["Epidemiology of mental disorders and access to mental health care. EZOP - Poland" - research methodology]

The Role of Religiosity and Spirituality in Helping Polish Subjects Adapt to Their Tinnitus

This study aims to assess whether religiosity and spirituality might be significant internal resources that help people with tinnitus to adapt to their condition. The study group comprised 256 Polish patients with tinnitus (123 women and 133 men) who answered the Tinnitus Handicap Inventory and Tinnitus Functional Index (both of which measure tinnitus annoyance) and the Self-Description Questionnaire (which measures: religious attitudes, ethical sensitivity, and harmony). Significant positive correlations between religious attitudes and tinnitus annoyance were found in subjects with tinnitus. The higher the religiosity, the higher tinnitus the annoyance, at least in the two TFI questionnaire dimensions: sense of control and quality of life (although these correlations were statistically significant only for men). Religiosity was found to be a positive predictor of tinnitus annoyance. Also, ethical sensitivity positively predicted tinnitus annoyance, whereas harmony was a negative predictor. We suggest that psychologists and audiologists should, in their diagnostic and therapeutic work with patients with tinnitus, pay attention to the religious and spiritual aspects of their patients' lives.

When perfectionists adopt health behaviors: perfectionism and self-efficacy as determinants of health behavior, anxiety and depression

Background

The study aims to show interrelations between self-efficacy, perfectionism (adaptive and maladaptive), health behavior, and mental health outcomes such as anxiety and depression as an exponent in maintaining optimal health. In the analyses, we focused on one category of health behaviors – preventive practices.

Participants and procedure

Of the gathered data, 295 complete datasets were analyzed (age: M = 28.16, SD = 9.41; 72.8% participants female). We pro-posed two path models with personality traits (as exogenous variables) and health behaviors (as endogenous variables) in predicting depression and anxiety.

Results

Multiple regression analysis revealed that maladaptive perfectionism and generalized self-efficacy significantly predicted health behaviors in general and mental health outcomes whereas adaptive perfectionism and generalized self-efficacy were significant predictors of preventive practices. The path analyses showed that generalized self-efficacy and perfectionism are related directly to mental health outcomes as well as indirectly, through health behaviors. Interestingly, we found a negative indirect effect of an interaction between generalized self-efficacy and preventive practices as well as of an interac-tion between adaptive perfectionism and preventive practices on mental health outcomes. The model fitted well with the data.

Conclusions

The findings show that a balanced and more holistic approach to maintaining health is beneficial for people high in self-efficacy in comparison with high focus on disease prevention. Additionally, the results demonstrate that adaptive perfec-tionists and people high in self-efficacy may also be prone to anxiety and depression (not just maladaptive perfectionists) when their health focus is too narrow.

COVID-19 Pandemic-Related Depression and Insomnia among Psychiatric Patients and the General Population

BACKGROUND

The COVID-19 pandemic and limited access to healthcare professionals pose a serious risk of worsening mental conditions. This study was designed to examine the changes in symptoms of insomnia and depression during the pandemic as compared to before the pandemic, as well as the factors correlated with abovementioned mental state deterioration.

METHODS

The study was conducted from 1 April to 15 May 2020, on 212 psychiatric outpatients and 207 healthy controls. Participants completed a survey focused on symptoms during and prior to COVID-19 (the Beck Depression Inventory, the Athens Insomnia Scale). The following correlations were analyzed: demographics, social support, work status, income, and possible participants' and their relatives' COVID-19 diagnoses.

RESULTS

Insomnia and depression severity intensified during the pandemic in both groups and were associated with age, gender, education, employment, and financial status. No correlations between social support nor becoming sick with COVID-19 and insomnia or depression were observed. Maintaining work and enough money for one's own needs were found to be significant protective factors of depression (OR 0.37 and 0.29, respectively).

CONCLUSIONS

Exacerbation of insomnia and depression during the pandemic needs to be addressed. Economic crisis seems to influence mental state even more than COVID diagnosis among study subjects/relatives.

Mental Health in the Era of the Second Wave of SARS-CoV-2: A Cross-Sectional Study Based on an Online Survey among Online Respondents in Poland

The main objective of this study was to assess mental health during the COVID-19 second wave. The study was conducted using a proprietary questionnaire that had been provided via the Internet to online respondents in Poland. The questionnaire questions included a socio-geographic assessment, proprietary questions assessing the respondents' current approach to the COVID-19 pandemic, as well as a standardised psychometric tool-GHQ-28. The study involved 2155 respondents, 99.8% of whom gave their consent for the participation in the study. A mean GHQ score was 29.25 ± 14.94 points. The criterion for minor mental disorders (≥24 points) was met by 1272 (59.2%) respondents. In overall interpretation as well as in each of GHQ-28 subscales, women obtained significantly higher scores than men (p < 0.001). The restriction on earning opportunities during the COVID-19 pandemic is significantly associated with the feeling of anxiety/insomnia severity among the respondents (9.96 vs. 8.82 points; p < 0.001). The COVID-19 pandemic, although it has already been experienced for nearly a year, has had a significant association with the general mental health of the respondents in Poland. There is a strong need to implement special programs that offer psychological support in the era of the COVID-19 pandemic, especially for those who had direct experience with COVID-19 infection.

Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic

Background: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of psychological problems, including stress-related disturbances. However, to date, there is not much research on the prevalence of adjustment disorder during the current pandemic. Objectives: This study aimed to assess the prevalence and severity of symptoms of adjustment disorder compared to posttraumatic symptoms, depression and generalized anxiety in a large sample of adult Poles, in the first phase of the current pandemic. Method: Self-report data from a web-based sample (N = 1,742) was collected between March 25 and April 27, just after the introduction of nationwide quarantine measures in Poland. Results: The current COVID-19 pandemic was a highly stressful event for 75% of participants and the strongest predictor of adjustment disorder. Increased symptoms of adjustment disorder were reported by 49%, and they were associated with female gender and not having a full-time job. However, after exclusion of co-occurring symptomatology, 14% of the sample were finally qualified as meeting diagnostic criteria of adjustment disorder. A substantial proportion of the sample screened also positive for generalized anxiety (44%) and depression (26%); the rate for presumptive PTSD diagnosis was 2.4%. Conclusions: High rates of negative mental health outcomes were found in the Polish population in the first weeks into the COVID-19 pandemic and lockdown measures. They indicate the intense current stress-related symptoms in the early phase of the pandemic and warrant further monitoring on population's mental health.

Sex-Specific Relationship of Childhood Adversity With Gray Matter Volume and Temperament

Background: To date, many studies have attempted to show a relationship between potentially harmful experiences in childhood and gray matter volume (GMV) in specific brain areas. These studies managed to identify several affected regions, yet most of them neglected the influence of sex or the occurrence of mental health problems. Furthermore, little is known about mechanisms linking childhood adversity (CA) and temperamental traits as plausible endophenotypes of psychopathology. Objective: The present study addresses these two issues by trying to identify sex-specific relationships between CA and brain volumes as well as to show the role of the latter in predicting temperament scores. Method: Forty-eight people (23 women) without anxiety or affective disorders participated in this study. CA was measured using the Childhood Questionnaire (CQ) and temperament was measured with the use of the behavioral inhibition system-behavioral activation system (BIS-BAS) Scales. Whole-brain MR imaging was performed to identify GMV differences. Results: In women, we identified negative relationships between CA and GMV in the left inferior parietal lobule (IPL), right cerebellum, and right precentral gyrus. In men, we found a negative correlation between CA and GMV in the right fusiform gyrus. We also identified sex-specific relationships between CA and temperament traits. Conclusions: The results of our study suggest a sex-specific pattern in the relationship between early adverse experiences and brain structure. The results can also help explain the role that temperament plays in the relationship between CA and the risk of psychopathology.

Fecal Microbiota Analysis in Patients Going through a Depressive Episode during Treatment in a Psychiatric Hospital Setting

Rationale: There is a worldwide prevalence of generalized anxiety and major depressive disorders (MDD). Gut–brain axis dysfunction, antibacterial activity, and modulatory effects of antidepressants toward intestinal bacteria have been shown both in vitro and in vivo. Objectives: In this study, we aimed to investigate the effects of hospital stay, including escitalopram administration, on gut microbiota in patients with depressive episodes. Methods: After admission to the hospital and 7-days washout from all medications the composition of fecal microbiota samples was evaluated at baseline (W0) and after 6 weeks (W6), using 16S rRNA sequencing. The study was conducted on 17 inpatients (52.9% females), who followed the same daily hospital routine, including a standard diet and received 5–20 mg daily doses of escitalopram. Results: At the end of treatment (W6), no change was observed in the Chao1 index. However, Shannon (median (Q1–Q3): W0 2.78 (2.67–3.02) vs. W6 3.11 (2.80–3.30)), and inverse Simpson (median (Q1–Q3): W0 9.26 (7.26–13.76) vs. W6 12.13 (9.17–15.73)) indices increased significantly compared to baseline values (False Discovery Rate p (q) = 0.031 and q = 0.011, respectively). We also found that between-subject W0 Bray–Curtis dissimilarities were significantly higher than W0–W6 within-subject dissimilarities (median (Q1–Q3): 0.68 (0.56–0.77) vs. 0.38 (0.35–0.52), two sided Mann–Whitney test p < 0.00001. The within-subject dissimilarities did not depend on sex, age, BMI, illness duration and a daily dose of escitalopram. No significant differences between taxa levels, at the studied time points, were observed when adjusted for multiple hypotheses testing procedures. Conclusions: We conclude that a six-week treatment in a psychiatric hospital setting resulted in increased alpha biodiversity in fecal microbiota, however its causal relationship with patients’ mental health was not proved. We have also found that individual microbiome stability was not affected by hospitalization.

Suicidality and its determinants among Polish patients with epilepsy

BACKGROUND AND PURPOSE

The aim of this study was to evaluate the prevalence of suicidal ideation among Polish patients with epilepsy and to assess the potential determinants of suicidality in this cohort.

MATERIAL AND METHODS

The study comprised 301 patients with epilepsy seen in the tertiary epilepsy clinic. Patients' characteristics included demographic variables, epilepsy-related variables, as well as occurrence of comorbidities, ongoing use of any other medications, family history of epilepsy and/or depression. Beck Depression Inventory (BDI) was used to assess depressive symptoms, and question no. 9 of BDI was specifically used to reveal suicidality.

RESULTS

Mean age of subjects was 35.5 years. 113 (37.5%) had frequent seizures and 96 patients (31.9%) had remission. BDI score>11 points (suggestive for depression) was found in 127 subjects. Suicidal ideation has been revealed in 30 (10.0%) out of 301 studied patients. Patients with suicidal ideation were older and more commonly reported frequent seizures. Almost all of them (93.3%) had clinically significant depressive symptoms (BDI score>11). Multivariate analysis revealed that severity of depressive symptoms (OR=1.16 per one-point increase in BDI score, 95% CI: 1.10-1.22, p<0.001) and the use of potentially depressogenic medication (OR=3.04, 95% CI: 1.04-8.89, p=0.04) were independent determinants of suicidality among studied patients.

CONCLUSIONS

Suicidal ideations were revealed by about 10% of studied epileptic patients who visited tertiary center for epilepsy. Independent predictors of suicidality among studied patients included depression itself and the use of potentially depressogenic medication.