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Zhou J, Hu T, Xue S, Dong Z, Tang W. The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem. J Clin Psychol 2024; 80:664-677. [PMID: 38265412 DOI: 10.1002/jclp.23646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients. METHODS Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships. RESULTS Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality. CONCLUSIONS Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.
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Affiliation(s)
- Jing Zhou
- Department of Psychosomatic Medicine, Leshan People's Hospital, Leshan, Sichuan, China
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- School of Education and Psychology, Chengdu Normal University, Chengdu, China
- Business School, Sichuan University, Chengdu, China
| | - Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Harlies CM, Friedlander W. Sleep quality of adult psychiatric outpatients at Chris Hani Baragwanath Academic Hospital. S Afr J Psychiatr 2023; 29:2113. [PMID: 38059196 PMCID: PMC10696565 DOI: 10.4102/sajpsychiatry.v29i0.2113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/12/2023] [Indexed: 12/08/2023] Open
Abstract
Background Sleep disorders are increasingly prevalent among the general population and individuals with mental disorders. However, little research has focused on the sleep quality of psychiatric patients beyond depression, despite its relevance in diagnostic criteria. Aim This study aimed to assess overall sleep quality in psychiatric outpatients and to assess for an association with socio-demographic variables. Setting This study took place at the adult psychiatric outpatient department of Chris Hani Baragwanath Academic Hospital. Methods A cross-sectional study design was employed to evaluate overall sleep quality using the self-administered Pittsburgh Sleep Quality Index (PSQI), a validated tool. The PSQI yields a global score ranging from 0 to 21, with scores of 5 or greater indicating poor sleep quality. Eligibility was determined through structured clinical interviews and data obtained from participant records. Results Poor sleep quality was found in 50% of participants. Sleep quality did not differ significantly based on sex or age. Subscale analysis revealed reduced sleep duration and efficiency, nocturnal disturbances and daytime dysfunction. Additionally, 38% of participants required pharmacological intervention for sleep issues, despite lacking a diagnosis of primary or comorbid sleep disorders. Conclusion Half of the psychiatric outpatients experienced poor sleep quality, irrespective of socio-demographic factors, psychiatric diagnosis, symptom remission or medication type. Contribution This study highlights the importance of addressing sleep disturbances as comorbid conditions in psychiatric patients. Comprehensive evaluation and management of sleep quality can lead to improved patient outcomes and quality of life.
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Affiliation(s)
- Celeste M Harlies
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wendy Friedlander
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Humbert A, Kohls E, Baldofski S, Epple C, Rummel-Kluge C. Acceptability, feasibility, and user satisfaction of a virtual reality relaxation intervention in a psychiatric outpatient setting during the COVID-19 pandemic. Front Psychiatry 2023; 14:1271702. [PMID: 37953932 PMCID: PMC10634536 DOI: 10.3389/fpsyt.2023.1271702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background The COVID-19 pandemic was particularly difficult for individuals with mental disorders. Due to governmental restrictions, face-to-face offers for psychiatric outpatients like therapies, psychoeducational groups or relaxation courses were limited. Virtual reality (VR) might be a new possibility to support these patients by providing them with a home-based relaxation tool. Objective The aim of this study was to evaluate the acceptability, feasibility, and user satisfaction of a supportive therapy-accompanying, relaxation VR intervention in psychiatric outpatients during the COVID-19 pandemic in Germany. Methods The four-weeks VR intervention consisted of regular watching of relaxing videos in the participants' home environment. Sociodemographics, feasibility (frequency of use, user-friendliness), satisfaction (Client Satisfaction Questionnaire-8), depressive symptoms (Patient Health Questionnaire-9), quality of life (abbreviated World Health Organization Quality of Life assessment), and credibility and expectancy (Credibility Expectancy Questionnaire-8) were measured in an intention-to-treat (ITT) analysis and a per-protocol (PP) analysis of completers. Results In total, N = 40 patients participated in the study. Most of the participants in the ITT analysis (n = 30, 75.0%) used the VR device three or 4 weeks. A majority of the N = 29 completers (PP: n = 18, 62.1%) used it all 4 weeks. Most participants used the device two or more times a week (ITT: n = 30, 83.3%; PP: n = 26, 89.7%) and described the user-friendliness as rather or very easy (ITT: n = 33, 91.7%; PP: n = 26, 89.7%). User satisfaction was high (ITT: 19.42, SD = 4.08; PP: M = 20.00, SD = 4.19) and did not correlate with participants' sex or age (all p < 0.05). Depressive symptoms and psychological quality of life improved significantly from pre-to post-intervention (ITT and PP, all p < 0.05). Higher pre-intervention credibility significantly correlated with a better outcome of satisfaction (ITT and PP), depressive symptoms, physical, psychological, and social quality of life (PP; all p < 0.05). Conclusion A supportive therapy-accompanying VR relaxation intervention is feasible and acceptable in a psychiatric outpatient setting. Due to the high satisfaction and user-friendliness, VR can be an easy to implement relaxation tool to support psychiatric outpatients. Clinical trial registration https://clinicaltrials.gov/, DRKS00027911.
