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1.
Chron Respir Dis ; 17: 1479973120962800, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33000648

RESUMEN

INTRODUCTION: The COVID pandemic has had a high psychological impact on healthy populations. Increased levels of perceived stress, depression, and insomnia are expected, especially in people with pre-existing medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD), who seem to be particularly vulnerable. However, the difference in psychological distress frequency between asthma and COPD patients is unknown. OBJECTIVE: To compare the prevalence of depression, perceived stress related to COVID, post-traumatic stress, and insomnia in asthma and COPD patients at a pulmonology clinic in Santa Marta, Colombia. METHODS: A cross-sectional study was designed. The patients were contacted by telephone. An electronic link was sent to those who accepted. The questionnaire asked for perceived stress related to COVID-19, post-traumatic stress symptoms, depressive symptoms, and insomnia risk. RESULTS: 148 asthma patients and 144 COPD patients participated in, between 18 and 96 years. The prevalence of high COVID-19 perceived stress was 10.6% (n = 31); post-traumatic stress risk, 11.3% (n = 33); depression risk, 31.5% (n = 92); and insomnia risk, 57.7% (n = 169). No significant differences were found between asthma and COPD in indicators of psychological distress. CONCLUSIONS: Asthma and COPD patients present similar frequencies of depression risk, COVID-19 perceived stress, post-traumatic stress risk, and insomnia risk during the Colombian lockdown. It is essential to evaluate and manage psychological distress among asthma and COPD patients. It can reduce the risk of exacerbation and improve the quality of life.


Asunto(s)
Asma , Infecciones por Coronavirus , Depresión , Pandemias , Neumonía Viral , Enfermedad Pulmonar Obstructiva Crónica , Calidad de Vida , Trastornos del Inicio y del Mantenimiento del Sueño , Trastornos por Estrés Postraumático , Asma/epidemiología , Asma/psicología , Betacoronavirus , Colombia/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Depresión/diagnóstico , Depresión/etiología , Depresión/psicología , Autoevaluación Diagnóstica , Femenino , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Distrés Psicológico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Investigación Cualitativa , Autoimagen , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología
2.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33006815
3.
Best Pract Res Clin Anaesthesiol ; 34(3): 553-560, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33004166

RESUMEN

This comprehensive review aims to explain the potential impact of coronavirus disease 2019 (COVID-19) on mental wellbeing of healthcare professionals (HCPs). Based on up-to-date research and psychological diagnostic manuals of Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 11th revision, we describe associated psychological disorders and experiences that may arise related to COVID-19. Appropriate psychological measures are introduced, along with potential methodological limitations. Lastly, resilience building and preventative measures with interventions that may mitigate the impact on mental health of HCPs are described.


Asunto(s)
Betacoronavirus , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Infecciones por Coronavirus/psicología , Personal de Salud/psicología , Neumonía Viral/psicología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Personal de Salud/estadística & datos numéricos , Humanos , Pandemias
4.
Psychiatr Danub ; 32(Suppl 3): 320-336, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030447

RESUMEN

The war in Bosnia and Herzegovina (1992-1995) was an extremely hard traumatic event with different losses, separations of people, injuries, hard physical and psychical suffering of everyone. Children were especially in difficult conditions. One of the most remarkable things about children, as anyone who works with them soon finds out, is their resilience. While children are vulnerable to psychic damage and, if the damage is deep enough, to delays in emotional and even physical growth, they also have an astonishing capacity to bounce back. This is one of the most rewarding things about treating traumatized children. For many children, it takes very little, perhaps only some words of understanding, to help them tap into their own ability to heal. Taking care of child war psycho-trauma was a difficult task for me, as the war-time head of Department of psychiatry, without enough knowledge in child psycho-trauma and as person with a high responsibility, to organize together with other psychological caretakers of children, especially refugee children. This presentation will be some kind of my remembrance of period of 20-25 years ago when we, I think did good work of what we could and what we knew.


