Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic...Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.展开更多
Obsessive-compulsive disorder(OCD)is a severe mental illness characterized by persistent,intrusive and distressing obsessions and/or compulsions.Such symptoms have been conceptualized as resulting from a failure in so...Obsessive-compulsive disorder(OCD)is a severe mental illness characterized by persistent,intrusive and distressing obsessions and/or compulsions.Such symptoms have been conceptualized as resulting from a failure in sourcemonitoring processes,suggesting that patients with OCD fail to distinguish actions they perform from those they just imagine doing.In this study,we aimed to provide an updated and exhaustive review of the literature examining the relationship between source-monitoring and OCD.A systematic search in the literature through January 2019 allowed us to identify 13 relevant publications investigating source-monitoring abilities in patients with OCD or participants with subclinical compulsive symptoms.Most of the retrieved studies did not report any source-monitoring deficits in clinical and subclinical subjects compared with healthy volunteers.However,most of the studies reported that patients with OCD and subclinical subjects displayed reduced confidence in source-monitoring judgments or global cognitive confidence compared to controls.The present review highlighted some methodological and statistical limitations.Consequently,further studies are needed to explore source monitoring with regard to the subcategories of OCD symptoms(i.e.,symmetryordering,contamination-washing,hoarding,aggressive obsession-checking,sexual-religious thoughts)and to clarify the relationship between sourcemonitoring subtypes(i.e.,reality or internal source-monitoring)and confidence in these populations.展开更多
AIM To investigate psychopathological correlates of child obesity via the Draw-A-Person test(DAP).METHODS The participants were 50 children with a mean age of 9.74 years.Body mass index(BMI) was used as a measure of b...AIM To investigate psychopathological correlates of child obesity via the Draw-A-Person test(DAP).METHODS The participants were 50 children with a mean age of 9.74 years.Body mass index(BMI) was used as a measure of body fat.Children were divided into normal(n = 17),overweight(n = 14) and obese(n = 19).Two qualitative methods of scoring the DAP based on an integrative approach were used to assess self-concept(ESW) and overall level of children's adjustment(EAC).A procedure for judging interpretative skills of clinicians was implemented before they evaluated children's drawings.RESULTS As predicted by our hypothesis,BMI was negatively correlated with ESW,r(50) =-0.29,P < 0.05,but not with EAC,r(50) =-0.08,P = ns.To evaluate the effect of gender,Pearson correlations were re-computedregrouping the sample accordingly:BMI and EAC reached a significant negative correlation in female subjects,r(24) =-0.36,P < 0.05,and a positive correlation in male subjects,r(26) = 0.37,P = < 0.05;negative correlation between BMI and ESW became stronger in females,r(24) =-0.51,P < 0.01 but not in males,whose correlation disappeared resulting not-significant,r(26) =-0.06,P = ns.No effect of age was found.Results indicate that obesity has a negative correlation exclusively on overall adjustment and self-concept in female children.CONCLUSION It was concluded that there is a negative bias toward females that reveals how the stigma of obesity is widespread in Western society.展开更多
Obesity is a multifactorial disease and the prominent factors playing a role in its pathogenesis are biological, environmental and psychological. There is a growing interest in understanding psychological functioning ...Obesity is a multifactorial disease and the prominent factors playing a role in its pathogenesis are biological, environmental and psychological. There is a growing interest in understanding psychological functioning of obese subjects and the influence of psychological factors on treatment outcome. The aim of the present narrative review is to critically analyze the current literature, in order to point out the most common psychological constructs studied in obesity and to give an overview of the main existing tools investigating psychological features which have been considered significant for the prediction of success in weight loss and maintenance programs in obese patients. In this framework, the most common psychological constructs studied are: self-motivation, self-efficacy, locus of control, health related quality of life, self-esteem, self-control, concerns about body image, outcome expectations, and personality traits. These features have been explored through a wide variety of psychometric instruments. However, as an overall, studies evaluating the association between psychological features and treatment outcome failed to give consistent results. A possible explanation may consist on the fact that many tools widely used to explore psychological features were not specifically designed for obese patients and none of them was comprehensive of all possible psychological features involved. The identification of well-defined subgroups of patients and the validation of more reliable and comprehensive tools, specifically designed for obese subjects, should be forecasted in order to reach a better knowledge of psychological functioning of obese individuals and to improve the outcome of weight loss programs.展开更多
