Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.535
Filtrar
1.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006815
2.
Best Pract Res Clin Anaesthesiol ; 34(3): 553-560, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004166

RESUMO

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.


Assuntos
Betacoronavirus , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Pandemias
3.
Psychiatr Danub ; 32(Suppl 3): 360-363, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030453

RESUMO

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.


Assuntos
Transtornos de Estresse Pós-Traumáticos/epidemiologia , Guerra/psicologia , Guerra/estatística & dados numéricos , Bósnia e Herzegóvina/epidemiologia , Criança , Humanos , Mães/psicologia , Comportamento Problema , Transtornos de Estresse Pós-Traumáticos/psicologia , Violência/psicologia , Violência/estatística & dados numéricos , Lesões Relacionadas à Guerra/epidemiologia , Lesões Relacionadas à Guerra/psicologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-32992515

RESUMO

BACKGROUND: The global outbreak of COVID-19set new challenges and threats for every human being. In the psychological field it is similar to deep existential crises or a traumatic experience that may lead to the appearance or exacerbation of a serious mental disorder and loss of life meaning and satisfaction. Courtney et al. (2020) discussed deadly pandemic COVID-19 in the light of TMT theory and named it as global contagion of mortality that personally affected every human being. Such unique conditions activate existential fears as people start to be aware of their own mortality. OBJECTIVE: The main aim of this study was to test the mediating effect of existential anxiety, activated by COVID-19 and life satisfaction (SWLS) on the relationship between PTSD symptoms and post-traumatic growth (PTG). We also examined the moderated mediating effect of severity of trauma symptoms on life satisfaction and existential anxiety and its associations with PTG. METHOD: We conducted an online survey during the peak of the COVID-19 outbreak in Poland. The participants completed existential anxiety scale (SNE), life satisfaction scale (SWLS), IES-R scale for measuring the level of PTSD symptoms and post-traumatic growth inventory (PTGI). RESULTS: The effect of PTSD on PTG was found to be mediated by existential anxiety and life satisfaction. We also confirmed two indirect effects: (1) the indirect effect of PTSD on PTG via existential anxiety and life satisfaction tested simultaneously; (2) the indirect effect of life satisfaction on PTG through severity of trauma symptoms. An intermediate or high level of PTSD level was related to less PTG when low and full PTSD stress symptoms strengthened PTG experiences. CONCLUSIONS: A therapeutic intervention for individuals after traumatic experience should attempt to include fundamental existential questions and meaning of life as well as the severity of PTSD symptoms. The severity of traumatic sensations may affect the relationship between life satisfaction and post-traumatic growth.


Assuntos
Ansiedade/psicologia , Infecções por Coronavirus/psicologia , Pandemias , Satisfação Pessoal , Pneumonia Viral/psicologia , Crescimento Psicológico Pós-Traumático , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Polônia/epidemiologia
5.
Transl Psychiatry ; 10(1): 319, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32950999

RESUMO

Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12-0.45), anxiety (OR = 0.26; 95% CI: 0.16-0.42), insomnia (OR = 0.19; 95% CI: 0.06-0.58), and PTSD (OR = 0.15; 95% CI: 0.04-0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Gestantes/psicologia , Distúrbios do Início e da Manutenção do Sono , Transtornos Somatoformes , Transtornos de Estresse Pós-Traumáticos , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Gravidez , Pesquisa Qualitativa , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
6.
Cochrane Database Syst Rev ; 9: CD012417, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32897548

