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1.
Int. j. clin. health psychol. (Internet) ; 23(1): 1-16, ene.-abr. 2023. ilus, tab, graf
Artículo en Inglés | IBECS | ID: ibc-213100

RESUMEN

Background/Objective: Anxiety disorders are highly prevalent and negatively impact daily functioning and quality of life. Transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (dlPFC), especially in the right hemisphere impacts extinction learning; however, the underlying neural mechanisms are elusive. Therefore, we aimed to investigate the effects of cathodal tDCS stimulation to the right dlPFC on neural activity and connectivity patterns during delayed fear extinction in healthy participants. Methods: We conducted a two-day fear conditioning and extinction procedure. On the first day, we collected fear-related self-reports, clinical questionnaires, and skin conductance responses during fear acquisition. On the second day, participants in the tDCS group (n = 16) received 20-min offline tDCS before fMRI and then completed the fear extinction session during fMRI. Participants in the control group (n = 18) skipped tDCS and directly underwent fMRI to complete the fear extinction procedure. Whole-brain searchlight classification and resting-state functional connectivity analyses were performed. Results: Whole-brain searchlight classification during fear extinction showed higher classification accuracy of threat and safe cues in the left anterior dorsal and ventral insulae and hippocampus in the tDCS group than in the control group. Functional connectivity derived from the insula with the dlPFC, ventromedial prefrontal cortex, and inferior parietal lobule was increased after tDCS. Conclusion: tDCS over the right dlPFC may function as a primer for information exchange among distally connected areas, thereby increasing stimulus discrimination. The current study did not include a sham group, and one participant of the control group was not randomized. Therefore, to address potential allocation bias, findings should be confirmed in the future with a fully randomized and sham controlled study. (AU)


Asunto(s)
Humanos , Estimulación Transcraneal de Corriente Directa , Trastornos de Ansiedad , Corteza Prefrontal , Autoinforme , Encuestas y Cuestionarios
2.
Rev. psicol. clín. niños adolesc ; 10(1): 31-41, Enero 2023. tab, graf
Artículo en Inglés | IBECS | ID: ibc-214142

RESUMEN

Anxiety disorders are highly prevalent in children and adolescents. The associated functional limitations and the negative psychological consequences have led to increased research into effective psychological interventions. What is missing, however, is a comprehensive review of the literatureaddressing the effectiveness of these treatments for specific disorders. A systematic review of systematic reviews and meta-analyses evaluating theeffectiveness of psychological treatments for specific anxiety disorders in children and adolescents was performed. The study followed PRISMAguidelines. Four bibliographic databases were searched: MEDLINE (PubMed), PsycINFO, Web of Science (Core Collection), and The CochraneLibrary. Two authors independently screened the articles by title, abstract, and full-text, according to established inclusion and exclusion criteria.Two independent authors evaluated the methodological quality of the included reviews using AMSTAR-2. Five records were included in this systematic review. Four studies included children and adolescents with specific phobias, generalized anxiety disorder, and separation anxiety disorderand one focused solely on nocturnal fears. Cognitive behavioral therapy-based interventions have been shown to be effective for the treatment ofthese diagnoses in both short and long term. The methodological quality of the included studies was classified as critically low. Cognitive behavioralinterventions are effective in treating specific phobias, generalized anxiety disorder, and separation anxiety disorder and nighttime fears in childrenand adolescents. The improvement of the methodological quality and the need for further studies focusing on the effectiveness of treatments forspecific disorders are discussed. (AU)


