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2.
Psychiatr Prax ; 46(8): 439-444, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31683334

RESUMO

OBJECTIVE: The investigation of mediating effects of empowerment and stigmatization on the association between depressive symptoms and subjective quality of life in patients with affective disorders. METHOD: Depressive Symptoms (BDI-II), internalized and perceived stigmatization (ISMI; PDDQ), empowerment (EPAS) and subjective quality of life (WHOQOL-BREF) were assessed in 37 patients with affective disorders (F31 - F33; ICD-10), age 18+ in inpatient, day hospital or outpatient psychiatric treatment. Data analyses were conducted by means of path-analysis. RESULTS: Empowerment and in low proportion internalized and perceived stigma turned out to be mediating variables between the severity of depression and subjective quality of life. 57 % of the variance of the subjective quality of life could be explained by the path model. CONCLUSION: Empowerment has meaningful influence mediating between depression and subjective quality of life. In order to improve the quality of life of patients with an affective disorder, strategies for increasing empowerment are to be integrated into treatment.


Assuntos
Transtornos do Humor/psicologia , Qualidade de Vida , Estigma Social , Alemanha , Humanos , Participação do Paciente , Índice de Gravidade de Doença
3.
Adv Exp Med Biol ; 1192: 251-261, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705498

RESUMO

Mood disorders include all types of depression and bipolar disorder, and mood disorders are sometimes called affective disorders. We will discuss newly developing two issues in affective disorders in children and adolescents. Those are the new diagnostic challenges using neuroimaging techniques in affective disorders and the introduction of disruptive mood dysregulation disorder (DMDD). During the 1980s, mental health professionals began to recognize symptoms of mood disorders in children and adolescents, as well as adults. However, children and adolescents do not necessarily have or exhibit the same symptoms as adults. It is more difficult to diagnose mood disorders in children, especially because children are not always able to express how they feel. Child mental health professionals believe that mood disorders in children and adolescents remain one of the most underdiagnosed mental health problems. We are currently trying to introduce the new diagnostic technique-machine learning in children and adolescents with MDD. We will discuss the current progress in the clinical application of machine learning for MDD. After that, we would also discuss a new challenging diagnosis-DMDD. We are still suffering from a lack of evidence when trying to treat the patients with DMDD. In addition, there are some debates about the diagnostic validity of DMDD. We will explain the current situation of DMDD studies and the future directions in the study of DMDD.


Assuntos
Aprendizado de Máquina , Transtornos do Humor/psicologia , Adolescente , Adulto , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Criança , Depressão , Emoções , Humanos , Transtornos do Humor/diagnóstico , Neuroimagem
4.
Arq Gastroenterol ; 56(4): 351-356, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618395

RESUMO

BACKGROUND: Physical activity in daily life and exercise capacity have not been assessed in patients with Crohn's disease to date. OBJECTIVE: To evaluate the physical activity in daily life, exercise capacity, quality of life, and prevalence of mood disorders in patients with moderate-to-severe Crohn's disease on infliximab-induced remission and the possible associations among variables. METHODS: A cross-sectional preliminary study was conducted. Twenty-six patients with Crohn's disease and 20 controls were selected. Participants underwent evaluation of physical activity in daily life (triaxial accelerometer), exercise capacity (shuttle walk test), handgrip strength, quality of life, and presence of mood disorders. RESULTS: The number of steps taken (7446±3081 vs 7898±2487), active time (80.6±42 vs 89.7±24.3min), shuttle walk test distance [665 (405) vs 710 (409) m] and handgrip strength [31 (15) vs 29 (20) kgf did not show any difference between the patients with Crohn's disease and the controls. The time spent lying down [95.8 (68.8) vs 60.9 (74.7) min] was greater and some domains of the quality of life were superior in the patients with Crohn's disease. No correlation was observed between the physical activity in daily life and quality of life or presence of mood disorders in patients with Crohn's disease. CONCLUSION: Patients with Crohn's disease on infliximab-induced remission, despite to more time spent lying down, they have the same level of physical activity in daily life and exercise capacity min compared with the controls.


