Hasil untuk "Psychiatry"

Amar Sarkar, S. Lehto, S. Harty et al.

A. Caspi, T. Moffitt

In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms. This single dimension of general psychopathology has been termed "p," because it conceptually parallels a dimension already familiar to behavioral scientists and clinicians: the "g" factor of general intelligence. As the g dimension reflects low to high mental ability, the p dimension represents low to high psychopathology severity, with thought disorder at the extreme. The dimension of p unites all disorders. It influences present/absent status on hundreds of psychiatric symptoms, which modern nosological systems typically aggregate into dozens of distinct diagnoses, which in turn aggregate into three overarching domains, namely, the externalizing, internalizing, and psychotic experience domains, which finally aggregate into one dimension of psychopathology from low to high: p. Studies show that the higher a person scores on p, the worse that person fares on measures of family history of psychiatric illness, brain function, childhood developmental history, and adult life impairment. A dimension of p may help account for ubiquitous nonspecificity in psychiatry: multiple disorders share the same risk factors and biomarkers and often respond to the same therapies. Here, the authors summarize the history of the unidimensional idea, review modern research into p, demystify statistical models, articulate some implications of p for prevention and clinical practice, and outline a transdiagnostic research agenda. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1910: A Study of Association in Insanity Grace Helen Kent and A.J. Rosanoff: "No sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states."(Am J Psychiatry 1910; 67(2):317-390 )].

Hai-xin Bo, Wen Li, Yuan Yang et al.

1. Department of Nursing, Peking Union Medical College Hospital, Beijing, China; 2. Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; 3. Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China; 4. Department of Psychiatry, Southern Medical University Nanfang Hospital & Guangdong-Hong Kong-Macao Greater Bay Area Center for Brian Science and Brain-Inspired Intelligence, Guangdong, China; 5. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China; 6. School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China

G. Ainslie

Emil Kraepelin

R. Lyons

Here, we bring readers extracts from the latest issues of The Cochrane Database of Systematic Reviews relevant to the fields of psychiatry and neurology. We feature a summary of the results, reviewers' conclusions, and implications for clinical practice and research, from selected new reviews featured in issues 6 and 7, 2011. For further information, visit www.thecochranelibrary.com. Copyright © 2011 Wiley Interface Ltd

J. Bowlby

G. Koob, M. Moal

Valerio Campolo, Valerio Campolo, Martin Kitzrow et al.

Parvovirus B19 infection is mostly asymptomatic in immunocompetent individuals but may cause severe manifestations when humoral immunity is impaired. Anti-CD20 therapies such as rituximab induce prolonged B-cell depletion and hypogammaglobulinemia, affecting the immune coordination and lowering the threshold for viral neuroinvasion and persistence within the central nervous system (CNS). We present a case of a 61-year-old patient who developed new-onset seizures 9 months after completing rituximab as fourth-line therapy for immune-mediated thrombocytopenia. Brain MRI showed a focal hyperintense lesion in the left peri-insular region with edema. Parvovirus B19 DNA was detected in the cerebrospinal fluid via polymerase chain reaction, while extensive testing for other infectious and autoimmune causes of encephalitis was negative. Immunological work-up demonstrated persistent depletion of CD19+ B lymphocytes and severe hypogammaglobulinemia. This case highlights the role of impaired humoral immunity in facilitating viral persistence within the CNS and emphasizes the need to consider parvovirus B19 and other uncommon pathogens as a potential cause of encephalitis in patients with prior anti-CD20 therapy, even months after treatment completion.

Hirohisa Fujikawa, Hidetaka Tamune, Yuji Nishizaki et al.

Abstract Although considerable bodies of literature have elucidated various determinants of burnout and job satisfaction among medical residents, one aspect that remains under-examined is the impact of patient care ownership (PCO). Therefore, we aimed to examine the associations between PCO, burnout, and job satisfaction among residents. This was a nationwide cross-sectional study, using online anonymous surveys from January 17 to March 31, 2024. The participants were residents who participated in the General Medicine In-Training Examination, a nationwide examination in Japan. The primary outcome was burnout, assessed using the Single-item Measure of Burnout Scale. The secondary outcome was job satisfaction, measured by the item included in the Mini-Z 2.0. The explanatory variable was PCO, as assessed by the Japanese version of the PCO Scale. 1816 participants were in the analysis. Multivariable logistic regression analyses revealed that, after adjustment for possible confounders, PCO showed a negative association with burnout, and that there was a positive association between PCO and job satisfaction. The findings suggest the importance of emphasizing PCO in the context of exploring burnout and job satisfaction among medical residents. This knowledge will inform educational interventions to help residents work with less burnout and greater job satisfaction, ultimately leading to better patient outcomes.

