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1.
PLoS One ; 16(10): e0258213, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34606507

RESUMO

Our objective was to describe how residents of Philadelphia, Pennsylvania, coped psychologically with the first wave of COVID-19 pandemic. In a cross-sectional design, we aimed to estimate the rates and correlates of anxiety and depression, examine how specific worries correlated with general anxiety and depression, and synthesize themes of "the most difficult experiences" shared by the respondents. We collected data through an on-line survey in a convenience sample of 1,293 adult residents of Philadelphia, PA between April 17 and July 3, 2020, inquiring about symptoms of anxiety and depression (via the Hospital Anxiety and Depression Scale), specific worries, open-ended narratives of "the most difficult experiences" (coded into themes), demographics, perceived sources of support, and general health. Anxiety was evident among 30 to 40% of participants and depression-about 10%. Factor analysis revealed two distinct, yet inter-related clusters of specific worries related to mood disorders: concern about "hardships" and "fear of infection". Regression analyses revealed that anxiety, depression, and fear of infection, but not concern about hardships, worsened over the course of the epidemic. "The most difficult experiences" characterized by loss of income, poor health of self or others, uncertainty, death of a relative or a friend, and struggle accessing food were each associated with some of the measures of worries and mood disorders. Respondents who believed they could rely on support of close personal network fared better psychologically than those who reported relying primarily on government and social services organizations. Thematic analysis revealed complex perceptions of the pandemic by the participants, giving clues to both positive and negative experiences that may have affected how they coped. Despite concerns about external validity, our observations are concordant with emerging evidence of psychological toll of the COVID-19 pandemic and measures employed to mitigate risk of infection.


Assuntos
Adaptação Psicológica , COVID-19/epidemiologia , Transtornos do Humor/diagnóstico , Adulto , Ansiedade/patologia , COVID-19/patologia , COVID-19/virologia , Estudos Transversais , Depressão/patologia , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Pandemias , Philadelphia/epidemiologia , Análise de Regressão , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários
2.
Medicine (Baltimore) ; 100(31): e26813, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397840

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) as a fatal epidemic has swept across the world, especially in India where the epidemic situation is the most serious. For COVID-19 patients, pulmonary rehabilitation training plays a significant role. However, it is still a controversial issue regarding the efficacy of WeChat APP-based pulmonary rehabilitation training in improving lung function, quality of life and bad mood of COVID-19 patients. To clarify this issue, a meta-analysis was conducted in this present study, so as to provide a basis for rehabilitation guidance of COVID-19 patients. METHODS: We systematically searched PubMed, medRxiv, Web of Science, Scopus, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-fang databases in May 2021 to identify randomized controlled trials and evaluate the effects of WeChat APP-based pulmonary rehabilitation training for COVID-19. Two researchers independently carried out data extraction. On the other hand, literature quality evaluation on the quality and meta-analysis of the included literature was performed with Revman5.3 software. RESULTS: The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will provide reliable evidence-based evidence on the effects of WeChat APP-based pulmonary rehabilitation training on lung function, bad mood, and quality of life in patients with COVID-19. ETHICS AND DISSEMINATION: Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/MKXCH.


Assuntos
Protocolos Clínicos , Reabilitação/instrumentação , Mídias Sociais/instrumentação , Ensino/normas , COVID-19/psicologia , COVID-19/terapia , Humanos , Pulmão/fisiopatologia , Metanálise como Assunto , Transtornos do Humor/etiologia , Transtornos do Humor/psicologia , Qualidade de Vida/psicologia , Reabilitação/métodos , Reabilitação/psicologia , Revisões Sistemáticas como Assunto
3.
PLoS One ; 16(8): e0249809, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351924

