the preceding year, their underlying pathology may not be adequately identified and treated. Our findings highlight the need for a multiagency approach to treatment and prevention.

Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003-2018.

BACKGROUND: There has been growing concern in the UK over recent years that a perceived mental health crisis is affecting children and adolescents, although published epidemiological evidence is limited. METHODS: Two population-based UK primary care cohorts were delineated in the Aurum and GOLD datasets of the Clinical Practice Research Datalink (CPRD). We included data from 9,133,246 individuals aged 1-20 who contributed 117,682,651 person-years of observation time. Sex- and age-stratified annual incidence rates were estimated for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) (age groups: 1-5, 6-9, 10-12, 13-16, 17-19), depression, anxiety disorders (6-9, 10-12, 13-16, 17-19), eating disorders and self-harm (10-12, 13-16, 17-19) during 2003-2018. We fitted negative binomial regressions to estimate incidence rate ratios (IRRs) to examine change in incidence between the first (2003) and final year (2018) year of observation and to examine sex-specific incidence. RESULTS: The results indicated that the overall incidence has increased substantially in both boys and girls in between 2003 and 2018 for anxiety disorders (IRR 3.51 95% CI 3.18-3.89), depression (2.37; 2.03-2.77), ASD (2.36; 1.72-3.26), ADHD (2.3; 1.73-3.25), and self-harm (2.25; 1.82-2.79). The incidence for eating disorders also increased (IRR 1.3 95% CI 1.06-1.61), but less sharply. The incidence of anxiety disorders, depression, self-harm and eating disorders was in absolute terms higher in girls, whereas the opposite was true for the incidence of ADHD and ASD, which were higher among boys. The largest relative increases in incidence were observed for neurodevelopmental disorders, particularly among girls diagnosed with ADHD or ASD. However, in absolute terms, the incidence was much higher for depression and anxiety disorders. CONCLUSION: The number of young people seeking help for psychological distress appears to have increased in recent years. Changes to diagnostic criteria, reduced stigma, and increased awareness may partly explain our results, but we cannot rule out true increases in incidence occurring in the population. Whatever the explanation, the marked rise in demand for healthcare services means that it may be more challenging for affected young people to promptly access the care and support that they need.

Occurrence of mood disorders among educationally active older adults in Bialystok, Poland: a cross-sectional study.

BACKGROUND: Mood disorders in older people are an increasingly serious health and social problem, and their prevalence increases with age. The most common mood disorders are bipolar disorder, which is the occurrence of mania and hypomania, and depressive disorders. The aim of this study was to determine the prevalence of mood disorders in a group of educationally active elderly people living in Bialystok, Poland. METHODS: The study included a total of 162 people-residents of Bialystok-aged 60 or older; 135 women (83.33%) and 27 men (16.67%). The study used five standardized psychometric scales: The Mood Disorder Questionnaire (MDQ), Hypomania Check List (HCL-32), Geriatric Depression Scale (GDS) and The Zung Self-Rating Depression Scale (Zung SDS). RESULTS: Nearly 90.00% of the respondents obtained GDS scores indicating the presence of mild depressive symptoms; however, on the Zung SDS, which also evaluates depression symptom levels, the result obtained in almost the same number of respondents showed an absence of these symptoms. A similar percentage of respondents also obtained values on the MDQ that allow to determine a lack of bipolar disorder characteristics in the studied population. Over half of the respondents (58.02%) did not show symptoms of hypomania using the HCL-32. There was a significant correlation between the results of the GDS and Zung SDS, the HCL-32 and MDQ, as well as the HCL-32 and Zung SDS in the total studied group. CONCLUSIONS: Mood disorders, particularly depression, constitute a significant social and health problem in the group of educationally active older adults living in Bialystok. In light of the obtained research results, it is recommended to conduct and improve already realized health education programs for the elderly on the subject of mood disorder prevention and their impact on quality of life. There is a need for further research on mood disorders in the elderly to determine their prevalence on a national scale.

Sleep disorders among educationally active elderly people in Bialystok, Poland: a cross-sectional study.