Asunto(s)
Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Guerra/psicología , Adolescente , Adulto , Anciano , Bosnia y Herzegovina , Niño , Familia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Refugiados/psicología , Resiliencia Psicológica , Trastornos por Estrés Postraumático/rehabilitación , Adulto Joven
5.
Psychiatr Danub ; 32(Suppl 3): 360-363, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030453

RESUMEN

The establishment of the United Nations after World War II raised hopes of a new era of peace. This was over-optimistic. Between 1945 and 1992, there were 149 major wars, killing more than 23 million people. Recent developments in warfare have significantly heightened the dangers for children. During the last decade child war victims have included: 2 million killed; 4-5 million disabled; 12 million left homeless; more than 1 million orphaned or separated from their parents; some 10 million psychologically traumatized. Researches indicate that children do develop PTSD after experiencing very stressful, life-threatening events such as happen in war. Wars of 21st century are often guerrilla-type civil wars in which women and children are not only the main victims, but are deliberately targeted. Thousands are displaced both internally and across borders. Wars at the end of nineties of 20th century in the region of ex Yugoslavian countries brought all the cruelty of war vivid again on European ground. Population were exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. During the War in Bosnia and Herzegovina 1992-1995 there were about 100 000 people killed (20% woman and 3.5% children) and about 18 000 children were orphaned because of war. Children are not capable to regulate their emotions and hyper-arousal on their own. It depends of the way how their parents (caretaker) regulate her/his own emotions. During the war weak child's ego is paralyzed with intensive stimuli and floating anxiety, it does not manage to make constructive solution for traumatic experiences in such a short time. Mothers with small children are especially vulnerable group during the war time: they are supposed to take care about children and feel happiness, what is almost impossible Severe war experiences could cause depressive symptoms in mothers, what reduce their emotional disposability and could lead in different form of the child's neglecting. PTSD symptoms were lasting longer in children if their mothers have had functioning problems. Traumatization of mothers is connected with different behavior problems in their children. Wars are continuing all over the world and there is a continuity of researches about their consequences on children. Any programs that intend to mitigate the psychological effects of such trauma need to adopt a public health approach aimed at reaching many thousands.


Asunto(s)
Trastornos por Estrés Postraumático/epidemiología , Guerra/psicología , Guerra/estadística & datos numéricos , Bosnia y Herzegovina/epidemiología , Niño , Humanos , Madres/psicología , Problema de Conducta , Trastornos por Estrés Postraumático/psicología , Violencia/psicología , Violencia/estadística & datos numéricos , Heridas Relacionadas con la Guerra/epidemiología , Heridas Relacionadas con la Guerra/psicología
6.
Psychiatr Danub ; 32(Suppl 3): 364-366, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030454

RESUMEN

Post-traumatic stress disorder (PTSD) is a spectrum disorder whose symptoms show psychological, neurobiological dysregulation and poorer functionality of a person on the social plane. PTSD characteristics are symptoms from four clusters: symptoms of intrusiveness, avoidance, negative changes in cognition and mood and changes in excitability and reactivity. Traumatic experiences of war veterans can have an impact on the development of psychopathology in their children's lives. The impact of posttraumatic stress disorder of war veterans is negatively manifested in a broader sense through secondary traumatization and is manifested differently in relation to the period of childhood and adolescence. The period of childhood and adolescence represents a delicate and dynamic period that requires adaptation and functionality in adulthood. The epidemiological studies so far indicate the link between the post-traumatic stress disorder of war veterans with the mental problems of their children.


Asunto(s)
Hijo de Padres Discapacitados/psicología , Desgaste por Empatía/psicología , Psicología del Adolescente , Psicología Infantil , Trastornos por Estrés Postraumático/psicología , Veteranos/psicología , Adolescente , Bosnia y Herzegovina , Niño , Femenino , Humanos , Masculino
7.
Psychiatr Danub ; 32(Suppl 3): 367-370, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030455

RESUMEN

Although family should be the basis for the development and formation of a child's personality, violence is mostly done in the family, and remains undiscovered for a long time. The real number of abused children is much more than that displayed in the registered cases. The secrecy of the problem is an important feature of this phenomenon. Families in which abuse takes place are mostly isolated. Social isolation does not come about by chance; secrecy is usually encouraged by an abuser to control over famoly members. In most cases, social reaction to violence is late, inadequate and focused on the consequences, but not on the causes. "Abuse implies an act of execution that directly inflicts damage, while neglect implies an act of non-fulfillment of something that is necessary for the well-being of a child". The most common forms of domestic violence are physical, emotional abuse in the presence of violence against the mother, and in a lesser extent sexual abuse. In addition, there is physical, emotional, educational and medical neglect. The presence of violence against the mother and the feeling of impotence leave the same consequences as the endured violence. It is considered that children living in violent families are likely to live under cumulative stress. Traumatic responses include a wide range of conditions from acute stress reactions through post-traumatic stress disorder to complex long-lasting, repeated trauma syndrome. All children will not react to this kind of experience in the same way, with the protective and risk factors in developmental psychopathology having a significant role to play. Because of their developmental vulnerability and dependency, children are at greater risk of violence than adults. Researches point to the need for a multidisciplinary approach to treatment and prevention of child abuse, with greater interaction between health institutions, relevant centers for social work, police, court, government and non-governmental sector, and the existence of adequate family and criminal laws.