RESUMO

We aimed to examine rates of breast and cervical cancer screening in women with immune-mediated inflammatory diseases (IMID), including inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) versus a matched cohort with IMID; and examine the association of psychiatric comorbidity with screening in these populations. We conducted a retrospective cohort study in Manitoba, Canada using administrative data. We identified women with IBD, MS and RA, and controls without these IMID matched on age and region. Annually, we identified individuals with any active mood/anxiety disorder. Using physician claims, we determined the proportion of each cohort who had cervical cancer screening within three-year intervals, and mammography screening within two-year intervals. We modeled the difference in the proportion of the IMID and matched cohorts who underwent mammography; and pap tests using log-binomial regression with generalized estimating equations, adjusting for sociodemographics, comorbidity and immune therapy use. We tested for additive interactions between cohort and mood/anxiety disorder status. During 2006-2016, we identified 17,230 women with IMID (4,623 with IBD, 3,399 with MS, and 9,458 with RA) and 85,349 matched controls. Having an IMID was associated with lower (-1%) use of mammography; however, this reflected a mixture of more mammography in the IBD cohort (+2.9%) and less mammography in the MS (-4.8 to -5.2%) and RA (-1.5%) cohorts. Within the IBD, MS and RA cohorts, having an active mood/anxiety disorder was associated with more mammography use than having an inactive mood/anxiety disorder. The MS and RA cohorts were less likely to undergo Pap testing than their matched cohorts. In the absence of an active mood/anxiety disorder, the IBD cohort was more likely to undergo Pap testing than its matched cohort; the opposite was true when an active mood/anxiety disorder was present. Among women with an IMID, mood/anxiety disorder influence participation in cancer screening.


Assuntos
Transtornos de Ansiedade/complicações , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/psicologia , Transtornos do Humor/complicações , Neoplasias do Colo do Útero/diagnóstico , Adulto , Transtornos de Ansiedade/psicologia , Artrite Reumatoide/complicações , Artrite Reumatoide/psicologia , Neoplasias da Mama/psicologia , Estudos de Casos e Controles , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/psicologia , Manitoba , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Estudos Retrospectivos , Neoplasias do Colo do Útero/psicologia
4.
Sci Rep ; 11(1): 13987, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34234173

RESUMO

There is increasing evidence supporting the association between gut microbiome composition and mood disorders; however, studies on the circulating microbiome are scarce. This study aimed to analyze the association of the serum microbial DNA composition with depressive and anxiety symptoms in patients with mood disorders. The sera of 69 patients with mood disorders, aged from 19 to 60, were analyzed. Bacterial DNA was isolated from extracellular membrane vesicles and, subsequently, amplified and quantified with specific primers for the V3-V4 hypervariable region of the 16S rDNA gene. Sequence reads were clustered into Operational Taxonomic Units and classified using the SILVA database. There were no significant associations between alpha diversity measures and the total Hamilton depression rating scale (HAM-D) or Beck anxiety inventory (BAI) scores. Only the weighted UniFrac distance was associated with the total HAM-D score (F = 1.57, p = 0.045). The Bacteroidaceae family and Bacteroides genus were negatively associated with the total HAM-D score (ß = - 0.016, p < 0.001, q = 0.08 and ß = - 0.016, p < 0.001, q = 0.15, respectively). The Desulfovibrionaceae family and Clostridiales Family XIII were positively associated with the total BAI score (ß = 1.8 × 10-3, p < 0.001, q = 0.04 and ß = 1.3 × 10-3, p < 0.001, q = 0.24, respectively). Further studies with larger sample sizes and longitudinal designs are warranted.


Assuntos
Ansiedade , Ácidos Nucleicos Livres/sangue , DNA Bacteriano , Depressão , Transtornos do Humor/sangue , Transtornos do Humor/psicologia , Adulto , Código de Barras de DNA Taxonômico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/etiologia , RNA Ribossômico 16S , Avaliação de Sintomas , Adulto Jovem
5.
Nurs Clin North Am ; 56(2): 229-247, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34023118

RESUMO

Sleep disruptions are frequently reported by persons with mood, anxiety, and post-traumatic stress disorders, and co-occur with psychiatric disorders. There is evidence that sleep disorders can predict the likelihood of developing a future psychiatric disorder and exacerbate existing symptoms. Understanding the inter-relationships between sleep and psychiatric disorders is important. The primary goals of this article are to describe the interactions between psychiatric and sleep disorders in the context of sleep disturbances, underscore the bidirectional effects of mental health treatments on sleep disorder outcomes, and provide general recommendations to optimize treatment in the context of sleep disturbances.


