Group Of Psychiatric Patients Research Articles

EEG complexity in emotion conflict task in individuals with psychiatric disorders

Analyzing EEG complexity may help to elucidate complex brain dynamics in individuals with psychiatric disorders and provide insight into neural connectivity and its relationship with deficits such as emotion-related impulsivity. EEG complexity was calculated through multiscale entropy and compared between a heterogeneous psychiatric patient group and a healthy control group during the emotion conflict resolution task. Twenty-eight healthy adults and ten psychiatric patients were recruited and compared on the multiscale entropy of EEG acquired in the task. Our results revealed a lower multiscale entropy in the psychiatric patient group compared to the healthy group during the task. This decrease in multiscale entropy suggests reduced long-range interaction between the left frontal region and other brain regions during the emotion conflict resolution task among psychiatric patients. Notably, a positive correlation was observed between multiscale entropy and impulsivity measures in the psychiatric patient group, where the higher the EEG complexity during the emotion regulation task, the higher the level of self-reported impulsivity in the psychiatric patients. Such impulsivity was evident in both healthy individuals and psychiatric patients, with healthy individuals showing shorter reaction times on incongruent conditions compared to congruent conditions and psychiatric patients displaying similar reaction times in both conditions, This study highlights the significance of investigating EEG complexity and its potential applications in the transdiagnostic exploration of impulsivity in psychiatric disorders.

Polish version of the Depression Anxiety Stress Scale (DASS-42) - adaptation and normalization.

This study aimed to present the Polish adaptation and preliminary normalization of the Depression Anxiety and Stress Scale - 42 (DASS-42). The study was conducted among 1,021 participants (625 females and 396 males) aged 18-83 years (M = 30.67; SD = 13.25). It was a non-clinical sample. Second sample was a group of 49 psychiatric patients (28 females and 21 males) aged 22-76 years (M = 49.40; SD = 13.34). The reliability of the DASS-42 was measured using Cronbach's α coefficients and intraclass correlation coefficients (ICC). In the non-clinical sample the Cronbach's alpha coefficient was 0.93 points for the depression subscale; 0.89 points for the anxiety subscale; 0.92 for the stress subscale, and 0.96 for the DASS-42 total score. The ICC were satisfactory, between 0.37 and 0.49 points. Psychiatric patients obtained significantly higher results in all subscales and in a total score of the DASS-42 (p< 0.001) than healthy participants. It is an indicator of good concurrent validity of the method. The effect size of the differences for all questionnaire indicators was large (0.96 <d< 1.44). The results for the healthy men and women differed, while the age did not differentiate the respondents. The sten scale was developed taking into account the gender of the respondents. The obtained results confirmed the satisfactory psychometric properties of the Polish version of the DASS-42. This inventory may be useful for screening in non-clinical groups and groups of psychiatric patients.

Assessment of prevalence of hyperprolactinemia in patients taking antipsychotic drugs in a tertiary care hospital in eastern India

Background: Researches done over different parts of the world show that hyperprolactinemia in psychotic patients is dependent on many factors such as age, gender, any thyroidal abnormality, drugs such as antipsychotics or antidepressants, psychological stress, and genre of psychosis. In patients taking antipsychotic treatments, prolactin blood levels may rise up to 10 times the normal values. It is very important to differentiate between prolactin-secreting tumor in pituitary and antipsychotic-induced hyperprolactinemia. There has been fewer researches on this topic in Eastern India, so it aims to properly estimate the amount of prolactin rise; a patient has to face after taking anti-psychotic medications and might also help the psychiatrists to adjust the dosage of anti-psychotics or to add some other drugs to lower the prolactin level along with the anti-psychotics in Eastern India. Aim and Objectives: The aims and objectives of the study are to estimate serum prolactin in diagnosed psychiatric patients taking antipsychotic drugs for at least 3 months and to study the difference in serum prolactin between recently diagnosed psychiatric patients taking antipsychotic drugs for at least 3 months and age and gender-matched mentally healthy patients without any psychiatric complication and without any history of in taking antipsychotic drugs. Materials and Methods: The study was conducted over a period of 4 months at Central Laboratory, Dept of Biochemistry, MCK. Before the conduct of the study, informed consent was taken. Patients diagnosed with psychiatric illness and consuming at least one antipsychotic drug for at least 3 months were enrolled after going through inclusion–exclusion criteria. Serum prolactin was measured with help of CLIA (ADVIA CENTAUR). Results: As per our study done in Eastern Indian population, in the female group of psychiatric patients (aged between 18 and 45 years) taking antipsychotics, the prolactin level was 23.6 ± 4.5 ng/ml, and in age-matched control female group, prolactin level was 9.2 ± 3.1 ng/mL, the difference is statistically significant (P &lt; 0.001). Moreover, in male psychiatric patients (aged between 18 and 45 years) taking antipsychotics, the prolactin level was 14.3 ± 1.7 ng/mL, and in age-matched control male group, prolactin level was 8.5 ± 1.5 ng/mL, the difference is statistically significant (P &lt; 0.001). Conclusion: As per our study, psychiatric patients of both gender taking antipsychotic drugs had higher serum prolactin level than age and gender-matched mentally healthy persons not taking antipsychotic drugs. Though the limitation of this study was small sample size and another issue that must be taken into consideration is the fact that prolactin levels can also be dependent of menstrual cycles in women, and in our study, there were 40 (57%) females who were still menstruating.

A novel technique for delineating the effect of variation in the learning rate on the neural correlates of reward prediction errors in model-based fMRI.

