Hasil untuk "Psychiatry"

M. Bauer, J. Kirchner

Centuries of experience make it clear that establishing the effectiveness of a clinical innovation is not sufficient to guarantee its uptake into routine use. The relatively new field of implementation science has developed to enhance the uptake of evidence-based practices and thereby increase their public health impact. Implementation science shares many characteristics, and the rigorous approach, of clinical research. However, it is distinct in that it attends to factors in addition to the effectiveness of the clinical innovation itself, to include identifying and addressing barriers and facilitators to the uptake of evidence-based clinical innovations. This article reviews the definition, history, and scope of implementation science, and places the field within the broader enterprise of biomedical research. It also provides an overview of this Special Issue of Psychiatry Research, which introduces the principles and methods of implementation science to mental health researchers.

S. Kooij, S. Bejerot, A. Blackwell et al.

BackgroundAttention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe.MethodsThe European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated.ResultsBesides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated?ConclusionsADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group.

M. Angermeyer, S. Dietrich

L. J. Friedman

N. Andreasen, M. Flaum, Stephan Arndt

L. Gottschalk, G. Gleser

alysis and academic psychiatry) are often important and delicately balanced." My experiences and my theoretical and clinical orientation as both a psychoanalyst and a psychiatrist made it clear to me that my position was unhesitatingly with Dr. James Mann's spirited paper. He makes clear that a blurring of psychiatry and psychoanalysis has taken place because psychoanalytic concepts have become so much a part of psychiatry and he proceeds to differentiate between the two. He points out specifically that so-called Neo-Freudians may minimize, ignore or discard significant unified psychoanalytic theoretical considerations but insist that the end result be considered psychoanalysis anyway. His focus is also upon residency training. He addresses himself to the issue of how much psychoanalytic insights, theories and procedures can and should be incorporated into basic psychiatric residency training, education and practice. His view is that a residency training program should be devoted to the intensive study of human behavior, individual and in small groups, in normal and in abnormal states, in children and adults, and that this intensive study rests upon fundamental psychoanalytic contributions. After this three-year basic training, residents are in a position to choose in which direction they want to go—including education and training in psychoanalysis. This differentiates Doctor Mann's position both from Doctor Lief's views concerning psychoanalysis and residency training and from Dr. Milton Miller's views about the kinds of psychiatrists he apparently feels we should be turning out. This collection of papers then is for the reader who would like a glimpse of some aspects of the relationship between psychoanalysis and psychiatry—USA—circa 1968. JACOB SWARTZ, MD The Measurement of Psychological States Through the Content Analysis of Verbal Behavior

W. R. Dunton

Jiachen Chen, Jiachen Chen, Jiachen Chen et al.

IntroductionThere are notable sex differences in the gray matter of Alzheimer’s disease(AD) patients’ brains, but current evidence is insufficient to prove these differences aid diagnosis effectively.MethodsMultivariate analysis of variance was performed on the preprocessed gray matter of healthy female and healthy male groups to identify the gray matter clusters with significant intergroup differences. Subsequently, multiple machine learning models were employed to develop sex-specific diagnostic models for AD.ResultsWe identified 11 brain regions showing sex differences, of which 8 were sex-specific in both female and male AD patients, exhibiting significant atrophy. Graph theory analysis demonstrated that the sex-specific gray matter structural brain networks in female and male AD patients exhibited distinct network alterations. We subsequently employed five advanced machine learning algorithms to develop diagnostic models for AD based on these sex-specific gray matter clusters, resulting in a notable improvement in performance.DiscussionSex-specific gray matter characteristics can facilitate more accurate diagnosis of AD.

Mekdes Demissie, Charlotte Hanlon, Lauren C. Ng et al.

