Chronic Psychological Distress Research Articles

Somatosensory profile in individuals with Duchenne muscular dystrophy: A quantitative sensory testing (QST) study

ObjectiveThis study aimed to quantify somatosensory profiles in individuals with Duchenne muscular dystrophy (DMD). MethodsWe included 28 participants with genetically confirmed DMD (aged 8 to 17 years), 14 with chronic pain (DMD-CP), and 14 without pain (DMD-NP), compared to 13 healthy controls (HC) matched for age and sex. Three quantitative sensory testing (QST) modalities were examined: pressure pain threshold (PPT), temporal summation of pain (TSP) and conditioned pain modulation (CPM). Characteristics related to chronic pain, fatigue, psychological distress, and health-related quality of life were assessed using questionnaires. ResultsDecreased PPTs were found in both DMD cohorts across body areas commonly affected by pain (rectus femoris, medial gastrocnemius, paraspinal muscles, upper trapezius), as well as in a less frequently affected remote area (thenar eminence), compared to HCs (p < 0.001). The DMD-CP group exhibited greater TSP compared to HCs (p = 0.025). There were no differences in CPM effects between DMD groups and HCs. No differences were detected in all QST measures between DMD-CP and DMD-NP. SignificanceThis study is the first to explore the somatosensory profile in DMD. Preliminary evidence suggests that generalized hyperalgesia may be a common feature in DMD regardless of pain status. QST measures appear to not distinguish individuals with chronic pain from those without and thus are not recommended for assessing pain in DMD or guiding treatment.

An update on tinea capitis in children.

Tinea capitis presents a significant public health care challenge due to its contagious nature, and potential long-term consequences if unrecognized and untreated. This review explores the prevalence, risk factors, diagnostic methods, prevention strategies, impact on quality of life, and treatment options for pediatric tinea capitis. Epidemiological analysis spanning from 1990 to 1993 and 2020 to 2023 reveals prevalence patterns of pediatric tinea capitis influenced by geographic, demographic, and environmental factors. Notably, Trichophyton species is most prevalent in North America; however, Microsporum species remain the primary causative agent globally, with regional variations. Risk factors include close contact and environmental conditions, emphasizing the importance of preventive measures. Accurate diagnosis relies on clinical evaluation, microscopic examination, and fungal culture. Various treatment modalities including systemic antifungals show efficacy, with terbinafine demonstrating superior mycological cure rates particularly for Trichophyton species. Recurrent infections and the potential development of resistance can pose challenges. Therefore, confirming the diagnosis, appropriately educating the patient/caregiver, accurate drug and dose utilization, and compliance are important components of clinical cure. Untreated or poorly treated tinea capitis can lead to chronic infection, social stigma, and psychological distress in affected children. Prevention strategies focus on early detection and healthy lifestyle habits. Collaborative efforts between healthcare providers and public health agencies are important in treating pediatric tinea capitis and improving patient outcomes. Education and awareness initiatives play a vital role in prevention and community-level intervention to minimize spread of infection. Future research should explore diagnostic advances, novel treatments, and resistance mechanisms in order to mitigate the disease burden effectively.

Multiple chronic diseases and psychological distress among adults in the United States: the intersectionality of chronic diseases, race/ethnicity, immigration, sex, and insurance coverage.