Assuntos
Doença de Crohn/tratamento farmacológico , Doença de Crohn/psicologia , Exercício/psicologia , Fármacos Gastrointestinais/administração & dosagem , Infliximab/administração & dosagem , Transtornos do Humor/psicologia , Qualidade de Vida/psicologia , Adulto , Estudos de Casos e Controles , Doença de Crohn/radioterapia , Estudos Transversais , Tolerância ao Exercício , Feminino , Humanos , Masculino , Prevalência , Índice de Gravidade de Doença
5.
PLoS Med ; 16(10): e1002905, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597983

RESUMO

BACKGROUND: Psychiatric disorders are reported to be present in 80% to 90% of suicide deaths in high-income countries (HIC), but this association is less clear in low- and middle-income countries (LMIC). There has been no previous systematic review of this issue in LMIC. The current study aims to estimate the prevalence of psychiatric morbidity in individuals with suicidal behaviour in LMIC. METHODS AND FINDINGS: PubMed, PsycINFO, and EMBASE searches were conducted to identify quantitative research papers (any language) between 1990 and 2018 from LMIC that reported on the prevalence of psychiatric morbidity in suicidal behaviour. We used meta-analytic techniques to generate pooled estimates for any psychiatric disorder and specific diagnosis based on International classification of disease (ICD-10) criteria. A total of 112 studies (154 papers) from 26 LMIC (India: 25%, China: 15%, and other LMIC: 60%) were identified, including 18 non-English articles. They included 30,030 individuals with nonfatal suicidal behaviour and 4,996 individuals who had died by suicide. Of the 15 studies (5 LMIC) that scored highly on our quality assessment, prevalence estimates for psychiatric disorders ranged between 30% and 80% in suicide deaths and between 3% and 86% in those who engaged in nonfatal suicidal behaviour. There was substantial heterogeneity between study estimates. Fifty-eight percent (95% CI 46%-71%) of those who died by suicide and 45% (95% CI 30%-61%) of those who engaged in nonfatal suicidal behaviour had a psychiatric disorder. The most prevalent disorder in both fatal and nonfatal suicidal behaviour was mood disorder (25% and 21%, respectively). Schizophrenia and related disorders were identified in 8% (4%-12%) of those who died by suicide and 7% (3%-11%) of those who engaged in nonfatal suicidal behaviour. In nonfatal suicidal behaviour, anxiety disorders, and substance misuse were identified in 19% (1%-36%) and 11% (7%-16%) of individuals, respectively. This systematic review was limited by the low number of high-quality studies and restricting our searches to databases that mainly indexed English language journals. CONCLUSIONS: Our findings suggest a possible lower prevalence of psychiatric disorders in suicidal behaviour in LMIC. We found very few high-quality studies and high levels of heterogeneity in pooled estimates of psychiatric disorder, which could reflect differing study methods or real differences. There is a clear need for more robust evidence in order for LMIC to strike the right balance between community-based and mental health focussed interventions.


Assuntos
Transtornos do Humor/epidemiologia , Ideação Suicida , Tentativa de Suicídio/psicologia , /psicologia , China/epidemiologia , Países em Desenvolvimento , Humanos , Índia/epidemiologia , Transtornos do Humor/psicologia , Morbidade , Pobreza , Prevalência , Fatores de Risco
6.
Ideggyogy Sz ; 72(9-10): 337-341, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31625700

RESUMO

Background - Modern health worries (MHWs) are asso-ciated with various indicators of negative affect, conspiracy theories, and paranormal beliefs in healthy individuals. Purpose - The current pilot study aimed to assess MHWs and indicators of negative affect in patients with affective disorders (N = 66), as well as the possible associations between MHWs and paranoid and schizophrenic tendencies. Results - Compared to somatic patients, psychiatric patients showed higher levels of MHWs, somatosensory amplification, health anxiety, and somatic symptoms. Medium level associations between MHWs and paranoid (r = 0.35, p < 0.01) and schizophrenic (r = 0.37, p < 0.01) tendencies were also revealed. Somatosensory amplification (ß = 0.452, p < 0.001) and paranoia (ß = 0.281, p < 0.01) significantly contributed to MHWs in multiple linear regression analysis (R2 = 0.323, p < 0.001). Discussion - High (i.e. pathological) levels of negative affect can impact a number of related characteristics. Non-pathological paranoid tendencies might contribute to MHWs. The identification of paranoid tendencies seems to be relevant for the treatment of psychiatric patients exhibiting MHWs. Conclusion - Patients with affective disorders are characterized by higher levels of modern health worries, health anxiety, and somatosensory amplification. Modern health worries are associated with paranoid tendencies.


