Depressive Reactions Research Articles

Personality and vocational interest typologies associated with better coping and resilience in paramedicine: A review of two models

Paramedics’ continued exposure to work-related stressors can negatively impact emotional wellbeing. Having or developing resilience contributes to better coping. Understanding differences in individual predispositions as they relate to resilience and coping can provide a needed understanding of why some people flourish while others are more at risk, with important implications for identifying and facilitating bespoke support for paramedics more at risk. The purpose of this article then is firstly to review two of the main well-validated models of innate dispositions in differential psychology, widely used in organisational and industrial psychology: personality and vocational interests. These are The Big-Five/Five-Factor Model and Holland's RIASEC. Then, we report which dispositions are an advantage for paramedic coping and resilience. Concerning personality, our findings from the literature suggest that for paramedics, lower levels of Neuroticism and Openness, and higher levels of Extraversion, Agreeableness and Conscientiousness are associated with higher resilience and better coping. RIASEC associations suggest person-environment congruence is also related to resilience and coping, this being for those with the profession's predominant Holland code of RSI (Realist, Social and Investigative inclinations). Paramedics approximating these preferences are, it appears, innately relatively less at risk of the negative effects associated with occupational stressors in paramedicine. Stressors typically include post-traumatic stress disorder, major depression and other psychological reactions that all can result in suicide. Importantly, such resilience does not mean an individual is instinctively protected from some form of emotional suffering. The implications of verifying the significance of predispositions implies the need to harness organisational psychology as part of training courses, and the need for involvement of psychologists in the field, both preventatively and in clinical care.

Depressive symptoms in Parkinson’s disease are insufficiently but more often treated than in other chronic conditions

Depressive symptoms in Parkinson’s disease (PD) are multifactorial and are partly linked to the underlying dopaminergic deficit. However, at least a subset of PD patients may exhibit an unspecific depressive reaction to chronic illness. Here, we compared the prevalence and severity of depressive symptoms in PD patients and disease controls (DC). PD patients reported depressive symptoms at similar frequencies as DC but were on antidepressants, especially Mirtazapine, more frequently. Still, in both groups, a high proportion of patients with clinically significant depressive symptoms was not receiving medication. Diagnosis and treatment of depressive symptoms both in PD and DC should be improved.

The need for longitudinal data on the value of fertility treatment for infertile patients' quality of life: A review and pilot study.

Infertility threatens the life goal of parenthood and, hence, quality of life (QoL) of (wo)men, but the fertility clinic trajectory might be burdensome. This review of longitudinal studies and pilot longitudinal study examines the impact of the pre-invitro fertilization (IVF) fertility clinic trajectory on patient-reported outcome measures (PROMs) for emotional well-being, including QoL. A publication found that the diagnostic workup decreases men's infertility-specific distress while publications disagree whether it decreases (wo)men's anxious and depressive reactions. Intrauterine insemination (IUI) was found to increase (wo)men's depressive reactions. Publications on infertility-specific, health-related, and overall QoL were missing. The pilot indicated that (wo)men's overall QoL is not affected by the diagnostic workup but is decreased by the time of the third IUI. Longitudinal studies on the impact of starting the fertility clinic trajectory on PROMs are needed as they are essential for patient-centered clinical decision-making and patient-centered policy-level decision-making.

Nickel-phytic acid hybrid for highly efficient electrocatalytic upgrading of HMF.

Electrocatalytic upgrading of 5-hydroxymethylfurfural (HMF) provides a promising way to obtain both high-value-added biomass-derived chemicals and clean energy. However, development of efficient electrocatalysts for oxidizing HMF with depressed side reactions remains a challenge. Herein, we report a nickel-phytic acid hybrid (Ni-PA) using natural phytic acid as building block for highly efficient electrocatalytic oxidation of HMF to 2, 5-furandicarboxylic acid (FDCA). Due to the coordination of nickel ion and phosphate groups of phytic acid molecule, high selectivity and yield of FDCA were achieved at 1.6V vs. RHE. Besides, Ni-PA has a higher electrochemical surface area and lower charge-transfer resistance than Cu/Fe-PA, which significantly promotes the oxidation of HMF to FDCA. This work demonstrates the potential of metal-phytic acid hybrids as effective electrocatalysts for biomass valorization.

