The COVID-19 pandemic accelerated adoption of telemental health (TMH). Providers with limited TMH experience faced challenges during the rapid switch to remote patient care. We investigated TMH providers' perceptions about remote care one year into the pandemic according to when providers adopted telemedicine (i.e., before vs. after March 2020) and how much of their caseloads were served remotely (i.e., less then 50% vs. ≥ 50%). Between February-March 2021, 472 TMH providers completed a cross-sectional, web-based survey that measured perceived benefits and satisfaction with telemedicine, therapeutic alliance, patient-centered communication, eHealth literacy, multicultural counseling self-efficacy, and facilitating factors of using telemedicine. Providers who began using telemedicine before the pandemic reported having better training, task-related therapeutic alliance with patients, and ability to conduct multicultural interventions, assessments, and session management. Providers who served ≥ 50% of their caseload remotely reported greater satisfaction with their practice, stronger beliefs about the benefits of telemedicine, and greater perceived effects of telemedicine on alleviating the impact of COVID-19. There were no differences in reports of patient-centered communication nor eHealth literacy. In conclusion, providers who adopted TMH more recently may require additional training and support to successfully establish a working alliance with their patients, especially with multicultural aspects of care.Besides affecting 8% of the general population, nightmares are one of the most frequent symptoms of traumatized individuals. This can be a significant factor in the treatment of post-traumatic disorders; indeed, several studies demonstrated its strong predictive and prognostic value. Sleep disorders, nightmares in particular, could be very distressing for individuals and need targeted interventions, especially if they are associated with a PTSD diagnosis. To date, the best technique for the treatment of traumatic sleep disturbances seems to be Imagery Rehearsal Therapy (IRT), an empirically supported method. Through a review of the literature on this matter, this article aims to outline the incidence and consequences of nightmares in PTSD, illustrate how IRT could prove useful in their treatment, and investigate its clinical applications.Subjects affected by schizophrenia present significant deficits in various aspects of social cognition, such as emotion processing, social perception and theory of mind (ToM). These deficits have a greater impact than symptoms on occupational and social functioning. https://www.selleckchem.com/products/Rolipram.html Therefore, social cognition represents an important therapeutic target in people with schizophrenia. Recent meta-analyses showed that social cognition training (SCT) is effective in improving social cognition in subjects with schizophrenia; however, real-life functioning is not always ameliorated. Integration of SCT with an intervention targeting metacognitive abilities might improve the integration of social cognitive skills to daily life functioning. Our research group has implemented a new individualized rehabilitation program the Social Cognition Individualized Activities Lab, SoCIAL, which integrates SCT with a module for narrative enhancement, an intervention targeting metacognitive abilities. The present multi-center randomized controlled study will compare the efficacy of SoCIAL and treatment as usual (TAU) in subjects diagnosed with a schizophrenia-spectrum disorder. The primary outcome will be the improvement of social cognition and real-life functioning; while the secondary outcome will be the improvement of symptoms, functional capacity and neurocognition. The results of this study will add empirical evidence to the benefits and feasibility of SCT and narrative enhancement in people with schizophrenia-spectrum disorders.
Major depressive disorder is considered the most common comorbidity of anorexianervosa in adolescence. Some evidence argues against antidepressant use in this population. Moreover, the fear of being threatened with autonomy and of becoming dependent specific to this adolescent population and at the very core of the anorexic disease, make the proposal of such a treatment difficult to accept. This qualitative research aimed to explore the perspectives of view of adolescents with anorexia nervosa about antidepressants.
We conducted interviews with adolescents suffering from anorexia nervosa who had been treated with an antidepressant agent during their inpatient or outpatient care at Cochin Hospital. Adolescents were chosen by convenience sampling. Both verbal and written questions were asked to elicit their lived experiences. Interpretative Phenomenological Analysis was used to examine the data.
Fifteen adolescents (13 girls and two boys) were interviewed. We have reached total data saturation. The analysof their anorexic illness.
Resilience incorporates the presence of a positive response to some type of stressor. To properly explore resilience, it is important to systematically identify relevant stressors. We aimed to identify (combinations of) stressors with the strongest relationship with observer-reported and self-reported mood outcomes in older residents of long-term care facilities (LTCFs) in The Netherlands.
We included 4,499 older (≥60) residents of 40 LTCFs who participated in the Dutch InterRAI-LTCF cohort between 2005 and 2018. The association of possible stressors (single stressors, number of stressors, and combinations of two stressors) in this population with observer-reported (Depression Rating Scale) and self-reported mood outcomes was analyzed using multilevel tobit models and logistic regressions.