RESUMO

BACKGROUND: People living in 'humanitarian settings' in low- and middle-income countries (LMICs) are exposed to a constellation of physical and psychological stressors that make them vulnerable to developing mental disorders. A range of psychological and social interventions have been implemented with the aim to prevent the onset of mental disorders and/or lower psychological distress in populations at risk, and it is not known whether interventions are effective. OBJECTIVES: To compare the efficacy and acceptability of psychological and social interventions versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at preventing the onset of non-psychotic mental disorders in people living in LMICs affected by humanitarian crises. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR), the Cochrane Drugs and Alcohol Review Group (CDAG) Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), Embase (OVID), PsycINFO (OVID), and ProQuest PILOTS database with results incorporated from searches to February 2020. We also searched the World Health Organization's (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov to identify unpublished or ongoing studies. We checked the reference lists of relevant studies and reviews. SELECTION CRITERIA: All randomised controlled trials (RCTs) comparing psychological and social interventions versus control conditions to prevent the onset of mental disorders in adults and children living in LMICs affected by humanitarian crises. We excluded studies that enrolled participants based on a positive diagnosis of mental disorder (or based on a proxy of scoring above a cut-off score on a screening measure). DATA COLLECTION AND ANALYSIS: We calculated standardised mean differences for continuous outcomes and risk ratios for dichotomous data, using a random-effects model. We analysed data at endpoint (zero to four weeks after therapy) and at medium term (one to four months after intervention). No data were available at long term (six months or longer). We used GRADE to assess the quality of evidence. MAIN RESULTS: In the present review we included seven RCTs with a total of 2398 participants, coming from both children/adolescents (five RCTs), and adults (two RCTs). Together, the seven RCTs compared six different psychosocial interventions against a control comparator (waiting list in all studies). All the interventions were delivered by paraprofessionals and, with the exception of one study, delivered at a group level. None of the included studies provided data on the efficacy of interventions to prevent the onset of mental disorders (incidence). For the primary outcome of acceptability, there may be no evidence of a difference between psychological and social interventions and control at endpoint for children and adolescents (RR 0.93, 95% CI 0.78 to 1.10; 5 studies, 1372 participants; low-quality evidence) or adults (RR 0.96, 95% CI 0.61 to 1.50; 2 studies, 767 participants; very low quality evidence). No information on adverse events related to the interventions was available. For children's and adolescents' secondary outcomes of prevention interventions, there may be no evidence of a difference between psychological and social intervention groups and control groups for reducing PTSD symptoms (standardised mean difference (SMD) -0.16, 95% CI -0.50 to 0.18; 3 studies, 590 participants; very low quality evidence), depressive symptoms (SMD -0.01, 95% CI -0.29 to 0.31; 4 RCTs, 746 participants; very low quality evidence) and anxiety symptoms (SMD 0.11, 95% CI -0.09 to 0.31; 3 studies, 632 participants; very low quality evidence) at study endpoint. In adults' secondary outcomes of prevention interventions, psychological counselling may be effective for reducing depressive symptoms (MD -7.50, 95% CI -9.19 to -5.81; 1 study, 258 participants; very low quality evidence) and anxiety symptoms (MD -6.10, 95% CI -7.57 to -4.63; 1 study, 258 participants; very low quality evidence) at endpoint. No data were available for PTSD symptoms in the adult population. Owing to the small number of RCTs included in the present review, it was not possible to carry out neither sensitivity nor subgroup analyses. AUTHORS' CONCLUSIONS: Of the seven prevention studies included in this review, none assessed whether prevention interventions reduced the incidence of mental disorders and there may be no evidence for any differences in acceptability. Additionally, for both child and adolescent populations and adult populations, a very small number of RCTs with low quality evidence on the review's secondary outcomes (changes in symptomatology at endpoint) did not suggest any beneficial effect for the studied prevention interventions. Confidence in the findings is hampered by the scarcity of prevention studies eligible for inclusion in the review, by risk of bias in the studies, and by substantial levels of heterogeneity. Moreover, it is possible that random error had a role in distorting results, and that a more thorough picture of the efficacy of prevention interventions will be provided by future studies. For this reason, prevention studies are urgently needed to assess the impact of interventions on the incidence of mental disorders in children and adults, with extended periods of follow-up.