BACKGROUND: Sleep disorders in an ageing society constitute a significant public health problem. It is estimated that approximately 50% of people aged 55 years and older have trouble sleeping, including initiating and maintaining sleep. The aim of this study was to determine the prevalence of sleep disorders in a group of educationally active elderly people living in Bialystok, Poland. METHODS: The study included a total of 182 people - residents of Bialystok - aged 60 or older; 146 women (80.22%) and 36 men (19.78%). The study used three standardized psychometric scales: The Athens Insomnia Scale (AIS), The Epworth Sleepiness Scale (ESS) and The Insomnia Severity Index (ISI). RESULTS: More than half of the respondents scored 6 or more points on the AIS, which is considered a value that indicates a high probability of insomnia symptom occurrence. A similar percentage of respondents obtained a point value on the ISI indicating the presence of insomnia. The vast majority of respondents scored below 11 points on the ESS, which means no symptoms of excessive sleepiness. There was a significant correlation between the results of the above scales in the examined group in total and also by sex. CONCLUSIONS: Sleep disorders, particularly insomnia, constitute a significant social and health problem in the group of educationally active elderly people living in Bialystok. In light of the obtained study results, it is recommended to conduct and improve existing health education programs aimed at the elderly regarding sleep disorders to improve the quality of their sleep, and thus quality of life, and raise the awareness of the elderly about the importance of sleep in everyday life. There is a need for further research in the field of sleep disorders in the elderly to determine the prevalence of these disorders on a national scale.

Self-assessment of the mental health status in older adults in Poland: a cross-sectional study.

BACKGROUND: Demographic aging of society poses numerous challenges, including the provision of health care to the elderly population. According to World Health Organization data, the most frequent mental disorders in the senior population are: dementia, depression, and drug and alcohol addiction. The aim of this study was to subjectively assess mental health status (the severity of non-psychotic symptoms of mental functions and depressive symptoms) in older adults of Bialystok (Poland). METHODS: The study included 300 people - inhabitants of Bialystok and its surrounding areas - aged over 60: 100 residents of a nursing home, 100 senior students of the University of the Third Age in Bialystok, and 100 senior students of the University of a Healthy Senior. Two standardized psychometric scales were used in the study: the General Health Questionnaire (GHQ-28) and the Beck Depression Inventory (BDI). RESULTS: The median GHQ total point value equaled 26 points, which indicated possible non-psychotic mental disorders. The overall BDI score showed that respondents had a subjective feeling of depressive symptom intensification at the level of 11 points out of 63 points, which indicated minor depressive disorders. Positive and statistically significant correlations were observed between suspicion of non-psychotic mental disorders and the occurrence of depressive symptoms both without distribution into groups and with distribution into sex, group affiliation, and age. CONCLUSIONS: Subjective assessment of mental health status in older adults, inhabitants of Bialystok, was negative. Social and demographic characteristics (sex, group affiliation, age) analyzed in the study, played no significant role in the assessment of depressive and non-psychotic mental symptom occurrence. Residents of the nursing home were characterized negatively in terms of subjective assessment mental health status from the other two study groups.

Illness acceptance, pain perception and expectations for physicians of the elderly in Poland.

BACKGROUND: Ageing of society is a significant challenge to public health, both socially and health wise. Adaptation to illness and its acceptance play an important role in control and patients' self-control in many diseases of old age. The right attitude of doctors to patients, especially, geriatric patients determines, among others, a patient's quality of life and acceptance of illness. Recently, there has been observed the rapid development of research on interactions between pain as a physiological process and its perception by an individual. The aim of the study was to evaluate the acceptance of illness, perception of pain and expectations of geriatric patients for physicians among the inhabitants of Bialystok (Poland) over the age of 60. METHODS: The study included 300 people, inhabitants of Bialystok and the surrounding area - aged over 60: 100 elderly residents of a nursing home, 100 students of the University of the Third Age in Bialystok and 100 students of the University of Healthy Senior. The study used three standardised psychometric scales: Patient Request Form (PRF), Acceptance of Illness Scale (AIS) and The Beliefs about Pain Control Questionnaire (BPCQ). RESULTS: The median of the overall score of AIS was 26 points, which is considered average in terms of acceptance of illness. The median value of the influence of internal factors on the control of pain in case of BPCQ scale was generally16 of 30 points, the influence of physicians - 15 of 24 points, while random events - 14 of 24 points. The overall result for PRF scale proved that the respondents were the least expected to look for emotional support (5 of 12 points). It was established that the group affiliation significantly affected the result of AIS (p < 0.001). There was also noted a negative relation between AIS and the search for emotional support (PRF) depending on the group. The higher the AIS value, the lower the score in case of search for emotional support (PRF). CONCLUSIONS: Neither gender nor age played a significant role in acceptance of illness, control of pain or expectations for physicians. The key variable determining the occurrence of dependencies between the studied features was being a part of a group. The elderly residents of the nursing home were negatively distinguished from the other two studied groups. The respondents, in regard to other groups described in the literature, were characterised by relatively high values in illness acceptance, pain control and expectations for physicians.

