OBJECTIVES: To depict overall psychological well-being of a large group of students of different universities in Ukraine three months after the emerge of the full-scale war. METHODS: A total of 1,142 participants were asked to measure their psychological well-being on a 0-10 scale before and after the onset of full-scale war. Mental health symptoms were measured with questionnaires targeting depression (PHQ-9), anxiety (GAD-7), sleep problems (ISI), eating disorders (SCOFF), alcohol abuse (CAGE), and PTSD symptoms (PC-PTSD-5). To evaluate the connection between variables a χ2 was conducted. Phi and Cramer's V coefficient were stated to demonstrate the power of the relationships. Additionally, machine learning (the XGBoost regression model) was used to build a predictive model for depressive symptoms. RESULTS: Of all respondents, 66% screened positive for PTSD symptoms, 45% - moderate and severe anxiety symptoms, 47% - moderate and severe depressive symptoms. Regarding sleep, alcohol use and eating behavior, 19% of surveyed students had signs of moderate and severe insomnia, 15% reported alcohol abuse and 31% disordered eating. The severity of the aforementioned disorders varied depending on gender, year of study, social status, etc. According to the predictive model, lower initial psychological well-being, female gender, younger age, first years of study and any traumatic experience, including multiple trauma, predicted increases in depression score. Return to home after relocation was a protective factor. CONCLUSIONS: The study demonstrated the high prevalence of mental health symptoms among university students in Ukraine during the first months of the full-scale war. The psychological well-being pre-war was the strongest predictor of depressive symptoms in the model.
Stress Disorders, Post-Traumatic , Students , Humans , Female , Ukraine/epidemiology , Male , Students/psychology , Students/statistics & numerical data , Adult , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Young Adult , Mental Health/statistics & numerical data , Depression/epidemiology , Depression/psychology , Anxiety/epidemiology , Anxiety/psychology , Surveys and Questionnaires , Psychological Well-Being
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BACKGROUND: Cross-sectional network analysis examines the relationships between symptoms to explain how they constitute disorders. Up to now, research focuses mostly on depression, posttraumatic stress disorder, and rarely assesses larger networks of various symptoms measured with instruments independent of classifications. Studies on large groups of psychotherapy patients are also rare. METHODS: Analyzing triangulated maximally filtered graph (TMFG) networks of 62 psychological symptoms reported by 4616 consecutive nonpsychotic adults in 1980-2015. RESULTS: Case-dropping and nonparametric bootstrap proved the accuracy, stability and reliability of networks in patients' sex-, age-, and time of visit divided subgroups. Feeling that others are prejudiced against the patient was the most central symptom, followed by catastrophic fears, feeling inferior and underestimated. Sadness, panic, and sex-related complaints were less central than we expected. All analysed symptoms were connected, and we found only small sex-related differences between subsamples' networks. No differences were observed for time of visit and age of patients. LIMITATION: Analyses were cross-sectional and retrospective, not allowing examination of directionality or causality. Further, data are at the between-person level; thus, it is unknown whether the network remains constant for any person over time. One self-report checklist and building binary network method may bias results. Our results indicate how symptoms co-occured before psychotherapy, not longitudinally. Our sample included public university hospital patients, all White-Europeans, predominantly females and university students. CONCLUSIONS: Hostile projection, catastrophic fears, feeling inferior and underestimated were the most important psychological phenomena reported before psychotherapy. Exploring these symptoms would possibly lead to enhancement of treatments.
Anxiety , Psychotherapy , Adult , Female , Humans , Male , Reproducibility of Results , Retrospective Studies , Psychotherapy/methods , Personality Disorders
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OBJECTIVES: To identify the set of symptoms most frequently co-occurring with hypochondriacal complaints in patients with neurotic or personality disorders. METHODS: Nonparametric Spearman rank correlations between the variables of symptom checklist "O" describing hypochondriacal symptoms and other symptoms were analyzed. To increase the reliability of the results, the analyses were performed independently in two groups: 3,929 patients before admission to a day hospital in the years 1980-2002 (group A) and 3,190 patients before admission in the years 2004-2015 (group B). RESULTS: For selected groups of patients, lists of correlation coefficients were obtained showing the most important (strongest) and statistically significant associations between five hypochondriacal symptoms and somatization symptoms coming from the muscular system, breathlessness, symptoms coming from the cardiovascular system, anxiety symptoms, and compulsive thoughts without specific content. CONCLUSIONS: The multidimensional nature of hypochondriacal complaints and their association with somatization symptoms similar to infection or inflammation were confirmed. Apart from the fears about patient's own health, fears about close relatives are also an important symptom, to which clinical attention should be paid.