Los trastornos de ansiedad son muy comunes en la infancia y adolescencia y repercuten negativamente enla vida del niño y la familia. Pese al aumento en el número de investigaciones centradas en estudiar la eficacia de las intervenciones psicológicas,hasta la fecha no se ha llevado a cabo una síntesis que haya dado cuenta de la eficacia de estas intervenciones para cada uno de los trastornosde ansiedad de manera específica. Se realizó una revisión sistemática de revisiones sistemáticas y metaanálisis. Se realizaron búsquedas en cuatrobases de datos: MEDLINE (PubMed), PsycINFO, Web of Science (colección principal) y The Cochrane Library. Dos autores examinaron de formaindependiente los artículos por título, resumen y texto completo, según unos criterios de inclusión y exclusión previamente establecidos. Dos autoresevaluaron de forma independiente la calidad metodológica de las revisiones incluidas mediante AMSTAR-2. Se incluyeron cinco estudios. Cuatroincluyeron participantes con fobias específicas, ansiedad generalizada y ansiedad por separación y uno se centró en miedos nocturnos. Las intervenciones basadas en la terapia cognitivo conductual demostraron ser efectivas para el tratamiento de estos trastornos a corto y a largo plazo. Lacalidad metodológica de los estudios incluidos se clasificó como críticamente baja. Las intervenciones basadas en la terapia cognitivo conductualson eficaces para los trastornos de ansiedad en niños y adolescentes. Se discute la necesidad de mejorar la calidad metodológica y de aumentarlos estudios centrados en la eficacia de los tratamientos para trastornos específicos. (AU)


Asunto(s)
Humanos , Niño , Adolescente , Trastornos de la Conducta Infantil/psicología , Trastornos de la Conducta Infantil/terapia , Adolescente , Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Terapéutica , Resultado del Tratamiento
3.
Int J Psychophysiol ; 184: 110-117, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36621629

RESUMEN

Threat-related attentional bias is thought to have a causal influence on the etiology of social anxiety. However, there is uncertainty on whether attention dwells on or diverts away from threats, and the measurements typically utilized to explore attentional bias cannot continuously quantify changes in attention. Here, we used steady-state visual evoked potentials (ssVEPs) as a continuous neurophysiological measure of visual attentional processing to examine the time course of attentional bias in social anxiety. Participants with high (n = 18) and low (n = 18) social anxiety passively viewed two faces flickering at 15 and 20 Hz frequency to evoke ssVEPs, and completed Attentional Control Scale. The results showed that angry faces, as compared to happy and neutral faces, elicited larger ssVEP amplitudes for the time window of 180-500 ms after facial stimuli onset only in the high socially anxious individuals, and the effect extended to the next two periods of 500-1000 ms and 1000-1500 ms. The ssVEP amplitudes differed most when individuals with high social anxiety viewed angry-neutral expression combinations. Additionally, attentional control was negatively correlated with social anxiety and threat-related attentional bias. The results suggested that individuals with social anxiety initially oriented attention toward the threat and subsequently exhibited difficulty in disengaging attention from it, possibly due to impaired attentional control.


Asunto(s)
Sesgo Atencional , Potenciales Evocados Visuales , Humanos , Miedo , Ansiedad , Trastornos de Ansiedad , Expresión Facial
5.
J Med Internet Res ; 25: e42672, 2023 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-36656625

RESUMEN

BACKGROUND: Anxiety and depression are the most common mental disorders worldwide. Owing to the lack of psychiatrists around the world, the incorporation of artificial intelligence (AI) into wearable devices (wearable AI) has been exploited to provide mental health services. OBJECTIVE: This review aimed to explore the features of wearable AI used for anxiety and depression to identify application areas and open research issues. METHODS: We searched 8 electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, IEEE Xplore, ACM Digital Library, Scopus, and Google Scholar) and included studies that met the inclusion criteria. Then, we checked the studies that cited the included studies and screened studies that were cited by the included studies. The study selection and data extraction were carried out by 2 reviewers independently. The extracted data were aggregated and summarized using narrative synthesis. RESULTS: Of the 1203 studies identified, 69 (5.74%) were included in this review. Approximately, two-thirds of the studies used wearable AI for depression, whereas the remaining studies used it for anxiety. The most frequent application of wearable AI was in diagnosing anxiety and depression; however, none of the studies used it for treatment purposes. Most studies targeted individuals aged between 18 and 65 years. The most common wearable device used in the studies was Actiwatch AW4 (Cambridge Neurotechnology Ltd). Wrist-worn devices were the most common type of wearable device in the studies. The most commonly used category of data for model development was physical activity data, followed by sleep data and heart rate data. The most frequently used data set from open sources was Depresjon. The most commonly used algorithm was random forest, followed by support vector machine. CONCLUSIONS: Wearable AI can offer great promise in providing mental health services related to anxiety and depression. Wearable AI can be used by individuals for the prescreening assessment of anxiety and depression. Further reviews are needed to statistically synthesize the studies' results related to the performance and effectiveness of wearable AI. Given its potential, technology companies should invest more in wearable AI for the treatment of anxiety and depression.


