Symptom Distress Research Articles

Serotonin Levels and Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Cross-Sectional Study.

Nausea and vomiting are distressing symptoms experienced by cancer patients undergoing treatment, impacting their physical well-being and quality of life. Serotonin, a neurotransmitter known for its role in regulating mood and gastrointestinal function, has been implicated in chemotherapy-induced nausea and vomiting (CINV). This study aimed to investigate serotonin level differences between CINV and non-CINV groups among cancer patients undergoing chemotherapy. An analytical observational investigation utilizing a cross-sectional design was conducted at Dr. Kariadi General Hospital from 2021-2022. Non-random consecutive sampling was employed to select participants meeting inclusion criteria, including age between 18 and 65 years, undergoing chemotherapy, non-smoking, and no recent antibiotic use. Platelet-poor plasma samples were analyzed for serotonin levels using a radioimmunoassay kit (Microplate reader ELx800). This study included 61 subjects compared serotonin levels in two groups to investigate their potential association with chemotherapy-induced nausea and vomiting (CINV). The non-CINV group (n=31) had a median serotonin level of 70 (IQR: 20) ng/mL, while the CINV group (n=30) had a significantly higher median of 170 ng/mL (IQR: 50) ng/mL. Age was associated with a 1.2 ng/mL increase in serotonin per year (95% CI: 0.5-1.9, p = 0.002), adjusted for sex. Being male correlated with a 40 ng/mL increase (95% CI: 10-70, p = 0.010), adjusted for age. This study underscores the importance of understanding serotonin's role in CINV and highlights the need for tailored treatment approaches based on chemotherapy emetogenicity.

Treating the disease and meeting the person with the illness-patient perspectives of needs during infective endocarditis, a qualitative study.

Infective endocarditis (IE) is a rare but severe infectious disease. Patients with IE are treated for weeks in the hospital and have profound impairments to their health. New treatment modalities increase options for outpatient care. Little is known about how patients perceive their disease and hospitalisation. We aimed to explore the needs of patients with IE during hospitalisation and the first few months after discharge. In this qualitative study, 20 patients (45-86 years of age) hospitalised due to IE in Swedish hospitals were interviewed a median of 112 (67-221) days after hospitalisation. Data were analysed with qualitative content analysis, identifying eight subcategories, two categories, and an overall theme. The overall theme illuminated a spectrum of needs of patients suffering from IE, between treating the disease and meeting the person with the illness. The needs encompassed eight axes with dual focus on both medical excellence and person-centred care. Medical excellence was needed to optimally treat, supervise, and offer follow-up on this rare and severe disease; patients longed to come home, and there were issues of reliability in the healthcare system. Person-centred care was requested, including individualised information leading to knowledge, reorientation, the beginning of health restoration, and being met as a unique person. Symptoms of fatigue, wasting, and cognitive and mental distress were often neglected by the caregiver. This explorative study shows the patient's needs as important areas in a spectrum between medical excellence and person-centred care. Care in specialised units secure quality. Early discharge is requested by patients. Multiprofessional individualizing outpatient care needs to develop with preserved safety and medical excellence. The disease trajectory after discharge progresses slowly, and the possibility of mitigating its progress is still unclear. Person-centred care, screening for delayed restoration and rehabilitation after endocarditis are important fields for future studies.

Assessment of prevalence and determinants of anxiety and psychological distress symptoms in Ebola child and adolescent survivors and orphans in Eastern Democratic Republic of the Congo during the COVID-19 pandemic

