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1.
Recenti Prog Med ; 112(3): 207-215, 2021 03.
Artigo em Italiano | MEDLINE | ID: mdl-33687359

RESUMO

OBJECTIVES: The recent lockdown, resulting from the SARS-CoV-2 pandemic, has had a strong social and psychological impact on the most fragile individuals and family structures. In the present work we investigated the experience of families without specific elements of social or health vulnerability during the quarantine period that occurred in the spring of 2020. MATERIALS AND METHODS: Between May and July 2020, 22 primary care pediatricians belonging to AUSL Romagna administered to a number of families a questionnaire to detect changes that occurred, during the lockdown, in family environment, school attendance and personal attitudes. RESULTS: A total of 721 questionnaires were collected, analyzing the associations between variables relating to home environment, daily rhythms, school and warning signs in relation to the age of children. As a result of the lockdown, family habits changed in 31% of cases, with a greater presence of the reference figure in 68% of these. Three out of four families reported they had sufficient domestic spaces, and nine out of ten had access to an outdoor, private or condominium space. Daily rhythms were preserved in 56.7% of cases; mood disorders appeared in 30% of adolescent children, followed by sleep, appetite and psychosomatic disorders. One in three children has made progress in terms of evolution and behavior, and one in 5 children has seen their relationships improve. The overall resilience of families during the lockdown period was considered good in 66.3%, sufficient in 31.3% and not satisfactory in only 2.4% of cases. CONCLUSIONS: Our data show that, in the interviewed families, the simultaneous presence of adults and children at home has generally intensified. Families refer, on the whole, a positive and resilient behavior in the lockdown period, even if initial emotional problems are reported in one out of three children-adolescents. The ability to maintain a family organized structure seems to be partially compromised. Forced cohabitation leads to competition for the same resources of time and space and affects the entire family unit. The school institution emerges as a protective factor for children, young people and also for the well-being of families themselves.


Assuntos
/prevenção & controle , Medicina Comunitária , Relações Familiares/psicologia , Pandemias , Pediatras , Psicologia do Adolescente , Psicologia da Criança , Quarentena/psicologia , Adolescente , Adulto , Atitude , Criança , Pré-Escolar , Aglomeração/psicologia , Emigrantes e Imigrantes/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Feminino , Pesquisas sobre Serviços de Saúde , Habitação , Humanos , Lactente , Recém-Nascido , Masculino , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Pais/psicologia , Transtornos Psicofisiológicos/epidemiologia , Transtornos Psicofisiológicos/etiologia , Instituições Acadêmicas , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia
2.
Tohoku J Exp Med ; 253(3): 203-215, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33775993

RESUMO

Coronavirus disease 2019 (COVID-19) is causing disruptions in the global social system. Japanese children and adolescents have had their schools closed, government-mandated activity restrictions imposed, and interactions outside the home reduced. These restrictions can have a considerable psychological impact on children and adolescents. This review aims to describe the impacts of COVID-19 pandemic on physical activity and psychological status of this population. The review was conducted by searching PubMed for information on the impact of COVID-19-related activity restrictions on children and adolescents. The search identified 11 articles, three of which contained data on anxiety and psychological problems due to physical inactivity. Next, a PubMed search was conducted about physical activity and psychological status in children and adolescents under psychological stress. The search identified 368 articles, 28 of which were included in the review. For children, data that revealed a correlation between physical activity and psychological health and sedentary time leading to mood disorders were included. For adolescents, there were nine studies that reported a correlation between physical activity and psychological health and four studies that reported no correlation between physical activity and psychological health. Of the studies that reported a correlation, seven reported that physical activity improves psychological health. The impact of psychologically stressful situations such as COVID-19 on children and adolescents has been experienced worldwide. Physical activity has been correlated with psychological health, and it may improve psychological status; physical activity should be recommended to better support the psychological health of children and adolescents under the influence of COVID-19.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Controle de Doenças Transmissíveis/métodos , Exercício Físico , Saúde Mental , Pandemias , Psicologia do Adolescente , Psicologia da Criança , Adolescente , Ansiedade/epidemiologia , Ansiedade/etiologia , /psicologia , Criança , Depressão/epidemiologia , Depressão/etiologia , Humanos , Japão/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Quarentena/psicologia , Instituições Acadêmicas/legislação & jurisprudência , Comportamento Sedentário , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Recursos Humanos
3.
Eur Arch Psychiatry Clin Neurosci ; 271(2): 259-270, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33544227

RESUMO

On March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.