Asunto(s)
Inteligencia Artificial , Depresión , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Depresión/diagnóstico , Depresión/terapia , Ansiedad/diagnóstico , Ansiedad/terapia , Trastornos de Ansiedad , Algoritmos
6.
BMC Psychiatry ; 23(1): 53, 2023 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-36658515

RESUMEN

BACKGROUND: Because they are prevalent, persistent, and have substantial negative effects on physical health, psychological well-being, and economic implications, common mental illnesses like depression, anxiety, and somatic complaints are major public health problems. Patients with mental illness are devoted to religious therapy including holy water as a coping mechanism for their illnesses. The aim of this study was to investigate the magnitude and associated factors of common mental illness among adult holy water users. METHODS: Facility-based cross-sectional study design was conducted in Amhara regional state orthodox Tewahido churches. A simple random sampling techinque was used to select participants. Data were collected by using the Brief Psychiatric Rating Scale for mental illnesses symptoms and a structured interviewer administered questionnaire was used. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Variables with a p-value of 0.25 in the bivariable logistic regression were entered into multivariable logistic regression. RESULT: Three hundred eighty-two participants were involved in the study. The magnitude of Common mental illnesses among holy water users was 58.9%. Unemployed, using more than one substance, having Poor and moderate social support, current daily alcohol drinker and past history of mental illness were significantly associated with common mental illness. CONCLUSION: The magnitude of common mental illness among adult holy water users was high. Giving special attention to decreasing unemployment, establishing social support services, and decreasing substance utilization are the keys to preventing common mental illnesses.


Asunto(s)
Trastornos Mentales , Humanos , Adulto , Etiopía/epidemiología , Estudios Transversales , Trastornos Mentales/epidemiología , Trastornos de Ansiedad , Consumo de Bebidas Alcohólicas
7.
BMC Psychiatry ; 23(1): 67, 2023 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-36698079

RESUMEN

BACKGROUND: The way how technology addiction relates to psychosis remains inconclusive and uncertain. The present study aimed to test the hypothesis of a mediating role of depression, anxiety and stress in the association between three technology (behavioral) addictions (i.e., Addiction to the Internet, smartphones and Facebook) and psychosis proneness as estimated through schizotypal traits in emerging adults. METHODS: A cross-sectional study was performed among non-clinical Tunisian university students (67.6% females, mean age of 21.5 ± 2.5 years) using a paper-and-pencil self-administered questionnaire. RESULTS: Results for the Pearson correlation revealed that higher smartphone, Internet, and Facebook addictions' scores were significantly and positively correlated with each of the depression, anxiety and stress subscores; whereas depression (r = 0.474), anxiety (r = 0.499) and stress (r = 0.461) scores were positively correlated with higher schizotypal traits. The results of the mediation analysis found a significant mediating effect for depressive, anxiety and stress symptoms on the cross-sectional relationship between each facet of the TA and schizotypal traits. CONCLUSION: Our findings preliminarily suggest that an addictive use of smartphones, Internet and Facebook may act as a stressor that exacerbates psychosis proneness directly or indirectly through distress. Although future longitudinal research is needed to determine causality, we draw attention to the possibility that treating psychological distress may constitute an effective target of interventions to prevent psychosis in adolescents with technology addictions.


Asunto(s)
Conducta Adictiva , Depresión , Adulto , Femenino , Adolescente , Humanos , Adulto Joven , Masculino , Depresión/psicología , Estudios Transversales , Ansiedad/psicología , Trastornos de Ansiedad , Adicción a la Tecnología , Conducta Adictiva/psicología
8.
J Psychopathol Clin Sci ; 132(1): 38-50, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36689369

