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1.
J Affect Disord ; 277: 893-900, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065831

RESUMO

BACKGROUND: The mental health status caused by major epidemics is serious and lasting. At present, there are few studies about the lasting mental health effects of COVID-19 outbreak. The purpose of this study was to investigate the mental health of the Chinese public during the long-term COVID-19 outbreak. METHODS: A total of 1172 online questionnaires were collected, covering demographical information and 8 common psychological states: depression, anxiety, somatization, stress, psychological resilience, suicidal ideation and behavior, insomnia, and stress disorder. In addition, the geographical and temporal distributions of different mental states were plotted. RESULTS: Overall, 30.1% of smokers increased smoking, while 11.3% of drinkers increased alcohol consumption. The prevalence rates of depression, anxiety, mental health problems, high risk of suicidal and behavior, clinical insomnia, clinical post-traumatic stress disorder symptoms, moderate-to-high levels of perceived stress were 18.8%, 13.3%, 7.6%, 2.8%, 7.2%, 7.0%, and 67.9%, respectively. Further, the geographical distribution showed that the mental status in some provinces/autonomous regions/municipalities was relatively more serious. The temporal distribution showed that the psychological state of the participants was relatively poorer on February 20, 24 to 26 and March 25, especially on March 25. LIMITATIONS: This cross-sectional design cannot make causal inferences. The snowball sampling was not representative enough. CONCLUSION: Our findings suggest that the prevalence rate of mental disorders in the Chinese public is relatively low in the second month of the COVID-19 pandemic. In addition, people's mental state is affected by the geographical and temporal distributions.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ideação Suicida , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Resiliência Psicológica , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fumar/epidemiologia , Fumar/psicologia , Transtornos Somatoformes/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
2.
J Trauma Stress ; 33(5): 634-642, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33007149

RESUMO

In response to COVID-19, continued workforce training is essential to ensure that evidence-based treatments are available on the frontline to meet communities' ongoing and emerging mental health needs. However, training during a pandemic imposes many new challenges. This paper describes a multisite training and implementation pilot program, facets of which allowed for continued training despite the onset of the COVID-19 pandemic and subsequent social distancing guidelines. This virtual facilitated learning collaborative in Written Exposure Therapy, an evidence-based treatment for posttraumatic stress disorder, included virtual workshop training, phone-based clinical consultation, implementation-focused video calls for program leadership, and program evaluation. Data are presented about program enrollees and patient impact following the onset of COVID-19-related social distancing restrictions. Challenges, successes, and practical guidance are discussed to inform the field regarding training strategies likely to be durable in an uncertain, dynamic healthcare landscape.


Assuntos
Infecções por Coronavirus/psicologia , Educação a Distância/organização & administração , Terapia Implosiva/educação , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Betacoronavirus , Medicina Baseada em Evidências/métodos , Humanos , Pandemias , Desenvolvimento de Programas/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia , Redação
3.
BMC Psychol ; 8(1): 105, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023667

RESUMO

BACKGROUND: Trauma has a major impact on the mental health and wellbeing of people globally. Friends, family and members of the public are often well positioned to provide initial assistance if someone is experiencing extreme distress following a potentially traumatic event. Expert consensus guidelines for high income, Western countries on how to do this were published in 2008. The aim of the current study was to re-develop these guidelines to ensure they are current and reflect best practice. METHODS: The Delphi consensus method was used to determine which helping statements should be included in the guidelines. Helping statements were derived from a systematic search of literature that considered how a member of the public could help someone experiencing extreme distress following a potentially traumatic event. Two expert panels, comprising 28 mental health professionals with expertise in managing trauma and 26 consumer advocates, rated each statement. Statements were accepted for inclusion in the guidelines if they were endorsed by at least 80% of each panel. RESULTS: Out of 183 statements, 103 were endorsed as appropriate helping actions in providing assistance to someone experiencing extreme distress following a potentially traumatic event. These statements were used to form the re-developed guidelines. CONCLUSION: This study has resulted in a more comprehensive set of guidelines than the original version, with the endorsement of 103 helping actions, compared to 65 previously. The updated guidelines better represent the complexities of experiencing trauma and the considered approach required when providing first aid after a potentially traumatic event. The additional guidance on providing initial assistance, talking about the trauma, offering short-term assistance and seeking appropriate professional help reflects current knowledge. A notable addition is the inclusion of content on how a first aider can assist after a disclosure of abuse. The guidelines are available to the public and will inform future updates of Mental Health First Aid training courses.


