General Psychological Symptoms Research Articles

The Relationship between the Mental Health of Refugee Parents and Their Children: An Investigation of Australian Longitudinal Data.

We investigated the relationship between parent and child mental health, including parents' general psychological distress, among refugees resettled in Australia. We utilised longitudinal data from a sample (N = 602 children and 377 parents) of recently settled refugees from the Building a New Life in Australia Survey). Parent psychological distress and post-traumatic stress symptoms (PTSS) were measured by the Kessler 6 and PTSD-8, respectively. Harsh and Warm parenting behaviours were also measured to explore the mechanisms underlying the parent-child mental health relationship. Child mental health was measured using the SDQ. Using path analysis, we found that increases in parent psychological distress directly contribute to harsher parenting practices, which in turn increase child mental health difficulties as reported by parents. Parent psychological distress at Waves 1 and 3 also directly impacted child emotional and conduct difficulties, whilst parent PTSS was indirectly associated with all measured child mental health problems. While both parent PTSS and psychological distress indirectly impacted child mental health, only psychological distress directly impacted on any area of child mental health difficulty and overall explained more variance in the final model. Our findings highlight that non-trauma specific symptoms warrant attention in refugee parents' and children's mental health. Clinicians should assess for general psychological symptoms in addition to trauma-specific symptoms, and we recommend that parental mental health is assessed and treated simultaneously when working with refugee children. Moreover, to reduce the impact of other stressors in refugees' lives, community sector organisations should be resourced adequately to support refugee families in settlement.

Chronic stress and functional health in older adults with concerns about falling: a study protocol of a randomized controlled trial with multicomponent exercise intervention (FEARFALL)

BackgroundMaintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function.MethodsIn this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up.DiscussionThis study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia.Trial registrationGerman Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022.

B - 126 Posttraumatic Stress Disorder Symptoms as a Predictor of Invalid Attention-Deficit/Hyperactivity Disorder and General Psychiatric Symptom Reporting among Adult Neuropsychology Referrals

Abstract Objective Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in adulthood is complicated by the nonspecific nature of attention complaints, which overlap with most forms of internalizing psychopathology as well as elevated rates of invalid symptom overreporting. This study assessed the relationship between posttraumatic stress disorder (PTSD) symptoms and overreporting of both ADHD and general psychological symptoms. Method Data from 308 consecutive adults (mean age = 29.0; mean education = 16.09; 57.5% female, 42.5% male; 35% White, 27% Hispanic, 18% Black, 13% Asian, 7% Other) referred for neuropsychological evaluation of possible ADHD were administered the PTSD Checklist for DSM-5 (PCL-5) and embedded symptom validity tests (SVTs) on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Patients were classified as overreporting/no overreporting ADHD and general psychiatric symptoms based on elevations on the CAT-A and MMPI-2-RF overreporting SVTs, respectively. Results Logistic regressions showed that higher PCL-5 scores significantly predicted overreporting of both ADHD symptoms on CAT-A (X2 = 7.47, p = 0.006; Classification Accuracy = 85.1%; Nagelkerke R2 = 0.04; B.025; p = 0.007) and psychiatric symptoms on MMPI-2-RF (X2 = 58.76, p < 0.001; Classification Accuracy = 71.4%; Nagelkerke R2 = 0.35; B = -1.92; p < 0.001), with significantly greater variance predicted for overreporting of psychiatric symptoms. Conclusions Higher PTSD symptoms predicted overreporting of ADHD symptoms (CAT-A) and, more significantly, broad psychopathology (MMPI-2-RF). Findings reinforce the necessity of SVTs when evaluating ADHD among adults, particularly in the context of elevated PTSD symptoms, and also indicate that neuropsychologists should consider routinely assessing patients’ trauma history/symptomatology during ADHD evaluations to improve diagnostic accuracy.