Psychological distress significantly contributes to the burdens of morbidity and mortality in the United States (U.S.), but our understanding is limited with regards to the risk factors associated with psychological distress. We used nationally representative data to examine (1) the comorbidities of chronic diseases and their risks for psychological distress and (2) the ways in which chronic diseases combine with demographic factors such as sex, race/ethnicity, immigration status, and health insurance coverage to affect the patterning of psychological distress. We analyzed the 2005-2018 National Health Survey Interview cross-sectional data on U.S. adults aged ≥ 18 years (n = 351,457). We fitted sequential multivariable logistic regression models. There was a dose-response relationship between the number of chronic diseases and psychological distress, with increased number of chronic diseases associated with increased psychological distress risk. Females (vs. males) and those without health insurance (vs. insured) were more likely to experience psychological distress. Immigrants (vs. non-immigrants) and racial/ethnic minorities (vs. White individuals) were less likely to experience psychological distress. There were significant interactions between chronic diseases and insurance coverage, immigration status, and race/ethnicity, but the three-way interactions were not statistically significant with psychological distress: chronic disease status vs. immigration status vs. health insurance coverage, and chronic disease vs. race/ethnicity vs. immigration status. The findings suggest a critical need to consider the complex ways in which chronic diseases and psychosocial factors combine to affect psychological distress and their implications for tailoring mental health screening, initiatives to reduce distress, and prevention strategies for effectively addressing health-related disparities in the general population.

Chronic Procrastination Among Iranians: Prevalence Estimation, Latent Profile and Network Analyses.

Procrastination is the deliberate, unjustified postponing of an intended course of action despite its costs or unfavorable effects. The present study used a self-report online survey and collected data from a large convenience sample of the general adult population (N = 2,076; females = 55.73%; Mage = 35.1years [SD ± 12.7]) with diverse demographics. Following the ring-curve distribution, the results indicated a 15.4% prevalence rate of procrastination among the Iranian community, which was significantly higher among women and divorced individuals and lower among nomadic individuals and those with higher academic degrees. A latent profile analysis demonstrated two distinct profiles, one for procrastinators (high scores on chronic procrastination, psychological distress, neuroticism, and extraversion; and low scores on general self-efficacy, self-esteem, satisfaction with life, openness, agreeableness, and conscientiousness) and one for non-procrastinators (demonstrating a reverse pattern compared to procrastinators). Moreover, additional network analysis suggested that the examined networks were invariant across procrastination status and gender. The results indicate that procrastination differs by demographic characteristics and is associated with a unique psychological profile. However, none of the aforementioned key study variables were considered a potential vulnerability for procrastinators due to the finding that all variables were peripheral and none were central in the examined networks.Therefore, relying on the differences in mean scores on psychometric scales does not appear to be an optimal way of determining the most important variables in a therapeutic context when treating procrastination.

Risk Factors for Acute Postsurgical Pain: A Narrative Review.

Acute postsurgical pain (APSP) has received growing attention as a surgical outcome. When poorly controlled, APSP can affect short- and long-term outcomes in patients. Despite the steady increase in awareness about postoperative pain and standardization of pain prevention and treatment strategies, moderate-to-severe APSP is frequently reported in clinical practice. This is possibly because pain varies widely among individuals and is influenced by distinct factors, such as demographic, perioperative, psychological, and genetic factors. This review investigates the risk factors for APSP, including gender, age, obesity, smoking history, preoperative pain history, pain sensitivity, preoperative anxiety, depression, pain catastrophizing, expected postoperative pain, surgical fear, and genetic polymorphisms. By identifying patients having an increased risk of moderate-to-severe APSP at an early stage, clinicians can more effectively manage individualized analgesic treatment protocols with a combination of pharmacological and non-pharmacological interventions. This would alleviate the transition from APSP to chronic pain and reduce the severity of APSP-induced chronic physical disability and social psychological distress.

A psychometric evaluation of the parental acceptance and action questionnaire (PAAQ) in parents of children with and without disabilities

Parental psychological inflexibility, particularly characterized by experiential avoidance, represents a significant risk factor for chronic stress and psychological distress. The Parental Acceptance and Action Questionnaire (PAAQ) is a context-specific instrument for the measurement of parental psychological inflexibility. This study aimed to evaluate the psychometric properties of the original composite version of the 19-item PAAQ across the three distinct Swedish samples; a community sample (n = 1018), a clinical sample of treatment-seeking parents of children with disabilities (n = 667), and a test-retest sample (n = 337). The Principal Axis Factoring of the PAAQ in the community sample yielded a 16-item, three-factor solution: 1) action-taking and flexibility in the parenting context, 2) experiential acceptance of internal experiences related to parenting, and 3) experiential acceptance of child's internal experiences. This factor model was supported by the confirmatory factor analysis in the test-retest sample. The associations observed with related constructs (r = between 0.49 and 0.61, p < 0.0001) indicated good discriminant validity. The Receiver Operator Characteristic analysis demonstrated that the PAAQ can effectively classify between the clinical and community sample, achieving 79% sensitivity and 68% specificity. The showed good test-retest reliability (r = 0.82). As anticipated, the parents in the clinical sample showed greater psychological inflexibility compared to parents in the community sample. To conclude, the 16-item Swedish version of the PAAQ demonstrates adequate to good psychometric qualities.