Assuntos
Ansiedade , Atitude Frente a Saúde , Depressão , Transtornos do Humor/psicologia , Humanos , Transtornos do Humor/diagnóstico , Projetos Piloto , Inquéritos e Questionários
7.
Actas esp. psiquiatr ; 47(5): 179-189, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185170

RESUMO

Introducción. El suicidio es un problema de salud importante en España. Examinamos la relación entre la reincidencia de los intentos y el nivel de letalidad alcanzado, y el perfil de los pacientes reincidentes que realizan intentos más letales. El objetivo es establecer los factores sociodemográficos y clínicos predictores de una mayor letalidad y reincidencia. Método. Todos los pacientes atendidos por intento suicida en un área sanitaria de 360.000 habitantes de 2009 a 2014 (N = 711) fueron valorados de forma sistemática. Comparamos las características clínicas y demográficas en función de la letalidad (leve versus moderada-severa) y la reincidencia (1-2 intentos versus > 2 intentos) usando análisis univariantes y modelos de regresión. Posteriormente, repe-timos los análisis tras distribuir la muestra en cuatro grupos en función de la presencia o ausencia de alta letalidad y/o reincidencia. Resultados. La reincidencia se asoció con la edad media (35-65 años), inactividad laboral, y los trastornos de personalidad o por uso de sustancias. La letalidad se asoció con el género masculino, edades extremas, método violento y los trastornos afectivos, pero no con la reincidencia. La coincidencia de múltiples intentos y letalidad severa en un mismo paciente parece relacionarse con el grupo de edad de 35-65 años, sexo masculino, uso de métodos violentos, trastornos mentales y la inactividad laboral. Conclusiones. Distintos factores demográficos y clínicos se asocian al riesgo de letalidad médica y de reincidencia. Nuestros resultados muestran que aquellos pacientes que repiten los intentos y realizan al menos un intento de alta letalidad, tienen mayor presencia de psicopatología, sobre todo trastornos afectivos


Introduction. Suicidal behaviour is a major health problem in Spain. The aim of this study is to examine the relationship between the recurrence of suicide attempts and the level of lethality reached, and the profile of repeaters who perform more lethal attempts. Method. All patients admitted for attempted suicide in a health area of 360,000 inhabitants from 2009 to 2014 (N = 711) were systematically assessed. We compared clinical and demographic characteristics of these patients in terms of lethality (low versus moderate-severe) and recidivism (1-2 attempts versus >2 attempts) using univariate analyses and regression models. Later, we repeated the analyses after distributing the sample into four groups depending on the presence or absence of high lethality and/or recidivism. Results. Recidivism was associated with the middle-age group (35-65 years), the lack of professional activity, and personality or substance use disorders. Lethality was associated with male gender, extreme age-groups, the use of a violent method, and affective disorders, but not with recidivism. Multiple suicide attempts and high lethality in a single patient was associated with 35-65 years age-group, male gender, violent methods, mental disorders, and inactivity. Conclusions. Different demographic and clinical factors indicate an increased risk of medical lethality and recurrence in suicidal patients. Our results show that at least some recidivist patients end up making more lethal and violent attempts with the passage of time, especially if they have psychiatric comorbidity


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tentativa de Suicídio/psicologia , Transtorno da Personalidade Antissocial/mortalidade , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Reincidência/psicologia , Modelos Lineares , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos do Humor/psicologia , Transtornos Mentais/mortalidade , Transtornos Mentais/psicologia
8.
Am J Psychother ; 72(3): 59-66, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31533455

RESUMO

This study supports the efficacy of transdiagnostic behavior therapy across various affective disorders, including depression and PTSD. These findings suggest a possible reduction in the number of treatment protocols providers need to learn in order to treat patients with affective disorders.