RESUMEN

Uncontrollable worry is a hallmark of generalized anxiety disorder and a transdiagnostic feature of psychopathology. Mindfulness-based strategies show promise for treating worry, but it is unknown which specific strategies are most beneficial, and how these skills might operate on a neurobiological level. We recruited 40 participants with clinically significant worry to undergo functional magnetic resonance imaging while engaging in real-time, idiographic worry and instructed disengagement using two mindfulness strategies (focused attention, acceptance) and one comparison strategy (suppression). Hypotheses were preregistered and partially supported. All disengagement strategies downregulated default mode and upregulated frontoparietal and salience networks, suggesting some shared mechanisms. Focused attention was most effective for promoting disengagement and elicited decreased activity in cognitive control and sensorimotor regions. Successful disengagement was associated with increased activity in rostrolateral prefrontal cortex and functional connectivity between posterior cingulate and primary somatosensory cortex. Findings support the role of cognitive control and somatosensory networks in disengagement from worry and suggest common and distinct mechanisms of disengagement, with focused attention a particularly promising strategy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Atención Plena , Humanos , Ansiedad , Trastornos de Ansiedad/psicología , Corteza Prefrontal , Atención
9.
Sci Rep ; 13(1): 1239, 2023 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-36690698

RESUMEN

Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single "doses" of virtual nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks, anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users, experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact mental health outcomes.


Asunto(s)
Ansiedad , Realidad Virtual , Humanos , Femenino , Adulto Joven , Adulto , Ansiedad/psicología , Trastornos de Ansiedad , Salud Mental , Estudiantes/psicología
10.
PeerJ ; 11: e14720, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36691480

RESUMEN

Objective: This study aimed to estimate the prevalence of generalized anxiety disorder in China during the coronavirus disease 2019 (COVID-19) pandemic and identify its associated factors. Methods: A cross-sectional study was conducted among the general population in China from March 16 to April 2, 2020. The participants were recruited using stratified random sampling. Data on demographic characteristics and COVID-19 related factors were obtained using self-administered questionnaires. The anxiety score was measured based on the Chinese version of the Generalized Anxiety Disorder 7-item Scale (GAD-7). Results: The study comprised 10,824 participants, of which 37.69% had symptoms of anxiety. The risk factors for anxiety symptoms included poor self-reported health (OR = 1.672, p < 0.001), chronic diseases (OR = 1.389, p < 0.001), and quarantine (OR = 1.365, p < 0.001), while participants' perceptions that COVID-19 would be controlled was a protective factor (OR = 0.774, p < 0.001). The interactions between quarantine and self-reported health (p < 0.001), as well as between perceptions of COVID-19 and self-reported health (p < 0.001) were found to have a significant effect on GAD-7 scores. Conclusions: Self-reported health status, chronic diseases, quarantine, and perceptions of COVID-19 were significantly associated with GAD-7 scores, indicating that mental health interventions are urgently needed during pandemics, especially for high-risk groups.


Asunto(s)
COVID-19 , Humanos , COVID-19/complicaciones , Estudios Transversales , Prevalencia , SARS-CoV-2 , Depresión/epidemiología , Trastornos de Ansiedad/epidemiología , Factores de Riesgo , China/epidemiología
11.
BMC Public Health ; 23(1): 161, 2023 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-36694166

RESUMEN

BACKGROUND: Mental disorders are conditions that affect the usual function of the brain, causing a huge burden on societies. The causes are often unclear, but previous research has pointed out, as is the case with many other diseases, that nutrition could have a major role in it. Amino acids, the building blocks of proteins, are the main precursor of neurotransmitters (the chemical messengers in the brain) malfunction of which is heavily associated with a wide range of brain disorders. METHODS: We assumed different sources of dietary protein could have different impacts on mental well-being. Hence, we decided to collect the nutritional data (with a validated and reliable semi-quantitative food-frequency questionnaire) from a sample of 489 Iranian women and investigate the association between animal and plant protein sources and the risk of depression, anxiety, and stress. Symptoms of these mental disorders were assessed using a validated Depression, Anxiety, and Stress Scales (DASS) questionnaire with 21 items. RESULTS: After multivariable adjustment, it was shown that women in the highest tertile of animal protein intake were more likely to show symptoms of depression (OR: 2.63; 95% CI: 1.45, 4.71; P = 0.001), anxiety (OR: 1.83; 95% CI: 1.04, 3.22; P = 0.03), and stress (OR: 3.66; 95% CI: 2.06, 6.50; p < 0.001). While no significant association was seen between plant protein and any of the studied mental disorders. CONCLUSION: Overall, our findings suggest that a diet high in animal protein could predispose individuals to mental illnesses.