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Affiliation(s)
- Annika Humbert
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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Yıldırım YE. Prevalence of Prolonged Grief Disorder and Related Clinical Factors Among Turkish Psychiatric Outpatients During the COVID-19 Pandemic. Omega (Westport) 2023:302228231187296. [PMID: 37386898 PMCID: PMC10315512 DOI: 10.1177/00302228231187296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Prolonged grief disorder (PGD), a new diagnosis in some classification systems, has gained prominence due to the high mortality rates observed during the Covid-19 pandemic. Herein, the prevalence of PGD (diagnosed with structured clinical interviews), death-related features, and associated clinical factors were investigated among outpatient psychiatric patients who lost a first-degree relative within the past 12-24 months. PGD was diagnosed in 30/68 patients (44.1%). PGD development did not differ based on cause of death (Covid-19-related vs. other causes) but was associated with higher age of the bereaved, younger age of the deceased, and degree of kinship. Higher rates of depression, insomnia, and anxious attachment were also observed in PGD patients. Finally, the unexpectedness of death predicted the development of PGD. Due to the high prevalence of PGD among psychiatric patients, clinicians should be aware of the disorder, monitor grief processes in high-risk patients, and consider PGD in treatment planning.
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Spidel A, Kealy D. Sexual risk behavior among individuals seeking outpatient mental health services: Associations with childhood emotional neglect and identity dysfunction. Bull Menninger Clin 2023; 87:6-24. [PMID: 36856476 DOI: 10.1521/bumc.2023.87.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
This study was developed to examine sexual risk behavior among patients seeking community-based mental health services, including associations with psychological distress, identity dysfunction, and childhood emotional neglect. A mediation model was examined regarding identity dysfunction mediating the link between emotional neglect and sexual risk behavior. A total of 245 outpatients completed questionnaires regarding perceived risky sexual behavior, psychological distress, identity dysfunction, and emotional neglect. Sexual risk behavior was found to be a prevalent issue among individuals seeking outpatient mental health services, with 13% reporting engagement in unsafe sexual practices at least some of the time. Mediation analysis revealed that childhood emotional neglect was indirectly linked with sexual risk behavior through the mediating effect of identity dysfunction. Thus, findings suggest a pathway to sexual risk behaviors through perceived childhood emotional neglect and identity dysfunction. Clinical attention to identity-related vulnerability among this population may be warranted in aiming to mitigate risk-taking associated with sexual practices.
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Affiliation(s)
- Alicia Spidel
- Lecturer in the Criminology Department of Kwantlen Polytechnic University, and a clinician in the Mental Health and Substance Use Services of the Fraser Health Authority, Surrey, British Columbia, Canada
| | - David Kealy
- Associate professor in the Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Iannattone S, Raffagnato A, Zanato S, Traverso A, Tascini B, Del Col L, Miscioscia M, Gatta M. Children with Psychopathology and Their Parents Facing the Covid-19 Pandemic: A Case-Control Study. Clin Neuropsychiatry 2021; 18:324-333. [PMID: 35096079 PMCID: PMC8785424 DOI: 10.36131/cnfioritieditore20210606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective This case-control study aimed to explore the effects of the COVID-19 outbreak on the mental well-being of pediatric psychiatric outpatients and their families, comparing them with children/adolescents and their parents from the general population. Method The case group consisted of 168 subjects: 56 patients (6-18 years old) with psychiatric disorders, and their 112 parents. The healthy control group included 189 subjects: 63 children and adolescents with no psychopathologies, and their 126 parents. Both groups were assessed during the first COVID-19 lockdown in Italy (T0) and 4 months later (T1), by administering the CBCL6-18 and DASS-21. Results Patients showed a good adaptation to the pandemic situation, while the children/adolescents in the healthy sample showed a greater variation in their general habits and a higher prevalence of stress symptoms during the lockdown. The patients’ parents likewise had fewer stress-related symptoms than caregivers in the healthy control group, both during the lockdown and 4 months later. At T0, patients’ mothers reported higher anxiety levels than mothers in the healthy group, while at T1 fathers of healthy children scored higher on the DASS-21 anxiety and stress scales than patients’ fathers. As concerns changes over time (T0-T1) in the parents’ psychological well-being, a general improvement was detected in both groups. Conclusions The pandemic and quarantine measures were confirmed as significant stressors for all children and adolescents, and negatively affected their parents’ adaptation. The findings of this study point to the need for preventive interventions to support the mental health of all parents and their children in uncertain and stressful times.