Pregnancy in a Young Patient with Metastatic HER2-Positive Breast Cancer—Between Fear of Recurrence and Desire to Procreate

Breast cancer is the most frequent neoplasm among women and the second leading cause of death by cancer. It is the most frequent cancer diagnosed during pregnancy. Pregnancy-associated breast cancer is defined as breast cancer that is diagnosed during pregnancy and/or in the postpartum period. Data about young women with metastatic HER2-positive cancer who desire a pregnancy are scarce. The medical attitude in these clinical situations is difficult and nonstandardized. We present the case of a 31-year-old premenopausal woman diagnosed in December 2016 with a stage IV Luminal HER2-positive metastatic breast cancer (pT2 N0 M1 hep). The patient was initially treated by surgery in a conservative manner. Postoperatively, the presence of liver metastases was found by CT investigation. Consequently, line I treatment (docetaxel l75 mg/m² iv; trastuzumab 600 mg/5 mL sq) and ovarian drug suppression (Goserelin 3.6 mg sq at 28 days) was administered. After nine cycles of treatment, the patient's liver metastases had a partial response to the therapy. Despite having a favorable disease evolution and a strong desire to procreate, the patient vehemently refused to continue any oncological treatment. The psychiatric consult highlighted an anxious and depressive reaction for which individual and couple psychotherapy sessions were recommended. After 10 months from the interruption of the oncological treatment, the patient appeared with an evolving pregnancy of 15 weeks. An abdominal ultrasound revealed the presence of multiple liver metastases. Knowing all the possible effects, the patient consciously decided to postpone the proposed second-line treatment. In August 2018, the patient was admitted in the emergency department with malaise, diffuse abdominal pain and hepatic failure. Abdominal ultrasound found a 21-week-old pregnancy which had stopped in evolution, multiple liver metastases and ascites in large quantity. She was transferred to the ICU department where she perished just a few hours later. Conclusions/Discussion: From a psychological standpoint, the patient had an emotional hardship to make the transition from the status of a healthy person to the status of a sick person. Consequently, she entered a process of emotional protection of the positive cognitive distortion type, which favored the decision to abandon treatment and try to complete the pregnancy to the detriment of her own survival. The patient delayed the initiation of oncological treatment in pregnancy until it was too late. The consequence of this delay in treatment led to the death of the mother and fetus. A multidisciplinary team worked to provide this patient with the best medical care and psychological assistance throughout the course of the disease.

Suicidal behavior as a result of maladjustment of servicemen to the conditions of military service in Ukraine

Introduction and aim. The purpose of the article is to analyze the peculiarities of suicidal behavior as a result of maladjustment of servicemen to the conditions of military service in Ukraine. The tasks of the article are to identify among militaries: 1) the most significant risk factors for autoregressive and suicidal behavior; 2) the psychological peculiarities of adaptive disorders that may lead to suicide; 3) protective factors against autoregressive and suicidal behavior. Material and methods. To solve the problem of our research, a set of methods was used: theoretical methods – theoretical and methodological analysis of scientific sources, their systematization, classification, generalization; empirical methods – the observation, the interview, a questionnaire, testing, the method of expert assessments. In general 420 militaries were participated in our research. The participants of the 1 st stage of the study were 240 militaries in the age 18-25 years old with suicidal and auto-aggressive behavior in anamnesis and one or more attempts of suicide. These militaries were treated in the psychiatric hospital No 1 in Kyiv (Ukraine). At the 2 nd stage of the study 180 militaries were participated. They were treated in the Main Military Clinical Hospital (the Center), Kyiv, Ukraine. The research was organized during May–November, 2021. Results. We investigated that 120 militaries had various forms of post-suicidal encephalopathy, such as acute affective, non-psychotic state. The number of patients with residual psychoorganic pathology was 41 people (34.16%); after poisoning there were 37 people, the number of patients with toxic encephalopathy – 33 people (27.5%); after self-arson – 9 people, there were 4 patients (3.33%) with burn encephalopathy. We identified the following clinical variants of depressive reactions as a result of maladjustment and suicidal attempts: 1) the reaction of disadaptation in combination with neurosis-like disorders (48.9%); 2) the reaction of maladjustment including hypochondriacal inclusions (in 23.4% of cases of respondents); 3) maladaptive reactions with an anxious component were observed in 28.6% of cases. Conclusion. It was shown that the suicidal behavior of soldiers depended on many external and internal risk factors. We showed protective factors against autoregressive and suicidal behavior.