Abstract Background There is a very large unmet need for appropriate psychological interventions for bipolar disorder (BD) for use in low- and middle-income countries. We developed a psychological intervention for BD in a primary health care (PHC) setting in Ethiopia using the Medical Research Council’s framework for the Development and Evaluation of Complex Interventions. The aim of this study is to investigate the feasibility, acceptability, and fidelity of this newly developed psychological intervention for BD in a PHC setting in south-central Ethiopia. Method A total of 12 euthymic people with bipolar disorder and five caregivers participated in five 20-min weekly sessions of the psychological intervention. We conducted a mixed-method evaluation, including in-depth qualitative interviews, fidelity ratings of a random selection of 25% of the audio recorded intervention sessions, and self-reported change in symptom severity. We used thematic analysis for qualitative data and descriptive analysis for quantitative data. Results Except for one caregiver, all participants completed all five sessions. Intervention providers and recipients expressed satisfaction with the intervention. Intervention providers reported that the intervention can be feasibly delivered in the PHC setting, although 20 min was considered insufficient. While participants acknowledged the importance of involving caregivers in the intervention, they raised privacy concerns. Intervention providers’ adherence to the manual was moderate. Preliminary findings indicate a reduction in depressive symptoms post-intervention and improvement in providers’ perceived knowledge and skills. Conclusions This contextually developed psychological intervention for bipolar disorder has promising feasibility, acceptability, and potential utility. Further studies should evaluate time considerations and effectiveness. Trial registration The trial was registered on 16 August 2024, retrospectively on the Pan African Clinical Trial Registry database [PACTR202408896160144],  https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=31727 .

Eric R. Cohn, José R. Zubizarreta

ABSTRACT Objective Inverse probability weighting is a fundamental and general methodology for estimating the causal effects of exposures and interventions, but standard approaches to constructing such weights are often suboptimal. Methods In this paper, we describe a recent approach for constructing such weights that directly balances covariates while optimizing the stability of the resulting weighting estimator. Results To illustrate the use of this approach in mental health research, we present an exploratory study of the effects of exposure to violence on the risk of suicide attempt. Conclusions The direct balancing approach to weighting should be given strong consideration in empirical research due to its robustness and transparency in building weighting estimators.

Lauren N. Miterko-Myers

Dystonia is a neurodevelopmental disorder characterized by severe involuntary twisting movements, hypothesized to arise from a dysfunctional motor network involving the cortex, basal ganglia, and cerebellum. Within this network, striatal cholinergic interneurons have been identified as possible contributors to dystonia pathophysiology. However, little is known about striatal cholinergic interneuron development in the mammalian brain, limiting our understanding of its role in dystonia and therapeutic potential. Here, I review striatal cholinergic interneuron development in the context of early-onset DYT1 (or “DYT-TOR1A”) dystonia. I discuss clinical and laboratory research findings that support cholinergic dysfunction in DYT1 dystonia and the implications of abnormal cholinergic cell development on disease penetrance and striatal connectivity.

Javier Sánchez-Gálvez, Javier Sánchez-Gálvez, Santiago Martínez-Isasi et al.

IntroductionSilver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds.MethodsThe review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers.Results740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies.ConclusionIn vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041].

Senthil Amudhan, Kavita Jangam, Kalaivani Mani et al.

Abstract Background There is an increasing need for Mental Health Promotion (MHP) among adolescents, especially in developing countries with limited resources and rapid socio-demographic transition. With the growing burden of mental health problems among adolescents (suicide, depression) and their preferences to seek help from their peers, improving Mental Health Literacy (MHL) and behaviours for First Aid in Mental Health (MH-FA) becomes crucial to promote their mental health. Methods Schools are ideal settings for reaching the vulnerable adolescents. The proposed study evaluates the effectiveness of a classroom-based teacher-led integrated school mental health intervention called SUMS (MHP + MHL + MH-FA). The study will involve a pragmatic, cluster-randomised waitlist-controlled design to evaluate the effectiveness of SUMS intervention using schools as unit-of-randomisation. The study will be conducted in Srinivaspura taluka (Sub-district) of Kolar district (administrative unit of health) of Karnataka in collaboration with a multi-disciplinary expert team from NIMHANS (National Institute of Mental Health And Neuro Sciences), Bangalore-India and Department of Education, Government of Karnataka, India. A total of 8 schools (400 students studying in 6–8 grade) from Srinivaspura taluka will be randomised into intervention and waitlist control group. The intervention group will receive SUMS intervention through 10–15 h of classroom sessions. The primary outcome is the improvement in positive mental health literacy, as measured by the Mental Health-Promoting Knowledge (MHPK-10) scale. Changes in MH-FA knowledge and intentions, Mental health stigma, help-seeking and resilience are assessed as secondary outcomes. Data will be collected at baseline, 6-weeks, 6-months and 12-months post-intervention. The waitlist-control schools will receive the interventions at the end of the 12-month follow-up assessment in intervention-schools. Discussion This is the first study to integrate Mental Health Literacy with Mental Health Promotion and behaviours for First Aid in Mental Health to promote mental health well-being among adolescent school children in India. With a need to build a more substantial evidence base on School Mental Health Promotion approaches in developing countries, the study findings will have implications for implementing and operationalising Health and Wellness Ambassador initiative in India. Trial registration Clinical Trials Registry - India, CTRI/2019/07/020394. Registered prospectively on 29 July 2019. ( ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=35724&EncHid=&userName=sums ).