Asunto(s)
Ansiedad , Depresión , Femenino , Humanos , Animales , Depresión/epidemiología , Depresión/etiología , Irán/epidemiología , Ansiedad/epidemiología , Ansiedad/etiología , Trastornos de Ansiedad , Dieta , Proteínas de Plantas , Encuestas y Cuestionarios
12.
BMC Med Educ ; 23(1): 57, 2023 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-36694199

RESUMEN

INTRODUCTION: Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents. METHODS: In 2020, using emailed invites we recruited a convenience sample of 28 internal medicine residents from a teaching hospital in Baltimore, Maryland to participate in an exploratory qualitative study. In one-on-one interviews, informants described experiences of imposter phenomenon during residency training. Using thematic analysis to identify meaningful segments of text, the authors developed a coding framework and iteratively identified and refined themes. Informants completed the Clance Imposter Phenomenon Scale. RESULTS: Informants described feelings and thoughts related to imposter phenomenon, the contexts in which they developed and the impact on learning. Imposter phenomenon has profound effects on residents including: powerful and persistent feelings of inadequacy and habitual comparisons with others. Distinct contexts shaping imposter phenomenon included: changing roles with increasing responsibilities; constant scrutiny; and rigid medical hierarchy. Learning was impacted by inappropriate expectations, difficulty processing feedback, and mental energy diverted to impression management. DISCUSSION: Internal medicine residents routinely experience imposter phenomenon; these feelings distort residents' sense of self confidence and competence and may impact learning. Modifiable aspects of the clinical learning environment exacerbate imposter phenomenon and thus can be acted upon to mitigate imposter phenomenon and promote learning among medical trainees.


Asunto(s)
Internado y Residencia , Médicos , Humanos , Autoimagen , Trastornos de Ansiedad , Medicina Interna/educación
13.
BJS Open ; 7(1)2023 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-36694387

RESUMEN

BACKGROUND: Informed consent is an ethical and legal requirement in healthcare and supports patient autonomy to make informed choices about their own care. This review explores the impact of digital technology for informed consent in surgery. METHODS: A systematic search of EBSCOhost (MEDLINE/CINAHL), Embase, Cochrane Central Register of Controlled Trials and Web of Science was performed in November 2021. All RCTs comparing outcomes of both digital and non-digital (standard) consent in surgery were included. Each included study underwent an evaluation of methodological quality using the Cochrane risk of bias (2.0) tool. Outcomes assessed included comprehension, level of satisfaction and anxiety, and feasibility of digital interventions in practice. RESULTS: A total of 40 studies, across 13 countries and 15 surgical specialties were included in this analysis. Digital consent interventions used active patient participation and passive patient participation in 15 and 25 studies respectively. Digital consent had a positive effect on early comprehension in 21 of 30 (70 per cent) studies and delayed comprehension in 9 of 20 (45 per cent) studies. Only 16 of 38 (42 per cent) studies assessed all four elements of informed consent: general information, risks, benefits, and alternatives. Most studies showed no difference in satisfaction or anxiety. A minority of studies reported on feasibility of digital technology in practice. CONCLUSION: Digital technologies in informed consent for surgery were found to have a positive effect on early comprehension, without any negative effect on satisfaction or anxiety. It is recommended that future studies explore the feasibility of these applications for vulnerable patient groups and busy surgical practice.


Asunto(s)
Tecnología Digital , Consentimiento Informado , Humanos , Participación del Paciente , Comprensión , Trastornos de Ansiedad
14.
Menopause ; 30(2): 225-234, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36696648