Acute depressive reaction as a consequence of war trauma exposure: a case report of a Ukrainian refugee.

We hereby report a case of a young Ukrainian woman refugee who immigrated in Italy after the war outbreak in February 2022. The researcher arrived in Italy in March 2022, thanks to a scholarship of the University of L'Aquila. Shortly after settling in L'Aquila, she started to manifest depressive symptoms, which eventually led her to seek psychological and pharmacological help in the local psychiatric unit. In April 2022, she accessed twice in a week to the emergency department of the "San Salvatore" Hospital of L'Aquila. The second time she presented an acute anxiety attack accompanied by psychomotor disturbances (negativism, mutism) that eventually required admission to the local psychiatric ward (Servizio Psichiatrico di Diagnosi e Cura - SPDC) with the aim of managing the clinical presentation from a pharmacological and psychotherapeutic perspective. The patient submitted a series of validated scales in her own language. After 13 days of hospitalization, the patient was discharged with a diagnosis of "Acute Depressive Disorder, mild severity", according to PHQ-9, and referred to psychiatric services with a dedicated program. The present report aims to underline the need to take into consideration the possibility of developing depressive symptoms and reactions among Ukrainian war refugees and, in light of this evidence, the importance of a cross-country shared program when addressing the mental health of all refugees.

Comparative characteristics of indicators of the psychophysiological state of emergency staff and icu departments

At present, there is a tendency towards an increase in emotional problems everywhere, this especially affects the working-age population – relationships in a team, professional work process – all this leads to the development of production-related stress. Health care workers are at the forefront of risk of developing stress reactions and its consequences. This is most pronounced in the specialties providing emergency medical care, among employees of ambulance teams and departments of anesthesiology and resuscitation.The aim of the study was to conduct a comparative analysis of the psychophysiological state of emergency medical staff and departments of anesthesiology and resuscitation.Materials and methods. The study involved 67 people – employees of ambulance teams and resuscitation and intensive care units in Saratov. To obtain the necessary data, all participants filled out questionnaires – the PSM-25 psychological stress scale, the HADS hospital anxiety and depression scale, and the symptomatic questionnaire by A. Volkova and N. Vodopyanova.Results. When questioned using the PSM-25 scale, which assesses mental tension, it was found that more than half of the respondents have a high level of stress, while the indicator of mental tension among ambulance workers is statistically significantly higher than among employees of intensive care units and intensive care units. An analysis of the HADS ques tionnaire showed that the vast majority of respondents, both in ambulance teams and in intensive care units, have a high level of anxiety and depression. In the study using the symptomatic questionnaire A. Volkova and N. Vodopyanova noted a high predisposition to the development of pathological stress reactions in most of the respondents.Conclusion. Doctors in the specialties we study are characterized by long-term chronic stress, which can lead to the development of anxiety, depression, and pathological stress reactions. To avoid the occurrence of the conditions described above, it is important to adjust the work schedule of employees in time, to observe occupational and rest hygiene.

Sufentanil combined with nalmefene reduce the adverse events in recovery period of patients undergoing uvulopalatopharyngoplasty – A randomized controlled trial

Background: The opioid receptors related to analgesia are mainly μ recipient, the μ receptor has a two-way mode of action: manifested by opioid analgesics and μ1 Receptor binding produces the desired analgesic effect, and μ2 Receptor binding may cause respiratory depression, nausea and vomiting and other adverse reactions. Nalmefene is an opioid receptor antagonist. Low dose Nalmefene has priority over μ2 Receptor binding makes opioid analgesics turn more to μ1 receptor binding, which is reversed μ2 Receptor mediated nausea, vomiting, respiratory depression and other adverse reactions, but does not reverse the analgesic effect. We assume that sufentanil combined with nalmefene could reduce respiratory adverse events in the patients who underwent uvulopalatopharyngoplasty during recovery.Methods: Patients with UPPP under general anesthesia were selected, and divided into control group (group C) and nalmefene group (group N) randomly. Patients in group N received sufentanil 0.1 μg/kg and nalmefene hydrochloride 0.25μg/kg at the end of the operation. Additionally, patients in group C received sufentanil 0.1 μg/kg at the end of the operation. The heart rate (HR) and mean arterial pressure (MAP) were observed and recorded before operation, immediately after extubation, and 5 min after extubation. The breathing recovery time, tracheal extubation time, consciousness score (Ramsay score、sedation-agitation scale (SAS)) and visual analog score (VAS) were carefully recorded at 5 min after extubation, and the various adverse reactions were monitored during the recovery period.Results: Ninety-six patients were finished our study finally. The breathing recovery and extubation time of group N was significantly shorter than those of group C (P < 0.05). The Ramsay score after extubation in group N was significantly lower as compared to that in group C (P < 0.05). The sedation-agitation scale of group N was observed to be significantly higher than that of group C (P < 0.05). Moreover, the incidences of respiratory depression, nausea and vomiting during the recovery period was significantly less than those in group C (P < 0.05).Conclusion: Nalmefene combined with sufentanil can significantly reduce adverse reactions in the cases of patients after UPPP, which may be beneficial to improve the quality and safety of emergence after general anesthesia.