C. Montejo, A. Rodríguez, M. Pascual-Vicente et al.

Olga Pollatos, Eleana Georgiou, Susanne Kobel et al.

BackgroundBody image dissatisfaction (BID) is related to an increased risk for various health issues including descreased health-related quality of life (HRQoL), the development of problematic eating behaviors and obesity. Previous research indicates that emotional intelligence is one important factor related to BID in adults. Whether this is the case in children, remains yet unknown. Taking this into consideration, the aim of this study was to explore the relationship between BID and trait-based emotion intelligence (TEI) as well as HRQoL in female and male primary school children.Materials and methodsTEI and BID were assessed via self-reports as well as HRQoL via parental reports in a large sample of 991 primary school children (429 girls) within the “Baden Württemberg Study”, which evaluated the effectiveness of the health prevention programm “Join the Healthy Boat” in Southwestern Germany.ResultsOur findings demonstrated the interrelation between higher levels of TEI and lower levels of BID among girls and boys. Positive associations were found between better HRQoL, better intrapersonal and stress management abilites (subscales of TEI) and lower BID, as reflected by parental and self-reports.ConclusionsOur results reveal an interconnectivity between TEI, BID, and better HRQoL in female and male primary school children. Although the observed correlations were rather small, they nervertheless support the idea that TEI consists a key-factor for the self-regulation of health-related behavior. Prevention programs could benefit from including processes, that sough to improve aspects of emotional intelligence such as intrapersonal, interpersonal abilities, and adaptability, as an effort of preventing problematic habits or lifestyles that could lead to disordered eating behaviors as well as to obesity in middle childhood.

Andrew J. Zele, Andrew J. Zele, Prakash Adhikari et al.

Background: Retinal photoreceptors provide the main stage in the mammalian eye for regulating the retinal illumination through changes in pupil diameter, with a small population of melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) forming the primary afferent pathway for this response. The purpose of this study is to determine how melanopsin interacts with the three cone photoreceptor classes in the human eye to modulate the light-adapted pupil response.Methods: We investigated the independent and combined contributions of the inner and outer retinal photoreceptor inputs to the afferent pupil pathway in participants with trichromatic color vision using a method to independently control the excitations of ipRGCs, cones and rods in the retina.Results: We show that melanopsin-directed stimuli cause a transient pupil constriction generated by cones in the shadow of retinal blood vessels; desensitizing these penumbral cone signals uncovers a signature melanopsin pupil response that includes a longer latency (292 ms) and slower time (4.1x) and velocity (7.7x) to constriction than for cone-directed stimuli, and which remains sustained post-stimulus offset. Compared to melanopsin-mediated pupil responses, the cone photoreceptor-initiated pupil responses are more transient with faster constriction latencies, higher velocities and a secondary constriction at light offset. The combined pupil responses reveal that melanopsin signals are additive with the cone signals.Conclusions: The visual system uses the L–, M–, and S–cone photoreceptor inputs to the afferent pupil pathway to accomplish the tonic modulations of pupil size to changes in image contrast. The inner retinal melanopsin-expressing ipRGCs mediate the longer-term, sustained pupil constriction to set the light-adapted pupil diameter during extended light exposures.