RESUMEN

IMPORTANCE: The menopausal transition has been related to worsening mental health. The literature also points out that being physically active during menopause is associated with a favorable effect on climacteric symptoms, specifically on psychological aspects. OBJECTIVES: The aims of the study are to analyze the effects of physical activity on mental health during menopause through an umbrella review and to evaluate the quality of the included Systematic Reviews and meta-analyses (MAs). EVIDENCE REVIEW: A MeaSurement Tool to Assess Systematic Reviews was used to evaluate the methodological quality of the included studies and the Grading of Recommendations Assessment, Development and Evaluation was applied to assess the level of the evidence of the results. In addition, the effect size of the revised meta-analyses (MAs) was calculated. FINDINGS: A total of 9 systematic reviews/MAs were included, published between 2014 and 2020. In the A MeaSurement Tool to Assess Systematic Reviews methodological quality assessment, 8 studies were classified as "high quality" and 1 as "low quality." In terms of quality of the evidence for each result through the Grading of Recommendations Assessment, Development and Evaluation classification, approximately 75% of the studies were classified as "moderate quality," 22.2% as "high quality," and 22.2% as "low quality," with the greatest bias concerning the high heterogeneity of the included studies. In addition, the studies showed low overlap. Despite the high heterogeneity, we can highlight the importance of the practice of physical activity by women in menopause, to prevent and/or reduce problems related to mental health. CONCLUSIONS AND RELEVANCE: There was a positive effect of the interventions on depression, however, with no difference between durations (short or long). Regarding stress, the interventions applied did not show a positive effect. The studies that investigated depression linked to anxiety presented conflicting results.


Asunto(s)
Ejercicio Físico , Salud Mental , Femenino , Humanos , Menopausia , Trastornos de Ansiedad , Ansiedad/terapia
16.
Am J Nurs ; 123(2): 16, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36698345

RESUMEN

Nurses can play a vital role in implementing this recommendation during primary care visits.


Asunto(s)
Ansiedad , Tamizaje Masivo , Niño , Humanos , Ansiedad/diagnóstico , Trastornos de Ansiedad , Comités Consultivos
17.
Am J Nurs ; 123(2): 62, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36698368

RESUMEN

According to this study: Mindfulness-based stress reduction is well tolerated and has comparable effectiveness to a first-line medication for people who have anxiety disorders.At least one study-related adverse event occurred in 78.6% of patients in the escitalopram group and in 15.4% of those in the mindfulness-based stress reduction group.


Asunto(s)
Atención Plena , Humanos , Estrés Psicológico/terapia , Depresión , Ansiedad/terapia , Trastornos de Ansiedad/tratamiento farmacológico
18.
BMC Psychiatry ; 23(1): 7, 2023 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-36597066

RESUMEN

BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.


Asunto(s)
Refugiados , Trastornos por Estrés Postraumático , Humanos , Salud Mental , Refugiados/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Ansiedad , Trastornos de Ansiedad/diagnóstico
20.
Transl Psychiatry ; 13(1): 4, 2023 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-36609484

RESUMEN

The authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of motor vehicle collision (MVC) survivors. More than two thousand MVC survivors were enrolled in the emergency department (ED) and completed a rotating battery of brief smartphone-based surveys over a 2-month period. Measurement models developed from survey item responses were used in latent growth curve/mixture modeling to characterize homogeneous symptom trajectories. Associations between individual trajectories and pre-trauma and peritraumatic characteristics and traditional outcomes were compared, along with associations within and between trajectories. APNS across all ten symptom domains were common in the first two months after trauma. Many risk factors and associations with high symptom burden trajectories were shared across domains. Both across and within traditional diagnostic boundaries, APNS trajectory intercepts, and slopes were substantially correlated. Across all domains, symptom severity in the immediate aftermath of trauma (trajectory intercepts) had the greatest influence on the outcome. An interactive data visualization tool was developed to allow readers to explore relationships of interest between individual characteristics, symptom trajectories, and traditional outcomes ( http://itr.med.unc.edu/aurora/parcoord/ ). Individuals presenting to the ED after MVC commonly experience a broad constellation of adverse posttraumatic symptoms. Many risk factors for diverse APNS are shared. Individuals diagnosed with a single traditional outcome should be screened for others. The utility of multidimensional categorizations that characterize individuals across traditional diagnostic domains should be explored.


Asunto(s)
Teléfono Inteligente , Trastornos por Estrés Postraumático , Humanos , Ansiedad/psicología , Trastornos de Ansiedad , Factores de Riesgo , Sobrevivientes/psicología , Trastornos por Estrés Postraumático/diagnóstico
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