BackgroundTo date, only three studies investigated the mental health of youth affected by Ebola virus disease (EVD). None explored anxiety and psychological distress symptoms in survivors or orphans. This study aimed to investigate the prevalence and determinants of anxiety and psychological distress symptoms among survivors and orphans of the 2018–2020 Ebola epidemic in Eastern Democratic Republic of the Congo (DRC) during the COVID-19 pandemic. MethodsA representative sample of 416 participants (mean age = 13.37, SD = 2.79, 51.20 % girls, 146 survivors, 233 orphans, and 34 orphan-survivor participants) completed measures evaluating anxiety, psychological distress, exposure, resilience, stigmatization related to Ebola and COVID-19. Results55.88 % and 55.96 % of survivors and orphans experienced severe symptoms of anxiety and psychological distress. Participants who were both survivors and orphans presented higher prevalence of anxiety and psychological distress (94.12 % and 100 %) compared to survivors (74.03 % and 81.82 %) or orphans (37.99 % and 33.33 %), χ2 = 70.63, p < .001; χ2 = 113.50, p < .001. Ebola and COVID-19 related stigmatization were the most important determinants of anxiety (B = 0.40, p < .001; B = 0.37, p < .001) and psychological distress (B = 0.48, p < .001; B = 0.44, p < .001). Resilience was negatively associated with both anxiety and psychological distress. The final regression models explained 49 % and 85 % of the variance of anxiety and psychological distress. LimitationsThe cross-sectional design used prevents to establish causal link. ConclusionsEbola children and adolescents' survivors and orphans are at major risk of experiencing anxiety and psychological distress in Eastern RDC affected by years of armed conflict. Massive resources are needed to develop and implement programs to reduce stigma and support mental health.

Developing and testing a community based, online vs. face-to-face peer led intervention to improve mental well-being in Cambodian adults with physical disabilities.

Despite growing international attention, there remains an urgent need to develop mental health services within low and middle income countries. The Khmer Rouge period in Cambodia saw the destruction of all health services infrastructure in the 1970s. Consequently, Cambodia has struggled to rebuild both its economy and healthcare system, with the number of qualified mental health clinicians remaining disproportionately low. Resultantly, there is a pressing need to develop low-cost community based alternatives of mental healthcare. Using a mixed methods design, researchers developed an 8-week peer-led intervention, known as a Friendship Group, for adults with physical disabilities using both face-to-face and online delivery methods. The Wilcoxon Signed-Rank test was used to assess changes in pre-post survey scores and qualitative data was collected in form of five focus groups post intervention. 41 participants were allocated across four Friendship groups - two were online and two face-to-face. Attrition rate was 22% post-intervention (n = 32). ITT analyses showed a statistically significant decrease in psychological distress scores [Z = -3.808, p < .001] from pre [Mdn = 20, IQR = 16.5-25.5] to post [Mdn = 16, IQR = 14-18.5] intervention. A Wilcoxon signed-ranks test also showed a statistically significant decrease in PTSD scores [Z = -2.239, p < .025] from pre [Mdn = 4, IQR = 3-5] to post [Mdn = 3, IQR = 2.75-4] intervention. There was also a statistically significant decrease in worry scores [Z = -3.904, p < .001] from pre [Mdn = 5, IQR = 3.5-6.5] to post [Mdn = 3, IQR = 3-4] intervention. There were no significant group differences between the face to face and online groups. A number of interconnected themes emerged from focus group data (n = 5), these included the mental health benefits of Friendship Groups as conceptualised through knowledge acquisition, skill development and peer support. The Friendship group intervention delivered in both online and face-to-face formats appears feasible and acceptable within the Cambodian context. Initial data revealed positive findings in terms of reduction in psychological distress, worry and PTSD symptoms as well increased feeling as calm.

Study protocol for Sauti ya Vijana (The Voice of Youth): A hybrid-type 1 randomized trial to evaluate effectiveness and implementation of a mental health and life skills intervention to improve health outcomes for Tanzanian youth living with HIV.