Assuntos
Primeiros Socorros , Guias como Assunto , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/terapia , Consenso , Técnica Delfos , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários
4.
Chron Respir Dis ; 17: 1479973120962800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000648

RESUMO

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.


Assuntos
Asma , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono , Transtornos de Estresse Pós-Traumáticos , Asma/epidemiologia , Asma/psicologia , Betacoronavirus , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Depressão/psicologia , Autoavaliação Diagnóstica , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Angústia Psicológica , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pesquisa Qualitativa , Autoimagem , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
5.
Psychiatr Danub ; 32(Suppl 3): 320-336, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030447

RESUMO

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.


Assuntos
Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Guerra/psicologia , Adolescente , Adulto , Idoso , Bósnia e Herzegóvina , Criança , Família/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Refugiados/psicologia , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/reabilitação , Adulto Jovem
6.
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
7.
Psychiatr Danub ; 32(Suppl 3): 364-366, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030454

RESUMO

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.


Assuntos
Filho de Pais Incapacitados/psicologia , Fadiga por Compaixão/psicologia , Psicologia do Adolescente , Psicologia da Criança , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adolescente , Bósnia e Herzegóvina , Criança , Feminino , Humanos , Masculino
8.
Psychiatr Danub ; 32(Suppl 3): 367-370, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030455

RESUMO

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.


Assuntos
Maus-Tratos Infantis/psicologia , Violência Doméstica/psicologia , Trauma Psicológico/psicologia , Adulto , Criança , Maus-Tratos Infantis/legislação & jurisprudência , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/terapia , Violência Doméstica/legislação & jurisprudência , Violência Doméstica/prevenção & controle , Feminino , Humanos , Masculino , Mães/psicologia , Trauma Psicológico/prevenção & controle , Trauma Psicológico/terapia , Fatores de Risco , Instituições Acadêmicas , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia
9.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006815
10.
Artigo em Inglês | MEDLINE | ID: mdl-33120930

RESUMO

The Coronavirus Disease 2019 (COVID-19) pandemic has deeply altered social and working environments in several ways. Social distancing policies, mandatory lockdowns, isolation periods, and anxiety of getting sick, along with the suspension of productive activity, loss of income, and fear of the future, jointly influence the mental health of citizens and workers. Workplace aspects can play a crucial role on moderating or worsening mental health of people facing this pandemic scenario. The purpose of this literature review is to deepen the psychological aspects linked to workplace factors, following the epidemic rise of COVID-19, in order to address upcoming psychological critical issues in the workplaces. We performed a literature search using Google Scholar, PubMed, and Scopus, selecting papers focusing on workers' psychological problems that can be related to the workplace during the pandemic. Thirty-five articles were included. Mental issues related to the health emergency, such as anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disorders are more likely to affect healthcare workers, especially those on the frontline, migrant workers, and workers in contact with the public. Job insecurity, long periods of isolation, and uncertainty of the future worsen the psychological condition, especially in younger people and in those with a higher educational background. Multiple organizational and work-related interventions can mitigate this scenario, such as the improvement of workplace infrastructures, the adoption of correct and shared anti-contagion measures, including regular personal protective equipment (PPE) supply, and the implementation of resilience training programs. This review sets the basis for a better understanding of the psychological conditions of workers during the pandemic, integrating individual and social perspectives, and providing insight into possible individual, social, and occupational approaches to this "psychological pandemic".