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Affiliation(s)
- Sara Iannattone
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.), Department of General Psychology, University of Padua, 35131 Padua, Italy,Corresponding author Sara Iannattone Department of General Psychology – University of Padua Via Venezia, 8 35131, Padua (PD), Italy E-mail:
| | - Alessia Raffagnato
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.)
| | - Silvia Zanato
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.)
| | - Annalisa Traverso
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.)
| | - Benedetta Tascini
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.)
| | - Lara Del Col
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.)
| | - Marina Miscioscia
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.), Department of General Psychology, University of Padua, 35131 Padua, Italy, Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Michela Gatta
- Department of Women's and Children's Health, Padua University Hospital, 35128 Padua, Italy; (S.I.); (A.R.); (S.Z.); (A.T.); (B.T.); (L.D.C); (M.M.); (M.G.)
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Raffagnato A, Iannattone S, Tascini B, Venchiarutti M, Broggio A, Zanato S, Traverso A, Mascoli C, Manganiello A, Miscioscia M, Gatta M. The COVID-19 Pandemic: A Longitudinal Study on the Emotional-Behavioral Sequelae for Children and Adolescents with Neuropsychiatric Disorders and Their Families. Int J Environ Res Public Health 2021; 18:9880. [PMID: 34574803 DOI: 10.3390/ijerph18189880] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022]
Abstract
This study aimed to investigate the immediate and short-term impact of the pandemic on the psychological well-being of Italian children and adolescents with psychiatric disorders and their families. Overall, 56 patients aged 6-18 (M = 13.4 years, SD = 2.77) and their parents were evaluated during the COVID-19 lockdown (T0) and after 4 months (T1). An ad hoc data sheet, Youth Self-Report 11-18 (YSR), Child Behavior Checklist 6-18 (CBCL), and Depression Anxiety Stress Scale-21 (DASS-21) were administered. Patients, mainly suffering from internalizing disorders, overall demonstrated a good adaptation to the pandemic context. Moreover, patients with behavioral disorders showed a greater psychological discomfort at both T0 and T1 compared to patients with internalizing disorders. Over time, patients presented an improvement on the emotional side, as proven by a significant decrease in internalizing and post-traumatic stress problems. Finally, no significant differences were found in the emotional-behavioral profile of patients according to the means of conducting neuropsychiatric interventions during the lockdown (i.e., in person/remotely/interrupted), thus allowing us to exclude important negative effects caused by the transition to remote therapy. Concerning parents, an inverse relationship emerged between the DASS-21 scores and the level of resilience, which therefore represents a protective factor against psychological maladjustment. Over time, an improvement in the psychological well-being of parents was observed, as shown by a significant decrease in mothers' anxiety and fathers' stress.
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Abstract
Objective: Sluggish cognitive tempo (SCT) symptoms uniquely contribute to psychiatric and functional outcomes in child samples; however, the psychometric properties of SCT measures among adult outpatients are unknown. Method: Adults (n = 124) presenting for an ADHD evaluation provided self- and collateral report of SCT symptoms. Results: The SCT scale had good internal consistency and yielded three factors across raters: Slow/Daydreamy, Sleepy/Sluggish, and Low Initiation/Persistence. SCT scores exhibited convergent validity with ADHD symptoms across raters. Individuals with ADHD received higher SCT ratings than those without ADHD via collateral report, a pattern that was similar when comorbidity was considered. SCT was associated with poorer functioning after accounting for ADHD symptoms with some differential effects based on reporting source. Conclusion: Findings support the internal consistency and validity of a three-factor SCT scale among adult outpatients. Differential results between self- and collateral report demonstrate the importance of multiple reporters of SCT in clinical settings.