Predictors of Symptom Reduction and Remission Among People with Anxiety: Secondary Analyses from a Randomized Controlled Trial

Despite the substantial disease burden of anxiety disorders, only limited or conflicting data on prognostic factors is available. Most studies include patients in the secondary healthcare sector thus, the generalizability of findings is limited. The present study examines predictors of symptom reduction and remission in patients with anxiety disorders in a primary care setting. 214 patients with anxiety disorders, recruited as part of the Collabri Flex trial, were included in secondary analyses. Data on potential predictors of anxiety symptoms at 6-month follow-up was collected at baseline, including patient characteristics related to demography, illness, comorbidity, functional level, life quality, and self-efficacy. The outcomes were symptom reduction and remission. Univariate and multivariate linear and logistic regression analyses were conducted to assess the associations between predictor variables and the outcome, and machine-learning methods were also applied. In multiple linear regression analysis, anxiety severity at baseline (β = -6.05, 95% CI = -7.54,-4.56, p < 0.001) and general psychological problems and symptoms of psychopathology (SCL-90-R score) (β = 2.19, 95% CI = 0.24,4.14, p = 0.028) were significantly associated with symptom change at 6 months. Moreover, self-efficacy was associated with the outcome, however no longer significant in the multiple regression model. In multiple logistic regression analysis, anxiety severity at baseline (OR = 0.54, 95% CI = -1.13,-0.12, p = 0.018) was significantly associated with remission at 6 months. There was no predictive performance of the machine-learning models. Our study contributes with information that could be valuable knowledge for managing anxiety disorders in primary care.

Predictors of frailty after cardiovascular surgery and the relationship between frailty and postoperative recovery: A cross-sectional study.

To investigate the factors affecting postoperative frailty and the relationship between frailty and postoperative recovery in patients undergoing cardiovascular surgery. The study was descriptive, cross-sectional, and predictive. Data were collected by researchers in a university research and application hospital cardiovascular surgery inpatient clinic between March 2022 and March 2023. Sociodemographic-Clinical Characteristics Form, Comorbidity Index, Edmonton Frail Scale, Postoperative Recovery, and Nutritional Risk Screening were used to collect the data. Of the 145 patients included in the study, 65.51% (n = 95) were male and the mean age was 62.02 ± 10.16 years. While frailty was not found to be significant by age group, it was found that women had more comorbidities and were more frail than men. It was found that 17.2% (n = 25) of patients had a history of falls before surgery, 26.2% (n = 38) had a fear of falling after surgery and 17.24% (n = 25) had rehospitalisations. While postoperative recovery index predicted fraility by 34% in patients undergoing cardiovascular surgery; general symptoms and psychological symptoms, which are the sub-dimensions of the postoperative recovery index and comorbidity and, fear of falling after surgery predicted frailty by 61%. The order of importance of variables on fraility: general symptoms (β = 0.297), fear of falling (β = 0.222), psychological symptoms (β = 0.218), Charlson Comorbidity Index (β = 0.183). This study clarifies the role of frailty as an important factor influencing the recovery process in patients undergoing cardiovascular surgery. The findings show that frailty has a determining effect on postoperative recovery in these patients. Among the factors affecting frailty status, comorbidities, fear of postoperative falls, and postoperative general and psychological symptoms were found to contribute. These findings emphasise that these factors should be taken into account when assessing and managing the postoperative recovery process. Understanding these factors that influence postoperative frailty is crucial for patient care. Recognising the multifaceted nature of frailty, personalised interventions are needed to improve patient care and postoperative outcomes. Personalised interventions are particularly important for older women with multiple comorbidities, as they are more likely to be frail.