Young people living with HIV (YPLWH) experience increased morbidity and mortality compared to all other age groups. Adolescence brings unique challenges related to sexual reproductive health, the elevated importance of peer groups, and often, emerging symptoms of emotional distress. Failure to address this unique life stage for YPLWH can lead to worse HIV and mental health outcomes. Herein lies the protocol for a hybrid-type-1 effectiveness-implementation trial designed to evaluate a mental health and life skills intervention that aims to address these needs for YPLWH in Tanzania. This is an individually randomized group-treatment trial designed to evaluate the effectiveness of Sauti ya Vijana (SYV: The Voice of Youth) toward improving viral suppression (HIV RNA <400 copies/mL) and mental health outcomes and to assess implementation including acceptability, feasibility, fidelity, and cost-effectiveness of the manualized intervention. The trial is being conducted across four geographically distinct regions of Tanzania. Peer group leaders (PGL) with lived HIV experience deliver the 10-session group-based intervention and two individual sessions during which participants describe their disclosure narrative (when they learned they live with HIV) and value-based goal setting. Caregiver or chosen supportive adults are encouraged to attend two specific group sessions with their youth. Participants are 10-24 years of age, prescribed antiretroviral therapy for at least 6 months, fully aware of their HIV status, able to commit to session attendance, and able to understand and meaningfully contribute to group sessions. Participant study visits occur at 5 time points for evaluation: baseline, 4-, 6-, 12-, and 18-months post baseline. A single booster session is conducted before the 12-month visit. Study visits evaluate mental health, adverse childhood events, interpersonal violence, resilience, stigma, HIV knowledge, substance use, sexual relationships, ART adherence, and HIV RNA. Implementation outcomes evaluate feasibility and acceptability through attendance, intervention session notes, focus discussion groups and qualitative interviews. Fidelity to the intervention is measured using fidelity checklists by a PGL observer at each group session. Cost effectiveness is calculated using an incremental cost-effectiveness ratio that utilizes a patient cost questionnaire and financial records of study costs. Few mental health interventions for YPLWH have demonstrated effectiveness. Results from this study will provide information about effectiveness and implementation of a peer-led intervention for delivering a mental health and life skills intervention in low-income settings. This trial is registered at clinicaltrials.gov NCT05374109.

Medical tattooing as a complementary cosmetic intervention to reduce body-image distress and mental health symptoms in U.S. breast cancer survivors.

A review of the literature revealed a high incidence of body-image distress among breast cancer survivors who had surgery. This cross-sectional study examined the relationship between medical tattooing as a complementary cosmetic intervention and body-image distress and mental health outcomes among breast cancer survivors following surgery. We examined 330 post-surgical breast cancer survivors collected through a nationwide online survey in the U.S., pursuing two main objectives. First, we investigated body-image distress, depression and anxiety symptoms, and perceived stress in survivors who underwent breast cancer surgery, comparing those with medical tattooing (n = 89) and those without (n = 226). Second, we assessed the influence of the participant's surgery type on body-image distress, depression and anxiety symptoms, and perceived stress. Additionally, we evaluated whether individual factors, such as appearance investment, satisfaction with decision, and cosmetic expectation discrepancy, predicted the participant's body-image distress. Findings suggest that participants with medical tattoos reported significantly lower body-image distress, depression and anxiety symptoms, and perceived stress compared to those without medical tattoos. The participant's surgery type did not significantly predict body-image distress, depression or anxiety symptoms, or perceived stress. However, participants who reported greater appearance investment endorsed higher body-image distress. Participants who reported higher satisfaction with their treatment decisions and lower cosmetic expectation discrepancy endorsed lower body-image distress. Medical tattooing may be a valuable tool in improving body-image distress and mental health for those who wish to pursue it, but more research is needed. Empirical studies supporting the mental health benefits of medical tattooing among survivors are crucial to standardize insurance coverage and promote its inclusion as a complementary intervention across insurance providers nationwide. This complementary intervention should be considered using a patient-centered approach that aligns with the patient's values and preferences.

Symptom experience and symptom distress in patients with malignant brain tumor treated with proton therapy: A five-year follow-up study