Assuntos
Infecções por Coronavirus/psicologia , Coronavirus , Pessoal de Saúde/psicologia , Saúde Mental/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Pneumonia Viral/psicologia , Angústia Psicológica , Local de Trabalho/psicologia , Ansiedade/psicologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Transtornos do Sono-Vigília/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia
11.
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
12.
Epidemiol Psychiatr Sci ; 29: e175, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33070799

RESUMO

AIMS: Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. METHODS: A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. RESULTS: Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. CONCLUSIONS: The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Terremotos , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adaptação Psicológica , Adolescente , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Coortes , Depressão/diagnóstico , Depressão/etnologia , Depressão/psicologia , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , Transtornos de Estresse Pós-Traumáticos/etnologia , Suicídio/psicologia , Tentativa de Suicídio/psicologia , Inquéritos e Questionários , Sobreviventes
13.
Afr J AIDS Res ; 19(3): 206-213, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32892702

RESUMO

Over-integration of HIV-related trauma into the client's memory in a negative emotional valence could be a serious health debilitating process which may result in negative post-traumatic health outcomes, affecting health-related quality of life (HRQoL) of people living with HIV (PLWH). We hypothesized that post-traumatic stress disorder (PTSD) symptoms are the mediating link between negative event centrality (NEC) and HRQoL among PLWH. Nine hundred and sixty-nine PLWH in Nigeria completed measures of NEC, PTSD symptoms and HRQoL. Model 4 of Hayes' regression-based PROCESS macro version 3.0 for SPSS was employed to investigate relationships between variables of interest. NEC was positively associated with all domains of HRQoL. PLWH who had high negatively centralized identity on HIV also had high scores on PTSD symptoms. PTSD symptoms were also positively associated with all domains of HRQoL. PTSD symptoms also mediated the relationship between NEC and all domains of HRQoL. Assessing and treating PTSD symptoms among PLWH by clinicians could be helpful in enhancing HRQoL.


Assuntos
Infecções por HIV/psicologia , Negativismo , Qualidade de Vida/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Nigéria/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia
14.
J Trauma Stress ; 33(5): 623-633, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32865850

RESUMO

The COVID-19 pandemic presents major challenges for mental health care providers. In particular, providers who treat posttraumatic stress disorder (PTSD) are now tasked with determining whether to initiate trauma-focused therapy during the pandemic and, if so, whether and how to adapt treatment. The purpose of this communication is to identify and organize key considerations for whether and how to deliver commonly used evidence-supported therapy protocols for trauma treatment-specifically, cognitive processing therapy (CPT) and prolonged exposure (PE) therapy-during the ongoing COVID-19 pandemic for adults who currently meet the criteria for PTSD. Based on relevant public health and clinical literature, we present a structured guide that can be used by treatment teams and individual providers to evaluate whether initiating CPT or PE is indicated given a particular patient-provider pair and system context amidst pandemic conditions. In addition, we suggest appropriate action steps, including problem-solving strategies, evidence-informed modifications to CPT and PE, and alternative intervention approaches.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Infecções por Coronavirus/psicologia , Assistência à Saúde/organização & administração , Terapia Implosiva/métodos , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Atitude do Pessoal de Saúde , Betacoronavirus , Continuidade da Assistência ao Paciente , Humanos , Pandemias , Cooperação do Paciente , Transtornos de Estresse Pós-Traumáticos/psicologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-32906590

RESUMO

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.