Improving our understanding of the social determinants of mental health: a data linkage study of mental health records and the 2011 UK census.

OBJECTIVES: To address the lack of individual-level socioeconomic information in electronic healthcare records, we linked the 2011 census of England and Wales to patient records from a large mental healthcare provider. This paper describes the linkage process and methods for mitigating bias due to non-matching. SETTING: South London and Maudsley NHS Foundation Trust (SLaM), a mental healthcare provider in Southeast London. DESIGN: Clinical records from SLaM were supplied to the Office of National Statistics for linkage to the census through a deterministic matching algorithm. We examined clinical (International Classification of Disease-10 diagnosis, history of hospitalisation, frequency of service contact) and socio-demographic (age, gender, ethnicity, deprivation) information recorded in Clinical Record Interactive Search (CRIS) as predictors of linkage success with the 2011 census. To assess and adjust for potential biases caused by non-matching, we evaluated inverse probability weighting for mortality associations. PARTICIPANTS: Individuals of all ages in contact with SLaM up until December 2019 (N=459 374). OUTCOME MEASURES: Likelihood of mental health records' linkage to census. RESULTS: 220 864 (50.4%) records from CRIS linked to the 2011 census. Young adults (prevalence ratio (PR) 0.80, 95% CI 0.80 to 0.81), individuals living in more deprived areas (PR 0.78, 95% CI 0.78 to 0.79) and minority ethnic groups (eg, Black African, PR 0.67, 0.66 to 0.68) were less likely to match to census. After implementing inverse probability weighting, we observed little change in the strength of association between clinical/demographic characteristics and mortality (eg, presence of any psychiatric disorder: unweighted PR 2.66, 95% CI 2.52 to 2.80; weighted PR 2.70, 95% CI 2.56 to 2.84). CONCLUSIONS: Lower response rates to the 2011 census among people with psychiatric disorders may have contributed to lower match rates, a potential concern as the census informs service planning and allocation of resources. Due to its size and unique characteristics, the linked data set will enable novel investigations into the relationship between socioeconomic factors and psychiatric disorders.

Temporal trends in eating disorder and self-harm incidence rates among adolescents and young adults in the UK in the 2 years since onset of the COVID-19 pandemic: a population-based study.