The Effectiveness of Child-Parent Psychotherapy on Traumatized Preschoolers and Their Caregivers: A Swedish Multi-Site Study

ABSTRACT Introduction: Trauma affects a child’s mental health and appears to be associated with challenges in caregiver-child dynamics. Nearly half of child trauma victims are under the age of six, yet few interventions are designed for this age group. Child-Parent Psychotherapy (CPP) is an attachment-based trauma treatment for preschool-aged victims of adversities and their caregivers. This study examines the effectiveness of CPP when implemented in a Swedish naturalistic multi-site clinical setting. Method: 57 children (age 2–6 years) with potentially traumatic experiences and their caregivers participated. They were recruited from 12 mental health services providing child treatment. The study has a one-group, pretest-posttest design. Outcome measures covered posttraumatic stress and general psychological symptoms in children and caregivers and caregivers’ perceptions of their relationship with their child. Paired t-tests were used to calculate within-group differences. Effect sizes were computed as Cohen’s d and associations between child and caregiver outcomes as Pearson’s correlation coefficient (r). A hierarchical regression analysis was tested to explore the correlation analysis. Results: Reductions in posttraumatic stress and general psychological symptoms with small-to-medium effect sizes were found in children and caregivers. Caregivers reported perceived improvements in their relationship with their child, with associations to findings in child posttraumatic stress reduction. Discussion: Findings support earlier results that CPP may be a suitable choice of treatment for preschoolers exposed to potentially traumatic events, such as violence. The dyadic treatment model seems to address the association between child traumatic stress and caregivers’ perceptions of the caregiving relationship. Further dissemination testing is suggested.

The effectiveness of reminiscence therapy on the symptom management, the life satisfaction, and the self-transcendence in palliative care patients: a randomized controlled trial

PurposeTo examine the effect of individualized reminiscence therapy on the management of global distress and physical and psychological symptoms, life satisfaction and self-transcendence levels of palliative care patients.MethodsIn a single-center palliative care service in western Turkey, 48 patients without cognitive impairment and able to communicate were included in the study. However, 44 patients completed the study. Patients who met the inclusion criteria were randomly assigned to the reminiscence therapy (intervention), unstructured social interviewing (placebo), and control groups (16 people for each group) before the start of the study. The sessions for the interview and placebo groups were conducted face-to-face in the patient's room (while the patient was sitting or lying down) for 15 days (2 weeks), every other day, for a total of eight sessions (each session was approximately 30 min). Data collection instruments—the Memorial Symptom Assessment Scale, the Contentment with Life Assessment Scale, and the Self-Transcendence Scale—were collected at baseline (first day) and after the intervention (day 15th). Statistical significance level was accepted as p < 0.05.ResultsThere was no decrease in physical and total symptom burden (p > 0.05). There were significant reductions in general distress and psychological symptoms in the intervention and placebo groups within the group (p < 0.05), but there were no significant differences between the control group and all groups when compared (p > 0.05). Group × time interactions were statistically significant for life satisfaction and self-transcendence (p < 0.001), and there was a substantial increase in the intervention group compared to the other groups.ConclusionIt may be recommended that reminiscence therapy intervention be included in routine nursing care as it may contribute positively to the psychological recovery of palliative care patients approaching the end of life.Trial registrationClinicalTrails.gov (Registration number: NCT05242016). Prospectively registered on 1 February 2022.

The bidirectional connection between family functioning and psychopathology: A network analysis in a large sample of adolescents with anorexia nervosa and their parents.

Family functioning is a risk and maintaining factor for anorexia nervosa (AN). This study aims to identify specific areas of family functioning according to adolescents and parental perspectives associated with eating and general psychological symptoms in people with AN. Four-hundred-forty-five adolescents with AN or atypical AN and their parents were enrolled. Adolescents completed the Eating Disorder Inventory-3, the Youth Self-Report questionnaire, and the Family Assessment Device (FAD). Their parents filled in the FAD. A network analysis was conducted including all subscales. The bridge function analysis was applied to identify the bridge nodes connecting each community constituted of family functioning perception with the communities of adolescents' eating and general psychological symptoms. Family communication was the node most strongly connecting fathers and mothers' perception of family functioning and adolescents' eating symptoms. Problem solving was the node with the highest bridge expected influence between mothers' family functioning and adolescents' general psychopathology. General functioning and problem solving were the bridge nodes between adolescents' view of family functioning and eating and general psychopathology. Maturity fear, interpersonal insecurity, and interpersonal alienation were the bridge nodes between adolescents' eating symptoms and mothers, fathers, and adolescents' family functioning communities respectively. Family members must be involved in the therapeutic process to improve family communication and problem solving diverting their attention toward emotional needs and interpersonal difficulties of adolescents with AN. Developing autonomy and independence from parents and building trustworthy relationships with peers may be favored by improving familiar dynamics and may contribute to prevent the maintenance of AN.