Assuntos
Emergências/psicologia , Transtornos Mentais/terapia , Pandemias , Psiquiatria/estatística & dados numéricos , Adulto , Idoso , Efeitos Psicossociais da Doença , Feminino , Alemanha , Humanos , Masculino , Transtornos Mentais/classificação , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/terapia , Transtornos Neuróticos/epidemiologia , Transtornos Neuróticos/psicologia , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Fatores Sexuais , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ideação Suicida
5.
JAMA Psychiatry ; 78(4): 380-386, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33502436

RESUMO

Importance: To date, the association of psychiatric diagnoses with mortality in patients infected with coronavirus disease 2019 (COVID-19) has not been evaluated. Objective: To assess whether a diagnosis of a schizophrenia spectrum disorder, mood disorder, or anxiety disorder is associated with mortality in patients with COVID-19. Design, Setting, and Participants: This retrospective cohort study assessed 7348 consecutive adult patients for 45 days following laboratory-confirmed COVID-19 between March 3 and May 31, 2020, in a large academic medical system in New York. The final date of follow-up was July 15, 2020. Patients without available medical records before testing were excluded. Exposures: Patients were categorized based on the following International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnoses before their testing date: (1) schizophrenia spectrum disorders, (2) mood disorders, and (3) anxiety disorders. Patients with these diagnoses were compared with a reference group without psychiatric disorders. Main Outcomes and Measures: Mortality, defined as death or discharge to hospice within 45 days following a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result. Results: Of the 26 540 patients tested, 7348 tested positive for SARS-CoV-2 (mean [SD] age, 54 [18.6] years; 3891 [53.0%] women). Of eligible patients with positive test results, 75 patients (1.0%) had a history of a schizophrenia spectrum illness, 564 (7.7%) had a history of a mood disorder, and 360 (4.9%) had a history of an anxiety disorder. After adjusting for demographic and medical risk factors, a premorbid diagnosis of a schizophrenia spectrum disorder was significantly associated with mortality (odds ratio [OR], 2.67; 95% CI, 1.48-4.80). Diagnoses of mood disorders (OR, 1.14; 95% CI, 0.87-1.49) and anxiety disorders (OR, 0.96; 95% CI, 0.65-1.41) were not associated with mortality after adjustment. In comparison with other risk factors, a diagnosis of schizophrenia ranked behind only age in strength of an association with mortality. Conclusions and Relevance: In this cohort study of adults with SARS-CoV-2-positive test results in a large New York medical system, adults with a schizophrenia spectrum disorder diagnosis were associated with an increased risk for mortality, but those with mood and anxiety disorders were not associated with a risk of mortality. These results suggest that schizophrenia spectrum disorders may be a risk factor for mortality in patients with COVID-19.


Assuntos
Transtornos de Ansiedade , Transtornos do Humor , Esquizofrenia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , /terapia , Comorbidade , Feminino , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Mortalidade , New York/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia
6.
J Affect Disord ; 281: 533-538, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33388464