Assuntos
Terapia Comportamental , Transtornos do Humor/terapia , Terapia Comportamental/educação , Protocolos Clínicos , Depressão/terapia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Resultado do Tratamento
9.
Twin Res Hum Genet ; 22(4): 233-239, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31498059

RESUMO

The Wisconsin Twin Project comprises multiple longitudinal studies that span infancy to early adulthood. We summarize recent papers that show how twin designs with deep phenotyping, including biological measures, can inform questions about phenotypic structure, etiology, comorbidity, heterogeneity, and gene-environment interplay of temperamental constructs and mental and physical health conditions of children and adolescents. The general framework for investigations begins with rich characterization of early temperament and follows with study of experiences and exposures across childhood and adolescence. Many studies incorporate neuroimaging and hormone assays.


Assuntos
Sintomas Afetivos/genética , Doenças em Gêmeos/genética , Transtornos do Humor/genética , Gêmeos/genética , Adolescente , Adulto , Sintomas Afetivos/fisiopatologia , Sintomas Afetivos/psicologia , Criança , Doenças em Gêmeos/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos do Humor/fisiopatologia , Transtornos do Humor/psicologia , Neurociências/tendências , Fenótipo , Psicologia do Desenvolvimento/tendências , Psicopatologia/tendências , Temperamento/fisiologia , Wisconsin
10.
Psychiatr Danub ; 31(Suppl 3): 434-437, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488767

RESUMO

The notion of "mixity" of the dysphoric phases of the bipolarity includes the most insidious symptoms of the bipolar spectrum of mood disorders: the overlapping between depression-restlessness-irritability-grief-tension-anxiety can cause worsening of the mood disorders and in the most acute phases may cause increased risk of major behavioural disruption including murder and suicide. The early utilization of the rating scale on mixed states, "GT-MSRS", which can demonstrate the level of "mixity" of the mood disorder, can prevent this.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Ansiedade/psicologia , Depressão/psicologia , Pesar , Homicídio/psicologia , Humanos , Humor Irritável , Agitação Psicomotora/psicologia , Suicídio/psicologia
11.
Psychiatr Danub ; 31(Suppl 3): 486-489, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488777

RESUMO

Mixed states are often underdiagnosed, with important consequences in terms of worsening prognosis, frequent admission to the hospital, higher suicide risk and poorer quality of life. For this reason, we analyzed retrospective data from patients admitted in the Psychiatric Hospital from January 1st to April 30th 2019 to identify clinical features of the mixed states by administering the G.T. MSRS scale. Within the 90 subjects of the sample, the large majority (75%) met criteria for mixed state. Of those only 16 were discharged with a diagnosis of Affective Disorder, however 26 (30.9%) were prescribed a mood stabilizer. This study shows that there is a high prevalence of mixed states in the inpatient unit admission, which is demonstrated both from the prescription of mood stabilizers, and confirmed by the diagnosis of mixed states rated with the scale. The scale can be a useful instrument to detect early in the course if the hospitalization the presence of mixed state, in order to guide a tailored psychopharmacological treatment, and improve prognosis.


Assuntos
Pacientes Internados/psicologia , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Unidade Hospitalar de Psiquiatria , Humanos , Transtornos do Humor/tratamento farmacológico , Prognóstico , Qualidade de Vida , Estudos Retrospectivos
12.
Gynecol Oncol ; 155(1): 126-134, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31416612