Real-Time Prediction of Medical Demand and Mental Health Status in Ukraine under Russian Invasion Using Tweet Analysis.

Russia's invasion of Ukraine (February 24, 2022) has begun and there are concerns about the impact on health care supply and mental health. This study analyzed tweets in the Ukrainian language to capture the medical needs and mental health conditions in wartime Ukraine by focusing on ostensibly relevant words. The number of tweets containing the keywords and their overall proportion was compared before and after the Russian invasion of Ukraine. The survey period was divided into four phases-the pre-2022 Russian invasion, acute phase (4 weeks), subacute phase (12 weeks), and the chronic phase (8 weeks) up to August 10, 2022. The analysis targeted tweets sent in Ukrainian. The tweets were screened using a set of six classes with 75 key groups and 303 Ukrainian (204 original Japanese) keywords. Overall, 98,526,440 tweets were analyzed, with a pre-invasion and post-onset average of 1,096,976 and 3,328,243 tweets/week (a 3.0-fold increase), respectively. Of these, 3,197,443 tweets contained the keywords, with a pre-invasion and invasion average of 26,241 and 114,640 tweets/week (a 4.4-fold increase), respectively. The post-onset phase witnessed a considerable increase in all classes-medical services, treatment, medical resources, medical situations, and special situations-but not in the symptom class. Keywords related to psychological distress and anxiety immediately increased during the acute phase; those related to depression and post-traumatic stress reactions continued increasing as the invasion persisted, which may have reflected the mental state of those impacted. Analyzing tweets is useful for predicting people's real-time physical and mental health needs during wartime.

Mentalno zdravlje studentske populacije tokom pandemije COVID-19

In 2019, the world public was confronted with the disease Coronavirus Disease 2019 (COVID-19) for the first time, when the new Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) was identified in the Chinese city of Wuhan. The pandemic of this viral infection has led to the biggest public health crisis at the global level in the last hundred years, while a special challenge has been set for professionals dealing with mental health protection. Students were also particularly affected due to the movement restriction measures caused by the closure of higher education institutions. The disease COVID-19 is a systemic disease with pronounced problems of a respiratory nature, and SARS-CoV-2 is a virus from the family of RNA viruses. The incubation period of the viral infection is between two and fourteen days, and transmission by aerosol, respiratory droplets, and direct contact is very easy and fast. The most common symptom of this disease is fever. The COVID-19 disease pandemic had a negative effect on the mental health of the student population around the world, and female students rated their mental health worse than male students. The main problems with mental health can be classified above all the increased levels of depression, anxiety, and stress in response to the COVID-19 pandemic. Depression is more common in students who care more about their health, in female students, and those with a lower socio-economic status. Also, persons who were, at some point, in contact with infected persons, without knowing about their illness, have more serious depressive reactions compared to those who haven't had such contact. Regarding anxiety reactions, students at the beginning of their studies experience anxiety reactions more often and those reactions are more intense compared to students in the last years of studies. The student population also showed high levels of stress reactions, which occur more often in female students, as well as in those students who come from urban areas. However, mental health problems can be overcome if the student population is provided with some form of social support or peer or expert consultation, depending on how much their mental health is impaired. The aim of this paper is to present the mental health of the student population around the world based on a review of the literature on the COVID-19 disease pandemic and to offer recommendations to reduce and prevent such reactions.