Background and purposeSince patients with primary brain tumor are expected to become long-term survivors, the prevention of long-term treatment-induced side effects is particularly important. This study aimed to explore whether symptom experience and symptom distress change over five years in adults with primary brain tumors treated with proton therapy. An additional aim was to explore whether symptom experience and symptom distress correlate. Materials and methodsThe study had a longitudinal observational design. Adult (≥18 years) patients (n = 170) with primary brain tumors treated with proton therapy were followed over five years. Symptom experience and symptom distress were evaluated using the patient-reported Radiotherapy-Related Symptom Assessment Scale. Data from baseline, 1, 12, and 60 months were analyzed using non-parametric tests. ResultsOf the 170 patients, the levels of symptoms and symptom distress were low. Fatigue increased at 1 (p=0.005) and 12 months (p=0.025) and was the most frequent symptom from baseline to 60 months’ follow-up. Cognitive impairment increased at 12 (p=0.027) and 60 months (p<0.001) and was the most distressing symptom at 60 months’ follow-up. There were significant, moderate to strong, correlations at all time points between symptom experience and symptom distress of fatigue, insomnia, pain, dyspnea, cognitive impairment, worry, anxiety, nausea, sadness, constipation, and skin reactions. ConclusionSymptom experience and symptom distress changed in intensity over time with cognitive impairment as the most distressing symptom at 60 months. Future research should focus on identifying effective interventions aimed at alleviating these symptoms and reducing symptom distress for this vulnerable group of patients.

Bladder fungoma (fungal bezoar) by two Candida species in Medellín, Colombia: a case report and review of the literature

The presence of fungal infections in the urinary bladder is rare; there are no extensive reviews on this subject in current literature, even less with the presence of two different types of fungi in the same culture. We present a case of an 82-years-old male patient with a history of benign prostatic hyperplasia (BPH) and type 2 diabetes mellitus (DM2) who underwent a simple suprapubic prostatectomy. Shortly thereafter, he was readmitted to the emergency room with symptoms of fever and urinary distress, eventually diagnosed with a fungal infection caused by Candida tropicalis and Candida glabrata in the urinary bladder, secondary to prostatic hyperplasia. He was admitted for assessment and multidisciplinary management. Guided treatment with caspofungin 50mg every 12 hours for 14 days resulted in clinical improvement. Proper diagnostic approaches are crucial for effective management of bladder fungomas, ensuring optimal patient outcomes.

Specific emotion regulation difficulties mediate the relationship between personal distress and depressive symptoms in medical students.

Several studies indicate a link between personal distress and vulnerability to depression. The literature also suggests that personal distress is associated with emotion dysregulation and that emotion dysregulation plays a role in depression. However, which of the various emotion regulation difficulties mediates the relationship between personal distress and depression remains unexplored. This study therefore aims to investigate the mediating role of specific emotion regulation difficulties in the relationship between personal distress and depression. Of the 702 initially recruited participants, 635 completed a survey comprising the Interpersonal Reactivity Index, the Difficulties in Emotion Regulation Scale, and the Beck Depression Inventory. A mediation analysis was used to explore which emotion regulation difficulties mediate the relationship between personal distress and depression. Over a quarter (27%) of participants reported moderate-severe depression symptoms. Difficulties in accessing adaptive emotion regulation strategies and in having a clear understanding about one's own emotions partly mediated the relationship between personal distress and depression symptoms. Our results are the first to indicate that personal distress is linked to depression risk through specific emotion regulation difficulties in medical students. They also highlight possible modifiable skills that could be targeted by prevention intervention.

The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment.

Distress tolerance, or the perceived ability to tolerate negative emotional states, is often associated with posttraumatic stress disorder (PTSD) such that higher distress tolerance is generally associated with less severe PTSD symptom levels. As distress tolerance is often considered a risk and maintenance factor in distress disorders, examining the association between changes in distress tolerance and changes in PTSD symptoms may have clinical relevance. The present study examined the associations between PTSD symptom severity and distress tolerance across three assessment points over 12 weeks among 212 patients receiving outpatient psychotherapy services. Using random-intercept cross-lagged panel modeling (RI-CLPM), concurrent and prospective associations between PTSD and distress tolerance were examined. PTSD symptoms at Time 1 and Time 2 significantly predicted distress tolerance at Time 2, β = -.296, and Time 3, β = -.395, respectively. Distress tolerance did not predict subsequent PTSD symptom severity. Exploratory analyses examined distress tolerance and four PTSD symptom clusters over time. Patterns of results differed across clusters, though it was consistent that only PTSD symptom clusters predicted subsequent distress tolerance and not vice versa. The results support the interrelationship of changes in psychopathology and emotional distress tolerance and indicate that distress tolerance may be an important factor in symptom remission during PTSD treatment.