RESUMO

BACKGROUND: Evidence on whether anxiety or mood disorders increases the risk of hypertensive disorders of pregnancy (HDP) has been conflicting. We aimed to evaluate the prevalence of maternal mental disorders over time and their associations with HDP. METHODS: This was a population-based retrospective study involving 9,097,355 pregnant women using Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) data from 2004 through 2014. We calculated the prevalence of maternal anxiety, depression, bipolar disorder and mood disorder and trends of gestational hypertension, preeclampsia and eclampsia during the study period. Multivariate logistic regression was used to examine the association between each mental disorder and HDP. RESULTS: Mental disorders showed increasing trends among pregnant women, with anxiety showing the greatest increase in rates. Unadjusted associations suggest all mental disorders increase the likelihood of HDP. When adjusted for sociodemographic characteristics and comorbidities, only anxiety showed consistently increased risk of gestational hypertension (adjusted odds ratio (aOR) 1.324, 95% CI 1.255-1.397), preeclampsia (aOR 1.522, 95% CI 1.444-1.604), with the strongest association with eclampsia (aOR 1.813, 95% CI 1.260-2.610). LIMITATIONS: Information on medication use is not available in the HCUP-NIS database and might have been contributory to our findings. CONCLUSIONS: Rates of maternal psychopathology are rising in the United States. Our study suggests that pregnant women with anxiety are at increased risk of HDP. Targeted screening for mental disorders as possible clinical risk markers may allow for timely prophylaxis and surveillance for the development of HDP.


Assuntos
Hipertensão Induzida pela Gravidez , Pré-Eclâmpsia , Ansiedade , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Transtornos do Humor/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco
7.
Epidemiol Psychiatr Sci ; 30: e4, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33413716

RESUMO

AIMS: There is currently no universally accepted measure for population-based surveillance of mood and anxiety disorders. As such, the use of multiple linked measures could provide a more accurate estimate of population prevalence. Our primary objective was to apply Bayesian methods to two commonly employed population measures of mood and anxiety disorders to make inferences regarding the population prevalence and measurement properties of a combined measure. METHODS: We used data from the 2012 Canadian Community Health Survey - Mental Health linked to health administrative databases in Ontario, Canada. Structured interview diagnoses were obtained from the survey, and health administrative diagnoses were identified using a standardised algorithm. These two prevalence estimates, in addition to data on the concordance between these measures and prior estimates of their psychometric properties, were used to inform our combined estimate. The marginal posterior densities of all parameters were estimated using Hamiltonian Monte Carlo (HMC), a Markov Chain Monte Carlo technique. Summaries of posterior distributions, including the means and 95% equally tailed posterior credible intervals, were used for interpretation of the results. RESULTS: The combined prevalence mean was 8.6%, with a credible interval of 6.8-10.6%. This combined estimate sits between Bayesian-derived prevalence estimates from administrative data-derived diagnoses (mean = 7.4%) and the survey-derived diagnoses (mean = 13.9%). The results of our sensitivity analysis suggest that varying the specificity of the survey-derived measure has an appreciable impact on the combined posterior prevalence estimate. Our combined posterior prevalence estimate remained stable when varying other prior information. We detected no problematic HMC behaviour, and our posterior predictive checks suggest that our model can reliably recreate our data. CONCLUSIONS: Accurate population-based estimates of disease are the cornerstone of health service planning and resource allocation. As a greater number of linked population data sources become available, so too does the opportunity for researchers to fully capitalise on the data. The true population prevalence of mood and anxiety disorders may reside between estimates obtained from survey data and health administrative data. We have demonstrated how the use of Bayesian approaches may provide a more informed and accurate estimate of mood and anxiety disorders in the population. This work provides a blueprint for future population-based estimates of disease using linked health data.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos do Humor/epidemiologia , Vigilância da População/métodos , Adolescente , Transtornos de Ansiedade/psicologia , Teorema de Bayes , Canadá/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Transtornos do Humor/psicologia , Prevalência
8.
Res Dev Disabil ; 110: 103856, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33497856

RESUMO

During the COVID-19 pandemic, the Oasi Research Institute of Troina (Italy) became an important hotbed for infection; in fact, 109 patients with different levels of Intellectual Disability (ID) tested positive for COVID-19. The procedures and interventions put in place at the Oasi Research Institute due to the COVID-19 pandemic are exhaustively reported in this paper. The description of the clinical procedures as well as remote/in person psychological support services provided to people with ID and their families are here divided into three different sections: Phase I (or Acute phase), Phase II (or Activity planning), and Phase III (or Activity consolidation). In each section, the main psycho-pathological characteristics of patients, the reactions of family members and the multidisciplinary interventions put in place are also described.