Asunto(s)
Maltrato a los Niños/psicología , Violencia Doméstica/psicología , Trauma Psicológico/psicología , Adulto , Niño , Maltrato a los Niños/legislación & jurisprudencia , Maltrato a los Niños/prevención & control , Maltrato a los Niños/terapia , Violencia Doméstica/legislación & jurisprudencia , Violencia Doméstica/prevención & control , Femenino , Humanos , Masculino , Madres/psicología , Trauma Psicológico/prevención & control , Trauma Psicológico/terapia , Factores de Riesgo , Instituciones Académicas , Trastornos por Estrés Postraumático/prevención & control , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia
9.
J Med Internet Res ; 22(9): e19716, 2020 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-32975521

RESUMEN

BACKGROUND: Most people who experience a potentially traumatic event (PTE) recover on their own. A small group of individuals develops psychological complaints, but this is often not detected in time or guidance to care is suboptimal. To identify these individuals and encourage them to seek help, a web-based self-help test called Mobile Insight in Risk, Resilience, and Online Referral (MIRROR) was developed. MIRROR takes an innovative approach since it integrates both negative and positive outcomes of PTEs and time since the event and provides direct feedback to the user. OBJECTIVE: The goal of this study was to assess MIRROR's use, examine its psychometric properties (factor structure, internal consistency, and convergent and divergent validity), and evaluate how well it classifies respondents into different outcome categories compared with reference measures. METHODS: MIRROR was embedded in the website of Victim Support Netherlands so visitors could use it. We compared MIRROR's outcomes to reference measures of PTSD symptoms (PTSD Checklist for DSM-5), depression, anxiety, stress (Depression Anxiety Stress Scale-21), psychological resilience (Resilience Evaluation Scale), and positive mental health (Mental Health Continuum Short Form). RESULTS: In 6 months, 1112 respondents completed MIRROR, of whom 663 also completed the reference measures. Results showed good internal consistency (interitem correlations range .24 to .55, corrected item-total correlations range .30 to .54, and Cronbach alpha coefficient range .62 to .68), and convergent and divergent validity (Pearson correlations range -.259 to .665). Exploratory and confirmatory factor analyses (EFA+CFA) yielded a 2-factor model with good model fit (CFA model fit indices: χ219=107.8, P<.001, CFI=.965, TLI=.948, RMSEA=.065), conceptual meaning, and parsimony. MIRROR correctly classified respondents into different outcome categories compared with the reference measures. CONCLUSIONS: MIRROR is a valid and reliable self-help test to identify negative (PTSD complaints) and positive outcomes (psychosocial functioning and resilience) of PTEs. MIRROR is an easily accessible online tool that can help people who have experienced a PTE to timely identify psychological complaints and find appropriate support, a tool that might be highly needed in times like the coronavirus pandemic.


Asunto(s)
Encuestas Epidemiológicas , Aplicaciones Móviles , Derivación y Consulta , Resiliencia Psicológica , Autocuidado/métodos , Autocuidado/normas , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Adulto , Ansiedad/diagnóstico , Lista de Verificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Depresión/diagnóstico , Análisis Factorial , Femenino , Humanos , Internet , Masculino , Países Bajos/epidemiología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Psicometría , Reproducibilidad de los Resultados , Estrés Psicológico/diagnóstico
10.
PLoS Med ; 17(9): e1003297, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32931504