Effects of Adjuvant Endocrine Therapy-Specific Perceptions on Response to a Behavioral Intervention for Adjuvant Endocrine Therapy Adherence in Patients With Breast Cancer.

Adjuvant endocrine therapy (AET) is a life-saving medication for patients with hormone-sensitive breast cancer, yet many struggle with adherence, warranting behavioral intervention. In our recent trial, participation in a group cognitive behavioral intervention (STRIDE) for symptom management and adherence was associated with improvements in symptom distress, coping, quality of life, and mood. We now explore whether baseline patient- and medication-specific factors-which may be modifiable by clinician-led discussions-moderated the effect of STRIDE on adherence rates. From October 2019 to June 2021, 100 patients with early-stage breast cancer reporting AET-related distress were enrolled and randomly assigned to STRIDE or a medication monitoring (MM) control group. All patients stored their AET in electronic pill bottles to track objective adherence. Patients also self-reported their adherence on the Medication Adherence Report Scale-5 and their perceptions of AET on the Cancer Therapy Satisfaction Questionnaire at baseline. We conducted hierarchical linear modeling to test moderators of intervention effects on objective adherence rates. We report the time × group × moderator effects. Among patients reporting greater perceived difficulties with AET adherence at baseline, STRIDE participants had higher adherence rates over time compared with MM (b = -13.80; SE = 4.56; P < .01). Patients with greater expectations of therapeutic benefit from AET also had improved adherence rates if they were assigned to STRIDE, versus MM (b = 0.25; SE = 0.10; P = .01). Patients who perceived taking AET as convenient and had been taking their AET for less time had higher adherence rates in STRIDE, versus MM. The current study identified patient- and medication-specific factors that may augment AET adherence interventions and may be modifiable through clinician-led discussions, such as perceptions of adherence problems, therapeutic efficacy, and convenience of AET.

Sexual health in patients with malignant hematological disease: a Danish cross-sectional study.

Patients who undergo treatment for hematologic malignancies may experience a decline in sexual health, alterations in sexual functioning, and reproductive capacity during survivorship. This study investigated the prevalence of sexual dysfunction and factors influencing sexual activity and functioning in patients with hematologic malignancies, to identify potential targets for interventions in clinical practice. This nationwide cross-sectional study included adult patients diagnosed with a hematologic malignant disease in Denmark in the period from January 20, 2013, to August 20, 2022. Eligible participants received electronic questionnaires through their officially assigned digital mailbox. Outcomes included the Female Sexual Function Index, International Index of Erectile Function, Female Sexual Distress Scale-Revised, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Sexual Health, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. A total of 362 patients, on average 5.7 ± 3.4 years postdiagnosis, completed the questionnaires. Of these, 52.5% women and 73.2% men reported sexual dysfunction, with more women (40.9%) than men (34.1%) being sexually inactive. Across gender, this was significantly more prevalent in patients >65years of age and in those with a low quality of life. In addition, for women a significant association with fatigue and sleep difficulties was observed. In total, 40.3% reported sexual-related personal distress, with the highest proportion among patients 40 to 65years of age. Most patients (98.7%) with sexual dysfunction had not discussed sexual issues with their healthcare professional. It is hoped that knowledge from this study will help healthcare professionals in clinical practice and encourage them to proactively address and discuss sexual health issues with their patients, irrespective of age. Sexually inactive participants may reduce the overall score of sexual function in the scoring of both the Female Sexual Function Index and International Index of Erectile Function. We therefore analyzed sexual function in a subgroup analysis in only those being sexually active to emphasize that level of dysfunction persists in sexually active participants. Patients report a high prevalence of sexual dysfunction, sexual distress, and gender-specific sexual symptoms following diagnosis and treatment of a malignant hematologic disease, impacting their quality of life.Sexual Health in Patients With Hematologic Malignancies; NCT05222282; https://clinicaltrials.gov/study/NCT05222282.

A Transdiagnostic Video-Based Internet Intervention (Uni Virtual Clinic-Lite) to Improve the Mental Health of University Students: Randomized Controlled Trial.