Assuntos
/epidemiologia , Deficiências do Desenvolvimento/reabilitação , Deficiência Intelectual/reabilitação , Sistemas de Apoio Psicossocial , Telemedicina , Academias e Institutos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/reabilitação , /fisiopatologia , Criança , Pré-Escolar , Comorbidade , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Surtos de Doenças , Epilepsia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Hipotireoidismo/epidemiologia , Lactente , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/psicologia , Itália , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Transtornos do Humor/reabilitação , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Transtornos da Personalidade/reabilitação , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/reabilitação , Índice de Gravidade de Doença , Adulto Jovem
9.
BMC Psychol ; 9(1): 3, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407846

RESUMO

BACKGROUND: Severe asthma affects a small population but carries a high psychopathological risk. Therefore, the psychodemographic profile of these patients is of interest. A substantial prevalence of anxiety, depression, alexithymia and hyperventilation syndrome in severe asthma is known, but contradictory results have been observed. These factors can also affect patients' quality of life. For this reasons, our purpose is to evaluate the psychodemographic profile of patients with severe asthma and assess the prevalence of anxiety, depression, alexithymia and hyperventilation syndrome and their impact on the quality of life of patients with severe asthma. METHODS: A cross-sectional study of 63 patients with severe asthma. Their psychodemographic profile was evaluated using the Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS-20), Nijmegen questionnaire and Asthma Control Test (ACT) to determine the state of anxiety and depression, alexithymia, hyperventilation syndrome and control of asthma, respectively. Quality of life was assessed with the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). RESULTS: The mean age was 60 ± 13.6 years. Personal psychopathological histories were found in 65.1% of participants, and 8% reported previous suicidal attempts. The rate of anxiety and/or depression (HADS ≥ 11) was 68.3%. These patients present higher scores on the TAS-20 (p < 0.001) for the level of dyspnea (p = 0.021), and for emotional function (p = 0.017) on the Mini-AQLQ, compared with patients without anxiety or depression. Alexithymia (TAS-20 ≥ 61) was observed in 42.9% of patients; these patients were older (p = 0.037) and had a higher HADS score (p = 0.019) than patients with asthma without alexithymia. On the other hand, patients with hyperventilation syndrome (Nijmegen ≥ 23) scored higher on the HADS (p < 0.05), on the Mini-AQLQ (p = 0.002) and on the TAS-20 (p = 0.044) than the group without hyperventilation syndrome. Quality of life was related to anxiety-depression symptomatology (r = - 0.302; p = 0.016) and alexithymia (r = - 0.264; p = 0.036). Finally, the Mini-AQLQ total score was associated with the Nijmegen questionnaire total score (r = - 0.317; p = 0.011), and the activity limitation domain of the Mini-AQLQ correlated with the ACT total score (r = 0.288; p = 0.022). CONCLUSIONS: The rate of anxiety, depression, alexithymia and hyperventilation syndrome is high in patients with severe asthma. Each of these factors is associated with a poor quality of life.


Assuntos
Sintomas Afetivos/psicologia , Ansiedade/psicologia , Asma/psicologia , Hiperventilação/psicologia , Transtornos do Humor/psicologia , Qualidade de Vida/psicologia , Adulto , Sintomas Afetivos/epidemiologia , Idoso , Ansiedade/epidemiologia , Asma/epidemiologia , Estudos Transversais , Humanos , Hiperventilação/epidemiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia
10.
Braz J Med Biol Res ; 54(1): e10285, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33503158