RESUMO

OBJECTIVES: Our aim was to investigate the prevalence and potential risk factors for persistent and troublesome physical and psychological symptoms following treatment for ovarian cancer (OC). METHODS: OvQuest is an international, internet-based, cross-sectional questionnaire which explored symptom burden and quality of life (QOL) after treatment for OC. Eligible women were aged 18 and over, diagnosed with OC at least 6 months previously and had received chemotherapy. Self-report data were collected including demographics, diagnosis and treatment, and standardised instruments for treatment-related toxicities, QOL, physical activity (PA) and supportive care needs. RESULTS: The survey included 1360 patients, of whom 421 (31%) had been treated for recurrent OC. 78% reported symptoms of peripheral neuropathy, 60% significant fatigue, 48% mood disturbance and 59% moderate-severe insomnia. Rates of fatigue, mood disorders, neuropathy and insomnia did not differ between women with or without recurrence. The majority of respondents were overweight or obese (high BMI, 59%) and 35% reported low PA. Low PA and high BMI were associated with poorer QOL scores and higher symptom burden across a range of domains. CONCLUSION: Women living after a diagnosis of OC report a substantial and ongoing symptom burden which impacts significantly on their quality of life across multiple domains. The reported associations between obesity, physical inactivity and poor QOL warrant prospective evaluation of lifestyle interventions to improve QOL.


Assuntos
Sobreviventes de Câncer/psicologia , Neoplasias Ovarianas/psicologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Fadiga/etiologia , Fadiga/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos do Humor/etiologia , Transtornos do Humor/psicologia , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/psicologia , Recidiva Local de Neoplasia/terapia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/fisiopatologia , Neoplasias Ovarianas/terapia , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
13.
Psychiatr Hung ; 34(2): 172-182, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417006

RESUMO

An increasing number of studies deal with the potential correspondence between suicidal behaviour and creativity nowadays. Psychobiographical analysis of the life of well known artists may help the better understanding of this phenomenon. In the present study predictive and protective factors of suicide are presented through the case of the well known suicidal poet and writer, Sylvia Plath. The most important predictive factors of suicide in her case are: affective disorder, comorbid anxiety disorder, prior attempt of suicide, and also her seriously affected personality, that mainly appears in her affective dependence. Her life events, both causes and effects of these, are also predisposing suicide. The early loss of her father, ambivalent relation with her mother and her marriage foredoomed to failure are the most significant of them. Although she used to write since her early childhood, the constant fluctuation of her psychological state had serious effect on her ability to write and also her motivation, both being an additional source of stress, due to her performance pressure. The fear of the acceptance of her works could also lay to increased amount of stress and anxiety on her sensitive personality. Her tragical life events, her psychiatric illness and her relentless templets towards herself could cause such a pressing stress, that neither creation, nor motherhood (the most important protective factor for women) could predominate. Neither moving to England, nor her last confessional book, "The Bell Jar" could cure her many kind of wounds, and these factors together lead to the suicide.


Assuntos
Criatividade , Transtornos do Humor/história , Transtornos do Humor/psicologia , Fatores de Proteção , Suicídio/história , Suicídio/psicologia , Transtornos de Ansiedade/complicações , Feminino , História do Século XX , Humanos , Transtornos do Humor/complicações , Mães/psicologia , Motivação , Fatores de Risco , Estresse Psicológico/complicações , Redação/história
14.
Comput Methods Programs Biomed ; 179: 104994, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31443867

RESUMO

BACKGROUND AND OBJECTIVE: Patients with mood disorders are known to have an emotion recognition deficit in facial emotion processing. Emotion perception involves two systems of cognitive and affective processes associated with brain activation in the fusiform gyrus and prefrontal cortices. To overcome the limitations of existing emotion perception tests, we designed an emotion perception index to assess the individuals' mood status. METHODS: We selected 66 emotional faces (22 pleasant, 22 unpleasant, and 22 neutral) for the emotion perception test and recruited 40 healthy participants to verify the test. The participants completed a demographic data questionnaire and were administered the Beck Depressive Inventory (BDI). They were also scanned to assess the brain functional connectivity (FC) between seeds of the fusiform gyrus and other brain regions using resting-state functional magnetic resonance imaging (rs-fMRI). After rs-fMRI scanning, the participants were administered the emotion perception test on a computer. RESULTS: In response to 108 questions regarding emotional face differentiation, the study group showed an average correct-answer rate of 90.7 ±â€¯6.4% and a mean reaction time of 1.4 ±â€¯0.4 s. We created an emotion perception index from the calculation of correct rate, number of correct responses, and reaction time in response to 108 questions; the mean of the emotion perception index in the study group was 3.8 ±â€¯0.2. The emotion perception index was positively correlated with the BDI scores (r = 0.4, p = 0.01); further, it was positively correlated with the FC from the fusiform gyrus to the left superior frontal gyrus (FDRq < 0.01), left medial frontal gyrus (FDRq < 0.01), left frontal precentral gyrus (FDRq = 0.02), left insula (FDRq < 0.01), and left occipital cuneus (FDRq = 0.01). The FC from the fusiform gyrus to the left insula was positively correlated with the BDI scores (r = 0.59, p < 0.001). CONCLUSIONS: The emotion perception index designed in this study may correctly indicate the mood status of individuals. In addition, the emotion perception test was associated with brain FC from the fusiform gyrus to the frontal and insular cortices.