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Dadfar M, Abdel-Khalek AM, Lester D. Love of life and its association with well-being in Iranian psychiatric outpatients. Nurs Open 2020; 7:1861-1866. [PMID: 33072372 PMCID: PMC7544882 DOI: 10.1002/nop2.575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/16/2020] [Accepted: 07/01/2020] [Indexed: 11/21/2022] Open
Abstract
Aim The aims of this study were as follows: (a) to investigate the psychometric properties of the Love of Life Scale (LLS); (b) to explore sex differences in LLS scores; (c) to explore LLS correlations with spiritual health and psychological well‐being; and (d) to compare the mean LLS score with previous studies. Design A cross‐sectional study. Methods A sample of 191 Iranian psychiatric outpatients was recruited from clinics at the School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), which is affiliated with the Iran University of Medical Sciences. They responded to the Farsi versions of the LLS, the Spiritual Well‐Being Scale (SWS) and the World Health Organization‐five Well‐Being Index (WHO‐5). Results Cronbach alpha for the LLS was 0.95, and a principal component analysis (PCA) of the LLS items extracted one component labelled "Love of life." The sex difference in LLS scores was not significant. All the correlations between the scales were statistically significant and positive. Patients who had high scores for their love of life had better spiritual health and psychological well‐being. Discussion The present sample obtained a lower mean LLS score than college students from eight countries except one. Further research should explore predictors of the love of life.
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Affiliation(s)
- Mahboubeh Dadfar
- School of Behavioral Sciences and Mental Health-Tehran Institute of Psychiatry International Campus School of Public Health, Student Committee of Education and Development Center (EDC) Iran University of Medical Sciences Tehran Iran
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Pia T, Galynker I, Schuck A, Sinclair C, Ying G, Calati R. Perfectionism and Prospective Near-Term Suicidal Thoughts and Behaviors: The Mediation of Fear of Humiliation and Suicide Crisis Syndrome. Int J Environ Res Public Health 2020; 17:ijerph17041424. [PMID: 32098414 PMCID: PMC7068323 DOI: 10.3390/ijerph17041424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/07/2020] [Accepted: 02/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Perfectionism has been linked to suicide. According to the Narrative-Crisis Model of suicide, individuals with trait vulnerabilities are prone to develop a certain mindset, known as a Suicidal Narrative, which may precipitate the Suicide Crisis Syndrome (SCS), culminating in suicide. The purpose of this study was to investigate the association between perfectionism (trait vulnerability), fear of humiliation (component of the Suicidal Narrative), SCS, and prospective near-term suicidal thoughts and behaviors (STB). METHODS Adult psychiatric outpatient participants (N = 336) were assessed at baseline with the Suicidal Narrative Inventory for perfectionism and fear of humiliation. The questions used to assess perfectionism were adapted from the Multidimensional Perfectionism Scale. The severity of the SCS was calculated using the Suicide Crisis Inventory. STB were assessed at baseline and after one month using the Columbia Suicide Severity Rating Scale. Serial mediation analyses were conducted using PROCESS version 3.3 in SPSS. RESULTS While the direct effect of perfectionism on prospective STB was not significant (b = 0.01, p = 0.19), the indirect effect of perfectionism on STB, through serial mediation by fear of humiliation and the SCS, was significant (indirect effect p = 0.007, 95% CI [0.003,0.013]). The indirect effect was not significant for models that did not include both mediators. LIMITATIONS Variables were assessed at one time only. CONCLUSION Perfectionism did not directly modulate STB. Perfectionism may be related to suicidal behavior through fear of humiliation, leading to the SCS. These results support the Narrative-Crisis Model of suicide and clarify the role of perfectionism in the etiology of suicide.
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Affiliation(s)
- Tyler Pia
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
| | - Allison Schuck
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Courtney Sinclair
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Gelan Ying
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
| | - Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY 10003, USA; (T.P.); (I.G.); (A.S.); (C.S.); (G.Y.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
- Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy
- Department of Adult Psychiatry, Nîmes University Hospital, 30029 Nîmes, France
- Correspondence:
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Abstract
BACKGROUND The Control Preferences Scale (CPS) is the most frequently used measure of patients' preferred roles in treatment decisions. The aim of this study was to provide data about the validity of CPS in psychiatric care of patients with emotional disorders. METHODS The original CPS was translated to Spanish using the process of cross-cultural adaptation of self-reported measures as the methodological model for Spanish translation. The final version was tested in a convenience sample of 621 consecutive psychiatric outpatients (461 depressive and 160 anxiety disorders) that also completed the Shared Decision-Making Questionnaire, the Multidimensional Health Locus of Control Scale, the Drug Attitude Inventory, and a questionnaire including sociodemographic and clinical variables. RESULTS CPS showed a moderate internal consistency and a good convergent validity. Patients with collaborative and passive preferences expressed a greater reliance on psychotropics. Patients preferring a collaborative role self-reported greater perception of involvement in decision-making about their treatment. Patients preferring a passive role showed a greater external health locus of control. The most common preferred role was the collaborative-passive. Older patients and those under longer treatments preferred a passive role, while patients with higher levels of education preferred a collaborative role. CONCLUSION The CPS is a valid measure of the amount of control that psychiatric outpatients with emotional disorders want to assume in the process of making decisions about their treatment.