RESUMO

The increasing number of cesarean sections worldwide has encouraged research on the long-term effects of this birth type on the offspring's mental health. The objective of this study was to investigate whether there is an association between birth by cesarean section and the development of mood disorders (depression and bipolar disorders) in adolescents. A cohort study was carried out with 1603 adolescents from 18 to 19 years old who participated in the third phase of a birth cohort study in São Luís, MA, in 2016. Information on birth type and weight, prematurity, mother's age and schooling, parity, marital status, and smoking behavior during pregnancy, were collected at birth. The study outcomes were depression, bipolar disorder, and "mood disorder" construct. A Directed Acyclic Graph (DAG) was developed to select the variables for minimal adjustment for confounding and collision bias. Associations were estimated through propensity score weighting using a two-step estimation model, and confounders for cesarean birth were used in the predictive model. There was no significant association in the relationship between birth type and depression (95%CI: -0.037 to 0.017; P=0.47), bipolar disorder (95%CI: -0.019 to 0.045; P=0.43), and mood disorder (95%CI: -0.033 to 0.042; P=0.80) in adolescents of both sexes. Birth by cesarean section was not associated with the development of mood disorders in adolescents.


Assuntos
Cesárea , Transtornos do Humor/epidemiologia , Adolescente , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Adulto Jovem
11.
J Affect Disord ; 281: 131-137, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33316718

RESUMO

Background The social distancing during COVID-19 is likely to cause a feeling of alienation, which may pose a threat to the public's mental health. Our research aims to examine the relationship between negative emotions and Post-Traumatic Stress Disorder (PTSD), considering the mediation effect of alienation and how it is moderated by anxiety and depression. Methods For this, the current study conducted a cross-sectional survey on 7145 participants during the outbreak of COVID-19, via online questionnaires comprised of a self-designed Negative emotions questionnaire, Symptom Check List 90 (SCL-90), PTSD Checklist-civilian version (PCL-C), and Adolescent Students Alienation Scale (ASAS). Results A total of 6666 pieces of data from the general population were included in the statistical analysis. The descriptive statistics showed a relatively mild level of mental disorders. Besides, results of Conditional Process Model analysis supported our hypotheses that negative emotions and alienation were both predictors for PTSD symptoms, and their direct and indirect effects were all moderated by the level of anxiety. Limitations This study was limited by the generality and causality of the conclusion. The moderating effect of depression was left for further study due to the collinearity problem of variables. Conclusions Social distancing may have an impact on individuals' mental health by the feeling of alienation, which was moderated by affective disorders. Clinical psychologists should identify individuals' particular cognition and mental disorders to provide a more accurate and adequate intervention for them.


Assuntos
/psicologia , Saúde Mental , Transtornos do Humor/epidemiologia , Transtornos de Estresse Pós-Traumáticos , Ansiedade , Estudos Transversais , Emoções , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários
12.
J Affect Disord ; 281: 485-492, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33383391

RESUMO

BACKGROUND: We examined correlates, psychiatric comorbidities, and social adjustment difficulties in children with disruptive mood dysregulation disorder (DMDD) from a national epidemiological study in Taiwan. METHODS: The sample consisted of 4816 children, who were 3rd, 5th, and 7th graders from schools randomly chosen based on the urbanization level in a recent national survey of childhood mental disorders. Among the 4816 children (2520 boys, 52.3%) interviewed using the Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia (K-SADS-E) for the DSM-5, 30 children were diagnosed as DMDD (23 boys, 76.7%). They and their parents also reported on the Social Adjustment Inventory for Children and Adolescents (SAICA). We conducted regressions for survey data that controlled for stratification and clustering. RESULTS: The weighted prevalence of DMDD was 0.3~0.76% in Taiwanese children. Lower parental educational levels, male predominance, higher psychiatric comorbidities, and worse self-report school functions (e.g., more behavioral problems with peers) were observed in children with DMDD than those without. Additional analyses revealed that oppositional defiant disorder (ODD) but not DMDD was related to conduct disorder. Children with ODD with or without DMDD had more problems regarding attitudes toward school, academic performance, and parent-child interaction at home than those with DMDD-only. LIMITATIONS: Small sample size of DMDD. CONCLUSIONS: DMDD is a rare disorder in the community. Children with DMDD had more psychiatric comorbidities, and subjectively experienced more difficulties than those without. DMDD and ODD both resulted in severe impairment yet in different domains.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Ajustamento Social , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Criança , Comorbidade , Humanos , Masculino , Transtornos do Humor/epidemiologia , Taiwan/epidemiologia
13.
J Affect Disord ; 278: 423-432, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33010567