The mediating role of health literacy between the presence of chronic disease and psychological distress among older persons in Xi’an city of China

BackgroundThe increased number of older persons in China, and the prevalence of most chronic diseases raised with age significantly increased the total disease burden. When a person ages, psychological distress happens when they are faced with stressors that they cannot cope with. Psychological distress refers to non-specific symptoms of depression, anxiety, and stress. Health literacy influences several health outcomes, such as emotional functioning among the population. The primary purpose of this study is to examine the mediator role of health literacy between the presence of chronic disease and psychological distress among older persons living in Xi’an city. Thus, this study used the Cognitive Behavior Theory (CBT) as a combination of the basic behavioral and cognitive psychology principles to explain the cognitive processes associated with psychological distress.MethodsThis study employs a quantitative research design using a cross-sectional survey of 300 older persons over 60 years living in the six urban districts of Xi’an city. Data were collected using the Health Literacy Questionnaire (HLQ) and the Depression Anxiety Stress Scale (DASS-21). This study employed descriptive statistics and inferential methods to analyze the data. The inferential methods applied structural equation modeling (SEM) to test the hypothesis of the mediator role of health literacy between the presence of chronic disease and psychological distress.ResultsIn this study, chronic disease had an effect on health literacy among older persons living in Xi’an city (β=-0.047, p < 0.01); chronic disease impact on psychological distress among older persons living in Xi’an city (β = 0.047, p < 0.01); health literacy was identified effect on psychological distress among older persons in Xi’an city (β=-0.738, p < 0.001); health literacy as a partial mediator between chronic disease and psychological distress (β = 0.07, p < 0.01).ConclusionPsychological distress among older persons is affected by chronic disease and health literacy. Health literacy had a partial mediating effect on the presence of chronic disease and psychological distress. Improved health literacy measures should be considered when treating older persons with psychological distress.

Association Between Symptoms of Chronic Psychological Distress and Myocardial Ischemia Induced by Mental Stress in Patients With Coronary Artery Disease.

Background Mental stress-induced myocardial ischemia is a frequent phenomenon in patients with coronary artery disease and is associated with a greater risk of future cardiovascular events. The association between chronic symptoms of psychological distress and mental stress-induced ischemia is not clear. Methods and Results We used a composite score of psychological distress derived from symptoms of depression, posttraumatic stress disorder, anxiety, anger, and perceived general stress. Participants underwent myocardial perfusion imaging with both mental (public speaking task) and conventional (exercise or pharmacological) stress testing. Overall, 142 (15.9%) patients experienced mental stress-induced myocardial ischemia. After adjusting for demographic factors, medical history, and medication use, patients in the highest tertile of psychological distress score had 35% higher odds of having mental stress-induced ischemia compared to those in the lowest tertile (odds ratio [OR], 1.35 [95% CI, 1.06-2.22]). Stratified analyses showed that the association between psychological distress score and mental stress-induced myocardial ischemia was significantly associated only within the subgroup of patients with a prior myocardial infraction, with patients with a prior myocardial infarction in the highest tertile having a 93% higher odds of developing myocardial ischemia with mental stress (95% CI, 1.07-3.60). There was no significant association between psychological distress and conventional stress-induced ischemia (OR, 1.19 [95% CI, 0.87-1.63]). Conclusions Among patients with a history of myocardial infarction, a higher level of psychosocial distress is associated with mental stress-induced myocardial ischemia but not with ischemia induced by a conventional stress test.