Assuntos
Ansiedade/complicações , Transtornos do Humor/complicações , Transtornos do Sono-Vigília/etiologia , Transtornos de Estresse Pós-Traumáticos/complicações , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Ansiedade/psicologia , Humanos , Transtornos do Humor/psicologia , Transtornos do Sono-Vigília/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia
6.
J Psychiatr Pract ; 27(3): 212-223, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33939376

RESUMO

Chronic mood disorders pose an important mental health problem. Individuals with these disorders experience a significant impairment, often fail to seek help, and their illnesses frequently do not respond to treatment. It is therefore important to develop innovative and attractive treatments for these disorders. Mindful yoga represents a promising treatment approach. This pilot study tested the feasibility of a 9-week manualized mindful yoga intervention for patients with chronic mood disorders. Eleven patients receiving standard treatment were recruited to complete a 9-week mindful yoga intervention. Qualitative methods were used to assess patients' experiences of the intervention and quantitative methods were used to assess psychological distress and mechanisms that play a role in chronic mood disorders. Eight patients completed the intervention and rated the overall quality of the intervention with a mean score of 8.8 (range of 8 to 9, using a scale of 1 to 10). All participants reported a reduction in psychological distress and no adverse events. Among the mechanisms that play a role in chronic mood disorders, the most potentially promising effects from the intervention were found for worry, fear of depression and anxiety, rumination, and areas related to body awareness, such as trusting bodily experiences and not distracting from sensations of discomfort. A 9-week mindful yoga intervention appears to be a feasible and attractive treatment when added to treatment as usual for a group of patients with chronic mood disorders. A randomized controlled trial to study the effects of mindful yoga is recommended.


Assuntos
Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Ioga/psicologia , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Adulto Jovem
7.
J Alzheimers Dis ; 82(1): 381-390, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34024833

RESUMO

BACKGROUND: Behavioral variant frontotemporal dementia (bvFTD) is generally considered a young-onset dementia, although age at onset is highly variable. While several studies indicate clinical differences regarding age at onset, no biomarker validated cohort studies with updated clinical criteria have been performed. OBJECTIVE: We aimed to examine behavior, cognition, and mortality over the full age spectrum in a cohort of bvFTD patients with neuroimaging, genetic, or histopathological confirmation and exclusion of positive Alzheimer's disease biomarkers or severe cerebrovascular damage. METHODS: In total, 315 patients with a clinical diagnosis of probable or definite bvFTD were included from the Amsterdam Dementia Cohort and grouped into quartiles by age-at-diagnosis. Neuropsychiatric symptoms and cognitive functioning were assessed with the neuropsychiatric inventory, the geriatric depression scale and a neuropsychological test battery. Data on mortality was obtained from the Dutch municipal register. Associations between age-at-diagnosis and clinical features and mortality risk were examined. RESULTS: Age-at-diagnosis ranged from 26 to 85 years and established quartiles with mean ages of 52±6, 61±2, 66±2, and 74±3 years. In the total sample, 44.4%exceeded an age of 65 years at time of diagnosis. Earlier age-at-diagnosis was associated with more severe behavioral symptoms, while later age-at-diagnosis was associated with more severe memory impairment. Unexpectedly, mortality risk was not associated with age-at-diagnosis. CONCLUSION: In bvFTD, symptom profile is associated with age-at-diagnosis. This should be taken into account with regard to diagnostics, patient management, and trial design. Additionally, based on our sample, the prevalence of late-onset bvFTD is higher than generally thought.


Assuntos
Demência Frontotemporal/fisiopatologia , Mortalidade , Testes Neuropsicológicos , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Ansiedade/fisiopatologia , Ansiedade/psicologia , Apatia/fisiologia , Delusões/fisiopatologia , Delusões/psicologia , Feminino , Demência Frontotemporal/psicologia , Alucinações/fisiopatologia , Alucinações/psicologia , Humanos , Inibição Psicológica , Humor Irritável/fisiologia , Masculino , Transtornos da Memória/fisiopatologia , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Transtornos do Humor/fisiopatologia , Transtornos do Humor/psicologia , Fenótipo , Índice de Gravidade de Doença
8.
J Clin Psychiatry ; 82(2)2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-33989461