RESUMEN

BACKGROUND: The psychological health of female sex workers (FSWs) has emerged as a major public health concern in many low- and middle-income countries (LMICs). Key risk factors include poverty, low education, violence, alcohol and drug use, human immunodeficiency virus (HIV), and stigma and discrimination. This systematic review and meta-analysis aimed to quantify the prevalence of mental health problems among FSWs in LMICs, and to examine associations with common risk factors. METHOD AND FINDINGS: The review protocol was registered with PROSPERO, number CRD42016049179. We searched 6 electronic databases for peer-reviewed, quantitative studies from inception to 26 April 2020. Study quality was assessed with the Centre for Evidence-Based Management (CEBM) Critical Appraisal Tool. Pooled prevalence estimates were calculated for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal behaviour. Meta-analyses examined associations between these disorders and violence, alcohol/drug use, condom use, and HIV/sexually transmitted infection (STI). A total of 1,046 studies were identified, and 68 papers reporting on 56 unique studies were eligible for inclusion. These were geographically diverse (26 countries), representing all LMIC regions, and included 24,940 participants. All studies were cross-sectional and used a range of measurement tools; none reported a mental health intervention. Of the 56 studies, 14 scored as strong quality, 34 scored as moderate, and 8 scored as weak. The average age of participants was 28.9 years (age range: 11-64 years), with just under half (46%) having up to primary education or less. The pooled prevalence rates for mental disorders among FSWs in LMICs were as follows: depression 41.8% (95% CI 35.8%-48.0%), anxiety 21.0% (95% CI: 4.8%-58.4%), PTSD 19.7% (95% CI 3.2%-64.6%), psychological distress 40.8% (95% CI 20.7%-64.4%), recent suicide ideation 22.8% (95% CI 13.2%-36.5%), and recent suicide attempt 6.3% (95% CI 3.4%-11.4%). Meta-analyses found significant associations between violence experience and depression, violence experience and recent suicidal behaviour, alcohol use and recent suicidal behaviour, illicit drug use and depression, depression and inconsistent condom use with clients, and depression and HIV infection. Key study limitations include a paucity of longitudinal studies (necessary to assess causality), non-random sampling of participants by many studies, and the use of different measurement tools and cut-off scores to measure mental health problems and other common risk factors. CONCLUSIONS: In this study, we found that mental health problems are highly prevalent among FSWs in LMICs and are strongly associated with common risk factors. Study findings support the concept of overlapping vulnerabilities and highlight the urgent need for interventions designed to improve the mental health and well-being of FSWs.


Asunto(s)
Trabajadores Sexuales/psicología , Trabajadores Sexuales/estadística & datos numéricos , Adolescente , Adulto , Ansiedad , Trastornos de Ansiedad , Niño , Estudios Transversales , Países en Desarrollo , Femenino , Infecciones por VIH/epidemiología , Humanos , Salud Mental , Persona de Mediana Edad , Pobreza , Prevalencia , Factores de Riesgo , Sexo Seguro , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Ideación Suicida , Intento de Suicidio , Violencia
11.
Cancer Cytopathol ; 128(9): 597-598, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32885911
12.
BMJ Case Rep ; 13(9)2020 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-32943446

RESUMEN

The global threat posed by the COVID-19 pandemic has highlighted the need to accurately identify the immediate and long-term postdisaster impacts on disaster-relief workers. We examined the case of a local government employee suffering from post-traumatic stress disorder (PTSD) and bipolar II disorder following the Great East Japan Earthquake. The complex and harsh experience provoked a hypomanic response such as elated feelings with increased energy, decreased need for sleep and an increase in goal-directed activity, which allowed him to continue working, even though he was adversely affected by the disaster. However, 3.5 years later, when he suffered further psychological damage, his PTSD symptoms became evident. In addition to treating mood disorders, trauma-focused psychotherapy was required for his recovery. Thereafter, we considered the characteristics of mental health problems that emerge in disaster-relief workers, a long time after the disaster, and the conditions and treatments necessary for recovery.


Asunto(s)
Trastorno Bipolar/psicología , Terremotos , Accidente Nuclear de Fukushima , Sistemas de Socorro , Trastornos por Estrés Postraumático/psicología , Tsunamis , Adulto , Betacoronavirus , Trastorno Bipolar/terapia , Infecciones por Coronavirus , Desastres , Humanos , Terapia Implosiva , Masculino , Pandemias , Neumonía Viral , Trastornos por Estrés Postraumático/terapia
13.
Artículo en Inglés | MEDLINE | ID: mdl-32906590