Neural indices of multimodal sensory and autonomic hyperexcitability in fibromyalgia

Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and psychological distress. Research suggests people with FM experience increased somatosensory sensitization which generalizes to other sensory modalities and may indicate neural hyperexcitability. However, the available evidence is limited, and studies including measures of neural responsivity across sensory domains and both central and peripheral aspects of the neuraxis are lacking. Thirty-nine participants (51.5 ± 13.6 years of age) with no history of neurological disorders, psychosis, visual, auditory, or learning deficits, were recruited for this study. People with FM (N = 19) and control participants (CNT, N = 20) did not differ on demographic variables and cognitive capacity. Participants completed a task that combined innocuous auditory stimuli with electrocutaneous stimulation (ECS), delivered at individually-selected levels that were uncomfortable but not painful. Event-related potentials (ERPs) and electrodermal activity were analyzed to examine the central and sympathetic indices of neural responsivity. FM participants reported greater sensitivity to ECS and auditory stimulation, as well as higher levels of depression, anxiety, ADHD, and an array of pain-related experiences than CNT. In response to ECS, the P50 deflection was greater in FM than CNT participants, reflecting early somatosensory hyperexcitability. The P50 amplitude was positively correlated with the FM profile factor obtained with a principal component analysis. The N100 to innocuous tones and sympathetic reactivity to ECS were greater in FM participants, except in the subgroup treated with gabapentinoids, which aligns with previous evidence of symptomatic improvement with GABA-mimetic medications. These results support the principal tenet of generalized neural hyperexcitability in FM and provide preliminary mechanistic insight into the impact of GABA-mimetic pharmacological therapy on ameliorating the neural excitation dominance.

MyKOA-Cope: the development of a culturally relevant integrative group psychological intervention for people with chronic knee osteoarthritis pain

Introduction: Knee osteoarthritis is a highly prevalent musculoskeletal condition that causes chronic pain and psychological distress. The biological aspects of arthritis pain can be effectively managed with medication, physiotherapy and surgical procedures. However, no known psychological interventions to manage the psychological aspects of chronic pain have been developed in Sri Lanka.Objective: The study aimed to develop a culturally relevant integrative group psychological intervention for patients with chronic knee osteoarthritis pain.Methods: The first phase involved a literature review of existing psychological interventions on chronic pain management, which was used to develop a culturally relevant group psychological intervention named as “MyKOA-Cope: Psychological intervention for chronic knee osteoarthritis”. In the second phase, a Delphi study and a focus group discussion were conducted to evaluate the feasibility of the newly developed intervention.Results: The MyKOA-Cope is a six-session, in-person group intervention that lasts 45-50 minutes per session. These sessions include: 1) orientation to the intervention; 2) relaxation training; 3) exercise and pacing; pleasant activity scheduling; 4) identify negative automatic thoughts; 5) cognitive restructuring and calming selfstatements and 6) termination and maintenance strategies.Conclusion: The present study developed a culturally appropriate psychological intervention to enhance paincoping skills among patients with chronic knee osteoarthritis. This intervention has the potential to address the psychological aspects of chronic pain and contribute to the biomedical model. Future research can validate and tailor the MyKOA-Cope to suit the needs of patients with different illness conditions, literacy levels, and those who speak in Tamil in Sri Lanka.

Mapping the associations of daily pain, sleep, and psychological distress in a U.S. sample.