An impact of the COVID-19 pandemia on the onset and course of mental disorders in elderly

To study the impact of COVID-19 on the onset and course of mental disorders in hospitalized elderly patients. We studied 67 inpatients, aged 50 to 95 years, with various mental illnesses in accordance with the ICD-10 criteria, who underwent COVID-19 from February 2020 to December 2021. Forty-six people were previously mentally ill, in 21 cases the disease developed for the first time. The group of primary diseased patients was dominated by depressive episodes (F32, (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability (F06.6), organic depression (F06.3), mild cognitive impairment (F06.7) and delirium (F05.86). In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions (F43), panic (F41.0) and generalized anxiety disorder (F41.1). In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia (F23.1) was diagnosed. The diagnoses of the previously mentally ill group were: affective disorders (F31, F32, F33 - 45.7%); organic disorders, including dementia (F06.3, F06.7, F00.1, F00.2 - 26.1%); schizophrenia spectrum disorders (F25, F21, F22, F20.01 - 19.6%), and neurotic somatoform disorders (F45 - 8.7%). In the acute and subacute periods of COVID-19 (≤3 months), acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in mentally ill patients with organic (50%) and schizophrenia spectrum (33.3%) disorders with a predominance of delirium. In the long-term period of COVID-19, mentally ill patients more often than primary diseased patients (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenic (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p<0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p<0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916). The age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The mentally ill, especially those of the organic and schizophrenia spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, affective and neurotic patients, CI was reversible or had the character of a mild cognitive disorder.

Why Does Grief Hurt?

Abstract. Grief is a major physical and psychological health concern for adults, as well as a key risk factor for depression. The direct and indirect costs of depression in adults place heavy burdens on societal resources. Indeed, bereavement is a stressful and profound life experience, with the grieving process combining reactions to a loss that may originate in complications for bereaved individuals. The goal of this systematic review is to synthesize the findings regarding depression and grief. Studies related to the topic were obtained from multiple databases through rigorous exclusion and inclusion criteria. Only empirical studies with quantitative methodologies were included. Objectives, sample (type of sample, % male, and age), instruments, and main conclusions were extracted from each study. Overall, there are personality and contextual factors that, in addition to affecting depressive reactions following a loss, may also interface with one’s ability to grieve. Furthermore, after the patient’s death, there was a decrease in depressive symptoms over time, indicating that these symptoms are dynamic. Individuals who experience prolonged grief exhibit depressive symptoms, and those who suffer a loss may have depressive symptoms, but in a natural and non-pathological way, that is, sadness and not depression. Depression tends to decrease over time, with the existence of more children and a focus on occupation.

The APSY-SED study: protocol of an observational, longitudinal, mixed methods and multicenter study exploring the psychological adjustment of relatives and healthcare providers of patients with cancer with continuous deep sedation until death

BackgroundSince 2016, France is the only country in the World where continuous deep sedation until death (CDSUD) is regulated by law. CDSUD serves as a response to refractory suffering in palliative situations where the patients’ death is expected to occur in the following hours or days. Little is known on the psychological adjustment surrounding a CDSUD procedure for healthcare providers (HCPs) and relatives. Our study aims to gather qualitative and quantitative data on the specific processes behind the psychological adjustment of both relatives and HCPs, after the administration of CDSUD for patients with cancer.MethodsThe APSY-SED study is a prospective, longitudinal, mixed-methods and multicenter study. Recruitment will involve any French-speaking adult cancer patient for who a CDSUD is discussed, their relatives and HCPs. We plan to include 150 patients, 150 relatives, and 50 HCPs. The evaluation criteria of this research are: 1/ Primary criterion: Psychological adjustment of relatives and HCPs 6 and 13 months after the death of the patient with cancer (psychological adjustment = intensity of anxiety, depression and grief reactions, CDSUD-related distress, job satisfaction, Professional Stress and Professional experience). Secondary criteria: a)occurrence of wish for a CDSUD in patients in palliative phase; b)occurrence of wish for hastened death in patients in palliative phase; c)potential predictors of adjustment assessed after the discussion concerning CDSUD as an option and before the setting of the CDSUD; d) Thematic analysis and narrative account of meaning-making process concerning the grief experience.DiscussionThe APSY-SED study will be the first to investigate the psychological adjustment of HCPs and relatives in the context of a CDSUD procedure implemented according to French law. Gathering data on the grief process for relatives can help understand bereavement after CDSUD, and participate in the elaboration of specific tailored interventions to support HCPs and relatives. Empirical findings on CDSUD among patients with cancer in France could be compared with existing data in other countries and with results related to other medical fields where CDSUD is also conducted.Trial registrationThis protocol received the National Registration Number: ID-RCB2021-A03042-39 on 14/12/2021.