RESUMO

BACKGROUND: Mood disorders and problematic substance use co-occur and confer reciprocal risk for each other. Few studies use analytic approaches appropriate for testing whether specific features of one disorder confer risk for the other. METHODS: 445 participants (59.8% female, Mean age = 20.3 years) completed measures of depression and hypo/mania symptoms and substance use-related impairment; 330 had complete data at follow-up. Of these, 28% reported a history of depression, 4% of bipolar spectrum disorder, 11% of substance use disorder, and 55% reported substance-related impairment. Symptoms and domains of substance-related impairment were modeled in cross-sectional and cross-lagged panel network models. RESULTS: Impulsive and interpersonal impairment were most highly comorbid with mood symptoms. Suicidal ideation, sadness, decreased need for sleep, and guilt were the symptoms most highly comorbid with impairment. Interpersonal impairment due to substance use was the strongest cross-construct predictor of mood symptoms and suicidal ideation was most predictive of impairment. Social, intrapersonal, and physical impairment due to substance use were most predicted by previous mood symptoms and decreased need for sleep, guilt, and euphoria were most strongly predicted by past impairment. LIMITATIONS: Measures do not assess all mood symptoms, participants with low reward sensitivity were excluded, only self-report measures were used, and some variables were single-items. CONCLUSIONS: Components of these syndromes that confer cross-construct risk might not be the same components that are predicted by the other construct. The bidirectional relationship between mood symptoms and problematic substance use might be better conceptualized at the element, rather than diagnostic, level.


Assuntos
Transtorno Bipolar , Transtornos Relacionados ao Uso de Substâncias , Adulto , Transtorno Bipolar/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos do Humor/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
14.
J Affect Disord ; 278: 502-505, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33017677

RESUMO

Disruptive mood dysregulation disorder (DMDD) is common in children with ADHD yet it is not known how persistent DMDD is in this population. As such we aimed to investigate the persistence of disruptive mood dysregulation disorder (DMDD) in a community sample of children with ADHD. The sample comprised children (n = 136) participating in a cohort study with data available at age 7 and age 10. DMDD status was ascertained using proxy items from the Diagnostic Interview Schedule for Children, Version IV. Of those with DMDD at age 7 (n = 30), eight (21.1%) had DMDD that persisted at age 10. In the first study investigating the longitudinal course of DMDD in ADHD one in five children with ADHD+DMDD at age 7 continued to meet diagnostic criteria for DMDD three years later.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Humanos , Humor Irritável , Transtornos do Humor/epidemiologia
15.
J Affect Disord ; 281: 289-296, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33341011

RESUMO

BACKGROUND: Neurocognitive impairment is recognised as a risk factor for suicidal behaviour in adults. The current study aims to determine whether neurocognitive deficits also predict ongoing or emergent suicidal behaviour in young people with affective disorders. METHODS: Participants were aged 12-30 years and presented to early intervention youth mental health clinics between 2008 and 2018. In addition to clinical assessment a standardised neurocognitive assessment was conducted at baseline. Clinical data was extracted from subsequent visits using a standardised proforma. RESULTS: Of the 635 participants who met inclusion criteria (mean age 19.6 years, 59% female, average follow up 476 days) 104 (16%) reported suicidal behaviour during care. In 5 of the 10 neurocognitive domains tested (cognitive flexibility, processing speed, working memory, verbal memory and visuospatial memory) those with suicidal behaviour during care were superior to clinical controls. Better general neurocognitive function remained a significant predictor (OR=1.94, 95% CI 1.29- 2.94) of suicidal behaviour in care after controlling for other risk factors. LIMITATIONS: The neurocognitive battery used was designed for use with affective and psychotic disorders and may not have detected some deficits more specific to suicidal behaviour. CONCLUSION: Contrary to expectations, better neurocognitive functioning predicts suicidal behaviour during care in young people with affective disorders. While other populations with suicidal behaviour, such as adults with affective disorders or young people with psychotic disorders, tend to experience neurocognitive deficits which may limit their capacity to engage in some interventions, this does not appear to be the case for young people with affective disorders.