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Affiliation(s)
| | - Wenceslao Peñate
- Department of Personality, Assessment and Psychological Treatments, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
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Soendergaard HM, Thomsen PH, Pedersen E, Pedersen P, Poulsen AE, Winther L, Nielsen JM, Henriksen A, Rungoe B, Soegaard HJ. Associations of Age, Gender, and Subtypes With ADHD Symptoms and Related Comorbidity in a Danish Sample of Clinically Referred Adults. J Atten Disord 2016; 20:925-933. [PMID: 24412968 DOI: 10.1177/1087054713517544] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim was to examine associations of age and gender with ADHD subtypes and subsequently to examine associations of age, gender, and subtypes with comorbid psychiatric disorders. METHOD Odds ratios were calculated and logistic regression performed using information from a clinical sample of 155 ADHD adults referred to a Danish specialized ADHD unit from 2010 to 2011. RESULTS A majority of men (65%) was found in the sample. Most patients were subtyped ADHD combined (78%), followed by ADHD inattentive (18%), and ADHD hyperactive-impulsive (4%). No significant differences were found in gender and age across subtypes. Current comorbid disorders were found in 57% of the ADHD patients. Significantly more comorbidity was found in the ADHD combined type and in patients ≥25 years. Significantly more men had substance use disorders and significantly more women had personality disorders. CONCLUSION When assessing adult ADHD patients' age, gender, subtype, and related comorbid symptom profiles should be taken into account.
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Affiliation(s)
| | | | - Erik Pedersen
- Regional Psychiatric Services West, Herning, Denmark
| | - Pernille Pedersen
- Psychiatric Research Unit West, Regional Psychiatric Services West, Herning, Denmark
| | | | - Lars Winther
- Regional Psychiatric Services West, Herning, Denmark
| | | | | | - Berit Rungoe
- Psychiatric Research Unit West, Regional Psychiatric Services West, Herning, Denmark
| | - Hans Joergen Soegaard
- Psychiatric Research Unit West, Regional Psychiatric Services West, Herning, Denmark
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Kealy D, Sierra-Hernandez CA, Ogrodniczuk JS. Childhood emotional support and borderline personality features in a sample of Canadian psychiatric outpatients. Int J Soc Psychiatry 2016; 62:452-4. [PMID: 27220722 DOI: 10.1177/0020764016650214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite links between early relational experiences and psychopathology, data regarding childhood emotional neglect among Canadian mental health services users are scarce. AIMS To explore the absence of emotional support experiences reported by Canadian psychiatric outpatients, and to examine the relationship between childhood emotional support and borderline personality disorder (BPD) features. METHODS A survey regarding childhood emotional support was completed by consecutively admitted adult outpatients, along with self-report assessments of symptom distress and BPD features. RESULTS A substantial proportion of outpatients reported absent emotional support experiences. After controlling for the effects of age and symptom distress, childhood emotional support was found to be significantly negatively associated with BPD features. CONCLUSION The findings add further support to the need for clinical attention to the early relational experiences of mental health service users.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Deberdt W, Thome J, Lebrec J, Kraemer S, Fregenal I, Ramos-Quiroga JA, Arif M. Prevalence of ADHD in nonpsychotic adult psychiatric care (ADPSYC): A multinational cross-sectional study in Europe. BMC Psychiatry 2015; 15:242. [PMID: 26462666 PMCID: PMC4604704 DOI: 10.1186/s12888-015-0624-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 09/30/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood. This study was designed to estimate the prevalence of ADHD in adult psychiatric outpatients in several European countries. METHOD ADHD diagnosis was made using the Diagnostic Interview for ADHD in Adults, version 2.0 (DIVA), according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) and 5th Edition (DSM-5). RESULTS Of 5662 patients present/approached, 2284 (40.3 %) consented, of whom 1986 patients (87.0 %) completed the study. Based on the DIVA, and applying DSM-IV-TR or DSM-5 criteria, 15.8 % (95 % confidence interval [CI] 14.2 %-17.4 %) or 17.4 % (95 % CI 15.7 %-19.0 %) of patients were diagnosed with ADHD, respectively. The prevalence of ADHD was 15.3 % when counting as non-ADHD those patients who screened positive but did not complete the DIVA (DSM-5). CONCLUSIONS Estimates from this study indicate that a relevant part of the psychiatric outpatient care population suffers from ADHD.