Major life stressor ["experiences that (threatened to) disrupt(ed) a person's daily routine and imposed some degree of readjustment"] and conflict with other care recipients and/or staff were most strongly associated with both mood outcomes. Furthermore, conflict was a particularly prevalent stressor (24%). Falls, fractures, and hospital visits were more weakly or not associated at all. Overall, the associations were similar for the mood outcomes based on observer-report and self-report, although there were some differences. Multiple stressors were more strongly associated with both mood outcomes than one stressor.
Major life stressor and conflict emerged as important stressors for resilience research within the psychological domain in LTCF residents. Further (longitudinal) research is necessary to determine the directionality and relevance of the strong association of conflict with mood for LTCF practice.
Major life stressor and conflict emerged as important stressors for resilience research within the psychological domain in LTCF residents. Further (longitudinal) research is necessary to determine the directionality and relevance of the strong association of conflict with mood for LTCF practice.The relationship between violence, gender and mental health is a complex one which is yet to be fully understood. Gender role stereotypes are social constructs that can powerfully influence and regulate human behaviour, including violence; and so it is likely that they also influence the nexus of violence management and mental health which is at the core of forensic psychiatry. In this article, we examine how gender role stereotypes might influence the practice of forensic psychiatry specifically, in relation to women as violent offenders, as patients in secure psychiatric care and as clinicians working in forensic settings. We identify areas of development in women's forensic mental health services, and examine whether patriarchal influences and gender role stereotypes may have inadvertently impacted upon these changes. We also consider whether these changes may maintain pre-existing barriers to treatment for both men and women.
Previous studies have shown the clinical effect of 2 Hz repetitive transcranial magnetic stimulation (rTMS) for depression; however, its underlying neural mechanisms are poorly understood. The aim of this study was to examine the effects of rTMS on the activity of the prefrontal cortex in patients with depression, using functional near-infrared spectroscopy (fNIRS).
Forty patients with major depressive disorder (MDD) and 40 healthy controls were enrolled in this study. Patients underwent 4 weeks of 2 Hz TMS delivered to the right dorsolateral prefrontal cortex (DLPFC). fNIRS was used to measure the changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex during a verbal fluency task (VFT) in depressed patients before and after rTMS treatment. The severity of depression was assessed using the Hamilton Rating Scale for Depression-24 item (HAMD-24).
Prior to rTMS, depressed patients exhibited significantly smaller [oxy-Hb] values in the bilateral prefrontal cortex during thponse to rTMS.
The objective of this study was to investigate the psychosocial and cardiovascular markers in healthcare professionals during the COVID-19 pandemic.
This was a STROBE compliant, blended exploratory study. Residents, staff physicians, nurses, and auxiliary healthcare professionals from both inpatient and outpatient medicine services were recruited using a planned random probability sample. The Maslach Burnout Inventory (MBI), Fuster-BEWAT score (FBS), and socio-demographic factors, as well as sleep quality, were studied. The correlations between burnout severity and cardiovascular risk were examined using multivariable linear regression models adjusted for confounding variables, such as sociodemographic and anthropometric characteristics.
The regression analysis with FBS as the outcome showed a negative association between cardiovascular health and emotional exhaustion [Coef.(95%CI) -0.029 (-0.048, -0.01),
= 0.002]. The higher the emotional exhaustion the lower the cardiovascular health. Further, the model showed a positive association between personal accomplishment and cardiovascular health [Coef.(95%CI) 0.045 (0.007, 0.082),
= 0.02]. Emotional exhaustion was significantly positive correlated with REM sleep and light average (Spearman's rank correlation 0.37 and 0.35, respectively, with
< 0.05).
The data from this study show that healthcare practitioners who are with burnout and emotional exhaustion have an elevated cardiovascular risk, however, causality cannot be determined. As an adaptive response to stressful situations, REM sleep increases. The findings of this study may be relevant in creating preventive strategies for burnout and cardiovascular risk reduction or prevention.
[www.ClinicalTrials.gov], identifier [NCT04422418].
[www.ClinicalTrials.gov], identifier [NCT04422418].
Children born to parents with severe mental illness have gained more attention during the last decades because of increasing evidence documenting that these children constitute a population with an increased risk of developing mental illness and other negative life outcomes. Because of high-quality research with cohorts of offspring with familial risk and increased knowledge about gene-environment interactions, early interventions and preventive strategies are now being developed all over the world. Adolescence is a period characterized by massive changes, both in terms of physical, neurologic, psychological, social, and behavioral aspects. It is also the period of life with the highest risk of experiencing onset of a mental disorder. Therefore, investigating the impact of various risk and resilience factors in adolescence is important.
The Danish High-Risk and Resilience Study started data collection in 2012, where 522 7-year-old children were enrolled in the first wave of the study, the VIA 7 study. The cohort was identified through Danish registers based on diagnoses of the parents.