A Narrative Review of the History of Burn-Related Depression and Stress Reactions.

While the roots of burn care date back several millennia, recognition and treatment of psychiatric trauma has had a more contemporary journey. Our understanding of burn care has evolved largely separately from our understanding of psychiatry; however, proper care of the burn patient relies on the comprehension of both disciplines. Historically, high burn mortality rates have caused clinicians to focus on the physiological causes of burn mortality. As burn care improved in the 20th century, providers began to focus on the long-term health outcomes of burn patients, including mitigating mental health consequences of trauma. This shift coincided with advances in our understanding of psychological sequelae of trauma. Subsequently, an association between burn trauma and mental illness began to emerge. The current standard of care is the result of thousands of years of evolving practices and theories, yet our understanding of the pathophysiology of depression among survivors of severe burn injury is far from complete. By taking measure of the past, we aim to provide context and evidence for our current standards and emphasize areas for future lines of research.

Hypoactive Sexual Desire Due to Mental and Neurological Disorders

The article presents data on hypoactive sexual desire which occurs in neurotic and stress-related disorders (neurasthenia, anxiety-phobic and obsessive-compulsive disorders, including the syndrome of anxious expectation of sexual failure, dissociative disorders, adaptation disorders [prolonged depressive reaction, anxiety-depressive reaction]). In particular, characterizing sexual disorders in patients with neurasthenia, one group of authors believes that these disorders differ depending on the form of this disease (hypersthenic, hyposthenic). In their opinion, in the hypersthenic form increased excitability of the sexual sphere is observed which can lead to the appearance of various sexual disorders, including increased libido. In the hyposthenic form of neurasthenia, according to this group of authors, various hypoactive sexual manifestations can be noted, including a decrease in libido, and in addition, premature ejaculation. Another group of researchers found in patients with neurasthenia, regardless of its form, only hypofunctional sexological manifestations, as well as premature ejaculation (that is, those symptoms that were named by the first group of authors as characteristic of the hyposthenic form of neurasthenia). The article also presents data on hypoactive sexual desire which can be observed in personality disorders and character accentuations (schizoid personality disorder and character schizoid accentuation, accentuations of the cycloid, asthenoneurotic, hysteroid, unstable, psychasthenic, sensitive and infantile-dependent types); mood disorders [affective disorders] (dysthymia [depressive neurosis], bipolar disorder); schizophrenia; mental retardations; dementia due to organic brain damages; epilepsy; organic brain damages; multiple sclerosis. Clinical observations are given; these concern hypoactive sexual desire in patients with schizophrenia and organic brain damage.

The impact of the COVID-19 epidemic on students' mental health: A cross-sectional study.

The COVID-19 pandemic is currently one of the biggest public health threats for people's mental health. A particularly endangered group were students, who became highly affected by measures of social distance due to their active lifestyle. Therefore, the aim of this paper is to assess the level of self-reported stress, anxiety and depression of the student population in Serbia, in relation to demographic characteristics, living and studying conditions, students' activities during the epidemic, potential coronavirus infection and general, mental and physical health. We conducted a cross-sectional study of 580 undergraduate medical students from the University of Belgrade during the 2020/2021 school year. Mental health data were collected using the Depression Anxiety Stress Scales (DASS-21). Both bivariate and multivariate logistic regression analysis were used to examine the association between independent variables with the dependent variable mental health. Women made up the majority of the sample with 80.3%. A total of 64.5%, 66.8% and 66.7% of students between the ages of 21 and 30 had severe depressive symptoms, severe degree of anxiety, and a severe degree of stress, respectively. Women almost twice as often (OR = 1.89) assessed their anxiety as severe and almost two and a half times more (OR = 2.39) perceived stress as severe compared to men. Students who lived with their families during studies two and a half times (OR = 2.57) more often assessed their stress as severe, compared to students who lived alone. Fifth- and sixth-year students were less likely to rate depression and anxiety as serious than the first-year students. Medical students reported their health as severely impaired in terms of depression, anxiety and stress reactions. The results indicate the need to launch a mental health program in the form of counseling and emotional support to students affected by the pandemic.