Chronic pain, sleep problems, and psychological distress (PD) can be disabling conditions and previous research has shown that they are associated. The nuances of the comorbid nature of these conditions may be important to understand for those who treat these conditions. This study examined the bidirectional associations of these health factors concurrently and over time in a sample of U.S. adults (N = 1,008, Mage = 57.68) from the Midlife in the United States (MIDUS) study. Participants reported on their daily pain, sleep quantity, and psychological distress over eight days. A modified Random Intercept Cross-lagged Panel Model was used to analyze the relations, starting with the whole sample and then a comparison of those with and without chronic pain. Results indicated that nightly variation in sleep quantity predicted next day psychological distress for both groups. Sleep quantity also predicted next-day pain, but only for individuals with chronic pain. Associations between pain and psychological distress were found both at the daily level and individual (between-person) level. This between-person association was stronger for those with chronic pain. The lagged associations between sleep, and both pain and psychological distress for the chronic pain group indicate that, increased quantity of sleep predicts decreased next-day pain and psychological distress. Providers could consider this unidirectional lagged relationship when prioritizing treatment for patients with these comorbid conditions. Future research may examine whether responsive, just-in-time treatments might intervene after participants wake from a poor night's sleep to counteract the negative effects of reduced sleep on PD and pain.

Abstract MP58: A Plasma Metabolite Score Related to Psychological Distress and Future Diabetes Risk: A Nested Case-Control Study in US Women

Introduction: Various forms of psychological distress, such as depression and anxiety, have been identified as risk factors for diabetes. However, there is limited evidence from population-based, epidemiologic studies investigating potential molecular mechanisms (e.g., metabolic dysregulation) linking psychological distress and diabetes development. Hypothesis: We assessed the hypothesis that a metabolite score reflecting psychological distress-related metabolic dysregulation is predictive of future diabetes risk in women. Methods: We conducted a nested case-control study of plasma metabolomics and diabetes risk in the Nurses’ Health Study, including 728 women (mean age: 55.2 years) with incident diabetes and 728 controls matched on age, race, fasting status, and time/date of blood collection. Blood samples were collected between 1989-1990 and incident diabetes was diagnosed between 1990-2012. Based on the metabolomic signature of chronic psychological distress we previously identified and validated in women (including coefficient estimates for individual metabolite associations), we calculated a weighted plasma metabolomic score of psychological distress comprised of 19 metabolites (e.g., serotonin, threonine, hippurate, biliverdin, glutamine, etc.). We used conditional logistic regression accounting for matching factors and other diabetes risk factors to estimate odds ratios (OR) and 95% CI for diabetes risk across quintiles of the distress-related metabolite score. Results: After adjusting for sociodemographic factors, family history of diabetes and health behaviors, the OR (95% CI) for diabetes risk across quintiles of the distress-related metabolite score was 1.00 (reference) for Q1, 1.11 (0.77, 1.61) for Q2, 1.64 (1.14, 2.35) for Q3, 2.07 (1.42, 3.01) for Q4, and 2.35 (1.60, 3.47) for Q5. Each 1-unit increase in the score was associated with 26% higher diabetes risk (95% CI: 1.15, 1.38; p-trend&lt;0.0001). This association was moderately attenuated after additional adjustment for baseline body mass index (OR per 1-unit increase: 1.13; 95% CI: 1.02, 1.25; p-trend=0.02). Further, psychological distress assessed via self-report (defined as presence of depression or anxiety) was associated with modestly increased diabetes risk in the same sample (OR: 1.25; 95% CI: 1.01, 1.55). The metabolite score mediated 20.7% (95% CI: 5.1, 56.1) of the association between psychological distress and diabetes risk (p=0.0065). Conclusions: Our results suggest that the distress-related metabolite score was significantly associated with diabetes risk in women and partly mediated the association between self-reported psychological distress and diabetes risk. These findings provide supporting evidence that metabolic dysregulation may be an important mechanism underlying the observed association between psychological distress and diabetes risk.

Middle School Psychological Distress and Sexual Harassment Victimization as Predictors of Dating Violence Involvement.