RESUMO

BACKGROUND: Separation anxiety disorder may be important when considering risk of suicide. The aim of this study was to examine the association between both childhood and adult separation anxiety (disorder) and measures of suicide risk in a large cohort of outpatients with anxiety and mood disorders. METHODS: The sample included 509 consecutive adult psychiatric outpatients with DSM-IV mood disorders or anxiety disorders as a principal diagnosis recruited at the Department of Psychiatry, University of Pisa, Italy, between 2015 and 2018. Suicide risk was evaluated by the Hamilton Depression Rating Scale (HDRS) item 3. Patients were classified in 2 groups: those with a score ≥ 1 and those with a score of 0 on HDRS item 3. Suicide risk was also evaluated by specific items within the Mood Spectrum, Self-Report (MOODS-SR), a questionnaire evaluating lifetime suicidal symptoms. Separation anxiety (disorder) was assessed based on the Structured Interview for Separation Anxiety Symptoms in Adulthood/Childhood (SCI-SAS-A/C), the Separation Anxiety Symptom Inventory (SASI), and the Adult Separation Anxiety Scale (ASA-27). RESULTS: Of the 509 patients, 97 had an HDRS item 3 score ≥ 1, and 412 had a score of 0. Adult separation anxiety disorder was more frequent among individuals who had suicidal thoughts (53.6%) than those who did not (39.6%) (P = .01). Dimensional separation anxiety symptoms on all scales were elevated in patients with suicidality when compared to patients without (SASI: P = .02; SCI-SAS-C: P < .001; SCI-SAS-A: P < .001; ASA-27: P = .002). Logistic regression found that adult separation anxiety disorder (odds ratio [OR] = 1.86, 95% CI = 1.16-2.97), major depression (OR = 7.13, 95% CI = 3.18-15.97), bipolar I disorder (8.15, 95% CI = 3.34-19.90), and bipolar II disorder (OR = 8.16, 95% CI = 3.50-19.05) predicted suicidal thoughts. Linear regression found that depression (P = .001) and ASA-27 separation anxiety (P = .001) significantly predicted lifetime suicide risk. Mediation analysis found that separation anxiety significantly mediated the association between depression and suicide risk. CONCLUSIONS: This study indicates a substantial role of separation anxiety in predicting suicidal thoughts, both as state-related symptoms (evaluated by HDRS item 3) and as longitudinal dimensional symptoms (as evaluated by MOODS-SR). Greater understanding of the influence of separation anxiety in patients with affective disorders may encourage personalized interventions for reducing suicide risk.


Assuntos
Transtornos de Ansiedade/psicologia , Ansiedade de Separação/diagnóstico , Transtornos do Humor/psicologia , Suicídio/psicologia , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/diagnóstico , Ansiedade de Separação/complicações , Ansiedade de Separação/psicologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/diagnóstico , Escalas de Graduação Psiquiátrica , Fatores de Risco , Inquéritos e Questionários
10.
Medicina (Kaunas) ; 57(4)2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33804912

RESUMO

Background and Objectives: This observational prospective study aims to examine the psychological and psychopathological impact of the pandemic stress on patients with pre-existing mood, anxiety and obsessive-compulsive disorders. Materials and Methods: The study includes 386 consecutive patients recruited from 10 March to 30 June 2020 among those being treated at the Institute of Psychopathology in Rome (Italy) with an age ≥18 years and meeting DSM-5 criteria for major depressive disorder (MDD) (35.2%), bipolar I (BD-I) (21.5%) or II (BD-II) (28.8%) disorder, obsessive-compulsive disorder (OCD) (7.5%), panic disorder (PD) (7.0%) or social anxiety (SA). A total of 34.2% had lifetime comorbid Axis I disorders and 15.3% had alcohol/drug abuse disorders. Using a semi-structured interview, we investigated if the impact of COVID-19 stress for patients has been similar, higher or lower than that of their family and friends and, for patients with relapse/symptoms worsening, if there was a relationship between the clinical condition worsening and the pandemic stress. Results: Compared with that experienced by their family members and friends, the psychological impact of pandemic stress was similar in 52.1% of the sample, better in 37.1% and worse in 10.8%. In 21 patients (5.4%), the stress triggered a recurrence or worsened the symptoms. Patients with OCD had a higher rate of worsening due to pandemic stress compared to patients with MDD (p = 0.033), although, overall, the χ2 test was not significant among primary diagnoses (χ2 = 8.368; p = 0.057). Conclusions: The psychological and psychopathological consequences of COVID-19 stress in our outpatients were very modest. The continuity of care offered during the lockdown could explain the results.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Bipolar/psicologia , COVID-19 , Transtorno Depressivo Maior/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno de Pânico/psicologia , Fobia Social/psicologia , Estudos Prospectivos , Cidade de Roma , SARS-CoV-2 , Adulto Jovem
11.
Epilepsia ; 62(6): 1382-1390, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33856044