Fear , Hospitalization , Humans , Reproducibility of Results , Inflammation , Personality Disorders , Hypochondriasis/diagnosis
The topic of this review is the clinical usefulness of techniques involving controlled breathing, based on Eastern traditions, aimed at restoring autonomic balance in psychiatry. Although these techniques have a long tradition as "relaxation methods", they gain additional meaning in the context of prolonged stress resulting from the ongoing COVID-19 pandemic. This review, however, is not limited to the pandemic; it also focuses on recent findings regarding clinical populations and provides basic information on the biological mechanisms of respiration and related markers (respiratory rate - RR and heart rate variability - HRV) and their use as effect indicators in research on the population of patients with mental disorders. On the basis of the available data from empirical studies and previous systematic and narrative reviews, it is possible to indicate the possible benefits of using techniques based on controlled breathing as a complementary method in the treatment of a number of mental health disorders. Possible side effects associated with the proposed techniques are also discussed.
COVID-19 , Psychiatry , Humans , Pandemics , Respiration , Autonomic Nervous System
Background: Psychopathology theory and clinical practice require the most complex knowledge about patients' complaints. In patients seeking for psychotherapy, body-related symptoms often complicate treatment. Aim: This study aimed at examining connections between body-related symptoms, and identification of symptoms which may be responsible for emergency and sustaining of anxiety, somatoform and personality disorders with the use of network analysis. Methods: In our retrospective research we used data from a sample of 4616 patients of the Department of Psychotherapy, University Hospital in Cracow, diagnosed with anxiety, somatoform or personality disorders. We constructed the Triangulated Maximally Filtered Graph (TMFG) networks of 44 somatoform symptoms endorsed in the symptom checklist "O" (SCL-O) and identified the most central symptoms within the network for all patients and in subgroups of women vs. men, older vs. younger, and diagnosed in 1980-2000 vs. 2000-2015. We used bootstrap to determine the accuracy and stability of five networks' parameters: strength, expected influence, eigenvector, bridge strength and hybrid centrality. Results: The most central symptoms within the overall network, and in six subnetworks were dyspnea and migratory pains. We identified some gender-related differences, but no differences were observed for the age and time of diagnosis. Conclusions: Self-reported dyspnea and migratory pains are potential important targets for treatment procedures.
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Objective: There has been a growing interest in examining why some individuals adapt and bounce back from multimorbidity (resilience) better than others. This paper investigates the positive role of protective health behaviors on multimorbidity resilience (MR) among older adults focusing on older persons with two or more concurrent chronic conditions, and separately for three multimorbidity chronic illness clusters. Methods: Using Baseline and Follow-up One data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 10,628 participants aged 65 years and older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: Cardiovascular/metabolic, Musculoskeletal, and Mental health. Associations between health behaviors and MR were evaluated using Linear Mixed Models, adjusting for socio-demographic, social/environmental, and illness context social determinants of health. Results: Among older adults with two or more illnesses, smoking, satisfaction with sleep, appetite, and skipping meals were associated with MR in the expected direction. Also, obesity (compared to normal weight) and skipping meals showed longitudinal interaction effects with survey wave. Most of the results were replicated for the physical multimorbidity clusters (Cardiovascular/metabolic and Musculoskeletal) compared to the full 2+ multimorbidity analyses; however, for the Mental health cluster, only satisfaction with sleep was supported as a lifestyle predictor of MR. Discussion: Several modifiable health behaviors identified in the broader health and aging literature are important in affecting levels of multimorbidity resilience in older age. These factors are important strength-based areas to target. Additionally, several social determinants of health are also supported and parallel research on multimorbidity risk. The effects of lifestyle factors for resilience among older adults is dependent on the type of multimorbidity measured. We conclude that the results have significant public health, program intervention, and clinical implications for healthy aging among persons coping with multimorbidity.
Health Behavior , Multimorbidity , Aged , Aged, 80 and over , Canada/epidemiology , Chronic Disease , Humans , Longitudinal Studies
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OBJECTIVES: A link between sexual functioning and depression has been reported. However, it is still unknown whether lower urinary tract symptoms (LUTS) coexist or correlate with sexual dysfunction (SD) in depressed individuals. Depressed patients represent a unique population because of a possible bidirectional relationship between SD and depression and between LUTS and depression. Thus, the aim of this study was to investigate relationships between depression severity, SD and LUTS for patients with depression. METHODS: In this cross-sectional study, we analyzed data on depression, sexual functioning and LUTS from depressed patients who were treated in our department of adult psychiatry. Data were obtained from the Hamilton Rating Scale for Depression, the International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), and the International Prostate Symptom Score (IPSS). RESULTS: We included one hundred two patients diagnosed with, and treated for, depression. The participants reported a high overall prevalence of SD (60.8%), and SD correlated with depression severity. LUTS were also highly prevalent with 86% of the participants reporting at least mild LUTS severity. Despite coexistence of LUTS and SD in multiple patients, we did not find a statistically significant relationship between LUTS and SD in our cohort. CONCLUSIONS: In our exclusive group of individuals diagnosed with, and treated for, depression, depression severity had a negative effect on sexual functioning. Although there was no statistically significant relationship between LUTS and SD, they coexisted in multiple patients. Therefore, LUTS and SD should still be systematically assessed in patients with depression.