Adolescent sexual harassment victimization is increasingly recognized as a strong risk factor for dating violence victimization and perpetration. Research on this association has focused on older adolescents and on sexual harassment at a single time point rather than chronic exposure. Furthermore, potential mechanisms, such as psychological distress, are not well understood. The goals of this study were to identify whether sexual harassment victimization and psychological distress were reciprocally related, whether chronic psychological distress and sexual harassment victimization in early adolescence were associated with higher levels of dating violence involvement measured in mid-adolescence, and whether these relationships differed between boys and girls. We used longitudinal data from 4,718 US middle school students to fit regression models for the associations between sexual harassment victimization and psychological distress. We then used data from a subset of 1,279 students followed up in high school to fit marginal structural models for sixth- to eighth-grade psychological distress and sexual harassment victimization as predictors of dating violence involvement measured in ninth grade. We found that (1) sexual harassment victimization was positively, concurrently associated with psychological distress, with a stronger association among girls than boys; (2) psychological distress was positively, prospectively associated with sexual harassment victimization among girls but not boys; (3) chronic sixth- to eighth-grade psychological distress was not significantly associated with dating violence victimization or perpetration measured in ninth grade; and (4) chronic sixth- to eighth-grade sexual harassment victimization was associated with significantly higher levels of dating violence victimization and perpetration measured in ninth grade. The results support a reciprocal relationship between distress and sexual harassment victimization for early adolescent girls, and they call for further attention to gender differences in the content and impact of sexual harassment. Furthermore, the findings indicate that preventing sexual harassment in early adolescence may be critical in reducing dating violence.

Chronic pain, psychological distress, and quality of life in males with Duchenne muscular dystrophy.

To describe chronic pain in Duchenne muscular dystrophy (DMD) from children's/adolescents' perspectives, explore patient variables associated with self-reported pain, and examine the relationship between chronic pain, psychological functioning, and health-related quality of life (HRQoL). This observational study included a paediatric cohort (aged 8-18 years; median age 9 years 4 months) with DMD under multidisciplinary care (n=45). Clinical data of the latest visit were extracted from the electronic health record and assessment of pain, psychological distress, and HRQoL were performed during the same visit. Thirty-two patients reported pain during the previous 4 weeks, and 18 reported persistent or recurrent chronic pain. Average pain intensity of chronic pain was mild, with regions of the legs (n=12), lower back (n=6), hips (n=6), and shoulder (n=6) most frequently affected. Older age, higher body mass index, being non-ambulatory, wheelchair dependency, and spinal deformities were contextual variables related to the presence of chronic pain. Furthermore, chronic pain was significantly associated with psychological distress and reduced HRQoL in paediatric patients with DMD. Chronic pain in paediatric DMD is frequent and widespread, highlighting the need for pain to be addressed in the routine care of affected young people. Chronic pain may make a significant contribution to psychological distress and impaired HRQoL in paediatric patients with DMD. Chronic pain differs in aetiology, scope, and nature compared with acute pain in paediatric Duchenne muscular dystrophy (DMD). Older age, higher body mass index, being non-ambulatory, wheelchair dependency, and spinal deformities are important patient variables. Chronic pain is significantly associated with psychological distress and reduced health-related quality of life in paediatric DMD.

It's made a really hard situation even more difficult: The impact of COVID-19 on families of children with chronic illness.

For over two years, the global COVID-19 pandemic has forced major transformations on health, social, and educational systems, with concomitant impacts on mental health. This study aimed to understand the unique and additional challenges faced by children with chronic illness and their families during the COVID-19 era. Parents of children receiving treatment for a chronic illness within the neurology, cancer, renal and respiratory clinics of Sydney Children's Hospital were invited to participate. We used qualitative methodology, including a semi-structured interview guide, verbatim transcription, and thematic analysis supported by QSR NVivo. Thirteen parents of children receiving tertiary-level care, for nine chronic illnesses, participated. Parents reported intense fears relating to their ill child's additional vulnerabilities, which included their risk of developing severe COVID-19 disease and the potential impact of COVID-19-related disruptions to accessing clinical care, medications, allied health support and daily care protocols should their parent contract COVID-19. Parents perceived telehealth as a highly convenient and preferred method for ongoing management of less complex healthcare needs. Parents reported that the accrual of additional stressors and responsibilities during the pandemic, experienced in combination with restricted social interaction and reduced access to usual support networks was detrimental to their own mental health. Hospital-based visitation restrictions reduced emotional support, coping, and resilience for both parents and children and in some cases led to marital discord, sibling distress, and financial loss. Supportive factors included increased time spent together at home during the pandemic and improved hygiene practices at school, which dramatically reduced the incidence of non-COVID-19-related communicable illnesses in chronically ill children. For families caring for a chronically ill child, COVID-19 made a difficult situation harder. The pandemic has highlighted the need for targeted psychosocial intervention for vulnerable families, to mitigate current mental health burden and prevent chronic psychological distress.