RESUMO

OBJECTIVE: Interictal dysphoric disorder (IDD) has been regarded as an affective disorder occurring only in people with epilepsy (PWE). Data showing similar characteristics and similar prevalence of IDD in patients with migraine and with psychogenic nonepileptic seizures question the epilepsy-specific nature of IDD. The aim of the study was to investigate the nature of IDD in people with prevalent epilepsy with mood disorders and people with mood disorders who are free of neurological disease. METHODS: This is a case-control study, with 142 patients with a confirmed diagnosis of epilepsy and major depressive disorder (MDD; cases) and 222 patients with MDD only (controls). MDD diagnosis was confirmed by a structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID-I-RV). We used the Beck Depression Inventory and the Beck Anxiety Inventory to estimate anxiety and depression levels and the Interictal Dysphoric Disorder Inventory (IDDI) to confirm the presence of IDD. Mann-Whitney U test, Pearson chi-squared, Spearman correlation, and logistic regression were used. RESULTS: No differences were found in the prevalence of IDD between PWE with MDD and people with MDD alone (88.73% vs. 85.13%, χ2 = .96, p = .32). There were no differences between the groups overall or for any IDDI subscales (all p > .05). In both groups, IDD symptoms were grouped with the same incidence and had the same duration and periodicity. IDD was not associated with epilepsy (odds ratio = .84, 95% confidence interval = .40-1.98, p = .72). No significant correlation was found between epilepsy, demographic characteristics, and all IDDI subscales (all p > .05). Notably, patients with IDD suffered from affective disorders longer (6.68 ± 6.82 years vs. 3.7 ± 3.97 years, p = .001) and also received higher scores on all psychometric scales (all p < .05). SIGNIFICANCE: This study does not confirm the specificity of IDD for epilepsy. The presence of IDD symptoms may be associated with a more severe course of MDD and significant anxiety distress.


Assuntos
Epilepsia/complicações , Epilepsia/psicologia , Transtornos do Humor/etiologia , Transtornos do Humor/psicologia , Convulsões/complicações , Convulsões/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Estudos de Casos e Controles , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/psicologia , Transtornos do Humor/epidemiologia , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Adulto Jovem
12.
Psychiatr Q ; 92(4): 1439-1457, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33904123

RESUMO

The study was designed to investigate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on mental health and perceived psychosocial support for elderly psychiatric patients in a longitudinal design. n = 32 patients with affective or anxiety disorders aged ≥60 years were included. Telephone interviews were conducted in April/May 2020 (T1) and August 2020 (T2). The psychosocial impact (PSI) of the pandemic and psychopathology were measured. Changes between T1 and T2 were examined. Patients' psychosocial support system six months before the pandemic and at T1/T2 was assessed. We found a significant positive correlation between general PSI and depression as well as severity of illness. General PSI differed significantly depending on social contact. Neither general PSI nor psychopathology changed significantly between T1 and T2. At T1, patients' psychosocial support systems were reduced as compared to six months before. Patients reported an increase in psychosocial support between T1 and T2 and high demand for additional support (sports, arts/occupational therapy, physiotherapy, psychotherapy). Elderly psychiatric patients show a negative PSI of the pandemic. They are likely to suffer from an impaired psychosocial situation, emphasizing the importance of developing concepts for sufficient psychosocial support during a pandemic.


Assuntos
Transtornos de Ansiedade , COVID-19 , Transtornos do Humor , Pandemias , Pacientes , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , COVID-19/epidemiologia , COVID-19/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Pacientes/psicologia , Pacientes/estatística & dados numéricos
14.
Int Rev Psychiatry ; 33(3): 280-299, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33648430

RESUMO

Individuals with autism experience substantially higher rates of mood problems compared to the general population, which contribute to reduced quality of life and increased mortality through suicide. Here, we reviewed evidence for the clinical presentation, aetiology and therapeutic approaches for mood problems in autism. We identified a lack of validated tools for accurately identifying mood problems in individuals with autism, who may present with 'atypical' features (e.g. severe irritability). Risk factors for mood problems in autism appear to be largely overlapping with those identified in the general population, including shared genetic, environmental, cognitive, physiological/neurobiological mechanisms. However, these mechanisms are exacerbated directly/indirectly by lived experiences of autism, including increased vulnerability for chronic stress - often related to social-communication difficulties(/bullying) and sensory sensitivities. Lastly, current therapeutic approaches are based on recommendations for primary mood disorders, with little reference to the neurobiological/cognitive differences associated with autism. Thus, we recommend: 1) the development and validation of (objective) tools to identify mood problems in autism and measure therapeutic efficacy; 2) an interactive approach to investigating aetiologies in large-scale longitudinal studies, integrating different levels of analysis (e.g. cognitive, neurobiological) and lived experience; 3) testing potential treatments through high-quality (e.g. sufficiently powered, blinded) clinical trials, specifically for individuals with autism.