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Affiliation(s)
- Walter Deberdt
- NV Eli Lilly Benelux, Markiesstraat 1, 1000, Brussels, Belgium.
| | - Johannes Thome
- Department of Psychiatry, University of Rostock, Gehlsheimer Str. 20, D-18147, Rostock, Germany.
| | - Jeremie Lebrec
- Lilly Deutschland GmbH, Werner Reimers-Str. 2-4, 61352, Bad Homburg, Germany.
| | - Susanne Kraemer
- Lilly Deutschland GmbH, Werner Reimers-Str. 2-4, 61352, Bad Homburg, Germany.
| | - Irene Fregenal
- Medical Liaison, Lilly Spain, Avenida de la Industria, 30. Alcobendas, E-28108, Madrid, Spain.
| | - J. Antoni Ramos-Quiroga
- ADHD Program, Department of Psychiatry, CIBERSAM Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona, Pg. Vall d’Hebron, 119-129 Barcelona, Spain
| | - Muhammad Arif
- Leicester (Adult) ADHD Service, Leicestershire Partnership NHS Trust, Leicester, United Kingdom.
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Kalaitzaki AE, Birtchnell J, Hammond S. Measuring change in relating and interrelating during the early stages of psychotherapy: Comparison with a nonpatients' sample. Psychother Res 2014; 26:85-94. [PMID: 25074711 DOI: 10.1080/10503307.2014.939118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The study examined whether the relative short time period of two months of individual psychotherapy improved patients' psychiatric symptoms, their negative relating (i.e., destructive and undesirable interpersonal attitudes and behavior to others) and their negative interrelating (i.e., destructive and undesirable relationship with their partners). A sample of 60 outpatients, reportedly suffering mainly from a mood or anxiety disorder, were compared with a sample of 48 nonpatients and their partners, over a comparable time span. It was shown that the patients' psychopathology scores dropped significantly. Significant changes in some relating and interrelating scores also occurred, even though the therapy had not specifically addressed these issues. Unexpectedly, the partners demonstrated some degree of deterioration both in their relating and their interrelating scores.
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Affiliation(s)
- Argyroula E Kalaitzaki
- a Social Work Department , School of Health and Social Welfare, Higher Technological Educational Institute (TEI) of Crete , Heraklion , Greece
| | | | - Sean Hammond
- c Department of Applied Psychology , University College Cork , Cork , Ireland
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Chen TT, Ko CH, Chen ST, Yen CN, Su PW, Hwang TJ, Lin JJ, Yen CF. Severity of alprazolam dependence and associated features among long-term alprazolam users from psychiatric outpatient clinics in Taiwan. J Formos Med Assoc 2014; 114:1097-104. [PMID: 24840273 DOI: 10.1016/j.jfma.2014.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 03/28/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/PURPOSE The aim of this study was to examine the correlations between the severity of alprazolam dependence and socio-demographic characteristics, the characteristics of alprazolam use, psychiatric comorbidity, and beliefs toward alprazolam use among long-term alprazolam users in Taiwan. METHODS A total of 148 long-term alprazolam users participated in this study. The Chinese version of the Severity of Dependence Scale was used to assess participants' severity of alprazolam dependence in the preceding month. Their socio-demographic characteristics, family function characteristics, dosage of prescribed alprazolam, duration of alprazolam use, alcohol use pattern, pain reliever and cigarette use pattern, severity of depressive symptoms, psychiatric diagnosis, and belief toward alprazolam use were investigated. RESULTS The results of multiple regression analysis indicated that a longer duration of alprazolam use, severe depressive symptoms, a high level of belief in the necessity of alprazolam treatment, and a high level of concern about the potential adverse consequences of alprazolam use were significantly associated with more severe alprazolam dependence. CONCLUSION Doctors should closely monitor the severity of alprazolam dependence among long-term users, especially patients' levels of depression, beliefs in the necessity of alprazolam treatment, and their concerns over the adverse consequences of continued treatment with alprazolam.
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Affiliation(s)
- Tzu-Ting Chen
- Department of Psychiatry, Yun-Lin Branch, National Taiwan University Hospital, Yunlin, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shao-Tsu Chen
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan; Department of Psychiatry, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chia-Nan Yen
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan, Taiwan
| | - Po-Wen Su
- Department of Psychiatry, Chu-Tung Branch, National Taiwan University Hospital, Hsinchu, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan.