Numerous studies have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, web-based video interventions are capable of targeting key mental health and related issues affecting university students and may be more engaging and accessible for this population. This study used a 2-arm randomized controlled trial to evaluate the effectiveness of Uni Virtual Clinic-Lite (UVC-Lite), a fully automated, transdiagnostic, web-based video intervention, relative to an attention-control condition. The primary outcomes were symptoms of depression and generalized anxiety disorder. The secondary outcomes included psychological distress, social anxiety symptoms, body appreciation, quality of life, well-being, functioning, general self-efficacy, academic self-efficacy, and help seeking. Program use (intervention uptake and engagement) and satisfaction were also assessed. University students (n=487) with mild to moderate symptoms of distress were recruited from universities across Australia and randomly allocated to receive access to the UVC-Lite intervention or an attention-control condition targeting general health for a period of 6 weeks. UVC-Lite includes 12 modules, each comprising a brief animated video and an accompanying exercise. Of the 12 modules, 7 also included a brief symptom screening quiz. Outcomes were assessed at baseline, postintervention, and 3- and 6-months postintervention. The primary and secondary outcomes were analyzed on an intention-to-treat basis using mixed models repeated measures ANOVA. The intervention was not found to be effective relative to the control condition on any of the primary or secondary outcomes. While 67.9% (114/168) of participants accessed at least 1 module of the intervention, module completion was extremely low. Subgroup analyses among those who engaged with the program (completed at least 1 video) and those with higher baseline distress (Distress Questionnaire-5 score ≥15) did not reveal any differences between the conditions over time. However, uptake (accessing at least 1 video) and engagement (completing at least 1 video) were higher among those with higher baseline symptoms. Satisfaction with the intervention was high. The UVC-Lite intervention was not effective relative to a control program, although it was associated with high satisfaction among students and was not associated with symptom deterioration. Given the challenges faced by universities in meeting demand for mental health services, flexible and accessible interventions such as UVC-Lite have the potential to assist students to manage symptoms of mental health problems. However, low uptake and engagement (particularly among students with lower levels of symptomatology) are significant challenges that require further attention. Future studies should examine the effectiveness of the intervention in a more highly symptomatic sample, as well as implementation pathways to optimize effective engagement with the intervention. Australian New Zealand Clinical Trials Registry ACTRN12621000375853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380146.

Preference for solitude paradox: The psychological influence of social isolation despite preference

BackgroundAlthough a preference for solitude (PS) may mitigate the negative effects of social isolation (SI) owing to the enjoyment of time alone, its impact on mental health and its underlying factors remain unclear. MethodsAn Internet survey was conducted with 9000 individuals aged 20–79 years in September 2023 and the analyses were performed across three generations. SI was defined as contact with non-cohabitating family members or relatives and friends/neighbors less than once a week. The PS scale, which was used to assess whether a person preferred spending time alone, stratified respondents into three PS-level groups. Mental health status was evaluated using the K6 (distress symptoms), the WHO-5 (well-being), and the UCLA Loneliness Score (severity of loneliness) as the main outcomes. The mediation analyses assessed whether troublesomeness in socializing, a potential negative aspect of PS, could explain the association between PS and mental health status. ResultsA mixed-design two-way analysis of covariance showed that both SI and PS had significant main effects on all outcomes without interactions across generations, indicating that SI and higher PS were associated with poor mental health status. The association between higher PS and poor mental status was mediated by socializing troublesomeness across generations. LimitationsThe cross-sectional design prevented making causal inferences from the results. Additionally, sampling bias from Internet surveys may limit the generalizability of the results. ConclusionsThe results confirmed that there is no protective effect of PS on social isolation-related poor mental health. The hassle of socializing may partly explain why people with a higher PS experience poor mental status, including greater loneliness.

Sex-specific clinical and neurobiological correlates of fatigue in older adults.