Assuntos
Transtorno Autístico , Transtornos do Humor , Transtorno Autístico/mortalidade , Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Bullying , Humanos , Transtornos do Humor/mortalidade , Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Qualidade de Vida , Suicídio
15.
J Alzheimers Dis ; 80(2): 533-537, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33554916

RESUMO

We explored the experience from caregivers of people with dementia (PwD) during mandatory confinement due to the COVID-19 pandemic in Spain. An online survey, which studied the perceptions of the main problems and consequences experienced during confinement, was answered by 106 family caregivers of PwD. Results showed that family caregivers of PwD experienced psychological problems, like anxiety, mood, sleep, or eating disorders during confinement and felt less supported when they had to handle challenging behaviors or offer meaningful activities. An innovative multi-tiered supportive approach is needed which considers a post-pandemic reality and ensures the continuity of quality care for PwD and their family careers.


Assuntos
Doença de Alzheimer/psicologia , Doença de Alzheimer/terapia , COVID-19/psicologia , Cuidadores/psicologia , Determinação de Necessidades de Cuidados de Saúde , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , COVID-19/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Transtornos do Sono-Vigília/psicologia , Transtornos do Sono-Vigília/terapia , Isolamento Social , Apoio Social , Espanha
16.
Br J Clin Psychol ; 60(2): 177-193, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33587764

RESUMO

OBJECTIVES: Hoarding is associated with poor interpersonal functioning, such as social isolation and difficulties in forming relationships, but the reasons for these social problems are not well understood. Previous studies have identified empathy as an important precursor to social functioning, particularly for clinical disorders characterized by social deficits. The aim of the current study was therefore to investigate associations between measures of cognitive and emotional empathy and hoarding symptoms. METHOD: A total of 278 participants recruited via MTurk completed online self-report questionnaires on hoarding, empathy (including cognitive and affective components), and depression. All participants subsequently completed The Awareness of Social Inference Test-Short version (TASIT-S), a behavioural measure of theory of mind, a concept used interchangeably with cognitive empathy. RESULTS: Hoarding symptoms were associated with greater self-reported emotional empathy, specifically emotional contagion, and less self-reported cognitive empathy. Emotional empathy predicted hoarding even after controlling for depression symptoms. Hoarding symptoms were also associated with poorer performance on the TASIT-S with respect to both emotion recognition and theory of mind, with theory of mind remaining a unique predictor of hoarding symptoms after controlling for depression. Participants who reported clinically significant hoarding symptoms were impaired in emotion recognition and theory of mind according to TASIT-S norms. CONCLUSIONS: Hoarding symptoms are associated with increased emotional contagion and decreased cognitive empathy. Empathy may be an avenue for understanding and treating interpersonal difficulties in hoarding disorder. PRACTITIONER POINTS: As hoarding increased, self-reported emotional contagion increased As hoarding increased, self-reported and behavioural cognitive empathy decreased Self-reported emotional empathy and behavioural cognitive empathy predicted hoarding even after controlling for depression Empathy may be an avenue for understanding social difficulties in hoarding disorder.


Assuntos
Cognição/fisiologia , Empatia/fisiologia , Transtorno de Acumulação/psicologia , Transtornos do Humor/psicologia , Adulto , Feminino , Humanos , Masculino , Autorrelato , Inquéritos e Questionários
17.
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
COVID-19/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 , COVID-19/mortalidade , COVID-19/fisiopatologia , COVID-19/psicologia , Criança , Pré-Escolar , Comorbidade , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Hotspot de Doença , 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 , Síndrome do Desconforto Respiratório/fisiopatologia , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto Jovem
18.
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
19.
Psychopharmacology (Berl) ; 238(2): 341-354, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33427944