BACKGROUND: Self-harm and eating disorders share multiple risk factors, with onset typically during adolescence or early adulthood. We aimed to examine the incidence rates of these psychopathologies among young people in the UK in the 2 years following onset of the COVID-19 pandemic. METHODS: We conducted a population-based study using the primary care electronic health records of patients aged 10-24 years in the UK Clinical Practice Research Datalink (CPRD). The observation period was from Jan 1, 2010, to March 31, 2022. We calculated the monthly incidence rates of eating disorders and self-harm according to the first record of each outcome. On the basis of antecedent trends between January, 2010, and February, 2020, negative binomial regression models were fitted to predict monthly incidence rates after the pandemic began in March, 2020. Percentage differences between observed and expected incidence were calculated to indicate changes since the onset of the pandemic, with stratification by sex, age, and deprivation quintile. FINDINGS: The primary care health records of 9 184 712 patients aged 10-24 years (4 836 226 [52·7%] female patients and 4 348 486 [47·3%] male patients; n=1881 general practices) were included for analysis. The incidence rates of eating disorders and self-harm among girls were higher than expected between March 1, 2020, and March 31, 2022. The observed incidence of eating disorders was 42·4% (95% CI 25·7-61·3) higher than expected for girls aged 13-16 years, and 32·0% (13·3-53·8) higher than expected for girls aged 17-19 years, whereas other age groups showed little difference between observed and expected incidence. Similarly, the increase in self-harm incidence was driven by girls aged 13-16 years, for whom the observed incidence was 38·4% (20·7-58·5) higher than expected. By contrast, among boys in all age groups, the incidence rates of eating disorders and self-harm were lower than, or close to, the expected rates. Among boys, the observed incidence of eating disorders was 22·8% (9·2-34·4) lower than expected, and the observed incidence of self-harm was 11·5% (3·6-18·7) lower than expected. The estimated increases in eating disorder and self-harm incidence among girls aged 13-16 years were largely attributable to increases within less deprived communities. INTERPRETATION: Although causes are uncertain, increased incidence of eating disorder diagnoses and self-harm among teenage girls in the UK during the first 2 years of the COVID-19 pandemic highlight an urgent need for intervention. Early identification of mental health difficulties by primary care clinicians is necessary. Timely access to treatments and sufficient support from general practitioners and mental health services needs to be available to manage presenting problems and to prevent exacerbations of conditions. FUNDING: National Institute for Health and Care Research.

Management of anxiety disorders among children and adolescents in UK primary care: A cohort study.

BACKGROUND: Anxiety disorders are common in childhood and adolescence but evidence-based guidance on their management is limited in the UK. In the absence of guidelines, we examined what treatment young people with anxiety disorders receive in primary care in the year following diagnosis. METHOD: We delineated a cohort of individuals diagnosed with anxiety disorders aged 10-18 using the Clinical Practice Research Datalink (CPRD). We estimated the annual prevalence of antidepressant and anxiolytic prescribing and referrals to mental health services in the year following diagnosis between 2003 and 2019 via Poisson models, adjusted for age, gender, and practice-level deprivation. RESULTS: 34,490 out of 52,358 (66 %) individuals were not prescribed or referred in the year following diagnosis. Those registered to practices in the most deprived compared to the least deprived areas were less likely to be referred (PR 0.80, 95%CI 0.76-0.84) and prescribed antidepressants (PR 0.77, 95%CI 0.72-0.82). Referrals increased 2003-2008 (22-28 %) and then declined until 2019 (28-21 %). Antidepressant prescribing decreased substantially between 2003 and 2005 (18-11 %) and then increased slightly between 2006 and 2019 (11-13 %). Anxiolytic prescribing declined between 2003 and 2019 (10-2 %). LIMITATIONS: Prescriptions in the CPRD are not coupled with information about indication. Some prescriptions may therefore have been incorrectly attributed to the treatment of anxiety disorders. CONCLUSION: The continued use of antidepressants necessitates the development of evidence-based guidance. The lower likelihood of being prescribed medication and/or referred among young people in more deprived practice populations, where incidence of anxiety disorder and other mental illnesses is higher, must also be investigated and rectified.

Mental Health of the Participants of the Third Age University Program: A Cross-Sectional Study.