Han Na Lee, Chang-Woo Ryu, Seong Jong Yun

Introduction: Vessel-wall magnetic resonance imaging (MRI) has been suggested as a valuable tool for assessing intracranial arterial stenosis with additional diagnostic features. However, there is limited conclusive evidence on whether vessel-wall MR imaging of intracranial atherosclerotic plaques provides valuable information for predicting vulnerable lesions. We conducted this systematic review and meta-analysis to evaluate which characteristics of intracranial-plaque on vessel-wall MRI are markers of culprit lesions.Methods: The MEDLINE, EMBASE, and Cochrane Library of Clinical Trials databases were searched for studies reporting the association between vessel-wall MRI characteristics of intracranial plaque and corresponding stroke events. Odds ratios (ORs) for the prevalence of stroke with intracranial-plaque MRI characteristics were pooled in a meta-analysis using a random-effects model.Results: Twenty studies were included in this review. We found a significant association between plaque enhancement (OR, 10.09; 95% CI, 5.38–18.93), positive remodeling (OR, 6.19; 95% CI, 3.22–11.92), and plaque surface irregularity (OR, 3.94; 95% CI, 1.90–8.16) with stroke events. However, no significant difference was found for the presence of eccentricity (OR, 1.22; 95% CI, 0.51–2.91).Conclusion: Based on current evidence, intracranial plaque contrast enhancement, positive remodeling, and plaque irregularity on MRI are associated with increased risk of stroke events. Our findings support the design of future studies on intracranial-plaque MRI and decision making for the management of intracranial atherosclerotic plaques.

Jivan Khlghatyan, Jivan Khlghatyan, Jean-Martin Beaulieu et al.

Dopamine receptors and related signaling pathways have long been implicated in pathophysiology and treatment of mental illnesses, including schizophrenia and bipolar disorder. Dopamine signaling may impact neuronal activity by modulation of glutamate neurotransmission. Recent evidence indicates a direct and/or indirect involvement of fragile X-related family proteins (FXR) in the regulation and mediation of dopamine receptor functions. FXRs consists of fragile X mental retardation protein 1 (Fmr1/FMRP) and its autosomal homologs Fxr1 and Fxr2. These RNA-binding proteins are enriched in the brain. Loss of function mutation in human FMR1 is the major genetic contributor to Fragile X mental retardation syndrome. Therefore, the role of FXR proteins has mostly been studied in the context of autism spectrum disorders. However, recent genome-wide association studies have linked this family to schizophrenia, bipolar disorders, and mood regulation pointing toward a broader involvement in mental illnesses. FXR family proteins play an important role in the regulation of glutamate-mediated neuronal activity and plasticity. Here, we discuss the brain-specific functions of FXR family proteins by focusing on the regulation of dopamine receptor functions, ionotropic glutamate receptors-mediated synaptic plasticity and contribution to mental illnesses. Based on recent evidence, we propose that FXR proteins are potential integrators of dopamine signaling and ionotropic glutamate transmission.

D. M. Bernstein

Nazmah Nazmah, Emmy Mariatin, Sri Supriyantini

Penelitian ini bertujuan untuk menguji pengaruh motivasi kerja dan keadilan organisasi terhadap <em>organizational citizenship behaviour</em> (OCB). Populasi penelitian adalah karyawan tetap/organikPT. Summit Oto Finance dengan masa kerja lebih dari dua tahun. Jumlah anggota populasi adalah 61 orang. Dikarenakan jumlah subyek yang terbatas, maka seluruhnya dilibatkan sebagai sampel penelitian (teknik total sampling). Data penelitian dikumpulkan dengan menggunakan skala motivasi kerja, skala persepsi keadilan organisas,i dan skala<em>organizational citizenship behaviour</em> (OCB). Analisis regresi linier berganda digunakan untuk menguji hipotesis penelitian. Analisa data menunjukkanadanya pengaruh  yang signifikan antara motivasi kerja dan keadilan organisasi terhadap <em>organizational citizenship behavior</em> pada karyawan PT. Summit Oto Finance. Variabel motivasi kerja dan keadilan organisasi memiliki kontribusi terhadap <em>organizational citizenship behavior</em> sebesar 54.7%. Secara spesifik diketahui bahwa karyawan PT. Summit Oto Finance memiliki motivasi kerja, persepsi mengenai keadilan organisasi, serta <em>organizational citizenship behavior </em>yang berada di kategori sedang.