RESUMO

RATIONALE: Major depressive disorder is one of the leading global causes of disability, for which the classic serotonergic psychedelics have recently reemerged as a potential therapeutic treatment option. OBJECTIVE: We present the first meta-analytic review evaluating the clinical effects of classic serotonergic psychedelics vs placebo for mood state and symptoms of depression in both healthy and clinical populations (separately). RESULTS: Our search revealed 12 eligible studies (n = 257; 124 healthy participants, and 133 patients with mood disorders), with data from randomized controlled trials involving psilocybin (n = 8), lysergic acid diethylamide ([LSD]; n = 3), and ayahuasca (n = 1). The meta-analyses of acute mood outcomes (3 h to 1 day after treatment) for healthy volunteers and patients revealed improvements with moderate significant effect sizes in favor of psychedelics, as well as for the longer-term (16 to 60 days after treatments) mood state of patients. For patients with mood disorder, significant effect sizes were detected on the acute, medium (2-7 days after treatment), and longer-term outcomes favoring psychedelics on the reduction of depressive symptoms. CONCLUSION: Despite the concerns over unblinding and expectancy, the strength of the effect sizes, fast onset, and enduring therapeutic effects of these psychotherapeutic agents encourage further double-blind, placebo-controlled clinical trials assessing them for management of negative mood and depressive symptoms.


Assuntos
Transtorno Depressivo Maior/tratamento farmacológico , Alucinógenos/uso terapêutico , Transtornos do Humor/tratamento farmacológico , Agonistas do Receptor de Serotonina/uso terapêutico , Afeto/efeitos dos fármacos , Banisteriopsis/química , Depressão , Transtorno Depressivo Maior/metabolismo , Transtorno Depressivo Maior/psicologia , Método Duplo-Cego , Voluntários Saudáveis , Humanos , Dietilamida do Ácido Lisérgico/uso terapêutico , Transtornos do Humor/metabolismo , Transtornos do Humor/psicologia , Psilocibina/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
20.
Neurosci Lett ; 744: 135600, 2021 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-33421489

RESUMO

BACKGORUND: Increasing experimental data confirm the crucial role of the endocannabinoid (eCB) system in the regulation of stress response and emotional processes. Despite of the fact, that genetically determined vulnerability for stress is a widely accepted concept in the pathomechanism of affective disorders, replicable human genetic results with interaction analyses of early life trauma and eCB genes are rare. The aim of this study is to test the associations between genetic variants of the eCB pathway, childhood trauma and affective phenotypes. METHODS: We selected 18,897 SNPs in the eCB pathway of a GWAS dataset in two general population cohorts (BP sample N = 837; MN sample N = 988). Association analyses were performed on the anxious and depressive subscales of the Brief Symptom Inventory (BSI-ANX and BSI-DEP, respectively). Childhood trauma was assessed by the Childhood Adversity Questionnaire (CAQ). Association analyses were performed in the R 2.0. statistical program using the SNPassoc package. REULTS: Genetic effect was more robust in the BP sample than in the MN sample. The most comprehensive results showed that SNPs in the CACNA1C gene associated with depressive phenotype in interaction with CAQ in both BP (p = 1.2 × 10-4) and MN samples (p = 1.6 × 10-4). Direct association analyses (without interaction) provided significant associations between SNPs in different genesets of the two study populations. SNPs in KCNJ3 and GNB5 genes on the BSI-DEP (p = 6.1 × 10-5; p = 7.1 × 10-4) and GNG12 gene on the BSI-ANX (p = 7.4 × 10-6) in the BP sample, while GABAergic, ADCY1 and HTR2A gene variants can be outlined from results of MN sample with less strong p-values. CONCLUSION: Our results confirmed the prominent role of CACNA1C gene in the pathogenic effect of early life stress in the development of affective vulnerability in two different study populations using GxE interaction analysis. CACNA1C gene, as it encodes for L-type voltage-gated calcium channel, contributes to neuronal excitability, plasticity and neurogenesis being a crucial effector of both eCB signaling and the BDNF-CREB pathway as well. Our findings suggest that childhood trauma related depression may have more robust genetically determined basis than without early life stress.


Assuntos
Canais de Cálcio Tipo L/genética , Endocanabinoides/genética , Testes Genéticos/métodos , Variação Genética/genética , Estudo de Associação Genômica Ampla/métodos , Transtornos do Humor/genética , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Fenótipo , Transdução de Sinais/genética , Adulto Jovem
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