INTRODUCTION: Population aging is a progressive demographic phenomenon observed in all countries worldwide. The progressive global process of population aging poses many threats, especially in the context of the mental health of the elderly. Third Age Universities are an essential preventive measure shown to improve the quality of life and psychological wellbeing of the elderly. OBJECTIVES: The aim of this study was to analyze the mental status of older persons attending Third Age Universities in Poland, with particular emphasis on sociodemographic sources of variance in psychological indices. METHODS: The study included a group of the Third Age University program participants from Poland. A total of 247 persons were enrolled, among them 215 women and 32 men. The study was carried out as a diagnostic survey, using the following validated psychometric scales: The Mood Disorder Questionnaire (MDQ), Geriatric Depression Scale (GDS), General Health Questionnaire-28 (GHQ-28), The Athens Insomnia Scale (AIS), Courtauld Emotional Control Scale (CECS), State-Trait Anxiety Inventory (STAI) and SMAST-G-Short Michigan Alcoholism Screening Test-Geriatric Version. RESULTS: The vast majority of the respondents did not screen positively for possible bipolar disorder. However, more than 90% of the participants presented with the symptoms of mild depression, and more than one-third had manifestations of non-psychotic mental morbidity. Nearly half of the respondents had complaints associated with insomnia, and in more than one-fourth, SMAST-G score raised suspicion of problem alcohol drinking. Retired participants were shown to present with significantly higher levels of anger control than the occupationally active respondents. Respondents with poor economic status had significantly higher levels of symptoms for non-psychotic mental disorders. Men significantly more often than women showed symptoms raising suspicion of alcohol-related problems. DISCUSSION: In conclusion, the study group was characterized primarily by the mild depressive and anxiety symptoms. The mental health of the Polish participants of the Third Age University program was significantly modulated by their socio-occupational and marital status, and financial condition. The study showed that persons with likely problem alcohol drinking differed from other respondents in terms of the occurrence of possible bipolar disorder, depression, and non-psychotic symptoms of mental disorders, state and trait anxiety levels and anger control. There is a need for further research in the field of mental health status in the Third Age Universities seniors to determine the prevalence of these phenomena on a national scale.

Pain Perception and Acceptance of Illness in Patients Undergoing Phacoemulsification Cataract Surgery under Drip Anesthesia.

For many years, cataracts have been the main cause of vision loss and vision impairments in the world (43% and 33%, respectively). Currently, the most common surgical method for treating cataracts is phacoemulsification. The aim of this study was to assess the pain perception and acceptance of illness connected with awaiting phacoemulsification cataract surgery under intravenous drip anesthesia, as well as to determine the effect of selected sociodemographic factors on the above. METHODS: The study was conducted in a group of patients of the Department of Ophthalmology, University Clinical Hospital in Bialystok, Poland suffering from cataracts, who underwent phacoemulsification surgery under intravenous drip anesthesia. The study group consisted of 151 people. The study used an original short questionnaire and three standardized psychometric scales: The acceptance of illness scale (AIS), the Beliefs about Pain Control Questionnaire (BPCQ), and the Coping Strategies Questionnaire (CSQ). RESULTS: The median overall AIS point value was 24 points, which is considered an average score in terms of disease acceptance. Respondents assessed the influence of individual factors on the level of perceived pain and the impact of individual strategies for coping with pain similarly. The level of perceived pain decreased with the patient's age. People with a higher education level experienced a greater level of pain; however, this relationship was not statistically significant. The place of residence did not affect the level of pain experienced during the procedure. Women had a greater level of acceptance of illness. The respondents' education level negligibly differentiated the approach to the disease. The place of residence also did not affect the assessment of illness acceptance as measured by the AIS. Whether the surgery pertained to the first or second eye did not significantly affect the approach to the disease. CONCLUSIONS: The level of acceptance of illness and pain perception were at a moderate level among the patients. The acceptance of illness was significantly influenced by the age of patients and the waiting period for phacoemulsification, and this level of acceptance decreased significantly with the increasing age of patients. The longer the waiting period for surgery, the lower the acceptance of illness. Sex significantly differentiated the level of pain experienced during the procedure. Education and place of residence did not significantly affect the acceptance of illness and the feeling of pain.

Framing effect, probability distortion, and gambling tendency without feedback are resistant to two nights of experimental sleep restriction.

Several studies suggest that sleep deprivation affects risky decision making. However, most of these are confounded by feedback given after each decision, indicating that decisions may be based on suboptimal feedback-learning rather than risk evaluation. Furthermore, few studies have investigated the effect of sleep loss on aspects of prospect theory, specifically the framing effect and probability distortion. In this within-subjects design, 25 people had (i) two nights of an 8 h sleep opportunity, and (ii) two nights of a 4 h sleep opportunity, in a counter-balanced order. Following the two nights, they performed a gambling task with no immediate feedback; for each round, they could either gamble for a full amount, or take a settlement framed as a gain or a loss for part of the amount. Sleep restriction did not significantly affect the tendency to gamble, the framing effect, or probability distortion, as compared to normal sleep. These results indicate that two nights of sleep restriction affects neither general gambling tendency, nor two of the main predictions of prospect theory. This resilience may be due to a less extreme sleep loss than in previous studies, but also indicates that learning components and risk biases should be separated when assessing the effect of sleep loss on risky behaviour.