BACKGROUND Italy retains a distinctive organization of mental health services according to a community-based model of care with a multidisciplinary team serving a welldefined catchment area under the coordination of t...BACKGROUND Italy retains a distinctive organization of mental health services according to a community-based model of care with a multidisciplinary team serving a welldefined catchment area under the coordination of the local department of mental health.The coronavirus disease 2019(COVID-19)pandemic is forcing Italian mental health services to develop new organizational strategies at all levels of care in order to face the associated challenges.AIM To explore factors associated with changes in psychiatric admissions to an inpatient psychiatric unit located in Lombardia Region,Italy.METHODS All hospital admissions(n=44)were recorded to an inpatient psychiatric unit during a three month national lockdown in Italy in 2020 and compared with those occurring over the same time period in 2019(n=71).For each admission,a 20-item checklist was completed to identify factors leading to admission.Statistical analyses were performed using Statistical Package for Social Sciences for Windows,release 11.0.Chi-square test(or Fisher’s exact test)and Mann-Whitney U-test were applied,where appropriate.RESULTS Hospital admissions dropped by 38%during the COVID-19 pandemic.No significant differences were found in demographics,clinical variables associated with hospital admissions and length of stay between 2019 and 2020.Compared with 2019,a significantly greater proportion of hospital admissions in 2020 were related to difficulties in organizing care programs outside the hospital(chi-square=4.91,df 1,one-way P=0.035)and in patients’family contexts(chi-square=3.71,df 1,one-way P=0.049).On the other hand,logistic and communication difficulties pertaining to residential facilities and programs were significantly more common in 2019 than in 2020(chi-square=4.38,df 1,one-way P=0.032).CONCLUSION Admissions to the inpatient psychiatric unit dropped significantly during the COVID-19 pandemic in 2020,with difficulties in organizing care programs outside the hospital and in patients’family contexts occurring more frequently compared with 2019.展开更多
Objectives:The nursing profession is considered to be at a high risk of workplace stress,workload,and burnout due to the high job demands.The nurses require the appropriate and prompt coping mechanisms to relieve the ...Objectives:The nursing profession is considered to be at a high risk of workplace stress,workload,and burnout due to the high job demands.The nurses require the appropriate and prompt coping mechanisms to relieve the effects of stress.The nurses have to be emotionally intelligent to overcome the work-related stress to meet the clinical-based duties.But there is a paucity of the effect of emotional intelligence(EI)on the clinical performance of nurses in the literature.Therefore,the role of dimensions of EI in the improvement of clinical performance of nurses was explored in this study.Methods:A total of 194 nurses with different education levels and experiences were included from various clinical departments and shifts of public hospitals in Iraqi Kurdistan.Results:The mean age of the nurses was 29.44 years,with ages ranging from 23 years to 36 years.The nurses were men(56.70%),married(53.10%),non-smokers(86.10%),physically active(55.70%),and irregular physically active(63.90%).Nurses were able to appraise their own emotions but not the emotions of other nurses.They regulated their own emotions but were weak in regulating the emotions of other nurses.They did not utilize emotions in coming up with new ideas and facing obstacles in clinical settings.Generally,the nurses reported that a little clinical performance is required in medical settings.The levels of interpersonal communication and problem solving were improved with an increasing appraisal and regulating own emotions.The level of problem solving was improved with appraising own emotions and utilizing emotions in facing obstacles.Conclusions:Nurses need to know how to regulate others’emotions and utilize these emotions in coming up with new ideas and facing the obstacles positively in medical settings.展开更多
Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternu...Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction. Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting PPS, and PPS and SBP response to TTT. Results: MDI score decreased 30% in non-users (p = 0.005) compared to 4% (p > 0.1) among users (between-group p = 0.003;effect size = 0.4). Resting PPS decreased in both the groups. Among most vulnerable patients with MDI ≥ 15, reductions in MDI score and resting PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depressive in non-users, only. Similarly, the association between the reduction in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors.展开更多
文摘Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.