Erectile Dysfunction , Lower Urinary Tract Symptoms , Sexual Dysfunction, Physiological , Adult , Cross-Sectional Studies , Depression/epidemiology , Erectile Dysfunction/complications , Erectile Dysfunction/epidemiology , Female , Humans , Lower Urinary Tract Symptoms/complications , Lower Urinary Tract Symptoms/epidemiology , Male , Sexual Dysfunction, Physiological/complications
Drawing on multidisciplinary research focusing on a spectrum ranging from individual experience to structural system-level risk response and resilience, this article develops a rationale for a Unified Model of Resilience and Aging (UMRA). In response to a broad range of adversities associated with aging, it details the ways in which some individuals are able to bounce back better than others, or adapt better than expected, termed resilience. However, resilience and aging theoretical models have developed out of different disciplinary developments, ranging from individual levels to structural level complex systems, including several gerontological theoretical models addressing adaptation to life course and aging processes. The article reviews and synthesizes prior conceptual and theoretical work, and their empirical groundings, in order to develop an integrated resilience model with wide applications to aging-related problems including chronic illness, mental health, widowhood, poverty, caregiving burden, etc. The article focuses specifically on COVID-19 pandemic risk, response and resilience in order to specify applications of the UMRA, and to suggest avenues for future research and testing of theoretical axioms.
COVID-19 , Resilience, Psychological , Aging/psychology , Humans , Mental Health , Pandemics
Strategic purchasing is a popular and frequently proposed policy for improving the efficiency and adaptiveness of health systems. The COVID-19 pandemic shocked health systems, creating a test of the adaptability and resiliency of their key features. This research study explores (i) what role purchasing systems and agents played in the COVID-19 pandemic, (ii) if it was strategic, and (iii) how it has contributed to a resilient health system. We conducted a qualitative, comparative study of six countries in the European Union-focusing on three as in-depth case studies-to understand how and when strategic purchasers responded to seven clearly defined health system "shocks" that they all experienced during the pandemic. We found that every case country relied on the federal government to fund and respond to the pandemic. Purchasers often had very limited, and if any then only passive, roles.
COVID-19 , Europe/epidemiology , Government Programs , Humans , Pandemics/prevention & control , Qualitative Research
BACKGROUND: Breathing difficulties are present in different medical conditions, yet seem to be underresearched in psychiatric patients. AIM: Assessment of prevalence of dyspnea complaints and their associations with personality traits in patients with neurotic or personality disorders referred to psychotherapy. METHODS: Retrospective chart review of medical records of 2450 patients with diagnoses F4-F6 (ICD-10). Analyses of associations between dyspnea reported in a symptom checklist SCL-O and pathological scores in the Neurotic Personality Questionnaire were carried out using univariate and multivariate regression analyses with ORs and 95%CI estimated with licensed STATISTICA 13 (StatSoftPL) software, and R version 4.1.0, RStudio version 1.4.1717 software. RESULTS: Dyspnea was reported by 46.3% women and 36.6% men (14.5% and 10.1% respectively assessed it as severely burdensome). Univariate regression analysis revealed several significant associations between reporting dyspnea or its extreme intensity and pathological scores in the NPQ. Multivariate regression analyses in women confirmed the importance of impulsiveness and exaltation for dyspnea occurrence, and feeling of being dependent on the environment, demobilization, and narcissistic attitude for its extreme intensity. In men impulsiveness, sense of being in danger, irrationality, and ponderings were associated with the presence of dyspnea, and sense of being in danger and envy with its extreme intensity. CONCLUSIONS: Complaints of dyspnea were pretty frequent. Several personality traits measured by the NPQ questionnaire were predictors of their occurrence and feeling of extreme burden.
Neurotic Disorders , Psychotherapy, Psychodynamic , Dyspnea/epidemiology , Female , Hospitals , Humans , Male , Neurotic Disorders/epidemiology , Neurotic Disorders/psychology , Personality , Retrospective Studies , Treatment Outcome