Assuntos
Emoções/fisiologia , Neuroimagem Funcional/métodos , Imagem por Ressonância Magnética/métodos , Percepção/fisiologia , Adulto , Encéfalo/diagnóstico por imagem , Conectoma/métodos , Conectoma/estatística & dados numéricos , Expressão Facial , Feminino , Neuroimagem Funcional/estatística & dados numéricos , Voluntários Saudáveis , Humanos , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Transtornos do Humor/diagnóstico por imagem , Transtornos do Humor/psicologia , Córtex Pré-Frontal/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Adulto Jovem
15.
Psychopharmacology (Berl) ; 236(10): 3063-3079, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31359117

RESUMO

Social Signal Transduction Theory of Depression is a biologically plausible, multi-level theory that describes neural, physiologic, molecular, and genomic mechanisms that link experiences of social-environmental adversity with internal biological processes that drive depression pathogenesis, maintenance, and recurrence. Central to this theory is the hypothesis that interpersonal stressors involving social threat (e.g., social conflict, evaluation, rejection, isolation, and exclusion) upregulate inflammatory processes that can induce several depressive symptoms, including sad mood, anhedonia, fatigue, psychomotor retardation, and social-behavioral withdrawal. The original article describing this formulation (Psychol Bull 140:774-815, 2014) addressed critical questions involving depression onset and recurrence, as well as why depression is strongly predicted by early life stress and comorbid with anxiety disorders and certain physical disease conditions, such as asthma, rheumatoid arthritis, chronic pain, and cardiovascular disease. Here, we extend the theory to help explain sex differences in depression prevalence, which is a defining feature of this disorder. Central to this extension is research demonstrating that ovarian hormone fluctuations modulate women's susceptibility to stress, brain structure and function, and inflammatory activity and reactivity. These effects are evident at multiple levels and are highly context-dependent, varying as a function of several factors including sex, age, reproductive state, endogenous versus exogenous hormones, and hormone administration mode and dose. Together, these effects help explain why women are at greater risk for developing inflammation-related depressed mood and other neuropsychiatric, neurodevelopmental, and neurodegenerative disorders during the reproductive years, especially for those already at heightened risk for depression or in the midst of a hormonal transition period.


Assuntos
Transtorno Depressivo Maior/imunologia , Hormônios Esteroides Gonadais/imunologia , Transtornos do Humor/imunologia , Caracteres Sexuais , Transdução de Sinais/fisiologia , Estresse Psicológico/imunologia , Encéfalo/imunologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/imunologia , Inflamação/psicologia , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/psicologia
16.
J Consult Clin Psychol ; 87(7): 617-628, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31219293