RESUMEN

The COVID-19 pandemic can not only affect physical health, but also mental health, resulting in sleep problems, depression, and traumatic stress. Our research investigates the level of posttraumatic stress, perceived social support, opinions on positive and negative consequences of the pandemic, sense of security and sense of meaning among nurses in the face of this new and not fully understood global epidemiological phenomenon. For this purpose, computer-assisted web interviews were conducted between May 1 and May 15, 2020. Participating nurses completed the following research tools: The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Changes in Outlook Questionnaire (CIOQ), The Safety Experience Questionnaire (SEQ) and The Meaning in Life Questionnaire (MLQ). Three hundred and twenty-five nurses of an average age of 39.18 ± 11.16 years and working throughout Poland joined the study. The average overall IES-R score in the study group was 1.78 ± 0.65. Among the dimensions of traumatic stress, the highest score was obtained in the "avoidance" dimension was 1.86 ± 0.73. Amongst participating nurses, the highest support rates were provided by significant others (22.58 ± 5.22). Higher average scores were noted among participants in the subscale measuring positive psychological changes (18.56 ± 4.04). The mean MLQ score was 5.33 ± 0.87. A slightly higher result was observed in the subscale "presence" (5.35 ± 1.14). The results of the research implemented during the period of severe psychological pressure associated with the COVID-19 pandemic provided information on symptoms of traumatic stress in the examined group of nurses. Their sense of security has been lowered and accompanied by an intensified reflection on issues concerning security. However, their current sense of meaning in life remains higher than the tendency to searching for it. The surveyed nurses received individual support mostly from significant others (i.e., other than family and friends). They see positive changes resulting from painful experiences related to the COVID-19 pandemic, which can be characterized by adaptation in the form of post-traumatic growth.


Asunto(s)
Infecciones por Coronavirus/psicología , Enfermeras y Enfermeros/psicología , Neumonía Viral/psicología , Trastornos por Estrés Postraumático/etiología , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Polonia , Sentido de Coherencia , Índice de Severidad de la Enfermedad , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología
14.
Z Kinder Jugendpsychiatr Psychother ; 48(5): 369-379, 2020 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-32880227

RESUMEN

Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial Abstract. Unaccompanied minor refugees (UMR) are a group particularly vulnerable to mental illness. They pose a great challenge not only for child and youth psychiatric and psychotherapeutic care, but also for youth-welfare institutions. The study examines the effectiveness of Stabilization Training for Adolescent Refugees with Trauma Induced Disorders in inpatient youth-welfare facilities. Methods: We conducted a randomized controlled trial with pre-post design in a naturalistic setting, randomly assigning 9 housing groups for UMRs to the intervention or waiting control condition. The mental stress of 46 UMRs was assessed by both self-report and educational staff-report. Two educational staff members conducted the Stabilization Training for Adolescent Refugees with Trauma Induced Disorders as an intervention in each of the respective residential groups. Results: Participation in training led to a reduction in subjective general psychological stress. At the end of the training, psychological stress in self-judgment was significantly lower in the intervention group than in the waiting control condition. The effectiveness of the training is apparently not reflected by educational staff assessments. Conclusions: Stabilization training is a suitable instrument for the preclinical care of UMR and thus an essential basis for further psychotherapy.


Asunto(s)
Psicoterapia , Refugiados/psicología , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Estrés Psicológico/psicología , Estrés Psicológico/terapia , Adolescente , Humanos , Resultado del Tratamiento
15.
Artículo en Inglés | MEDLINE | ID: mdl-32751624

RESUMEN

The number of health workers infected with COVID-19 in Spain is one of the highest in the world. The aim of this study is to analyse posttraumatic stress, anxiety and depression during the COVID-19 pandemic. Associations between burnout, resilience, demographic, work and COVID-19 variables are analysed. Cross-sectional data on 1422 health workers were analysed. A total of 56.6% of health workers present symptoms of posttraumatic stress disorder, 58.6% anxiety disorder, 46% depressive disorder and 41.1% feel emotionally drained. The profile of a health worker with greater posttraumatic stress symptoms would be a person who works in the Autonomous Community of Madrid, in a hospital, is a woman, is concerned that a person he/she lives with may be infected, and thinks that he/she is very likely to be infected. The risk variables for anxiety and depression would be a person that is a woman, working 12- or 24-h shifts, and being worried that a family member could be infected. High scores on emotional exhaustion and depersonalization are risk factors for mental health, with resilience and personal fulfilment being protective variables. Data are provided to improve preventive measures for occupational health workers.