Sheila Guise-Moores

planned as the first of a trilogy, the two subsequent volumes to be concerned wi' methodology and technique. This first book is addressed to all the different discipli?e. whose concern goes beyond the treatment of mental illness to the improvement 0 mental health, and who work in a community setting, where professional boundary-are as yet ill-defined, and roles less certain. The author confidently and persuasiv^ charts a course through this complex field, offering a conceptual model for primfr! prevention and going on to deal with secondary and tertiary prevention, social acti0^ to improve basic socio-cultural supplies, community planning, and mental hea''r consultation. In his foreword, Dr. Felix writes: "This book is not only a primer f?' the community mental health worker?it is a Bible." Be that as it may, it is also a mo5 stimulating book, rich in ideas and starting points for discussion, and likely to havi a major influence in this growing field. , One question is fundamental. How can we make the most effective use of the limite number of professional workers available? The author's approach draws up0(1 Lindeman's crisis theory. Help can be maximised if concentrated on people ''"J crisis", facing some developmental or accidental hazard which involves a loss, thi& or challenge. These people, it is thought, are at points where growth or breakdo^11 may occur, and where short-term intervention is likely to have maximum impact. Th'j theory is central to the book, and has much to teach us, but offers such a convenieI1 framework for community planning that it could be accepted too uncritically. Of.. may doubt if these external crises are always the relevant ones, if the effect of cris'j intervention will not pass with the crisis, if we do not risk making some development3 stages more critical by anticipating difficulties. Although the author repudiates any idea of "government by psychiatrist", he sef him in a position of considerable power in his community role, influencing econofl111 and political decisions and modifying attitudes and behaviour. He must seek out the population at risk before breakdown occurs, and through mental health consultati^ with both professional and "informal" care-givers, improve the prophylactic he'? offered. Mental health consultation is a principal tool, and the two valuable chaptef" devoted to this give a foretaste of one of the volumes to come. ..

Michelle Chang

Hyein Kim, Seongae Kwon, Sunyoung Park et al.

Abstract Background Ecological momentary assessment (EMA) has seen increasing application in mental health research. However, there is a challenge in applying EMA to assess daily suicide risk in community settings due to poor adherence to the complex protocol and high dropout rates. The aim of this study is to assess the feasibility and adherence to the EMA when monitoring the daily risk of suicide in community-dwelling adults with suicidal ideation. Methods This secondary analysis was based on primary data from an observational study. The study participants with suicidal ideation responded to a 28-day EMA online survey and pressed an event marker on an actigraphic device when feeling strong suicidal impulses. Feasibility was evaluated using the EMA response rate and actigraphic device adherence rate based on descriptive statistics. Mental health characteristics related to feasibility were assessed in self-reporting questionnaires, and nonparametric correlation coefficients were identified to assess the relevance to feasibility. Results A total of 22 participants were enrolled, with 20 remaining in the final sample (90.9%). The average EMA response rate was 82.05%, decreasing from 86.96% during the first 2 weeks to 76.31% in the second 2 weeks. The Actiwatch adherence rate was maintained at 98.1%. Actiwatch adherence and EMA response rates were moderately correlated (r =.53, p =.016). Higher depression and anxiety scores were associated with lower Actiwatch adherence, whereas a higher perceived stress score was associated with lower EMA response rates. The peak of suicidal impulse patterns in event button activations usually occurred between 9 to 10 pm, while activations were lowest in the early morning hours, particularly between 4 and 6 am. Discussion This study indicated that EMA using smartphones and actigraphic devices were feasible to monitor suicidal ideation and impulse for a month in community-dwelling adults; thus, it could be a complementary tool to assess daily suicide risk. However, there are still challenges to be overcome when EMA-based monitoring in the community is used for those with mental vulnerability. Thus, mental health professionals should carefully tailor the pros and cons of EMA based on our findings to enhance this vulnerable group’s participation and adherence to EMA for suicide prevention.

Luciana Cristina Mancio Balico, Gabrielle Siota Schramm, Eduarda Taube Rotta et al.