Assuntos
Países em Desenvolvimento , Transtornos Mentais/prevenção & controle , Psicoterapia , Problemas Sociais/psicologia , Estresse Fisiológico , Estresse Psicológico/complicações , Adolescente , Adulto , Fatores Etários , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Viés , Criança , Depressão/diagnóstico , Depressão/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Humanos , Transtornos Mentais/etiologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Listas de Espera
7.
PLoS Med ; 17(9): e1003297, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32931504

RESUMO

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.


Assuntos
Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , Ansiedade , Transtornos de Ansiedade , Criança , Estudos Transversais , Países em Desenvolvimento , Feminino , Infecções por HIV/epidemiologia , Humanos , Saúde Mental , Pessoa de Meia-Idade , Pobreza , Prevalência , Fatores de Risco , Sexo Seguro , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Tentativa de Suicídio , Violência
8.
PLoS Med ; 17(9): e1003337, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32956381

RESUMO

BACKGROUND: Globally, the number of refugees and asylum seekers has reached record highs. Past research in refugee mental health has reported wide variation in mental illness prevalence data, partially attributable to methodological limitations. This systematic review aims to summarise the current body of evidence for the prevalence of mental illness in global refugee populations and overcome methodological limitations of individual studies. METHODS AND FINDINGS: A comprehensive search of electronic databases was undertaken from 1 January 2003 to 4 February 2020 (MEDLINE, MEDLINE In-Process, EBM Reviews, Embase, PsycINFO, CINAHL, PILOTS, Web of Science). Quantitative studies were included if diagnosis of mental illness involved a clinical interview and use of a validated assessment measure and reported at least 50 participants. Study quality was assessed using a descriptive approach based on a template according to study design (modified Newcastle-Ottawa Scale). Random-effects models, based on inverse variance weights, were conducted. Subgroup analyses were performed for sex, sample size, displacement duration, visa status, country of origin, current residence, type of interview (interpreter-assisted or native language), and diagnostic measure. The systematic review was registered with PROSPERO (CRD) 42016046349. The search yielded a result of 21,842 records. Twenty-six studies, which included one randomised controlled trial and 25 observational studies, provided results for 5,143 adult refugees and asylum seekers. Studies were undertaken across 15 countries: Australia (652 refugees), Austria (150), China (65), Germany (1,104), Italy (297), Lebanon (646), Nepal (574), Norway (64), South Korea (200), Sweden (86), Switzerland (164), Turkey (238), Uganda (77), United Kingdom (420), and the United States of America (406). The prevalence of posttraumatic stress disorder (PTSD) was 31.46% (95% CI 24.43-38.5), the prevalence of depression was 31.5% (95% CI 22.64-40.38), the prevalence of anxiety disorders was 11% (95% CI 6.75-15.43), and the prevalence of psychosis was 1.51% (95% CI 0.63-2.40). A limitation of the study is that substantial heterogeneity was present in the prevalence estimates of PTSD, depression, and anxiety, and limited covariates were reported in the included studies. CONCLUSIONS: This comprehensive review generates current prevalence estimates for not only PTSD but also depression, anxiety, and psychosis. Refugees and asylum seekers have high and persistent rates of PTSD and depression, and the results of this review highlight the need for ongoing, long-term mental health care beyond the initial period of resettlement.


Assuntos
Transtornos Mentais/epidemiologia , Refugiados/psicologia , Ansiedade/epidemiologia , Transtornos de Ansiedade , Depressão/epidemiologia , Transtorno Depressivo , Feminino , Humanos , Masculino , Saúde Mental/tendências , Prevalência , Transtornos de Estresse Pós-Traumáticos/epidemiologia
9.
Cancer Cytopathol ; 128(9): 597-598, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32885911
11.
Cogn Neuropsychiatry ; 25(5): 348-363, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32847486

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Imagens, Psicoterapia/tendências , Saúde Mental/tendências , Pneumonia Viral/terapia , Trauma Psicológico/terapia , Transtornos de Estresse Pós-Traumáticos/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Emoções/fisiologia , Humanos , Imagens, Psicoterapia/métodos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Pensamento/fisiologia
12.
Psychol Trauma ; 12(7): 812-819, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32853011