Dynorphin promotes stress-induced depressive behaviors by inhibiting ventral pallidal neurons in rats.

Endogenous dynorphin signaling via kappa opioid receptors (KORs) plays a key role in producing the depressive and aversive consequences of stress. We investigated the behavioral effects of the dynorphin/KOR system in the ventral pallidum (VP) and studied the underlying mechanisms. To investigate the effects of dynorphin on the VP, we conducted behavioral experiments after microinjection of drugs or shRNA and brain-slice electrophysiological recordings. Histological tracing and molecular biological experiments were used to identify the distribution of KORs and the possible sources of dynorphin projections to the VP. An elevated dynorphin concentration and increased KOR activity were observed in the VP after acute stress. Infusion of dynorphin-A into the VP produced depressive-like phenotypes including anhedonia and despair and anxiety behaviors, but did not alter locomotor behavior. Mechanistically, dynorphin had an inhibitory effect on VP neurons-reducing their firing rate and inhibiting excitatory transmission-through direct activation of KORs and modulation of downstream G-protein-gated inwardly rectifying potassium (GIRK) channels and high-voltage gated calcium channels (VGCCs). Tracing revealed direct innervation of VP neurons by dynorphin-positive projections; potential sources of these dynorphinergic projections include the nucleus accumbens, amygdala, and hypothalamus. Blockade of dynorphin/KOR signaling in the VP by drugs or viral knock-down of KORs significantly reduced despair behavior in rats. Endogenous dynorphinergic modulation of the VP plays a critical role in mediating depressive reactions to stress.

Maternal depressive symptoms and child internalizing problems: The mediation of emotion socialization

AbstractObjectiveThis study examined the mediation of mothers' ratings of their maternal emotion socialization practices in the relation between mothers' depressive symptoms and children's internalizing problems in a Brazilian community sample.BackgroundMaternal depression and maternal emotion socialization reactions contribute to children's internalizing problems, but the mechanisms through which these variables interact remain unclear.MethodParticipants were 153 mothers of children between 3 and 8 years old. The Coping with Children's Negative Emotions Scale (CCNES) evaluated mothers' ratings of their emotion socialization practices, the Child Behavior Checklist (CBCL) assessed children's internalizing behaviors, and the Beck Depression Inventory I (BDI‐I) measured maternal depressive symptoms.ResultsMaternal ratings of non‐supportive emotion socialization reactions partially mediated the relation between maternal depressive symptoms and children's internalizing problems. There were no effects of maternal depressive symptoms on maternal supportive emotion socialization reactions and child internalizing problems.ConclusionEarly psychosocial interventions that reduce non‐supportive reactions to children's emotions may be an important way of assisting children in understanding and managing their negative emotions.

Factors Regarding Suicide Decline in Japan: A Longitudinal Study on Psychiatric Diagnosis of Serious Suicide Attempters.

The number of suicides in Japan decreased during the period from 2012 through 2019. Because data on factors associated with this decline are limited, we conducted a retrospective longitudinal study of psychiatric diagnoses of serious suicide attempters before 2012 and after 2019. Serious suicide attempters admitted to the critical care medicine (CCM) department of Nippon Medical School Hospital between 2006 and 2017 were included and classified as those before and after the suicide decline in 2012. Chi-square test and residual analysis were used to analyze changes in the proportion of suicide attempters among all patients admitted to CCM and to examine differences in the proportion of psychiatric diagnoses. The proportion of suicide attempters among CCM hospitalized patients decreased overall (χ2 (1) =18.29, p<.01). The proportion of psychiatric diagnoses changed significantly (χ2 (8) =62.21, p<0.001); specifically, it decreased for schizophrenia (residual: -2.28), depressive disorders (residual: -5.39), persistent mood disorders (residual: -3.58), and reaction to stress disorders (residual: -2.73). Depressive disorders decreased and had a large contribution ratio in both sexes. The decrease in the proportion of attempted suicides among patients admitted to CCM was consistent with the decline in suicides in Japan. Analysis by psychiatric diagnosis confirmed a significant decrease in the proportion of suicide attempts associated with depressive disorders, schizophrenia, and reaction to stress disorders, which were the most common disorders associated with attempted suicide. Depressive disorders made the greatest contribution to the reduction in suicide attempts.