Fatigue is a common and distressful symptom in older people and has been associated with adverse health outcomes. Nevertheless, its sex-specific pathophysiological underpinnings and clinical correlates have been scarcely investigated. We aimed to comprehensively explore the clinical and neurobiological determinants of fatigue in cognitively unimpaired older adults. A sex-stratified analysis was conducted to look for differences in the clinical expression of fatigue among women and men. Data on cognitively normal individuals were gathered from the Alzheimer's Disease Neuroimaging Initiative (ADNI) 2 study. Fatigue was defined based on self-report at baseline. For each participant, information on sociodemographics, comorbidities, mood, cognitive performance, frailty, and biomarkers of brain pathology was collected. Logistic regression models, stratified by sex, were conducted to explore the factors associated with fatigue. Among the 291 participants selected, 44 subjects (15.1% of the total sample) self-reported fatigue at baseline. Subjects reporting fatigue were more likely women, had higher frailty degrees, and more severe depressive symptoms than those without fatigue. Moreover, they tended to have lower MRI hippocampus volumes. Among women, those reporting fatigue exhibited higher frailty levels, worse depression, and lower MRI hippocampus volumes relative to those without fatigue. Higher frailty degrees were also observed in men reporting vs. non-reporting fatigue. In the adjusted logistic regression model, more severe depression (OR 1.64, 95% CI 1.18-2.28; p < 0.01) and lower MRI hippocampus volumes (OR 0.41, 95% CI 0.19-0.90; p = 0.03) resulted independently associated with fatigue in women, while higher frailty degrees (OR 3.10, 95% CI 1.27-7.54 per 0.1 increase in a 39-item Frailty index; p = 0.01) in men. Fatigue is a complex symptom with a sex-specific pattern of clinical and neurobiological correlates. A better understanding of the underlying mechanisms of these associations is warranted to develop sex-informed approaches for personalized treatments.

Cigarette Smoking in Women Victims of Police-Reported Intimate Partner Violence: The Role of Childhood Maltreatment, Type of Partner Abuse, and Psychological Distress Symptoms

ABSTRACT Existing research on the relationship between intimate partner violence (IPV) and cigarette smoking primarily involves low-risk, physical IVP-focused studies on community women. As a result, the risks associated with cigarette smoking in women victims of severe IPV have not been fully explored. This study examined the association between exposure to different forms of childhood maltreatment, exposure to physical, psychological, and sexual IPV, and current psychological distress symptoms with cigarette smoking in a high-risk sample of women victims of police-reported severe IPV. Participants included 162 women victims of police-reported severe IPV recruited in shelters for domestic violence and Child Protective Services in Portugal. Participants provided self-reports on childhood maltreatment physical, psychological, and sexual violence), physical, psychological, and sexual IPV, psychological distress symptoms (anxiety, depressive, somatic, and posttraumatic stress disorder symptoms), and daily cigarette consumption. Results revealed significant associations between daily cigarette consumption and exposure to IPV, physical abuse during childhood, psychological IPV, and anxiety symptoms in women experiencing police-reported severe IPV. Childhood maltreatment may increase vulnerability for emotion dysregulation, promoting addictive behaviors to regulate distress. Smoking can be an unhealthy regulating strategy to reduce the distress related to chronic exposure to psychological IPV. Future effective health promotion interventions in women facing severe forms of IPV may target emotional regulation and incorporate a trauma-focused approach.

A Latent Profile Analysis of Emotion Regulation in Relation to Distress of Symptoms in Youth with Prodromal Psychotic Symptoms.

(1) Background: Although abnormal emotion regulation is a key characteristic of youth with prodromal psychotic symptoms and is closely related to the degree of distress caused by these symptoms, research on the internal heterogeneity of emotion regulation within this clinically high-risk population has been insufficient. (2) Methods: The current study analyzed data from 394 college students with prodromal psychotic symptoms, using latent profile analysis (LPA) to identify emotion regulation profiles based on differences in expressive suppression and cognitive reappraisal. One-way ANOVA was employed to examine the relationship between the identified latent profiles and distress of symptoms. (3) Results: Three latent profiles were identified: "high cognitive reappraisal group" (n = 117, 29.70%), "moderate cognitive reappraisal group" (n = 233, 59.14%), and "low cognitive reappraisal group" (n = 44, 11.16%). Significant differences in distress of negative symptoms (F = 9.122, p < 0.05) and perceptual abnormalities (F = 3.103, p < 0.05) were observed across the latent profiles but not in unusual thought content and specific perceptual abnormalities (both p > 0.05). The "low cognitive reappraisal group" exhibited the most severe distress of symptoms, followed by the "moderate cognitive reappraisal group", while the "high cognitive reappraisal group" experienced the least distress. (4) Conclusions: The current study provides evidence for the heterogeneity of emotion regulation among youth with prodromal psychotic symptoms and reveals differences in distress of perceptual abnormalities and negative symptoms between the latent profiles of emotion regulation. These findings support the development of targeted psychological interventions to alleviate the distress of symptoms and improve quality of life.