文摘Obsessive-compulsive disorder(OCD)is a severe mental illness characterized by persistent,intrusive and distressing obsessions and/or compulsions.Such symptoms have been conceptualized as resulting from a failure in sourcemonitoring processes,suggesting that patients with OCD fail to distinguish actions they perform from those they just imagine doing.In this study,we aimed to provide an updated and exhaustive review of the literature examining the relationship between source-monitoring and OCD.A systematic search in the literature through January 2019 allowed us to identify 13 relevant publications investigating source-monitoring abilities in patients with OCD or participants with subclinical compulsive symptoms.Most of the retrieved studies did not report any source-monitoring deficits in clinical and subclinical subjects compared with healthy volunteers.However,most of the studies reported that patients with OCD and subclinical subjects displayed reduced confidence in source-monitoring judgments or global cognitive confidence compared to controls.The present review highlighted some methodological and statistical limitations.Consequently,further studies are needed to explore source monitoring with regard to the subcategories of OCD symptoms(i.e.,symmetryordering,contamination-washing,hoarding,aggressive obsession-checking,sexual-religious thoughts)and to clarify the relationship between sourcemonitoring subtypes(i.e.,reality or internal source-monitoring)and confidence in these populations.
文摘AIM To investigate psychopathological correlates of child obesity via the Draw-A-Person test(DAP).METHODS The participants were 50 children with a mean age of 9.74 years.Body mass index(BMI) was used as a measure of body fat.Children were divided into normal(n = 17),overweight(n = 14) and obese(n = 19).Two qualitative methods of scoring the DAP based on an integrative approach were used to assess self-concept(ESW) and overall level of children's adjustment(EAC).A procedure for judging interpretative skills of clinicians was implemented before they evaluated children's drawings.RESULTS As predicted by our hypothesis,BMI was negatively correlated with ESW,r(50) =-0.29,P < 0.05,but not with EAC,r(50) =-0.08,P = ns.To evaluate the effect of gender,Pearson correlations were re-computedregrouping the sample accordingly:BMI and EAC reached a significant negative correlation in female subjects,r(24) =-0.36,P < 0.05,and a positive correlation in male subjects,r(26) = 0.37,P = < 0.05;negative correlation between BMI and ESW became stronger in females,r(24) =-0.51,P < 0.01 but not in males,whose correlation disappeared resulting not-significant,r(26) =-0.06,P = ns.No effect of age was found.Results indicate that obesity has a negative correlation exclusively on overall adjustment and self-concept in female children.CONCLUSION It was concluded that there is a negative bias toward females that reveals how the stigma of obesity is widespread in Western society.
文摘Obesity is a multifactorial disease and the prominent factors playing a role in its pathogenesis are biological, environmental and psychological. There is a growing interest in understanding psychological functioning of obese subjects and the influence of psychological factors on treatment outcome. The aim of the present narrative review is to critically analyze the current literature, in order to point out the most common psychological constructs studied in obesity and to give an overview of the main existing tools investigating psychological features which have been considered significant for the prediction of success in weight loss and maintenance programs in obese patients. In this framework, the most common psychological constructs studied are: self-motivation, self-efficacy, locus of control, health related quality of life, self-esteem, self-control, concerns about body image, outcome expectations, and personality traits. These features have been explored through a wide variety of psychometric instruments. However, as an overall, studies evaluating the association between psychological features and treatment outcome failed to give consistent results. A possible explanation may consist on the fact that many tools widely used to explore psychological features were not specifically designed for obese patients and none of them was comprehensive of all possible psychological features involved. The identification of well-defined subgroups of patients and the validation of more reliable and comprehensive tools, specifically designed for obese subjects, should be forecasted in order to reach a better knowledge of psychological functioning of obese individuals and to improve the outcome of weight loss programs.