Preferences and attitudes of older adults of Bialystok, Poland toward the use of over-the-counter drugs.

PURPOSE: The aim of the study was to assess preferences and attitudes toward the use of over-the-counter (OTC) drugs among residents of Bialystok aged 60 or older. PATIENTS AND METHODS: The study included 170 people, inhabitants of Bialystok aged over 60: 85 students of the University of a Healthy Senior and the University of Psychogeriatric Prophylaxis, and 85 students of the University of the Third Age in Bialystok. The study made use of a diagnostic survey conducted via a questionnaire prepared by the authors. RESULTS: The vast majority of respondents bought OTC drugs for own use. About one-third of the respondents from each analyzed group bought OTC drugs less often than once every 3 months. Over half of the respondents bought OTC drugs due to a cold. A majority of the respondents were of the opinion that OTC drugs should be sold only in pharmacies. Over 40% of seniors took 1 OTC drug regularly. Most respondents also took vitamins and supplements. The main sources of information on OTC drugs for the studied seniors were their doctor and pharmacist. Respondents did not always consult the treatment method with a doctor or pharmacist. Over half of the respondents familiarized themselves with the contents of the OTC drug package leaflet. Over three-quarters of the respondents were familiar with drug disposal methods; however, despite declarations of being familiar with these principles, a significant percentage did not bring back medication to a pharmacy or clinic, or threw the drugs into the trash. CONCLUSION: Our study found that in our sample there were many OTC drug consumers who did not always demonstrate responsible attitudes toward using this group of drugs. Thus, older people should be educated on the possible adverse effects of taking OTC drugs without consulting a doctor or pharmacist as well as basic drug disposal principles. Furthermore, legislation should be introduced that will limit the wide availability of OTC drugs, particularly to the elderly; and thus, lower the costs of hospitalization and outpatient treatment of this age group. Also, a wider-reaching study should be conducted. It should include a larger group of elderly people as well as information on intake of prescribed medications in order to be able to determine the frequency of drug consumption in this population, as well as seniors' preferences and attitudes in this regard.

Sexual Quality of Life, Sexual Knowledge, and Attitudes of Older Adults on the Example of Inhabitants Over 60s of Bialystok, Poland.

Introduction: Aging has a strong influence on the quality of relationships and sexual functioning, but in itself does not cause a lack of sexual desire. Objectives: The aim of this study was to assess the quality of sexual life and define sexual knowledge and attitudes of older people on the example of residents of Bialystok, Poland at the age of 60 and over. Methods: The study included 170 people, inhabitants of Bialystok, Poland aged over 60: 85 students of the University of Healthy Senior and the University of Psychogeriatric Prophylaxis and 85 students of the University of the Third Age. The study used three standardized psychometric scales: Sexual Quality of Life Questionnaire-Male (SQoL-M), Sexual Quality of Life Questionnaire-Female (SQoL-F), and Aging Sexual Knowledge and Attitudes Scale (ASKAS). Results: The overall mean score for the ASKAS scale for knowledge was 65.21 ± 12.32 and for attitudes -124.65 ± 22.00. The overall mean SQOL score was 62.92 ± 18.18. Taking into account the gender of the respondents, the knowledge of men on sexuality of seniors was at the level of 63.48 ± 12.63, while in the female group -65.74 ± 12.23. The attitudes of men on sexuality of seniors was at the level of 128.80 ± 21.56, while in the female group -123.38 ± 22.05. Satisfaction with sex life among men (72.36 ± 27.49) was significantly higher than among women (60.02 ± 12.88). Discussion: The seniors were characterized by moderate knowledge and attitudes to sexuality of older people and the average level of sexual satisfaction. There was no significant relationship between knowledge on sexuality and sexual satisfaction in the study groups, and there was a positive correlation between attitudes toward sexuality and the satisfaction of sex life outside the group of men. In addition, a significant positive relationship was found between attitudes toward sexuality and sexual satisfaction. In order to improve the knowledge of senior citizens about sexuality of old age and to overcome the taboos that are prevalent in this topic, a structured training should be provided in this field. Such training should be carried out by specialists in the field of sexology. It is desirable to conduct in-depth studies in the assessment of knowledge, attitudes, and quality of sexual life in a larger research group, in order to get results for the population of the whole country.