Palliative care needs and utilisation of specialist services for people diagnosed with motor neuron disease: a national population-based study

IntroductionThere is a growing emphasis on the importance of the availability of specialist palliative care for people with motor neuron disease (MND). However, the palliative care needs of this population...

Work-related violence, occupational stress and psychological distress among medical staff in China: A structural equation modeling analysis.

Psychological issues and work-related violence are the main challenges faced by medical staff. The situation has become even more prevalent during the COVID-19 pandemic. This research aimed to analyze the relationships among work-related violence, occupational stress and psychological distress and to further identify the direct or indirect effects of violence on psychological distress. A total of 1,765 medical staff members were surveyed using the Kessler Psychological Distress Scale and Revised Occupational Stress Inventory. Work-related violence was assessed using a self-made 5-question questionnaire. STATA 14.0 and Amos 21.0 software were used for correlation analysis, variance analysis, and structural equation modeling analysis. A total of 66.1% of the medical staff suffered workplace violence, and 61.2% witnessed workplace violence. The psychological distress score (Kessler 10 Scale) of the medical staff was 22.7±7.67. The psychological strain score and physical strain score were 26.8±7.14 and 24.2±6.51, respectively. Work-related violence (suffered: β= 0.467; witnessed: β= 0.258) and occupational stress (psychological strain: β= 0.269; physical strain: β= 0.317) were predictors of psychological distress, and social support (β= -0.265) was a protective factor. Work-related violence and social support had both direct and indirect effects on psychological distress, and the intermediate factor was occupational stress. The total effects of suffered workplace violence and witnessed workplace violence were 0.181 and 0.092, respectively, and the total effect of social support was -0.262. Work-related violence may exacerbate symptoms of occupational stress and psychological distress. Reducing workplace violence and protecting medical staff from work-related violence are extremely important aspects of mental health prevention.

Psychiatric Manifestations in Early to Middle Stages of Fragile X-Associated Tremor-Ataxia Syndrome (FXTAS).

The purpose of the present study was to assess the psychiatric manifestations of early to middle stages of fragile X-associated tremor-ataxia syndrome (FXTAS) and their relationship with executive function and FMR1 cytosine-guanine-guanine (CGG) repeat numbers across genders. Cross-sectional data from 100 participants (62 men, 38 women; mean±SD age=67.11±7.90 years) with FXTAS stage 1, 2, or 3 were analyzed, including demographic information, cognitive measures, psychiatric assessments (Symptom Checklist-90-Revised and Behavioral Dyscontrol Scale-II [BDS-II]), and CGG repeat number. Participants with FXTAS stage 3 exhibited significantly worse psychiatric outcomes compared with participants with either stage 1 or 2, with distinct gender-related differences. Men showed differences in anxiety and hostility between stage 3 and combined stages 1 and 2, whereas women exhibited differences in anxiety, depression, interpersonal sensitivity, obsessive-compulsive symptoms, and somatization, as well as in the Global Severity Index, the Positive Symptom Distress Index, and the Positive Symptom Total. Among male participants, negative correlations were observed between BDS-II total scores and obsessive-compulsive symptoms, as well as between anxiety and CGG repeat number. These findings suggest that even at early FXTAS stages, patients have significant cognitive and other psychiatric symptoms, with notable gender-specific differences. This study underscores the clinical and prognostic relevance of comorbid psychiatric conditions in FXTAS, highlighting the need for early intervention and targeted support for individuals with relatively mild motor deficits.