文摘BACKGROUND Italy retains a distinctive organization of mental health services according to a community-based model of care with a multidisciplinary team serving a welldefined catchment area under the coordination of the local department of mental health.The coronavirus disease 2019(COVID-19)pandemic is forcing Italian mental health services to develop new organizational strategies at all levels of care in order to face the associated challenges.AIM To explore factors associated with changes in psychiatric admissions to an inpatient psychiatric unit located in Lombardia Region,Italy.METHODS All hospital admissions(n=44)were recorded to an inpatient psychiatric unit during a three month national lockdown in Italy in 2020 and compared with those occurring over the same time period in 2019(n=71).For each admission,a 20-item checklist was completed to identify factors leading to admission.Statistical analyses were performed using Statistical Package for Social Sciences for Windows,release 11.0.Chi-square test(or Fisher’s exact test)and Mann-Whitney U-test were applied,where appropriate.RESULTS Hospital admissions dropped by 38%during the COVID-19 pandemic.No significant differences were found in demographics,clinical variables associated with hospital admissions and length of stay between 2019 and 2020.Compared with 2019,a significantly greater proportion of hospital admissions in 2020 were related to difficulties in organizing care programs outside the hospital(chi-square=4.91,df 1,one-way P=0.035)and in patients’family contexts(chi-square=3.71,df 1,one-way P=0.049).On the other hand,logistic and communication difficulties pertaining to residential facilities and programs were significantly more common in 2019 than in 2020(chi-square=4.38,df 1,one-way P=0.032).CONCLUSION Admissions to the inpatient psychiatric unit dropped significantly during the COVID-19 pandemic in 2020,with difficulties in organizing care programs outside the hospital and in patients’family contexts occurring more frequently compared with 2019.
文摘Objectives:The nursing profession is considered to be at a high risk of workplace stress,workload,and burnout due to the high job demands.The nurses require the appropriate and prompt coping mechanisms to relieve the effects of stress.The nurses have to be emotionally intelligent to overcome the work-related stress to meet the clinical-based duties.But there is a paucity of the effect of emotional intelligence(EI)on the clinical performance of nurses in the literature.Therefore,the role of dimensions of EI in the improvement of clinical performance of nurses was explored in this study.Methods:A total of 194 nurses with different education levels and experiences were included from various clinical departments and shifts of public hospitals in Iraqi Kurdistan.Results:The mean age of the nurses was 29.44 years,with ages ranging from 23 years to 36 years.The nurses were men(56.70%),married(53.10%),non-smokers(86.10%),physically active(55.70%),and irregular physically active(63.90%).Nurses were able to appraise their own emotions but not the emotions of other nurses.They regulated their own emotions but were weak in regulating the emotions of other nurses.They did not utilize emotions in coming up with new ideas and facing obstacles in clinical settings.Generally,the nurses reported that a little clinical performance is required in medical settings.The levels of interpersonal communication and problem solving were improved with an increasing appraisal and regulating own emotions.The level of problem solving was improved with appraising own emotions and utilizing emotions in facing obstacles.Conclusions:Nurses need to know how to regulate others’emotions and utilize these emotions in coming up with new ideas and facing the obstacles positively in medical settings.
文摘Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction. Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting PPS, and PPS and SBP response to TTT. Results: MDI score decreased 30% in non-users (p = 0.005) compared to 4% (p > 0.1) among users (between-group p = 0.003;effect size = 0.4). Resting PPS decreased in both the groups. Among most vulnerable patients with MDI ≥ 15, reductions in MDI score and resting PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depressive in non-users, only. Similarly, the association between the reduction in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors.