RESUMO

OBJECTIVE: The aim of this study was to identify differential baseline profiles of interpersonal problems in patients with emotional disorders and investigate their ability to predict the extent to which alliance is important for early treatment outcome in therapy. METHOD: Ninety-six patients diagnosed with emotional disorders were admitted to psychotherapy at an independent practice center. After the first session, participants completed the Inventory of Interpersonal Problems and, after each of the first four sessions, the Alliance Negotiation Scale and the Outcome Questionnaire. We characterized the interpersonal problems of the sample using the circular statistics and the structural summary methods. Based on evidence of heterogeneity between patients, we conducted cluster analysis to identify differential profiles of interpersonal problems. We tested whether the identified profiles can predict the strength of the association between alliance negotiation and early treatment outcome using hierarchical linear models. RESULTS: A two-cluster solution showed the best fit for the data. One cluster was characterized by Cold interpersonal problems (too hostile) and the other by Overly Nurturant interpersonal problems (too dependent). The identified profiles were significant predictors of the early alliance negotiation-outcome association. Overly Nurturant patients showed greater early improvements in outcome in the face of a stronger alliance negotiation. CONCLUSIONS: Results support the importance of personalized approaches using patients' interpersonal profiles to determine the importance of alliance negotiation for early treatment outcome. Findings should be replicated in randomized controlled trials using strategies to manipulate alliance negotiation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos do Humor/terapia , Psicoterapia/métodos , Aliança Terapêutica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Inquéritos e Questionários , Resultado do Tratamento
17.
Int J Mol Sci ; 20(12)2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31212931

RESUMO

Inhibitory interneurons make up around 10-20% of the total neuron population in the cerebral cortex. A hallmark of inhibitory interneurons is their remarkable diversity in terms of morphology, synaptic connectivity, electrophysiological and neurochemical properties. It is generally understood that there are three distinct and non-overlapping interneuron classes in the mouse neocortex, namely, parvalbumin-expressing, 5-HT3A receptor-expressing and somatostatin-expressing interneuron classes. Each class is, in turn, composed of a multitude of subclasses, resulting in a growing number of interneuron classes and subclasses. In this review, I will focus on the diversity of somatostatin-expressing interneurons (SOM+ INs) in the cerebral cortex and elucidate their function in cortical circuits. I will then discuss pathological consequences of a malfunctioning of SOM+ INs in neurological disorders such as major depressive disorder, and present future avenues in SOM research and brain pathologies.


Assuntos
Córtex Cerebral/citologia , Córtex Cerebral/metabolismo , Regulação da Expressão Gênica , Interneurônios/metabolismo , Somatostatina/genética , Somatostatina/metabolismo , Animais , Fenômenos Eletrofisiológicos , Humanos , Aprendizagem , Memória , Transtornos do Humor/etiologia , Transtornos do Humor/metabolismo , Transtornos do Humor/psicologia , Sinapses , Transmissão Sináptica
18.
Psychiatr Rehabil J ; 42(3): 284-295, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31246076

RESUMO

OBJECTIVE: Veterans with "invisible injuries" (a mental health diagnosis or a traumatic brain injury) often pursue higher education to enhance employment and community reintegration, but frequently experience challenges to success. This mixed methods study examined how the educational experiences of Veterans with invisible injuries become intertwined with broader transitions between military and civilian life and the resulting implications for rehabilitation services. METHOD: Thirty-eight Veterans with mental illness or a traumatic brain injury who served in a post-9/11 conflict and attended a postsecondary institution within the past 60 months completed in-depth interviews and questionnaires. We used a constant comparative approach to analyze barriers and facilitators to educational functioning and community reintegration. RESULTS: Managing school-specific challenges, coping with mental and physical health problems, forming a new sense of self, and forging new career pathways were major factors influencing education experiences and reintegration. Participants discussed the challenges of balancing these processes while progressing toward an academic degree, which often resulted in a longer, nonlinear educational pathway. While some participants attempted to "compartmentalize" educational goals, separate from health and family concerns, these aims were inevitably interlaced. In addition, multiple and longer military deployments tended to lengthen the time to degree completion. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Many Veterans with invisible injuries face complex challenges stemming from military experiences, the family dynamics to which they return, and reintegration issues that demand novel forms of resilience. Collaboration between university staff and health practitioners may be important in enhancing support for student Veterans coping with invisible disabilities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade , Lesões Encefálicas Traumáticas , Educação Profissionalizante , Transtornos do Humor , Transtornos de Estresse Pós-Traumáticos , Veteranos , Adulto , Transtornos de Ansiedade/psicologia , Lesões Encefálicas Traumáticas/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Pesquisa Qualitativa , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados Unidos , United States Department of Veterans Affairs , Universidades , Veteranos/psicologia , Adulto Jovem
19.
Nat Hum Behav ; 3(10): 1116-1123, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31209369