ABSTRACT Introduction This study explores the associations between Adverse Childhood Experiences (ACEs) and child health in Brazil using data from the PEARLS-BR study. It aims to assess the prevalence and impact of ACEs in a Brazilian cultural context and their relationship with health outcomes. Methods A cross-sectional study was conducted at a Multidisciplinary Health Care Clinical Center and a General Hospital - Reference Center for Child and Adolescent Care, involving 202 caregivers of children and teens aged 0 to 18 years. The PEARLS-BR instrument was used to document the frequency and distribution of ACEs and related life events and their association with health outcomes. Results Caregivers participants reported a median of 2 (IQR 1-5) adversities of their child, with 78.2% reporting at least one adversity. Higher PEARLS-BR scores were significantly associated with poorer physical health (OR: 1.18, 95% CI: 1.01–1.38) and mental health (OR: 1.50, 95% CI: 1.33–1.71), ADHD symptoms (OR: 1.21, 95% CI: 1.09–1.37), infections (OR: 1.13, 95% CI: 1.02–1.26), gastrointestinal disorders (OR: 1.26, 95% CI: 1.12–1.43), and headaches/migraines (OR: 1.22, 95% CI: 1.11–1.35). Related life events were linked to higher odds of obesity (OR: 1.37, 95% CI: 1.02–1.88) and atopic conditions (OR: 1.28, 95% CI: 1.01–1.63). Conclusions The PEARLS-BR score identifies children at risk for various adverse health outcomes. The study highlights the need for targeted interventions and comprehensive strategies to address the impact of childhood adversities on health, providing valuable insights for public health strategies and clinical practices in Brazil.

Lincy Koodaly, Erika Friedmann, Nancy R. Gee et al.

<b>Background:</b> The growth of the older adult population calls for innovative and cost-effective ways of promoting their physical, psychological, and cognitive health. Human–animal interaction, including pet ownership, is related to positive and negative aspects of human health. Not all pet owners respond in the same way. The levels of pet attachment and pets’ influence on their owners’ lives could moderate the relationship between psychological status and health outcomes. <b>Purpose:</b> We examined the moderating role of pet attachment in the relationships of psychological status (mental wellbeing, happiness, anxiety, depression) to physical function (physical wellbeing, usual- and rapid-gait speeds, physical performance battery) in community-residing older adult pet owners. <b>Methods:</b> A cross-sectional, secondary analysis of pet-owning older adult participants in the Baltimore Longitudinal Study of Aging (n = 178). <b>Results:</b> In regression analyses, controlling for age, gender, and comorbidities, pet attachment and pet influence moderated the relationships of physical wellbeing to mental wellbeing and anxiety (<i>p</i> < 0.05). Pet influence also moderated the relationship between anxiety and usual gait speed (<i>p</i> < 0.05). <b>Conclusions:</b> Greater attachment and influence buffer the relationship of perceptions of poor mental function with perceptions of poor physical wellbeing suggesting one mechanism for health benefits of human-animal interaction.

R. Kendell

D. Leigh

H. Bird, M. Gould, Beatriz Staghezza

Maria Bevz

This paper aims to highlight some issues, challenges and trends caused by the COVID-19 pandemic in the drug scene and the system of drug prevention in Ukraine. This article is based on the official statistics, available qualitative and quantitative studies conducted by the Institute for Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of the Ministry of Health of Ukraine (Ukrainian National Focal Point), the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and Ukrainian researchers. Of course, some studies are not representative of the general population; however, they give some information on the drug scene in Ukraine during the pandemic. The data used in the article were collected mainly in 2019–2020. Every actor on the drug scene had to adapt to the new reality caused by anti-pandemic measures. Drug sellers proposed “stable work” during lockdown; drug dealers dropped ordered substances closer to the customer’s place. At the same time, OST facilities implemented home-treatment, and many private facilities appeared. OST patients misused methadone and sold it on the illicit market, while drug users started to find substitutes of their main drug and notably increased drug-related deaths.

Daiki X. Sato, Yukiko U. Inoue, Nahoko Kuga et al.

Summary: The human vesicular monoamine transporter 1 (VMAT1) harbors unique substitutions (Asn136Thr/Ile) that affect monoamine uptake into synaptic vesicles. These substitutions are absent in all known mammals, suggesting their contributions to distinct aspects of human behavior modulated by monoaminergic transmissions, such as emotion and cognition. To directly test the impact of these human-specific mutations, we introduced the humanized residues into mouse Vmat1 via CRISPR/Cas9-mediated genome editing and examined changes at the behavioral, neurophysiological, and molecular levels. Behavioral tests revealed reduced anxiety-related traits of Vmat1Ile mice, consistent with human studies, and electrophysiological recordings showed altered oscillatory activity in the amygdala under anxiogenic conditions. Transcriptome analyses further identified changes in gene expressions in the amygdala involved in neurodevelopment and emotional regulation, which may corroborate the observed phenotypes. This knock-in mouse model hence provides compelling evidence that the mutations affecting monoaminergic signaling and amygdala circuits have contributed to the evolution of human socio-emotional behaviors.