| | - Jin-Jia Lin
- Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan; Department of Psychiatry, Chi-Mei Hospital, Liuying Campus, Tainan, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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De las Cuevas C, Peñate W, de Rivera L. To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making? Patient Prefer Adherence 2014; 8:1547-53. [PMID: 25395840 PMCID: PMC4226444 DOI: 10.2147/ppa.s73029] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
RATIONALE Nonadherence to prescribed medications is a significant barrier to the successful treatment of psychiatric disorders in clinical practice. It has been argued that patient participation in shared decision making improves adherence to treatment plans. PURPOSE To assess to what extent treatment adherence of psychiatric patients is influenced by the concordance between their preferred participation and their actual participation in decision making. MATERIALS AND METHODS A total of 967 consecutive psychiatric outpatients completed the Control Preference Scale twice consecutively before consultation, one for their preferences of participation, and the other for the style they had usually experienced until then, and the eight-item self-report Morisky Medication Adherence Scale 8. RESULTS Most psychiatric outpatients preferred a collaborative role in decision making. Congruence was achieved in only 50% of the patients, with most mismatch cases preferring more involvement than had been experienced. Self-reported adherence was significantly higher in those patients in whom there was concordance between their preferences and their experiences of participation in decision making, regardless of the type of participation preferred. CONCLUSION Congruence between patients' preferences and actual experiences for level of participation in shared decision making is relevant for their adherence to treatment.
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Affiliation(s)
- Carlos De las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
- Correspondence: Carlos De las Cuevas, Department of Internal Medicine, Dermatology and Psychiatry, School of Medicine, Campus de Ofra, University of La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife 38071, Spain, Fax +34 922 319 353, Email
| | - Wenceslao Peñate
- Department of Personality, Assessment and Psychological Treatments, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Luis de Rivera
- Department of Psychiatry, University Autónoma de Madrid, Madrid, Spain
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De Las Cuevas C, Peñate W, Perestelo-Pérez L, Serrano-Aguilar P. Shared decision making in psychiatric practice and the primary care setting is unique, as measured using a 9-item Shared Decision Making Questionnaire (SDM-Q-9). Neuropsychiatr Dis Treat 2013; 9:1045-52. [PMID: 23950646 PMCID: PMC3742346 DOI: 10.2147/ndt.s49021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND To measure and compare the extent to which shared a decision making (SDM) process is implemented both in psychiatric outpatient clinical encounters and in the primary care setting from the patient's perspective. METHODS A total of 1,477 patients recruited from the Canary Islands Health Service mental health and primary care departments were invited to complete the nine-item Shared Decision Making Questionnaire (SDM-Q-9) immediately after their consultation. MANCOVA, Student's t-test, and Pearson correlations were used to assess the relationship and differences between SDM-Q-9 scores in patient samples. RESULTS No differences were found in SDM-Q-9 total scores between the two patient samples, but there were relevant differences when item by item analysis was applied; differences were observed according to the different steps of the SDM process. SDM is present to a very limited extent in the routine psychiatric setting compared to primary care. Patients' age, education, type of appointment, and treatment decision all play a specific role in predicting SDM. CONCLUSION The study provides evidence that SDM is a complex process that needs to be analyzed according to its different steps. SDM patterns were different in the primary care and psychiatric outpatient care settings and reflect quite a different perspective of the decision making process.
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Affiliation(s)
- Carlos De Las Cuevas
- Department of Psychiatry, University of La Laguna, Tenerife, Spain ; Health Services Research Network for Chronic Diseases (REDISSEC), Tenerife, Spain
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De las Cuevas C, Rivero-Santana A, Perestelo-Pérez L, Pérez-Ramos J, Serrano-Aguilar P. Attitudes toward concordance in psychiatry: a comparative, cross-sectional study of psychiatric patients and mental health professionals. BMC Psychiatry 2012; 12:53. [PMID: 22646974 PMCID: PMC3403848 DOI: 10.1186/1471-244x-12-53] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 05/30/2012] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Concordance and Shared Decision-Making (SDM) are considered measures of the quality of care that improves communication, promotes patient participation, creates a positive relationship with the healthcare professional, and results in greater adherence with the treatment plan. METHODS This study compares the attitudes of 225 mental health professionals (125 psychiatrists and 100 psychiatry registrars) and 449 psychiatric outpatients towards SDM and concordance in medicine taking by using the "Leeds Attitude toward Concordance Scale" (LATCon). RESULTS The internal consistency of the scale was good in all three samples (Cronbach's α: patients = 0.82, psychiatrists = 0.76, and registrars = 0.82). Patients scored significantly lower (1.96 ± 0.48) than professionals (P < .001 in both cases), while no statistically significant differences between psychiatrists (2.32 ± 0.32) and registrars (2.23 ± 0.35) were registered; the three groups showed a positive attitude towards concordance in most indicators. Patients are clearly in favor of being informed and that their views and preferences be taken into account during the decision-making process, although they widely consider that the final decision must be the doctor's responsibility. Among mental health professionals, the broader experience provides a greater conviction of the importance of the patient's decision about treatment. CONCLUSIONS We observed a positive attitude towards concordance in the field of psychotropic drugs prescription both in professionals and among patients, but further studies are needed to address the extent to which this apparently accepted model is reflected in the daily practice of mental health professionals.