RESUMO

Anxiety is characterized by altered responses under uncertain conditions, but the precise mechanism by which uncertainty changes the behaviour of anxious individuals is unclear. Here we probe the computational basis of learning under uncertainty in healthy individuals and individuals suffering from a mix of mood and anxiety disorders. Participants were asked to choose between four competing slot machines with fluctuating reward and punishment outcomes during safety and stress. We predicted that anxious individuals under stress would learn faster about punishments and exhibit choices that were more affected by those punishments, thus formalizing our predictions as parameters in reinforcement learning accounts of behaviour. Overall, the data suggest that anxious individuals are quicker to update their behaviour in response to negative outcomes (increased punishment learning rates). When treating anxiety, it may therefore be more fruitful to encourage anxious individuals to integrate information over longer horizons when bad things happen, rather than try to blunt their responses to negative outcomes.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo Maior/psicologia , Aprendizagem/fisiologia , Estresse Psicológico/psicologia , Incerteza , Adolescente , Adulto , Transtornos de Ansiedade/fisiopatologia , Estudos de Casos e Controles , Transtorno Depressivo Maior/fisiopatologia , Feminino , Humanos , Masculino , Transtornos do Humor/fisiopatologia , Transtornos do Humor/psicologia , Transtorno de Pânico/fisiopatologia , Transtorno de Pânico/psicologia , Punição , Recompensa , Estresse Psicológico/fisiopatologia , Adulto Jovem
20.
Turk Psikiyatri Derg ; 30(1): 42-50, 2019.
Artigo em Turco | MEDLINE | ID: mdl-31170306

RESUMO

OBJECTIVE: The aim of this study was to evaluate the reliability and validity of the Schedule for Affective Disorders and Schizophrenia for School-Age ChildrenPresent and Lifetime Version, DSM-5 November 2016 -Turkish Adaptation (K-SADS-PL-DSM-5-T).  METHOD: A total of 150 children and adolescents between 6 and 17 years of age were assessed with K-SADS-PL-DSM-5-T. The degree of agreement between the DSM-5 criteria diagnoses and the K-SADS-PL-DSM-5-T diagnoses were considered as the measure of consensus validity. In addition, concurrent validity was examined by analyzing the correlation between the diagnoses on K-SADS-PL-DSM-5-T and relevant scales. Interrater reliabilities were assessed on randomly selected 20 participants. Likewise, randomly selected 20 other participants were interviewed with K-SADS-PL-DSM-5-T three weeks after the first interview to evaluate test-retest reliability.  RESULTS: The consistency of diagnoses was almost perfect for eating disorders, selective mutism and autism spectrum disorder (κ=0.92-1.0), substantial for elimination disorders, obsessive-compulsive disorder, oppositional defiant disorder, generalized anxiety disorder, social anxiety disorder, depressive disorders, disruptive mood dysregulation disorder and attention deficit hyperactivity disorder (κ=0.67-0.80). Interrater reliability was perfect for selective mutism (κ=1.0), substantial for oppositional defiant disorder, disruptive mood dysregulation disorder, attention deficit hyperactivity disorder, depressive disorders and social anxiety disorder (κ=0.63-0.73). Test-retest reliability was almost perfect for autism spectrum disorder (κ=0.82), substantial for attention deficit hyperactivity disorder, oppositional defiant disorder, disruptive mood dysregulation disorder, depressive disorders and generalized anxiety disorder (κ=0.62-0.78).  CONCLUSION: The results of this study show that the K-SADS-PL-DSM-5-T is an effective instrument for diagnosing major childhood psychiatric disorders including selective mutism, disruptive mood dysregulation disorder and autism spectrum disorder which have recently been added to the schedule.


Assuntos
Transtornos do Humor/psicologia , Esquizofrenia/complicações , Adolescente , Serviços de Saúde do Adolescente , Criança , Serviços de Saúde da Criança , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Turquia
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