Association Between COPD Symptoms and Psychological Distress Among Farmers.

Farmers have an increased risk of developing chronic obstructive pulmonary disease (COPD) and psychological distress. The potential role of psychological distress in worsening COPD symptoms has been reported among the general population, but no studies have examined this relationship among farmers with COPD, which is the purpose of this study. This study used the data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). Farmers reporting both psychological distress and COPD symptoms were included in this study (n = 239). Both unadjusted and adjusted logistic regressions were used to explore the association among psychological distress, age, health status, smoking, and COPD symptoms, with crude and adjusted odds ratio (OR) and 95% CIs reported. The unadjusted analysis suggested that COPD symptoms were significantly associated with psychological distress among farmers (OR = 2.05 [1.18, 3.58]). While adjusted models showed the significant association between COPD symptoms and psychological distress among farmers after controlling for smoking, age, and health status (adjusted OR = 2.08 [1.10, 4.01]). These results suggest that psychological distress is associated with an increased risk of COPD symptoms in farmers, which is consistent with observations from studies in non-farmers. Occupational health professionals need to provide screen for COPD among farmers as well as psychological distress screening and mental health promotion among farmers with COPD.

Clinical MRI morphological analysis of functional seizures compared to seizure-naïve and psychiatric controls

PurposeFunctional seizures (FS), also known as psychogenic nonepileptic seizures (PNES), are physical manifestations of acute or chronic psychological distress. Functional and structural neuroimaging have identified objective signs of this disorder. We evaluated whether magnetic resonance imaging (MRI) morphometry differed between patients with FS and clinically relevant comparison populations. MethodsQuality-screened clinical-grade MRIs were acquired from 666 patients from 2006 to 2020. Morphometric features were quantified with FreeSurfer v6. Mixed-effects linear regression compared the volume, thickness, and surface area within 201 regions-of-interest for 90 patients with FS, compared to seizure-naïve patients with depression (n = 243), anxiety (n = 68), and obsessive–compulsive disorder (OCD, n = 41), respectively, and to other seizure-naïve controls with similar quality MRIs, accounting for the influence of multiple confounds including depression and anxiety based on chart review. These comparison populations were obtained through review of clinical records plus research studies obtained on similar scanners. ResultsAfter Bonferroni–Holm correction, patients with FS compared with seizure-naïve controls exhibited thinner bilateral superior temporal cortex (left 0.053 mm, p = 0.014; right 0.071 mm, p = 0.00006), thicker left lateral occipital cortex (0.052 mm, p = 0.0035), and greater left cerebellar white-matter volume (1085 mm3, p = 0.0065). These findings were not accounted for by lower MRI quality in patients with FS. ConclusionsThese results reinforce prior indications of structural neuroimaging correlates of FS and, in particular, distinguish brain morphology in FS from that in depression, anxiety, and OCD. Future work may entail comparisons with other psychiatric disorders including bipolar and schizophrenia, as well as exploration of brain structural heterogeneity within FS.