Asunto(s)
Ansiedad/psicología , Betacoronavirus/aislamiento & purificación , Agotamiento Profesional/psicología , Infecciones por Coronavirus/psicología , Depresión/psicología , Personal de Salud/psicología , Neumonía Viral/psicología , Resiliencia Psicológica , Trastornos por Estrés Postraumático/psicología , Adulto , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología
16.
Rehabilitation (Stuttg) ; 59(4): 237-250, 2020 Aug.
Artículo en Alemán | MEDLINE | ID: mdl-32851609

RESUMEN

Due to significant changes in the new ICD-11 classification, stress-related disorders have advanced further into clinical and scientific focus. In contrast to the ICD-10 classification, complex posttraumatic stress disorder as well as prolonged grief have been established as independent diagnoses. Additionally, the diagnostic criteria for adjustment disorder were newly conceptualized and refined. Stress-related disorders have a high relevance for out- and inpatient rehabilitation centers. Posttraumatic stress disorder (PTSD) has a 1-year-prevalence in Germany of 1-2%. Comorbidities such as depression or anxiety disorders are common. PTSD may also result from physical illness and can in turn complicate the course of the disease or even lead to chronification of symptoms. The most effective treatment is a trauma-focused psychotherapy, which usually takes place in an outpatient setting. Psychosomatic inpatient rehabilitation is a valuable resource in the treatment plan of PTSD. The optimal point is mostly following the acute therapy when reintegration to work and social life is the aim. As rehabilitation centers can provide a safe therapeutic setting for patients, allowing them to open up about their trauma, it can pave the way to a trauma focused treatment. Additionally, socio-medical aspects of trauma-related disorders will be touched upon in this overview.


Asunto(s)
Trastornos de Ansiedad/psicología , Trastornos Psicofisiológicos/psicología , Trastornos por Estrés Postraumático/rehabilitación , Alemania , Humanos , Clasificación Internacional de Enfermedades , Trastornos por Estrés Postraumático/psicología
17.
Cogn Neuropsychiatry ; 25(5): 348-363, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32847486

RESUMEN

INTRODUCTION: One route to advancing psychological treatments is to harness mental health science, a multidisciplinary approach including individuals with lived experience and end users (e.g., Holmes, E. A., Craske, M. G., & Graybiel, A. M. (2014). Psychological treatments: A call for mental-health science. Nature, 511(7509), 287-289. doi:10.1038/511287a). While early days, we here illustrate a line of research explored by our group-intrusive imagery-based memories after trauma. METHOD/RESULTS: We illustrate three possible approaches through which mental health science may stimulate thinking around psychological treatment innovation. First, focusing on single/specific target symptoms rather than full, multifaceted psychiatric diagnoses (e.g., intrusive trauma memories rather than all of posttraumatic stress disorder). Second, investigating mechanisms that can be modified in treatment (treatment mechanisms), rather than those which cannot (e.g., processes only linked to aetiology). Finally, exploring novel ways of delivering psychological treatment (peer-/self-administration), given the prevalence of mental health problems globally, and the corresponding need for effective interventions that can be delivered at scale and remotely for example at times of crisis (e.g., current COVID-19 pandemic). CONCLUSIONS: These three approaches suggest options for potential innovative avenues through which mental health science may be harnessed to recouple basic and applied research and transform treatment development.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Imágenes en Psicoterapia/tendencias , Salud Mental/tendencias , Neumonía Viral/terapia , Trauma Psicológico/terapia , Trastornos por Estrés Postraumático/terapia , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Emociones/fisiología , Humanos , Imágenes en Psicoterapia/métodos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Trauma Psicológico/epidemiología , Trauma Psicológico/psicología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Pensamiento/fisiología
18.
PLoS One ; 15(8): e0237859, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32833986

RESUMEN

OBJECTIVES: The aim of our study is to examine the association between knowledge about the World War II (WWII)-related traumatic experiences of their ancestors and subjective well-being (SWB) of young adults, i.e., descendants of Polish survivors of WWII. Specifically, we focus on the life satisfaction and the mental, physical, and psychosocial well-being of our participants in relation to their knowledge about WWII trauma in their family histories. METHOD: The sample comprised 500 Polish young adults recruited from a nonclinical general population. Participants first filled out a questionnaire assessing their knowledge about traumatic events that their ancestors could have experienced during WWII (see grandparents/mothers, great-grandparents/mothers). After that, subjects were given inventories to assess their SWB, i.e., the Satisfaction with Life Scale (SWLS) and the General Health Questionnaire (GHQ-28). RESULTS: Latent profile analysis was applied to extract profiles of participants differing with regard to the scope of knowledge about WWII-related traumatic experiences among ancestors. Specifically, six profiles were observed, and a general lack of knowledge about this kind of trauma in the family was characteristic of the sample. We also found differences in SWB across profiles of participants, with worse SWB in the profiles with the highest lack of knowledge about WWII-related traumatic experiences in the family. CONCLUSION: Our study adds to the literature on intergenerational trauma by applying a person-centred perspective, a methodological approach almost invisible in research on that topic. In addition, our findings can serve as a stimulus for more comprehensive debate on WWII trauma in Polish society.


