Quality of Life Predictors in a Group of Informal Caregivers during the COVID-19 Pandemic.

Background and Objectives: The informal caregiver's contribution to the wellbeing of dementia patients is critical since these individuals become dependent on others for all daily activities. Our goal was to investigate the dynamics of anxiety, depression, burnout, sleep, and their influence on quality of life over a 6-month period in the context of pandemic distress in a sample of informal caregivers of Alzheimer's patients. Materials and Methods: For this prospective, longitudinal study, we conducted a 6-month telephonic survey between 2021 and 2022, administering a series of questionnaires at three timepoints (baseline, 3 months and 6 months) to a group of informal caregivers of patients suffering from dementia due to Alzheimer's disease. Results: A total of 110 caregivers were included at baseline, out of which 96 continued to the second stage and 78 followed through to the last stage. The majority of the participants were female (most likely the patients' daughters), around 55 years old, living in urban areas, married, with children, having a high school degree or a higher education degree, and working in jobs that required physical presence; in the best-case scenario, they were sharing their responsibilities with another two-three caregivers. More than half of the 110 participants (50.9%) reported mild to moderate anxiety at baseline, and 27.3% reported significant anxiety, with no changes between the three timepoints, F(2, 154) = 0.551, p = 0.57; 25% reported moderate-severe depression at the start, with no changes between the three timepoints, F(2, 154) = 2.738, p = 0.068; and many reported a decrease in quality of life, poor quality of sleep, and decreased fear of COVID infection. Cynicism, professional effectiveness, anxiety, depression, and sleep quality explained up to 87.8% of the variance in quality of life. Conclusions: Caregivers' decreased quality of life during the pandemic was explained by their levels of burnout, anxiety, and depression throughout the 6-month period.

Somatic Symptoms and Sleep Disorders: A Literature Review of Their Relationship, Comorbidities and Treatment.

This study aimed to investigate the relationship between somatic symptom disorder (SSD) and sleep disorders, following three research questions: (1) How are these disorders correlated? (2) What are the comorbidities reported in these patients? and (3) What are the most effective pharmacological and non-pharmacological treatments for both conditions? PubMed, Scopus, OVID, Medline, and ProQuest databases were searched for relevant articles published between 1957-2020. Search terms included "somatic symptoms disorder", "sleep disorders", "insomnia", "somatoform", "somatization", "therapeutic", "psychotherapy", and alternative, formerly used terms for SSD. Forty papers were finally included in the study. Prevalence of insomnia in SSD patients ranged between 20.4-48%, with this being strongly correlated to somatic symptoms and psychosocial disability. The most relevant comorbidities were generalized anxiety disorder, depression, fatigue, negative mood, substance use, orthorexia, alexithymia, anorexia, weight loss, poor eating habits, and acute stress disorder. Patients receiving antidepressant therapy reported significant improvements in insomnia and somatic symptoms. In terms of non-pharmacological interventions, cognitive-behavioral therapy (CBT) showed improvements in sleep outcomes, while the Specialized Treatment for Severe Bodily Distress Syndromes (STreSS) may represent an additional promising option. Future research could include other medical and psychosocial variables to complete the picture of the relationship between sleep disorders and somatic symptoms.

Meaning in Life, Subjective Well-Being, Happiness and Coping at Physicians Attending Balint Groups: A Cross-Sectional Study.

This study aimed to measure the scores of well-being, subjective happiness, sense of meaning, and coping in Romanian physicians and the potential impact on them of systematically attending Balint groups. Eighty participants (33 men, 47 women, mean age 38.90, SD 9.73) were included in the study. From them, 43 had systematically attended a Balint group in the last two years, while the others represented the controls. All participants were administered the Meaning of Life Questionnaire, the Job-related Affective Well-being Scale, the Brief COPE Scale, and the Subjective Happiness Scale. t-tests and MANOVA were used to compare the group scores and the impact of Balint training on the study variables. Results showed that Balintian participants had a lower use of denial and self-blame and were more oriented towards the seeking of emotional and instrumental support. They also reported higher scores in high pleasurable-low arousal emotions, positive emotions, and in the perception of the presence of meaning. Still, when considering other additional predictors (gender, age), the distinct impact of Balint training remained limited to the preference for certain coping mechanisms. These results could stimulate the use of Balint groups as a tool for the physician's formation programs.

Clinical Validity of Subjective Clinical Prognosis in First Episode Psychosis Schizophrenia Patients: An Analysis of Data from the European First Episode Schizophrenia Trial (EUFEST) Study.

PURPOSE: This study examined the validity of subjective clinical prognosis (SCP), a commonly used clinical tool, in first episode psychosis patients included in the European First Episode Schizophrenia Trial (EUFEST) study. PATIENTS AND METHODS: The study comprised 455 patients from the EUFEST trial (mean age 25.92, SD=5.45; 188 (41.31%) women, 267 (58.69%) men). SCP was classified into three mutually exclusive groups: "good prognosis" (GP) (n=265), "average prognosis" (AP) (n=131), and "poor prognosis" (PP) (n=59). The validity of the SCP was assessed by investigating the differences between the SCP groups and completer or responder status of the patients, during 1 year of the trial. RESULTS: The proportion of completers was significantly higher in the GP group (64.4%) compared to the AP group (25.6%) (OR=1.62, 95% CI=1.062-2.476, p<0.031) and the PP group (10%) (OR=2.17, 95% CI=1.226-3.853, p<0.009) throughout the whole duration of the trial. In what concerns responsiveness, a significantly higher number of responders were registered in the GP group compared to the AP and the PP groups in the first three months of treatment, but this outcome did not persist afterwards. CONCLUSION: In terms of its predictive value at first episode schizophrenic patients, SCP seems to be reliable for treatment completion, but has a limited utility in what concerns responsiveness to treatment. This finding suggests the necessity of creating a prediction model potentially including, besides SCP, other measurement-based variables.

Role of stress in modulation of skin neurogenic inflammation.

There are complex interconnections between the nervous system and the skin highlighted by the impact of stress and neuroendocrine factors on various dermatological conditions. We investigated the influence of stress on skin neurogenic inflammation induced by capsaicin. A total of 31 healthy subjects were randomized into two groups: subjects in the stress group underwent a stress-inducing protocol and those in the control group were exposed to indifferent conditions. Subsequently, topical capsaicin cream was administered on the non-dominant anterior forearm of each subject from the two groups. The assessment of the local inflammatory reaction induced by capsaicin was performed by thermography at 25 and 40 min post-application. In both groups the inflammatory reaction induced by capsaicin was evidenced at 25 min and was maintained at 40 min post-application. However, at 40 min post-application the hyperthermal area was larger in subjects from the stress group, suggesting that stress exposure is associated with an amplification of the mechanisms involved in capsaicin-induced skin neurogenic inflammation.