Assuntos
Transtornos Psicóticos , Ideação Suicida , Adolescente , Adulto , Criança , Cognição , Feminino , Humanos , Masculino , Transtornos do Humor/epidemiologia , Testes Neuropsicológicos , Fatores de Risco , Adulto Jovem
16.
Artigo em Russo | MEDLINE | ID: mdl-33244959

RESUMO

OBJECTIVE: To identify characteristics of and possible differences in clinical and electroencephalographic parameters in patients with alcohol dependence with- and without comorbid affective disorders. MATERIALS AND METHODS: Ninety-five patients, including 74 with an established diagnosis of alcohol dependence and 21 with alcohol dependence and affective disorders, were examined. Duration of alcohol dependence and affective disorder (years), number of hospitalizations and suicidal attempts were analyzed as anamnestic data. Hamilton's anxiety and depression scale (HDRS), the Alcohol Use Disorders Identification Test (AUDIT), the General clinical impression scale (CGI-s) were used as psychometric tools. The study of bioelectric activity of the brain was carried out using a 16-channel encephalograph. The background electroencephalogram was recorded, the values of absolute spectral power and coherence of theta, alpha and beta rhythms were analyzed. RESULTS AND CONCLUSION: Patients with comorbidity of alcohol dependence and affective disorders have a significantly higher risk of suicidal behavior, a greater frequency of hospitalizations, higher levels of anxiety compared with patients without affective disorders. Electrophysiological data have shown that patients with comorbidity of alcohol dependence and affective disorders have higher values of spectral power of alpha-rhythm in all parts of the cerebral cortex (except for temporal lobes) and beta-rhythm in the occipital cortex, as well as an increase in interhemispheric coherence in all frequency ranges.


Assuntos
Alcoolismo , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Comorbidade , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Tentativa de Suicídio
17.
Epidemiol Psychiatr Sci ; 29: e173, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32988427

RESUMO

AIMS: The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. METHODS: We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. RESULTS: The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). CONCLUSIONS: This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/psicologia , Adulto , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , República Tcheca/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Suicídio/estatística & dados numéricos , Inquéritos e Questionários
18.
Soc Psychiatry Psychiatr Epidemiol ; 55(12): 1549-1562, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32895729

RESUMO

PURPOSE: It is plausible that offspring born to mothers using tobacco during pregnancy may have increased risk of mood disorders (depression and bipolar disorders); however, mixed results have been reported. We conducted a systematic review and meta-analysis to investigate the magnitude and consistency of associations reported between prenatal tobacco use and mood disorders in offspring. METHODS: We systematically searched EMBASE, SCOPUS, PubMed and Psych-INFO for studies on mood disorders and prenatal tobacco use. Methodological quality of studies was assessed with the revised Newcastle-Ottawa Scale. We estimated pooled relative risk (RR) with inverse variance weighted random-effects meta-analysis. We performed leave-one-out analyses, and stratified analyses by a subgroup (depression and bipolar disorder). Potential publication bias was assessed by inspection of the funnel plot and Egger's test for regression asymmetry. This study protocol was prospectively registered in PROSPERO (CRD42017060037). RESULTS: Eight cohort and two case-control studies were included in the final meta-analysis. We found an increased pooled relative risk of mood disorders in offspring exposed to maternal prenatal tobacco use RRs 1.43 (95% CI 1.27-1.60) compared to no prenatal tobacco use. Similarly, the pooled relative risks of bipolar and depressive disorders in offspring were 1.44, (95% CI 1.15-1.80) and 1.44, (95% CI 1.21-1.71), respectively. Moreover, the pooled estimated risk of mood disorders was not significantly attenuated in the studies that reported sibling comparison results [RR = 1.21 (95% CI 1.04-1.41)]. CONCLUSION: Taken together, there was strong evidence for a small (RR < 2) association between prenatal tobacco use and mood disorders in offspring.