Effectiveness of an online dialectical behavior therapy skills training in adults with attention-deficit/hyperactivity disorder: A randomized controlled trial

Objective The current study aims to examine the efficacy of an add-on dialectical behavior therapy skills training (DBT-ST) on adult attention-deficit/hyperactivity disorder (ADHD). The DBT-ST was applied online under the pandemic conditions that occurred after the study had started. Methods The current randomized controlled trial consists of an intervention group to whom the DBT-ST was applied in online setting and a waitlist control group who received treatment as usual (TAU). Data were collected pre-, post-, and mid-treatment. ADHD symptoms (with the sub-dimensions of inattention and hyperactivity), impulsivity, mindfulness, difficulty with emotion regulation, interpersonal effectiveness, distress tolerance, life satisfaction, functionality in daily life, and general psychological symptom levels were measured with self-report scales. The data were analyzed using mixed-design ANOVA. Results The global ADHD, inattention, and hyperactivity symptoms of the DBT-ST group significantly decreased more than those in the TAU control group. The DBT-ST group also showed a significant decrease regarding difficulty with emotion regulation and increases in life satisfaction and functionality, though the group × time effect was not significant. Conclusion DBT-ST was found effective against the participants’ ADHD symptoms. The treatment was additionally found to improve their emotion regulation and quality of life. Further investigation is needed to investigate DBT-ST in an online setting.

Common gastrointestinal symptoms and their impact on psychological state and quality of life in patients with inflammatory bowel disease: a cross-sectional multicenter study in China.

To explore the impact of common gastrointestinal (GI) symptoms on psychological symptoms, sleep quality, and quality of life in patients with inflammatory bowel disease (IBD). A unified questionnaire was developed to collect clinical data on the mental psychology and quality of life of IBD patients from 42 hospitals in 22 provinces in P. R. China from September 2021 to May 2022. The general clinical characteristics, psychological symptoms, sleep quality, and quality of life of IBD patients with different numbers of GI symptoms were analyzed by descriptive statistical analysis. A total of 2,478 IBD patients were finally analysed in this study, including 365 without GI symptoms (14.7%), 752 with single symptoms (30.4%), 841 with double symptoms (33.9%), and 520 with three symptoms (21.0%). Compared with patients without GI symptoms, patients with only simple abdominalgia or diarrhea or hematochezia showed significantly higher levels of anxiety and depression and worse quality of life (all P < 0.05). Compared with asymptomatic patients, patients with double symptoms (e.g. abdominalgia plus hematochezia, diarrhea plus hematochezia, abdominalgia plus diarrhea) and patients with three symptoms (abdominalgia, diarrhea, and hematochezia) showed significantly higher levels of anxiety and depression and worse sleep quality and quality of life (all P < 0.05). Compared with IBD patients without gastrointestinal symptoms, patients with gastrointestinal symptoms were more likely to experience anxiety, depression, sleep disturbances, and poorer quality of life.

Cognitive Biases and Insomnia Symptoms in People With and Without Chronic Pain

Chronic pain and insomnia symptoms are highly comorbid; however, the psychological mechanisms driving this comorbidity are not well understood. The aim of the present study was to assess whether 2 cognitive biases that occur separately in chronic pain and insomnia, that is, interpretation bias and attentional bias, are heightened in people with comorbid chronic pain and elevated insomnia symptoms. A final sample of N = 109 people with chronic pain and N = 79 people without pain who varied in insomnia symptoms were recruited through Prolific Academic to complete this cross-sectional study. Participants completed measures of sleep and pain-related interpretation bias (ambiguous sentences task) and attentional bias (dot-probe task), as well as questionnaires assessing insomnia symptoms, pain symptoms, and general psychological symptoms. We found an interaction between pain status and insomnia symptoms for sleep-related interpretation bias. That is, people with chronic pain showed greater sleep-related interpretation bias than those without pain, but only when insomnia symptoms were also elevated. This interaction did not extend to pain interpretation bias or attentional bias, although we did find an elevated pain interpretation bias in people with chronic pain compared to pain-free individuals. We also found that both pain and sleep-related interpretation bias were associated with depression symptoms, suggesting that interpretation bias could potentially drive a trimorbidity of chronic pain, insomnia, and depression. Taken together, these findings suggest promise for the role of interpretation bias in the mutual maintenance of chronic pain and insomnia symptoms and the importance of also considering depression. PerspectiveThis article presents data on the cognitive biases that are present in chronic pain, and that are associated with increased insomnia symptoms. Identifying such cognitive biases could help in explaining the high comorbidity between chronic pain and insomnia, leading to more effective and targeted treatments.

Ecological anxiety and pro-environmental behaviour: The role of attention

Climate change is a serious threat to human health and the awareness of this threat can elicit ecological anxiety (eco-anxiety), which could be considered a rational and potentially adaptive response. However, the experience of eco-anxiety does not always lead to adaptive behaviour. The present study investigated whether differential patterns of selective attention towards climate-related information, and variability in this attention, might explain this inconsistent relationship. Participants completed a dot-probe assessment of attentional bias to images of both climate change mitigation strategies and of climate change causes and consequences, and measures of eco-anxiety, climate change belief, environmental self-efficacy, and general psychological symptoms. Engagement in pro-environmental behaviours was measured using a daily behavioural diary. Eco-anxiety and attentional bias independently predicted behaviour, but did not interact. However, attentional bias variability moderated the relationship between eco-anxiety and behaviour, such that higher eco-anxiety predicted greater behavioural engagement, but only when attentional bias variability was low. This was the first known study to examine the potential moderating effect of attentional bias on the relationship between eco-anxiety and pro-environmental behaviours. This growing field of research can help in identifying how the rational response of eco-anxiety can be better harnessed to motivate an adaptive response to the climate crisis.

Effects of an outdoor horticultural activities program on cognitive and behavioral functioning, mood, and perceived quality of life in people with dementia: a pilot study.

One of various non-pharmacological treatments for people with dementia (PwD) is horticultural therapy. The aim of this double-blind, pre- and post-test, pilot study was to examine the effects of horticultural activities (HA) for PwD at a residential and daytime care facility. Whether combining HA with elements drawn from other psychosocial interventions (cognitive stimulation) would maximize any benefits was also newly examined. Twenty-four PwD were involved either in HA, alone (TG1, N = 7) or combined with some cognitive stimulation (TG2, N = 8), or in indoor treatment-as-usual activities (CG, N = 9). Benefits were assessed in terms of general cognitive functioning (for participants with mild-to-moderate dementia), mood, behavioral and psychological symptoms, and quality of life. No differences emerged between TG1 and TG2 in any outcome measure, so the two groups were combined (N = 15). Compared with the CG, the TG involved in HA exhibited less frequent and severe behavioral and psychological symptoms and an improved mood after the intervention. Caregivers also reported less distress in the TG after the intervention than in the CG. Considering only PwD with mild-to-moderate dementia, the TG also showed benefits in a measure of general cognitive functioning, and self-reported quality of life, compared with the CG. Our results further confirm that engaging PwD in participatory HA in contact with natural elements can decrease their dementia symptoms and their caregivers' distress, but also increase PwD's quality of life. Our findings also suggest the need to consider dementia severity when assessing the benefits of horticultural therapy.

Social functioning mediates the relationship between psychiatric symptoms and recovery among veteran and community service users with serious mental illness.

Previous research has established the impact of psychiatric symptoms on social functioning, while there is a paucity of research examining how social functioning relates to personal recovery, an individual's self-assessment of their mental health recovery. This study examined the mediating effect of social engagement, interpersonal communication, and satisfaction with support in the relationship between distinct psychiatric symptom clusters and perceived mental health recovery. In a cross-sectional study, both patient self-report and provider assessment data were collected for 250 patients with serious mental illness (SMI) across four mental health service sites. Parallel mediation analytic models were used. Interpersonal communication partially mediated the relationship between positive and negative symptom clusters and personal recovery. Satisfaction with social supports partially mediated the relationship between excited symptoms and personal recovery. Both interpersonal communication and satisfaction with social supports partially mediated the relationship between general psychological distress and depressive symptoms and personal recovery. Collectively, social functioning mediators explained nearly half of the relationship between general psychological distress and excited symptoms and personal recovery and nearly all of the relationship between positive symptoms and personal recovery. Clinical providers working with persons with SMI should regularly assess social functioning in addition to assessing psychiatric symptoms and personal recovery factors and should incorporate social skills education into SMI group and individual treatments. Social functioning as a target of treatment may be especially beneficial for patients who are dissatisfied with other interventions or feel they have experienced the maximum benefit from treatment and are seeking additional methods to support personal recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mental health outcomes and quality of life of Ukrainian refugees in Germany

The war in Ukraine has generated an increase in the number of refugees. As one of the top recipients of refugees, Germany has introduced policies to ease the integration of Ukrainians. The current study explores mental health outcomes and their association with quality of life among a sample of Ukrainian refugees in Germany. Cross-sectional data were collected from a sample of Ukrainian refugees in Germany (n = 304) using standardised instruments. A t-test was used to check for possible significant differences based on gender. Multiple regression analysis was used to analyse potential associations between general health (GHQ-12) and depressive symptoms and anxiety (PHQ-4), and quality of life (EUROHIS-QOL 8 item). Female participants reported significantly higher psychological distress, depressive symptoms and anxiety. The significant model (p < .001) for the males accounts for 33.6% of the variance in quality of life. General psychological distress (β = − .240) and depressive symptoms and anxiety (β = − .411) are associated with decreased quality of life. For the female sample (p < .001), the model explains 35.7% of the variance in quality of life. General psychological distress (β = − .402) and depressive symptoms and anxiety (β = − .261) are associated with decreased quality of life. The current study provides the first knowledge on the prevalence of mental health problems and their associations with quality of life among Ukrainian refugees. The findings further identify the vulnerability of women refugees to poorer mental health outcomes. The results also confirm that traumatic experiences in the context of war explain a considerable bulk of mental health problems.

Gender Differences in Psychological Symptoms and Quality of Life in Patients with Inflammatory Bowel Disease in China: A Multicenter Study

To explore the gender differences in the psychological symptoms, sleep quality, and quality of life of patients with inflammatory bowel disease (IBD). A unified questionnaire was developed to collect clinical data on the psychology and quality of life of IBD patients from 42 hospitals in 22 provinces in China from September 2021 to May 2022. The general clinical characteristics, psychological symptoms, sleep quality, and quality of life of IBD patients of different genders were analyzed via a descriptive statistical analysis. A multivariate logistic regression analysis was conducted, and independent influencing factors were screened to construct a nomogram to predict the quality of life. The consistency index (C-index), receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), and calibration curve were used to evaluate the discrimination and accuracy of the nomogram model. Decision curve analysis (DCA) was used to evaluate the clinical utility. A total of 2478 IBD patients (1371 patients with ulcerative colitis (UC) and 1107 patients with Crohn's disease (CD)) were investigated, including 1547 males (62.4%) and 931 females (37.6%). The proportion of anxiety in females was significantly higher than in males (IBD: 30.5% vs. 22.4%, p < 0.001; UC: 32.4% vs. 25.1%, p = 0.003; CD: 26.8% vs. 19.9%, p = 0.013), and there were differences in the severity of anxiety between the genders (IBD: p < 0.001; UC: p < 0.001; CD: p = 0.050). The proportion of depression in females was higher than in males (IBD: 33.1% vs. 27.7%, p = 0.005; UC: 34.4% vs. 28.9%, p = 0.031; CD: 30.6% vs. 26.6%, p = 0.184), and there were differences in the severity of depression between the genders (IBD: p = 0.004; UC: p = 0.022; CD: p = 0.312). The proportion suffering from sleep disturbances among females was slightly higher than among males (IBD: 63.2% vs. 58.4%, p = 0.018; UC: 63.4% vs. 58.1%, p = 0.047; CD: 62.7% vs. 58.6%, p = 0.210), and the proportion of females with a poor quality of life was higher than that of males (IBD: 41.8% vs. 35.2%, p = 0.001; UC: 45.1% vs. 39.8%, p = 0.049; CD: 35.4% vs. 30.8%, p = 0.141). The AUC values of the female and male nomogram prediction models for predicting poor quality of life were 0.770 (95% CI: 0.7391-0.7998) and 0.771 (95% CI: 0.7466-0.7952), respectively. The calibration diagrams of the two models showed that the calibration curves fitted well with the ideal curve, and the DCA that showed nomogram models could bring clinical benefits. There were significant gender differences in the psychological symptoms, sleep quality, and quality of life of IBD patients, suggesting that females need more psychological support. In addition, a nomogram model with high accuracy and performance was constructed to predict the quality of life of IBD patients of different genders, which is helpful for the timely clinical formulation of personalized intervention plans that can improve the prognosis of patients and save medical costs.

Comparison between emerging adults and adults in terms of contamination fear, post-COVID-19 PTSD and psychiatric comorbidity.

The present study compared Chinese emerging adults and adults regarding the association between contamination fear, posttraumatic stress disorder post-COVID-19 and psychiatric comorbidity after controlling for demographic and trauma exposure variables. 1089 Chinese civilians (M = 382; F = 707) with a mean age of 26 years (M = 26.36, SD = 8.58) were recruited from different provinces in China via an online survey posted on mainstream Chinese social networking platforms. They completed a demographic page with questions on trauma exposure, the Vancouver Obsessional Compulsive Inventory, the Posttraumatic Stress Disorder Checklist for DSM-5 and the General Health Questionnaire-28. Results showed that 12.7%, 68.7% and 18.6% met criteria for full, partial and no PTSD, respectively. Emerging adults reported significantly lower levels of symptoms of re-experiencing, avoidance, somatic problems, anxiety and fear of contamination than adults. In both emerging adults and adults, contamination fear was correlated with PTSD and psychiatric comorbidity. High educational attainment was significantly correlated with psychiatric comorbidity in emerging adults, but with PTSD in adults. Length of quarantine was correlated with psychiatric comorbidity only in adults. In conclusion, both emerging adults and adults developed varying levels of contamination fear, posttraumatic stress and general psychological symptoms following the outbreak of COVID-19. Emerging adults were more resilient than adults in coping with distress.

Women with gynaecological cancer awaiting radiotherapy: Self-reported wellbeing, general psychological distress, symptom distress, sexual function, and supportive care needs

ObjectiveTo better serve women with gynaecological cancers, we need a sound understanding of their health, wellbeing and needs. This study sought to explore these issues in a sample of Australian women before commencing curative radiotherapy. MethodsWe undertook a secondary analysis of baseline data from a supportive care trial (n = 311). Descriptive statistics were used to summarise responses to measures of wellbeing, general psychological distress, symptom distress, sexual function and vaginal changes, and supportive care needs. Pre-specified regression models were used to examine sources of variation in wellbeing and sexual function. ResultsWomen reported lower emotional, functional and physical wellbeing than population norms (all p < 0.001). The prevalence of general psychological distress was 31% (95% CI 26–36%). Distress caused by physical symptoms was typically low. Health system and information needs comprised eight of the top ten moderate-to-high supportive care needs. Most women reported no change in interest for physical contact or sex compared to pre-diagnosis, but some sexually active women (16–24%) reported smaller vaginal size, increased dryness, and more pain on intercourse. General psychological distress was a robust marker of poorer wellbeing and sexual function. ConclusionsBefore radiotherapy, a substantial minority of women with gynaecological cancers experience general psychological distress, reduced wellbeing and moderate-to-high health system and information needs. A model of comprehensive care incorporating assessment of unmet needs, general psychological distress, and sexual issues is recommended. Healthcare providers may require training to elicit and respond to a constellation of interrelated issues and access relevant services for women requiring additional support.

National roll-out of early intervention for eating disorders: Process and clinical outcomes from first episode rapid early intervention for eating disorders.

First Episode Rapid Early Intervention for Eating Disorders (FREED) is an early intervention model for young people with recent-onset eating disorders (ED). Promising results from a previous single-centre study and a four-centre study (FREED-Up) have led to the rapid national scaling of FREED to ED services in England (FREED-4-All). Our aim was to evaluate duration of an untreated ED (DUED), wait time target adherence, and clinical outcomes in FREED-4-All and compare these to the (benchmark) findings of the earlier FREED-Up study. FREED services submit de-identified data to the central FREED team quarterly. The current study covers the period between September 2018 and September 2021. This FREED-4-All dataset includes 2473 patients. These were compared to 278 patients from the FREED-Up study. DUED was substantially shorter in the FREED-4-All dataset relative to the FREED-Up study (15 vs. 18 months). Adherence to the wait time targets was comparable in both cohorts (~85% of engagement calls attempted in <2 days, ~50%-60% of assessments offered in <14 days, ~40% of treatment offered in <28 days). Patients in the FREED-4-All dataset experienced significant improvements in ED and general psychological symptoms from pre- to post-treatment that were comparable to the FREED-Up study. These findings should be interpreted cautiously as only 6% of FREED-4-All patients had post-treatment data. Data from the FREED-4-All evaluation suggest that FREED is replicating at scale. However, these data are flawed, uncertain, proximate, and sparse and should therefore be used carefully alongside other evidence and clinical experience to inform decision making.

Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial

BackgroundBulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating. They are associated with medical complications, impaired adaptive function and often a high BMI, for which a multidisciplinary treatment approach may be needed. This study explored the efficacy of a novel intervention integrating Cognitive Behavioural Therapy- Enhanced (CBT-E) and weight management for people with recurrent binge eating episodes and high BMI with respect to physical, psychopathological and quality of life outcomes.MethodsNinety-eight adults diagnosed with BN, BED, or Other Specified/Unspecified Feeding or Eating Disorder (OSFED/UFED) and BMI ≥ 27 to <40 kg/m2 were randomized to a multidisciplinary approach, the Healthy APproach to weIght management and Food in Eating Disorders (HAPIFED) or to CBT-E. Metabolic parameters, health-related quality of life, general psychological and ED symptoms and ED diagnostic status outcomes are reported. Data were analyzed with mixed effects models adopting multiple imputed datasets where data were missing.ResultsBoth HAPIFED and CBT-E showed statistical significance for the time effect, with reduction in stress (p < 0.001), improvement in mental health-related quality of life (p = 0.032), reduction in binge eating severity (p < 0.001), and also in global ED symptoms scores (p < 0.001), with the significant changes found at end of treatment and sustained at 12-month follow-up. However, no statistical significance was found for differences between the interventions in any of the outcomes measured. Despite a high BMI, most participants (> 75%) had blood test results for glucose, insulin, triglycerides and cholesterol within the normal range, and 52% were within the normal range for the physical component of quality of life at baseline with no change during the trial period.ConclusionIntegrating weight and ED management resulted in comparable outcomes to ED therapy alone. Although adding weight management to an ED intervention had no adverse effects on psychological outcomes, it also had no beneficial effect on metabolic outcomes. Therefore, more intense weight management strategies may be required where indicated to improve metabolic outcomes. Safety will need to be concurrently investigated.Trial registrationUS National Institutes of Health clinical trial registration number NCT02464345, date of registration 08/06/2015. Changes to the present paper from the published protocol paper (Trials 18:578, 2015) and as reported in the Trial registration (clinicaltrials.gov) are reported in Supplementary File 1.