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Affiliation(s)
- Carlos De las Cuevas
- Faculty of Medicine, University of La Laguna, Campus de Ofra s/n, San Cristóbal de La Laguna, Canary Islands 38071, Spain.
| | - Amado Rivero-Santana
- Fundación Canaria de Investigación en Salud (FUNCIS), Santa Cruz de Tenerife, Spain
| | - Lilisbeth Perestelo-Pérez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain,Health Technology Assessment Unit, Canary Islands Health Service, Government of the Canary Islands, Pérez de Rozas 5, 4th floor, Santa Cruz de Tenerife, Canary Islands 38004, Spain
| | - Jeanette Pérez-Ramos
- Fundación Canaria de Investigación en Salud (FUNCIS), Santa Cruz de Tenerife, Spain
| | - Pedro Serrano-Aguilar
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain,Health Technology Assessment Unit, Canary Islands Health Service, Government of the Canary Islands, Pérez de Rozas 5, 4th floor, Santa Cruz de Tenerife, Canary Islands 38004, Spain
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Gaudiano BA, Zimmerman M. Does comorbid posttraumatic stress disorder affect the severity and course of psychotic major depressive disorder? J Clin Psychiatry 2010; 71:442-50. [PMID: 20021993 PMCID: PMC3671375 DOI: 10.4088/jcp.08m04794gre] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Accepted: 01/02/2009] [Indexed: 01/16/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are commonly comorbid conditions that result in greater severity, chronicity, and impairment compared with either disorder alone. However, previous research has not systematically explored the potential effects of the psychotic subtyping of MDD and comorbid PTSD. METHOD The sample in this retrospective case-control study conducted from December 1995 to August 2006 consisted of psychiatric outpatients with DSM-IV-diagnosed psychotic MDD with PTSD, psychotic MDD without PTSD, or nonpsychotic MDD with PTSD presenting for clinic intake. Clinical indices of severity, impairment, and history of illness were assessed by trained diagnosticians using the Structured Clinical Interview for DSM-IV Axis I Disorders supplemented by items from the Schedule for Affective Disorders and Schizophrenia. RESULTS In terms of current severity and impairment, the psychotic MDD with PTSD (n = 34) and psychotic MDD only (n = 26) groups were similar to each other, and both tended to be more severe than the nonpsychotic MDD with PTSD group (n = 263). In terms of history of illness, the psychotic MDD with PTSD group tended to show greater severity and impairment relative to either the psychotic MDD only or nonpsychotic MDD with PTSD groups. Furthermore, the psychotic MDD with PTSD patients had an earlier time to depression onset than patients with either psychotic MDD alone or nonpsychotic MDD with PTSD, which appeared to contribute to the poorer history of illness demonstrated in the former group. CONCLUSIONS Future research should explore the possibility of a subtype of psychotic depression that is associated with PTSD, resulting in a poorer course of illness. The current findings highlight the need for pharmacologic and psychotherapeutic approaches that can be better tailored to psychotic MDD patients with PTSD comorbidity.
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Affiliation(s)
- Brandon A. Gaudiano
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University,Psychosocial Research Program, Butler Hospital
| | - Mark Zimmerman
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University,Department of Psychiatry, Rhode Island Hospital
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Elkington KS, McKinnon K, Mann CG, Collins PY, Leu CS, Wainberg ML. Perceived mental illness stigma and HIV risk behaviors among adult psychiatric outpatients in Rio de Janeiro, Brazil. Community Ment Health J 2010; 46:56-64. [PMID: 19543974 PMCID: PMC2820157 DOI: 10.1007/s10597-009-9209-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 06/04/2009] [Indexed: 10/20/2022]
Abstract
We examined the associations between perceived mental illness stigma and HIV risk and protective behaviors among adults with severe mental illness (SMI) in Rio de Janeiro, Brazil. We measured mental illness stigma across three domains ("Personal Experiences," "Perceived Attractiveness," and "Relationship Discrimination"), and examined the relationship between experiences of stigma in each domain and HIV risk and protective behaviors over the past 3 months in 98 outpatients with SMI. Those who reported greater "Relationship Discrimination" stigma were significantly more likely to be sexually active and to have unprotected sex; they were significantly less likely to report deliberately having fewer partners as a way to protect themselves from HIV. The role of stigma in unprotected sexual behavior should be examined further and considered in any HIV prevention intervention for people with SMI.
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Affiliation(s)
- Katherine S Elkington
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive #15, New York, NY, 10032, USA.
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