RESUMO

Objective: The objective of this study was to assess the emergence of posttraumatic stress symptoms (PTSS) in Greek health care professionals during the COVID-19 pandemic. Method: A cross-sectional study was conducted via an online survey from April 10 until April 13, 2020. The survey included sociodemographic questions and the following psychometric tools: the Peritraumatic Distress Inventory, the Posttraumatic Stress Disorder-8 questionnaire, the Brief Patient Health Questionnaire Depression scale, the Athens Insomnia Scale, and 3 questions about negative perceptions of COVID-19. The survey was distributed through social media and comprises part of a larger survey targeting the general population. Altogether, 270 health care professionals responded to the survey. Results: Health care professionals appeared to be moderately stressed from the COVID-19 crisis, with women scoring higher on all clinical scales and the difference between women and men being statistically significant. Criteria for a probable posttraumatic stress disorder diagnosis were met by a total of 16.7% (21.7% of women; 5.1% of men). Negative emotion and threatened or physical tension are positive significant predictors of PTSS. Those suffering with higher levels of PTSS scored positively for insomnia and exhibited significantly higher peritraumatic distress. Conclusion: Health care professionals could benefit by being screened for PTSS and insomnia. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Grécia/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores Sexuais , Adulto Jovem
13.
Am J Geriatr Psychiatry ; 28(10): 1030-1039, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32753338

RESUMO

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.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Aposentadoria/estatística & dados numéricos , Apoio Social , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Sobreviventes/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Convalescença , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Depressão/psicologia , Emprego/estatística & dados numéricos , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Fatores de Proteção , Angústia Psicológica , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Sobreviventes/psicologia
14.
PLoS Med ; 17(8): e1003262, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32813696

RESUMO

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.


Assuntos
Saúde Mental , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/psicologia , Antipsicóticos/uso terapêutico , Terapia Cognitivo-Comportamental/métodos , Comorbidade , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Transtornos de Estresse Pós-Traumáticos/epidemiologia
15.
PLoS One ; 15(8): e0237578, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797104

RESUMO

Although rurality is often treated as an aspect of diversity, researchers disagree regarding whether the traditional rural values of self-reliance, distrust of outsiders, religiosity, centrality of family, and fatalism continue to differentiate rural versus urban undergraduates. The present study examined 1) whether differences in these values exist between rural and urban college students in the United States and 2) whether these rural values might mediate the association between geographic remoteness and posttraumatic stress symptom (PTSS) severity. College undergraduates in the United States who reported experiencing traumatic and/or stressful events (N = 213) completed measures of these constructs through an online survey. T-test results indicated that rural respondents had significantly higher levels of PTSS severity and distrust of outsiders and significantly lower levels of religiosity when compared with urban participants. After controlling for gender, distrust of outsiders and religiosity also emerged as significant mediators of the relationship between geographic remoteness and PTSS severity. Thus, despite research that highlights differences based on geographic location, similarities and differences exist for rural and urban undergraduates in the United States with regard to traditionally rural values. For rural undergraduate clients presenting with trauma symptoms, our results suggest that building trust and religious and/or spiritual self-care may be particularly critical.


Assuntos
População Rural/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estudantes/psicologia , População Urbana/estatística & dados numéricos , Adolescente , Características Culturais , Feminino , Humanos , Masculino , Religião , Autocuidado/psicologia , Índice de Gravidade de Doença , Estudantes/classificação , Estados Unidos/epidemiologia , Adulto Jovem
16.
Psychiatry Res ; 292: 113347, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32763477