Assuntos
Transtornos do Humor , Efeitos Tardios da Exposição Pré-Natal , Uso de Tabaco , Estudos de Coortes , Feminino , Humanos , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Mães , Gravidez , Risco , Uso de Tabaco/efeitos adversos
19.
Br J Clin Psychol ; 59(4): 461-479, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32715513

RESUMO

OBJECTIVES: The aim of the current study was to assess the feasibility, safety, and effectiveness of a newly developed Acceptance and Commitment Therapy (ACT) intervention developed specifically to address the unique context of pregnancy and parenthood. The intervention was delivered to women accessing a specialist Perinatal Community Mental Health Service (PCMHS). DESIGN: An open-label pilot study was conducted of an 8-week, group-delivered ACT intervention targeting women with moderate-to-severe mood and/or anxiety disorders during pregnancy and/or postpartum. METHODS: Outcomes included session attendance rates, dropout rates, crisis/inpatient service use, and standardized symptom scales. Participant's responses to open-ended questions contained in an end of therapy questionnaire were analysed using thematic analysis. RESULTS: Seventy-four women were referred to the intervention with 65 (88%) completing treatment. The median number of sessions attended was 7. No women required input from crisis/inpatient services. All reported finding the intervention helpful. The implementation of ACT in daily life, therapist support, and group processes were cited as helpful aspects of the intervention. At post-treatment, there was a significant reduction in global distress (d = 0.99) and depressive symptoms (d = 1.05), and an increase in psychological flexibility (d = 0.93). On the secondary outcome of global distress, 38% of women were classified as recovered, 31% had reliably improved, 27% remained the same, and 4% had reliably deteriorated. CONCLUSIONS: The delivery of ACT in a routine practice setting is feasible, safe, and effective. A randomized control trial (RCT) is needed to establish the efficacy and cost-effectiveness of this group-delivered ACT intervention. PRACTITIONER POINTS: Group-delivered Acceptance and Commitment Therapy (ACT) is acceptable for women with moderate-to-severe perinatal mood and/or anxiety disorders and can be feasibly delivered in a routine practice setting. The trans-diagnostic nature of ACT enables the concurrent treatment of depressive and anxiety symptoms within the same intervention which is particularly helpful in the perinatal context given the comorbidity of mood and anxiety disorders. With training and supervision, mental health practitioners without extensive education in the delivery of psychological therapies can facilitate the ACT group programme. As this was a feasibility study, there was no control group, adherence to the manual was not assessed, and the absence of a follow-up period limits our knowledge of the longer-term benefits of the ACT group programme.


Assuntos
Terapia de Aceitação e Compromisso/estatística & dados numéricos , Transtornos de Ansiedade/terapia , Transtornos do Humor/terapia , Psicoterapia de Grupo/organização & administração , Terapia de Aceitação e Compromisso/métodos , Adulto , Afeto , Ansiedade/terapia , Transtornos de Ansiedade/epidemiologia , Serviços Comunitários de Saúde Mental/organização & administração , Comorbidade , Estudos de Viabilidade , Feminino , Humanos , Saúde Mental , Transtornos do Humor/epidemiologia , Cooperação do Paciente , Projetos Piloto , Gravidez , Estudo de Prova de Conceito , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento
20.
Psychiatry Res ; 292: 113317, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32721785

RESUMO

The spread of COVID-19 throughout Italy, particularly Lombardy, led to adopt quarantine measures, known to exacerbate pre-existing psychiatric conditions. We described a telephone-based surveillance on 101 euthymic Mood Disorder outpatients in Milan by a non-standardized survey to evaluate reactions to lockdown measures and the presence of quarantine stressors. Frustration was the most represented quarantine stressor. Being jobless was significantly related to the presence of frustration, somatization, increased alertness, psychic anxiety and low mood; younger age to the presence of psychic anxiety, alertness and financial concerns. No recurrences were observed at the time of writing.


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Transtornos do Humor/epidemiologia , Pacientes Ambulatoriais/psicologia , Pneumonia Viral/psicologia , Vigilância da População/métodos , Quarentena/psicologia , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Inquéritos e Questionários , Telefone
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