The level of emotion control, anxiety, and self-efficacy in the elderly in Bialystok, Poland.

PURPOSE: The aim of the study was to assess the level of emotion control, anxiety, and self-efficacy in the inhabitants of Bialystok (Poland) aged above 60. PATIENTS AND METHODS: The study included 300 people above the age of 60, inhabitants of Bialystok and its neighborhoods: 100 residents of public nursing home, 100 participants of the University of the Third Age in Bialystok, and 100 students of the University of Healthy Senior. The three standardized psychometric scales were used in the study: Courtauld Emotional Control Scale (CECS), State-Trait Anxiety Inventory (STAI), and General Self-Efficacy Scale (GSES). RESULTS: The median of the overall score of CECS equaled 54 points, which is considered average in terms of negative emotions acceptance. The mean score of perceiving anxiety as the condition of STAI (X1) was 48 points, while anxiety as a trait of STAI (X2) was 49 points. The overall score for GSES proved that respondents had a subjective feeling of self-efficacy at the level of 29 points out of 40 points possible, which means that their self-efficacy was rather at the high level in their self-assessment. In women, a negative correlation was revealed between the sense of self-efficacy and age (r=-0.320, P<0.001). Analyzing the study group affiliation of respondents, a negative correlation was reported between the sense of self-efficacy and age among the elderly residents of public nursing home (r=-0.408, P<0.001). Taking into consideration the study group affiliation of respondents, a positive correlation between anger control (CECS) and the sense of anxiety as a trait of STAI (X2) was found among participants of the University of Healthy Senior (r=0.307, P=0.002). CONCLUSION: The social and demographic features (gender, group affiliation, age) analyzed in the study were found to be correlated significantly with the control of negative emotions, the level of anxiety, and self-efficacy. The study group affiliation was a key variable conditioning the relations between the analyzed features. The elderly residents of public nursing home belonged to the group distinguishing negatively compared to other two study groups. The study respondents were characterized by the relatively high perception of anxiety, which may be as a result of the health and social problem present in this age group. In order to improve the quality of life, the study population should reduce level of perceived anxiety and increase the control of negative emotions and self-efficacy by social integration of seniors. The study scores in the scale of CECS, STAI, and GSES do not deviate from the world norms obtained by other researchers in the rest of the world.

Improving transparency and reproducibility through registration: The status of intervention trials published in clinical psychology journals.

OBJECTIVE: Prospective registration increases the validity of randomized controlled trials (RCTs). In the United States, registration is a legal requirement for drugs and devices regulated by the Food and Drug Administration (FDA), and many biomedical journals refuse to publish trials that are not registered. Trials in clinical psychology have not been subject to these requirements; it is unknown to what extent they are registered. METHOD: We searched the 25 highest-impact clinical psychology journals that published at least 1 RCT of a health-related psychological intervention in 2013. For included trials, we evaluated their registration status (prospective, retrospective, not registered) and the completeness of their outcome definitions. RESULTS: We identified 163 articles that reported 165 RCTs; 73 (44%) RCTs were registered, of which only 25 (15%) were registered prospectively. Of registered RCTs, only 42 (58%) indicated their registration status in the publication. Only 2 (1% of all trials) were registered prospectively and defined their primary outcomes completely. For the primary outcome(s), 72 (99%) of all registrations defined the domain, 67 (92%) the time frame, and 48 (66%) the specific measurements. Only 19 (26%) and 5 (7%) defined the specific metric and method of aggregation, respectively, for all primary outcomes. CONCLUSIONS: Very few reports of RCTs published in clinical psychology journals were registered prospectively and completely. Clinical psychology journals could improve transparency and reproducibility, as well as reduce bias, by requiring complete prospective trial registration for publication and by including trial registration numbers in all reports of RCTs. (PsycINFO Database Record