Could the complying with WHO physical activity recommendations improve stress, burnout syndrome, and resilience? A cross-sectional study with physical education teachers

PurposeTeachers are exposed to inherent psychosocial risks in the workplace such as chronic stress, psychological distress, exhaustion, and burnout syndrome. To compare the values in psychosocial variables based on compliance with the recommendations for physical activity by the World Health Organization (WHO) and the type of physical activity performed.MethodsThe study had a non-experimental and comparative design, with measurements in a single group. The sample was composed of 415 physical education teachers from Spain, with an age range of 21–53 years (28.78 ± 6.15) and a heterogeneous distribution of gender (69.4% male; 30.6% women). The Perceived Stress Scale, the Maslach Burnout Inventory, the Connor–Davidson Resilience Scale, and an Ad-Hoc questionnaire were used to record the sociodemographic aspects and physical-sports practice.ResultsMost of the teachers complied with the recommendations for physical activity practice (n = 335; 80.7%). Physical activity was associated with lower signs of burnout and a greater ability to overcome. Although, teachers who did not comply with WHO recommendations, showed greater stress and emotional exhaustion. In conclusion, enough practice of physical activity based on WHO was shown as a preventive factor of stress and signs of burnout.ConclusionsThe findings suggest that perform physical activity based on the WHO recommendations helps for work stress prevention and burnout syndrome in teachers, as well as to overcome work adversities.

Shared Decision-Making Among Adolescent and Young Adult Cancer Survivors and Noncancer Adults: Associated Medical Expenditures and Health Care Utilization.

Purpose: Engagement of patients in their care can lead to better health outcomes, especially for adolescent and young adult (AYA) cancer survivors who experience mental and physical illnesses more often than noncancer adults. We examined how patient engagement in care influences health care expenses and use. Methods: AYA cancer survivors (n = 1162) and a comparison group of matched adults with no history of cancer (n = 2954) were identified from the 2011 to 2016 Medical Expenditure Panel Survey (MEPS) data. Medical expenditures and health care utilization associated with shared decision-making (SDM) measured by a self-administered questionnaire adapted from the Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CAHPS-CG) survey were evaluated using multivariable regression models. Results: AYA cancer survivors were more likely to report poor SDM compared with adults with no history of cancer (odds ratio = 1.31, 95% confidence interval [CI]): 1.06 to 1.62). AYA cancer survivors with poor SDM were more likely to report poor mental and physical health compared with AYAs with good SDM. AYA cancer survivors with poor SDM had $3037 (CI: $110 to $7032) in additional annual medical expenses and 4.86 (CI: 2.00 to 8.52) in additional office visits compared with AYA cancer survivors with optimal SDM, even after adjusting for chronic conditions and psychological distress. Conclusion: Our results highlight the substantial economic burden associated with poor SDM in AYA cancer survivors. Our research suggests that interventions to improve SDM in AYA cancer survivors may contribute to patients' positive perception of their health and result in AYAs seeking fewer medical services resulting in lower medical expenses.

Ms. Noemi Monika Szeifert

IntroductionWorking in COVID – 19 Health Care Units – Psychological impacts (PTSD, Depression, Anxiety Disorders) Working in the frontline during COVID-19 has put under extreme psychological and physical pressure the health care workers. The severe psychological symptomps can emerge on short, mid and long term as well. Our research is focusing on the psychological impacts of front line health care workers.Objectives In our lecture, we summarize our reserach made in the National Traumatology Center, Budapest, Hungary among health care workers who worked in the front and in the second line during the most severe period of the pandemic in Hungary, and discuss probable risk factors for PTSD and chronic psychological distress related to COVID-19. Furthermore we make an overview on the most frequently used coping skills for dealing with the psychological stress caused by the pandemic among the health care workers. The sample taking was processed in July 2021, after 3 month the 3rd COVID – 19 wave officially ended in Hungary.Methods 123 health care workers completed the online survey anonimously, included Beck Depression Inventory, Spielberger Anxiety State Inventory, PTSD Checklist, Lazarus Coping Scale.Results23% of HCW reported symptomps of depression, nearly 25% dealing with sleeping disorders and 38% with chronic fatigue, 42,50 % HCW suffering from anxiety disorders, 22% HCW experiencing symptomps of PTSD.ConclusionsWith our results we would like to raise awareness of the challenges and severe psychological consequences that these colleagues, our national heroes we can say, are facing after working in COVID-19 Health Care Units.DisclosureNo significant relationships.