Assuntos
Infecções por Coronavirus/psicologia , Enfermeiras e Enfermeiros/psicologia , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Polônia , Senso de Coerência , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia
16.
Cancer Cytopathol ; 128(9): 597-598, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32885911
17.
J Med Internet Res ; 22(10): e22635, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-32936777

RESUMO

BACKGROUND: The COVID-19 pandemic is impacting mental health, but it is not clear how people with different types of mental health problems were differentially impacted as the initial wave of cases hit. OBJECTIVE: The aim of this study is to leverage natural language processing (NLP) with the goal of characterizing changes in 15 of the world's largest mental health support groups (eg, r/schizophrenia, r/SuicideWatch, r/Depression) found on the website Reddit, along with 11 non-mental health groups (eg, r/PersonalFinance, r/conspiracy) during the initial stage of the pandemic. METHODS: We created and released the Reddit Mental Health Dataset including posts from 826,961 unique users from 2018 to 2020. Using regression, we analyzed trends from 90 text-derived features such as sentiment analysis, personal pronouns, and semantic categories. Using supervised machine learning, we classified posts into their respective support groups and interpreted important features to understand how different problems manifest in language. We applied unsupervised methods such as topic modeling and unsupervised clustering to uncover concerns throughout Reddit before and during the pandemic. RESULTS: We found that the r/HealthAnxiety forum showed spikes in posts about COVID-19 early on in January, approximately 2 months before other support groups started posting about the pandemic. There were many features that significantly increased during COVID-19 for specific groups including the categories "economic stress," "isolation," and "home," while others such as "motion" significantly decreased. We found that support groups related to attention-deficit/hyperactivity disorder, eating disorders, and anxiety showed the most negative semantic change during the pandemic out of all mental health groups. Health anxiety emerged as a general theme across Reddit through independent supervised and unsupervised machine learning analyses. For instance, we provide evidence that the concerns of a diverse set of individuals are converging in this unique moment of history; we discovered that the more users posted about COVID-19, the more linguistically similar (less distant) the mental health support groups became to r/HealthAnxiety (ρ=-0.96, P<.001). Using unsupervised clustering, we found the suicidality and loneliness clusters more than doubled in the number of posts during the pandemic. Specifically, the support groups for borderline personality disorder and posttraumatic stress disorder became significantly associated with the suicidality cluster. Furthermore, clusters surrounding self-harm and entertainment emerged. CONCLUSIONS: By using a broad set of NLP techniques and analyzing a baseline of prepandemic posts, we uncovered patterns of how specific mental health problems manifest in language, identified at-risk users, and revealed the distribution of concerns across Reddit, which could help provide better resources to its millions of users. We then demonstrated that textual analysis is sensitive to uncover mental health complaints as they appear in real time, identifying vulnerable groups and alarming themes during COVID-19, and thus may have utility during the ongoing pandemic and other world-changing events such as elections and protests.


Assuntos
Ansiedade/diagnóstico , Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Saúde Mental/estatística & dados numéricos , Processamento de Linguagem Natural , Pneumonia Viral/epidemiologia , Grupos de Autoajuda/estatística & dados numéricos , Mídias Sociais/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Betacoronavirus , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/psicologia , Feminino , Saúde Global , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Adulto Jovem
18.
BMJ Case Rep ; 13(9)2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943446

RESUMO

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.


Assuntos
Transtorno Bipolar/psicologia , Terremotos , Acidente Nuclear de Fukushima , Socorro em Desastres , Transtornos de Estresse Pós-Traumáticos/psicologia , Tsunamis , Adulto , Betacoronavirus , Transtorno Bipolar/terapia , Infecções por Coronavirus , Desastres , Humanos , Terapia Implosiva , Masculino , Pandemias , Pneumonia Viral , Transtornos de Estresse Pós-Traumáticos/terapia
19.
J Med Internet Res ; 22(9): e19716, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32975521

RESUMO

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.


Assuntos
Inquéritos Epidemiológicos , Aplicativos Móveis , Encaminhamento e Consulta , Resiliência Psicológica , Autocuidado/métodos , Autocuidado/normas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Ansiedade/diagnóstico , Lista de Checagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Análise Fatorial , Feminino , Humanos , Internet , Masculino , Países Baixos/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Psicometria , Reprodutibilidade dos Testes , Estresse Psicológico/diagnóstico
20.
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
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