Asunto(s)
Familia , Conocimiento , Trastornos por Estrés Postraumático/psicología , Segunda Guerra Mundial , Adolescente , Adulto , Femenino , Humanos , Masculino , Negociación , Satisfacción Personal , Estadística como Asunto , Encuestas y Cuestionarios , Adulto Joven
19.
Am J Geriatr Psychiatry ; 28(10): 1030-1039, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32753338

RESUMEN

OBJECTIVE: To examine the psychological distress and the associated predictor factors of the 2019 corona-virus disease (COVID-19) on survivors in the early convalescence in Shenzhen. METHOD: A survey questionnaire consisting of post-traumatic stress disorder self-rating scale (PTSD-SS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) was presented to COVID-19 survivors still in quarantine. Scores of each scale and subscale were dependent variables in the Mann-Whitney test and stepwise regression analysis. RESULTS: A total of 126 subjects were included in the study, the mean scores of PTSD-SS, SDS, and SAS were 45.5 ± 18.9, 47.3 ± 13.1, and 43.2 ± 10.2, respectively, meanwhile, 9 (31.0%), 28 (22.2%), and 48 (38.1%) of the survivors met the cut-score for clinical significant symptoms of stress response, anxiety, and depression, respectively. Infected family members, and postinfection physical discomforts were significantly associated with scores on all three scales. Social support, retirement, and being female had significant associations with the PTSD-SS score. The survivors aged 60 or above experienced less severe stress response symptoms, fewer emotional symptoms of depression, and fewer anxiety symptoms than younger survivors. CONCLUSION: The occurrence rate of psychological distress among the COVID-19 survivors in early convalescence was high, highlighting the need for all COVID-19 survivors to be screened for psychological distress regularly for timely intervention. The predictors indicated by the current study may help to identify those at high-risk. Besides, the results indicated the older survivors suffered less emotional reactivity and fewer stress response symptoms from infectious diseases than the younger ones.


Asunto(s)
Ansiedad/epidemiología , Infecciones por Coronavirus/psicología , Depresión/epidemiología , Neumonía Viral/psicología , Jubilación/estadística & datos numéricos , Apoyo Social , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico/epidemiología , Sobrevivientes/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Ansiedad/psicología , Betacoronavirus , China/epidemiología , Convalecencia , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Depresión/psicología , Empleo/estadística & datos numéricos , Familia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Factores Protectores , Distrés Psicológico , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/psicología , Sobrevivientes/psicología
20.
PLoS Med ; 17(8): e1003262, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32813696