RESUMO

Emerging evidence suggests rates of posttraumatic stress and psychological stress in the general population are elevated due to COVID-19. However, a meta-analysis is needed to attain more precise prevalence estimates due to between-study variability. Thus, we performed a rapid review and meta-analysis of posttraumatic stress and general psychological stress symptoms during COVID-19. Electronic searches were conducted up to May 26th, 2020 using key terms: mental illness and COVID-19. A total of k = 14 non-overlapping studies were identified for inclusion. Random effects meta-analyses indicated that the pooled prevalence of posttraumatic stress symptoms and psychological stress in the general population was 23.88% and 24.84%, respectively. In both meta-analyses, the prevalence of stress symptoms was higher in unpublished compared to peer-reviewed studies. Overall, nearly one-in-four adults experienced significant stress due to the COVID-19 pandemic. Psychological resources and services must be allocated to help address the mental health burden of COVID-19. High quality, longitudinal research on the long-term mental health effects of the pandemic is greatly needed.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/epidemiologia , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Saúde Mental , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia
17.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32817266

RESUMO

OBJECTIVES: To test the effect of a 4-month telehealth home monitoring program (REACH), layered on usual care, on postdischarge outcomes in parents of infants recovering from cardiac surgery and their infants. METHODS: Randomized trial of infants discharged from the hospital after cardiac surgery for congenital heart disease. Consecutive infants with complex congenital heart disease undergoing cardiac surgery within 21 days of life were enrolled at 3 university-affiliated pediatric cardiac centers. RESULTS: From 2012 to 2016, 219 parent-infant dyads were enrolled; 109 were randomly assigned to the intervention group and 110 to the control group. At 4 months postdischarge, parenting stress was not significantly different between groups (total Parenting Stress Index in the intervention group was 220 and in the control group was 215; P = .61). The percentages of parents who met posttraumatic stress disorder (PTSD) criteria and parent quality of life inventory scores were also not significantly different between the 2 groups (PTSD in the intervention group was 18% and was 18% in the control group; P =.56; the mean Ulm Quality of Life Inventory for Parents in the intervention group was 71 andwas 70 in the control group; P = .88). Infant growth in both groups was suboptimal (the mean weight-for-age z scores were -1.1 in the intervention group and -1.2 in the control group; P = .56), and more infants in the intervention group were readmitted to the hospital (66% in the intervention group versus 57% in the control group; P < .001). CONCLUSIONS: When added to usual care, the REACH intervention was not associated with an improvement in parent or infant outcomes. Four months after neonatal heart surgery, ∼20% of parents demonstrate PTSD symptoms. Suboptimal infant growth and hospital readmissions were common.


Assuntos
Cardiopatias Congênitas/cirurgia , Pais/psicologia , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Telemedicina , Adulto , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Monitorização Ambulatorial/métodos , Readmissão do Paciente/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Resultado do Tratamento
18.
J Health Psychol ; 25(9): 1164-1175, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32627606

RESUMO

This study aims to explore the relationship between psychological distress and post-traumatic stress disorder among Chinese participants as the result of COVID-19 outbreak. This study was conducted within 1 month after COVID-19 appeared in China, it included 570 participants age from 14 to 35. The results indicated that 12.8% of all participants with the symptoms of post-traumatic stress disorder and the effects of psychological distress on post-traumatic stress disorder was mediated by negative coping style. Gender moderated the direct effect between psychological distress and post-traumatic stress disorder, which is a significant discovery for relevant departments to take further measures.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Angústia Psicológica , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Adaptação Psicológica , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
19.
Soins Psychiatr ; 41(326): 24-29, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32718523

RESUMO

Frequently overlooked during the patient's treatment, psychological trauma can constitute a significant part of the addiction problem. Clinical data reveal a high incidence of post-traumatic stress disorder for which addictive behaviours may be a way of repressing the anxiety caused by the trauma. Systematic screening for trauma would help to ensure an appropriate treatment plan is put in place.


Assuntos
Comportamento Aditivo/psicologia , Comportamento Aditivo/terapia , Trauma Psicológico/diagnóstico , Ansiedade/psicologia , Humanos , Trauma Psicológico/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA