Search Results (161)

Background: Evaluating associations between fear of COVID-19 and psychopathology in clinical samples can yield valuable insights for the formulation of public health policies and for the training of mental health professionals in future major health crises. The objectives of our study were to evaluate the following aspects among patients diagnosed with insomnia disorder during the most critical period of the COVID-19 pandemic in Brazil: (a) the frequency of symptoms of depression and anxiety, fear of COVID-19, and severity of insomnia; (b) possible gender differences in the variables analyzed; and (c) associations between fear of COVID-19, symptoms of depression and anxiety, severity of insomnia, and sociodemographic variables. Method: A total of 353 individuals who sought treatment at a psychiatric hospital in the Brazilian public health system and were diagnosed with insomnia disorder (DSM-5) participated. The following instruments were used: the Hospital Depression and Anxiety Scale, Insomnia Severity Index, Fear of COVID-19 Scale, and a sociodemographic questionnaire. The assessments were carried out via the REDCap platform between March and July 2021. Results: Mild to moderate levels of fear of COVID-19 were identified in the majority of participants. Symptoms of depression, anxiety, and insomnia were reported at a moderate level. Although all scores were higher among women, only the fear of COVID-19 reached significant differences between groups. Fear of COVID-19 was positively correlated with symptoms of depression and anxiety and with the severity of insomnia. Anxiety scores had a positive and statistically significant effect on insomnia severity and on fear of COVID-19. Being a man and performing physical activity had a negative and statistically significant effect on fear of COVID-19. Conclusions: Being a woman, being sedentary, and having symptoms of anxiety were predictors of fear of COVID-19 among participants with insomnia disorder. This finding highlights the importance of gender-sensitive public health policies for the care of patients with insomnia during future major health crises. The associations between anxiety symptoms and fear of COVID-19 and the severity of insomnia verified in our study suggest the relevance of addressing anxiety symptoms through encouraging physical activity to mitigate the severity of insomnia and fear of pathogens in patients with insomnia. Full article

(1) Background: Mental health significantly impacts personal relationships and societal integration. Portugal faces a high prevalence of psychiatric illnesses and psychological distress, which the COVID-19 pandemic might have exacerbated. Therefore, this study aims to study risk factors that lead to psychological problems, using data available in the primary health care centers of the region of Aveiro. (2) Methods: This observational and retrospective study analyzes data from 2009 to 2022 on psychological consultations in the Aveiro municipalities. Variables considered are municipality, International Classification of Primary Care problem, sex, and comorbidities (cancer, obesity, and diabetes). Summary statistics and graphs were employed for data understanding, with R software used for analysis. Regression models, odds ratios, and association tests were calculated. Also, cluster analysis was performed on municipalities. (3) Results: A new, significant increase in the appointment growth rate was observed in 2021 and 2022. Anxiety and depressive disorders contribute to the identified growth. Women reported more problems than men. Cancer was the most present comorbidity. (4) Conclusions: The study reveals increased mental health problems, with primary health care users in Aveiro experiencing worsened psychosocial health, resulting in more medical consultations for psychological reasons. Risk factors included being female and having chronic conditions such as cancer. The findings provide insights into the burden of mental health issues in the region, highlighting the need for effective mental health interventions and resources to address health inequalities and support at-risk groups. Full article

Suicide in Italy represents a serious public health problem, with significant data highlighting the urgency for prevention interventions. According to the epidemiological data, in the two-year period 2020–2021, 7422 suicides were recorded, representing an increase compared to previous years. Suicide is the most extreme self-harm. The contributing factors that surround this event are multiple, typically in conditions of serious distress or psychological distress, in particular in people suffering from serious psychiatric and/or mental disorders, such as depression. The role of the forensic pathologist in the context of suicide is crucial for ascertaining the contributing factors of death and for understanding the circumstances that lead to the suicidal act. Forensic medicine plays a crucial role in the analysis and understanding of suicides, addressing both the legal and medical implications. The aim of this study was to accurately describe the phenomenon of suicide in Italy. The accuracy of the review was very important in paying attention to the large difference in how the phenomenon manifests itself in the male population compared to the female population. The different ages at which suicide is committed were highlighted. The geographical difference between the North and the South and between the more urbanized areas compared to the rural areas where suicide is committed was analyzed. This scientific work also aimed to explore how forensic pathologists contribute to the resolution of complex forensic investigations. Psychological autopsy is an investigative method used primarily in cases of violent or questionable death, with the aim of understanding the psychological and social circumstances that led to an individual’s death. This practice is distinct from forensic autopsy, which focuses on the physical analysis of the body to determine the cause of death. The role of forensic pathologists in investigating suicide cases is crucial, as they not only determine the cause of death but also analyze the psychological implications that may have led to the extreme act. The main objective of a forensic pathologist in these cases is to gather and interpret evidence that can help understand the psychological and social context that influenced the decision to commit suicide, identifying any warning signs and underlying motivations and factors that may have contributed to the suicide. This approach provides valuable information for prevention, enhancing the understanding of the psychological mechanisms behind suicide and supporting targeted interventions in the future. The manuscripts also have an explanatory purpose and may have a therapeutic role in helping surviving relatives understand suicide. Knowledge of the messages contained in suicide notes could be useful for suicide prevention programs. Full article

Background: Treating psychiatric illnesses or influencing mental states with neurofeedback is challenging, likely due to the limited spatial specificity of EEG and the complications arising from the inadequate signal-to-noise ratio reduction of single-trial EEG. Objective: This pilot study aimed to investigate the feasibility of employing a binaural pulse mode-modulation (BPM) device to reduce anxiety by self-regulation. We desired to determine whether anxiety could be significantly reduced or regulated using BPM-type systems. Methods: Sixty adult participants were examined with self-reported anxiety tests (COVID Stress Scale, Generalized Anxiety Disorder 7, Beck Depression Inventory-II), which were completed before treatment, after four weeks, and after 12 weeks post-treatment. This BPM device produced two frequencies which combined to create a binaural pulse through differential auditory tone presentations. The participant calibrated the suitable target tone for optimal treatment efficacy. Each participant adjusted the binaural pulse to enhance the emotional intensity felt when envisioning an experience with comparable emotional significance or while performing a cognitive task while concurrently listening to music. The “treatment” relied on the individual’s regulation of binaural pulses to obtain the desired state. The training concentrated on particular facets of their psychological challenges while listening to an auditory tone, adjusting a knob until the sound amplified the intended emotional state. Another knob was turned to intensify the emotional state associated with distress reduction. Results: On the self-reported measures, the BPM treatment group was significantly better than the sham treatment (control) groups (p < 0.01). These findings indicate that over the four-week intervention period, BPM was similarly effective. On the GAD-7, the significant difference over time was noted before treatment and at the end of treatment for the experimental group, with the average GAD-7 score at the end of treatment being significantly lower (p < 0.01). Conclusions: BPM seems to induce a short-term alteration in self-reported distress levels during therapy. This study’s limitations are examined, and recommendations for future research are provided. Full article

(1) Background: Validated instruments to measure mental health variables related to sanitary crises can provide data for prevention or intervention plans. The objectives of this study were: (1) to evidence the psychometric factorial internal structure of the Battery for Assessing Mental Health–Pandemic Version (BASM-P) in the sample; (2) to investigate the psychosocial impact of the COVID-19 pandemic in Brazilian post-peak period among individuals with and without pre-existing psychiatric conditions using the BASM-P; and (3) to analyze relationships between the mental health variables measured by the BASM-P in both groups. (2) Methods: This is an internet-based quantitative, cross-sectional study with a non-probabilistic convenience sample. The participants (n = 209) were divided into a non-psychiatric group (n = 168) and a psychiatric group (n = 41). The instruments were the BASM-P and a sociodemographic questionnaire. Data were collected throughout the second semester of 2022 and analyzed with JASP software. (3) Results: The BASM-P demonstrated robust psychometric factorial internal structure. Significant differences were observed between the two groups across all variables. In the non-psychiatric group, obsessive thoughts presented strong connections to fear, distress, and grief from job loss. (4) Conclusions: This study highlights the central role of obsessive thoughts in shaping the psychosocial impact of the COVID-19 pandemic in the Brazilian post-peak period. Full article

The substantial evidence supporting the ketogenic diet (KD) in epilepsy management has spurred research into its effects on other neurological and psychiatric conditions. Despite differences in characteristics, symptoms, and underlying mechanisms, these conditions share common pathways that the KD may influence. The KD reverses metabolic dysfunction. Moreover, it has been shown to support neuroprotection through mechanisms such as neuronal energy support, inflammation reduction, amelioration of oxidative stress, and reversing mitochondrial dysfunction. The adequate intake of dietary nutrients is essential for maintaining normal brain functions, and strong evidence supports the role of nutrition in the treatment and prevention of many psychiatric and neurological disorders. Obsessive–compulsive disorder (OCD) is a neuropsychiatric condition marked by persistent, distressing thoughts or impulses (obsessions) and repetitive behaviors performed in response to these obsessions (compulsions). Recent studies have increasingly examined the role of nutrition and metabolic disorders in OCD. This narrative review examines current evidence on the potential role of the KD in the treatment of OCD. We explore research on the KD’s effects on psychiatric disorders to assess its potential relevance for OCD treatment. Additionally, we identify key gaps in the preclinical and clinical research that warrant further study in applying the KD as a metabolic therapy for OCD. Full article

Background/Objectives: Ischemic heart disease (IHD) significantly affects mental health, with gender-specific differences being observed in psychological responses. This pilot study aimed to explore these differences in the demographic, clinical, psychological, psychiatric, and social profile of patients diagnosed with IHD. Methods: A descriptive, cross-sectional design was used, recruiting 183 adult patients diagnosed with coronary artery disease and depression at the Psychiatry Department of Arad County Emergency Hospital, Romania, between May 2021 and May 2024. Data were collected using a self-developed tool, named the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ), alongside standardized assessments. Statistical analysis was performed using JASP statistical software (Version 0.19.1, University of Amsterdam, Amsterdam, Netherlands), employing binomial and multinomial tests for categorical data, and Cronbach’s alpha was used to assess internal consistency. Results: This study found significant demographic differences, with female patients exhibiting higher levels of emotional distress and severe depression compared with the male subjects. Women reported greater social isolation and a stronger desire to seek for psychological or psychiatric support. Furthermore, a positive correlation between depression severity and physical symptoms was observed in both genders. Conclusions: These findings highlight the importance of recognizing gender-specific responses to IHD, emphasizing the need for tailored interventions in mental healthcare and cardiac rehabilitation. Future research should further explore these differences to enhance the understanding of the psychosocial/psychiatric aspects of IHD and improve patient outcomes. Full article

Post-Traumatic Stress Disorder (PTSD) is a multifaceted psychiatric disorder triggered by traumatic events, leading to prolonged psychological distress and varied symptoms. Rat models have been extensively used to explore the biological, behavioral, and neurochemical underpinnings of PTSD. This review critically examines the strengths and limitations of commonly used rat models, such as single prolonged stress (SPS), stress–re-stress (S-R), and predator-based paradigms, in replicating human PTSD pathology. While these models provide valuable insights into neuroendocrine responses, genetic predispositions, and potential therapeutic targets, they face challenges in capturing the full complexity of PTSD, particularly in terms of ethological relevance and translational validity. We assess the degree to which these models mimic the neurobiological and behavioral aspects of human PTSD, highlighting areas where they succeed and where they fall short. This review also discusses future directions in refining these models to improve their utility for translational research, aiming to bridge the gap between preclinical findings and clinical applications. Full article

This entry reviews the health condition known as Roemheld syndrome, or gastrocardiac syndrome in modern medicine. A pathology of gastrointestinal origin, the syndrome relies on a gut–brain–heart triad, interconnected by the vagus nerve. Pressure from the intestines pushes the stomach into the diaphragm and activates the vagus nerve, which affects the heart rate and gives the perception of cardiac issues. This distressing sensation, which usually comes after meals or with other digestive problems, causes anxiety or panic. Although events not arising from anatomic abnormalities are relatively harmless, hypersensitivity to these uncomfortable sensations may precipitate psychiatric problems (anxiety or depression) that cause repeated gastrocardiac events through sympathetic activation and the disruption of peristalsis. Treatment is usually symptomatic and may include diet, lifestyle changes, probiotics, or prescriptions that increase gut motility, but this specific set of reproducible symptoms may also be caused by hiatal hernia or side effects from medication/surgery and treated with respect to those mechanical causes. This review highlights details from the most current knowledge of the condition and offers suggestions for clinical management based on the literature. Full article

Background/Objectives: The impact of exercise on affective disorders has been demonstrated in various studies. However, almost no data are available on performance effects. Therefore, this study investigated exercise performance related to the severity of depression symptoms in a pre–post within-subjects design in a 6-week standard inpatient psychiatric rehabilitation program. Methods: A total of 53 individuals (20 female; mean age, 40.98 ± 11.33) with a primary diagnosis of depression performed a cardiopulmonary exercise test (CPX) to obtain maximal oxygen uptake (VO_2max), maximal power output (P_max), and the first and second ventilatory threshold (VT₁, VT₂) at the start and the end of the rehabilitation. Degree of depression was assessed by Becks Depression Inventory (BDI) and the Brief Symptom Inventory test (BSI). Overall activity was measured by accelerometer step-counts. Results: Mean total step-count per day during rehabilitation was high (12,586 ± 2819 steps/day). Patients’ BDI and BSI at entry were 21.6 ± 8.83 and 65.1 ± 6.8, respectively, and decreased significantly (p < 0.001) following rehabilitation, to 10.1 ± 9.5 and 54.5 ± 11.3, respectively. P_max and VO_2max increased significantly (p < 0.001) from entry values (182.6 ± 58.7 W, 29.74 ± 5.92 mL·kg⁻¹·min⁻¹) following rehabilitation: by 11.91 ± 12.09 W and 1.35 ± 2.78 mL·kg⁻¹·min⁻¹, respectively. VT₁ and VT₂ showed a similar behavior. An increase in physical performance could predict improvement in BDI (R² = 0.104, F(1,48) = 5.582, p = 0.022) but not in BSI. Conclusions: The program was associated with improved mental health status in all patients and increased performance in the majority of patients, although increases were small. Since improvements in exercise performance may be positively related to depression symptoms and comorbidities, it is recommended to individualize and tailor exercise programs, which could yield larger effects. Full article

Background/Objectives: The diagnosis of Autism Spectrum Disorders (ASD) is undergoing significant revisions, impacting prevalence estimates in the general population. Moreover, the rise of a dimensional perspective on psychopathology has broadened our understanding of autism, recognizing that subthreshold autistic features extend throughout the general population. However, there remains a limited understanding of the prevalence of ASD traits in individuals with psychiatric disorders, particularly in young adults, who are at an age where several mental health conditions emerge. The aim of this study was to evaluate the prevalence of ASD traits in a sample of young adults (18–24 years old) attending a generalized mental health outpatient clinic. Methods: A total of 259 young adult patients completed the self-report screening questionnaires Autism Quotient (AQ) and Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R). Results: A total of 16.2% of our sample scored above the cut-off in both scales; this percentage decreased to 13.13% when restricting the RAADS-R cut-off to >119, as suggested for clinical samples. The association with sociodemographic features is discussed. Conclusions: We argue that screening for autistic traits should be integrated into the assessment of young adults presenting with nonspecific psychiatric symptoms or psychological distress. Although there is ongoing debate over the use of self-report screening tools, a positive result on both the AQ and RAADS-R should prompt clinicians to pursue a comprehensive diagnostic evaluation using structured or semi-structured interviews. Full article

Background: Although screening for distress is recommended by many cancer care guidelines, the uptake of such screening in cancer centers remains limited. Improving the acceptability of screening programs in cancer centers requires a reduction in clinical burden and an improved detection of distress. The purpose of this study was to validate the performance of the two-step screening algorithm used in the Distress Assessment and Response Tool (DART) for identifying cases of anxiety and depression. Methods: This retrospective validation study consisted of patients at the Princess Margaret Cancer Centre (PM) who completed the DART, which includes the Edmonton Symptom Assessment System depression (ESAS-D) and anxiety (ESAS-A) items, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7). We evaluated the performance of a two-step screening approach, which modeled the ESAS-D, followed by the PHQ-9 and ESAS-A, then the GAD-7 for predicting a diagnosis of depression and anxiety disorders, respectively. A clinical psychiatric assessment was used as the gold standard reference. Results: A total of 172 patients with cancer were included in this study. A total of 59/172 (34%) and 39/172 (23%) were diagnosed with a depression or anxiety disorder, respectively. The sequential administration of the PHQ-9 ≥15 following the ESAS-D (>2) significantly increased the post-test probability of depression from 37% to 60% and improved the performance of predicting depression compared to both the ESAS-D or the PHQ-9 as standalone tests. The sequential administration of the GAD-7 after the ESAS-A did not improve the predictability of an anxiety diagnosis beyond the performance of the ESAS-A or the GAD-7 as standalone tests. Conclusions: The present study is among the first to demonstrate that a two-step screening algorithm for depression may improve depression screening in cancer using real-world data. Further research on optimal screening approaches for anxiety in cancer is warranted. Full article

Background/Objectives: Although rare in the Western world, dog bites may be lethal or lead to physically severe outcomes. However, little attention is given to their psychological consequences. We aimed to review their psychological consequences in children 1–14 years of age, focusing on the prevalence and nature of psychological disorders, evaluating the impact on future mental health of children and their families, and assessing the effectiveness of preventive interventions and measures. Methods: On 23 May 2024, we investigated the PubMed, CINAHL, and PsycINFO/PsycARTICLES databases using (“dog bite” OR animal-induced OR animal-caused) AND (psychol* OR mental OR psychiatr* OR anxiety OR anxious OR depress* OR obsess* OR trauma* OR psychosis OR psychotic OR schizophren* OR schizoaffect*) filtered for ages 0–18 years. This resulted in 311 records, of which 50 were eligible. These included original research, case reports, patient surveys, and reviews/meta-analyses. Results: Findings indicate that younger children are particularly vulnerable, often suffering head/neck bites, leading to severe injuries and psychological distress, with post-traumatic stress disorder (PTSD) being a common outcome. Symptoms such as nightmares, flashbacks, anxiety, and social withdrawal were frequently reported. Positive parental support and timely psychological interventions were found to mitigate these effects. Conclusions: Interdisciplinary approaches integrating education, cognitive restructuring, and behaviour modification are needed to effectively prevent and address the psychological impacts of dog bites. Summarising, dog bites in children result in substantial psychological sequelae, necessitating robust prevention and intervention strategies to improve their quality of life and reduce the risk of chronic mental conditions. Full article

Personalized psycho-oncology represents a major challenge for the holistic care of cancer patients. It focuses on individualized psychotherapeutic and psychiatric interventions to address specific psychological needs. This narrative review summarizes the current literature on personalized psycho-oncology and highlights the prevalence and impact of psychiatric/psychological disorders in cancer patients. Personalized approaches, including tailored interventions and interdisciplinary collaboration, have been shown to be effective in improving mental health and overall quality of life. The integration of inflammatory biomarkers into treatment plans is a promising but challenging way to alleviate mental health problems. In addition, there is a need for specific diagnostic tools and treatment guidelines that take into account the specific psychological impact of different types of cancer. Future research should aim to refine these personalized strategies, improve diagnostic accuracy, and evaluate the cost-effectiveness of these interventions to improve both the psychological well-being and treatment outcomes of cancer patients. Full article

Healthcare workers were substantially impacted by the COVID-19 pandemic. Front-line workers continue to suffer higher rates of distress and burnout than they had before the pandemic. In order to heal the front-line workforce and plan for the next disaster in healthcare, it is necessary to carefully reflect on the COVID-19 pandemic and integrate that experience with the existing literature on disaster mental health. In this narrative review, the disaster MH framework for community disasters is adapted to the healthcare setting. The first principle of disaster mental health is to distinguish between normative distress and psychopathology. The second step in the framework includes stabilization, triage, and referral to psychiatry. The third step in disaster mental health framework is intervention for psychological distress and psychiatric illness. Interventions for emotional distress may include psychological first aid (PFA), psychological debriefing, crisis counseling, and psychoeducation, whereas interventions for psychopathology include pharmacotherapy and/or psychotherapy. Unfortunately, many front-line HCWs were indeed damaged by the pandemic and continue to report high levels of burnout and distress, in part because the MH response to the pandemic was lacking or otherwise inadequate. Screening, triage and referral to MH resources, and interventions are fundamental aspects of an MH response to disaster and may be coordinated with formal operational procedures within incident command structures. Setting up these structures in advance, preferentially, and establishing networks of psychiatrists and crisis MH responders who will implement them are essential. By reflecting on the pandemic and learning from prior disasters, we can care for those who care for our sickest patients. Full article