RESUMEN

BACKGROUND: Complex traumatic events associated with armed conflict, forcible displacement, childhood sexual abuse, and domestic violence are increasingly prevalent. People exposed to complex traumatic events are at risk of not only posttraumatic stress disorder (PTSD) but also other mental health comorbidities. Whereas evidence-based psychological and pharmacological treatments are effective for single-event PTSD, it is not known if people who have experienced complex traumatic events can benefit and tolerate these commonly available treatments. Furthermore, it is not known which components of psychological interventions are most effective for managing PTSD in this population. We performed a systematic review and component network meta-analysis to assess the effectiveness of psychological and pharmacological interventions for managing mental health problems in people exposed to complex traumatic events. METHODS AND FINDINGS: We searched CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, International Pharmaceutical Abstracts, MEDLINE, Published International Literature on Traumatic Stress, PsycINFO, and Science Citation Index for randomised controlled trials (RCTs) and non-RCTs of psychological and pharmacological treatments for PTSD symptoms in people exposed to complex traumatic events, published up to 25 October 2019. We adopted a nondiagnostic approach and included studies of adults who have experienced complex trauma. Complex-trauma subgroups included veterans; childhood sexual abuse; war-affected; refugees; and domestic violence. The primary outcome was reduction in PTSD symptoms. Secondary outcomes were depressive and anxiety symptoms, quality of life, sleep quality, and positive and negative affect. We included 116 studies, of which 50 were conducted in hospital settings, 24 were delivered in community settings, seven were delivered in military clinics for veterans or active military personnel, five were conducted in refugee camps, four used remote delivery via web-based or telephone platforms, four were conducted in specialist trauma clinics, two were delivered in home settings, and two were delivered in primary care clinics; clinical setting was not reported in 17 studies. Ninety-four RCTs, for a total of 6,158 participants, were included in meta-analyses across the primary and secondary outcomes; 18 RCTs for a total of 933 participants were included in the component network meta-analysis. The mean age of participants in the included RCTs was 42.6 ± 9.3 years, and 42% were male. Nine non-RCTs were included. The mean age of participants in the non-RCTs was 40.6 ± 9.4 years, and 47% were male. The average length of follow-up across all included studies at posttreatment for the primary outcome was 11.5 weeks. The pairwise meta-analysis showed that psychological interventions reduce PTSD symptoms more than inactive control (k = 46; n = 3,389; standardised mean difference [SMD] = -0.82, 95% confidence interval [CI] -1.02 to -0.63) and active control (k-9; n = 662; SMD = -0.35, 95% CI -0.56 to -0.14) at posttreatment and also compared with inactive control at 6-month follow-up (k = 10; n = 738; SMD = -0.45, 95% CI -0.82 to -0.08). Psychological interventions reduced depressive symptoms (k = 31; n = 2,075; SMD = -0.87, 95% CI -1.11 to -0.63; I2 = 82.7%, p = 0.000) and anxiety (k = 15; n = 1,395; SMD = -1.03, 95% CI -1.44 to -0.61; p = 0.000) at posttreatment compared with inactive control. Sleep quality was significantly improved at posttreatment by psychological interventions compared with inactive control (k = 3; n = 111; SMD = -1.00, 95% CI -1.49 to -0.51; p = 0.245). There were no significant differences between psychological interventions and inactive control group at posttreatment for quality of life (k = 6; n = 401; SMD = 0.33, 95% CI -0.01 to 0.66; p = 0.021). Antipsychotic medicine (k = 5; n = 364; SMD = -0.45; -0.85 to -0.05; p = 0.085) and prazosin (k = 3; n = 110; SMD = -0.52; -1.03 to -0.02; p = 0.182) were effective in reducing PTSD symptoms. Phase-based psychological interventions that included skills-based strategies along with trauma-focused strategies were the most promising interventions for emotional dysregulation and interpersonal problems. Compared with pharmacological interventions, we observed that psychological interventions were associated with greater reductions in PTSD and depression symptoms and improved sleep quality. Sensitivity analysis showed that psychological interventions were acceptable with lower dropout, even in studies rated at low risk of attrition bias. Trauma-focused psychological interventions were superior to non-trauma-focused interventions across trauma subgroups for PTSD symptoms, but effects among veterans and war-affected populations were significantly reduced. The network meta-analysis showed that multicomponent interventions that included cognitive restructuring and imaginal exposure were the most effective for reducing PTSD symptoms (k = 17; n = 1,077; mean difference = -37.95, 95% CI -60.84 to -15.16). Our use of a non-diagnostic inclusion strategy may have overlooked certain complex-trauma populations with severe and enduring mental health comorbidities. Additionally, the relative contribution of skills-based intervention components was not feasibly evaluated in the network meta-analysis. CONCLUSIONS: In this systematic review and meta-analysis, we observed that trauma-focused psychological interventions are effective for managing mental health problems and comorbidities in people exposed to complex trauma. Multicomponent interventions, which can include phase-based approaches, were the most effective treatment package for managing PTSD in complex trauma. Establishing optimal ways to deliver multicomponent psychological interventions for people exposed to complex traumatic events is a research and clinical priority.


Asunto(s)
Salud Mental , Psicoterapia/métodos , Trastornos por Estrés Postraumático/tratamiento farmacológico , Trastornos por Estrés Postraumático/psicología , Antipsicóticos/uso terapéutico , Terapia Cognitivo-Conductual/métodos , Comorbilidad , Humanos , Trastornos Mentales/tratamiento farmacológico , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Trastornos por Estrés Postraumático/epidemiología
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