Computational models play an increasingly important role in describing variation in neural activation in human neuroimaging experiments, including evaluating individual differences in the context of psychiatric neuroimaging. In particular, reinforcement learning (RL) techniques have been widely adopted to examine neural responses to reward prediction errors and stimulus or action values, and how these might vary as a function of clinical status. However, there is a lack of consensus around the importance of the precision of free parameter estimation for these methods, particularly with regard to the learning rate. In the present study, I introduce a novel technique which may be used within a general linear model (GLM) to model the effect of mis-estimation of the learning rate on reward prediction error (RPE)-related neural responses. Simulations employed a simple RL algorithm, which was used to generate hypothetical neural activations that would be expected to be observed in functional magnetic resonance imaging (fMRI) studies of RL. Similar RL models were incorporated within a GLM-based analysis method including derivatives, with individual differences in the resulting GLM-derived beta parameters being evaluated with respect to the free parameters of the RL model or being submitted to other validation analyses. Initial simulations demonstrated that the conventional approach to fitting RL models to RPE responses is more likely to reflect individual differences in a reinforcement efficacy construct (lambda) rather than learning rate (alpha). The proposed method, adding a derivative regressor to the GLM, provides a second regressor which reflects the learning rate. Validation analyses were performed including examining another comparable method which yielded highly similar results, and a demonstration of sensitivity of the method in presence of fMRI-like noise. Overall, the findings underscore the importance of the lambda parameter for interpreting individual differences in RPE-coupled neural activity, and validate a novel neural metric of the modulation of such activity by individual differences in the learning rate. The method is expected to find application in understanding aberrant reinforcement learning across different psychiatric patient groups including major depression and substance use disorder.

Oral Health-Related Quality of Life in Adult Patients with Depression or Attention Deficit Hyperactivity Disorder (ADHD).

The aim of this cross-sectional study was the evaluation of the oral health-related quality of life (OHRQoL) in patients with depression or attention-deficit/hyperactivity disorder (ADHD) in comparison with a group of mentally healthy individuals. Patients from the Department of Psychiatry and Psychotherapy, University of Leipzig, Germany, were recruited. A healthy comparison group (HC) was recruited from the Department of Cariology, Endodontology and Periodontology. The OHRQoL was assessed using the Oral Health Impact Profile G14 (OHIP G14). Furthermore, a questionnaire regarding oral hygiene behaviour was applied. A total of 141 patients with depression or ADHD (depression n = 94, ADHD n = 47) and 145 HC individuals with a balanced age and gender distribution were surveyed. OHIP G14 median scores were significantly higher in the overall psychiatric patient group compared to HC (5.00 vs. 0.00, p < 0.001). This was also found for the four dimensions of OHIP G14 (p < 0.001). The OHIP G14 sum score of patients with depression and ADHD was comparable (5.00 vs. 6.50, p = 0.302). A significant association among psychiatric patients between smoking, gum bleeding, professional tooth cleaning, oral health education, interdental cleaning, and elevated OHIP scores was found (p < 0.001). In conclusion, patients with depression and adults with ADHD show a reduced OHRQoL. A contradictory association between oral hygiene/oral health behaviour and OHRQoL supports the hypothesis of a changed perception of oral conditions in patients with mental diseases. Interdisciplinary collaboration between psychiatric specialists and dentists should be fostered.

Exploring the added value of virtual reality biofeedback game DEEP in forensic psychiatric inpatient care-A qualitative study.

Low motivation and suboptimal cognitive skills are common among forensic psychiatric patients. By focusing on doing and experiencing, innovative technologies could offer an alternative to existing treatment for this patient group. One promising technology is DEEP, a VR biofeedback game that teaches diaphragmatic breathing, which has shown its potential in reducing stress in other populations. This exploratory study aimed at identifying if, how and for whom DEEP can be of added value in forensic mental healthcare. This study used a qualitative approach. Six focus groups with 24 healthcare providers and 13 semi-structured interviews with forensic psychiatric inpatients were conducted in two Dutch forensic mental healthcare organizations. All healthcare providers and patients experienced DEEP before participating. The data were coded inductively, using the method of constant comparison. The data revealed six themes with accompanying (sub)codes, including (1) the possible advantages and (2) disadvantages of DEEP, (3) patient characteristics that could make DEEP more or (4) less suitable and beneficial, (5) ways DEEP could be used in current treatment, and (6) conditions that need to be met to successfully implement DEEP in forensic mental healthcare. The results showed that DEEP can offer novel ways to support forensic psychiatric patients in coping with negative emotions by practicing diaphragmatic breathing. Its appealing design might be suitable to motivate a broad range of forensic psychiatric patient groups. However, DEEP cannot be personalized, which might decrease engagement and uptake of DEEP long-term. Regarding its place in current care, DEEP could be structurally integrated in existing treatment programs or used ad hoc when the need arises. Finally, this study showed that both healthcare providers and patients would need practical support and information to use DEEP. With its experience-based and gamified design, DEEP could be useful for forensic mental healthcare. It is recommended that patients and healthcare providers are included in the evaluation and implementation from the start. Besides, a multilevel approach should be used for formulating implementation strategies. If implemented well, DEEP can offer new ways to provide forensic psychiatric patients with coping strategies to better control their anger.

Malignant complications of masturbation - a case study.

We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a result of long-acting antipsychotic's injection. Since the initial ineffectiveness of benzodiazepines, the course of electroconvulsive therapy (ECT) has been carried out. In spite of the initial promising response to ECT 3 weeks after the admission her somatic and mental state deteriorated greatly, that was hardly explicable solely by the potential loss of effectiveness of ECT or laboratory tests. Diagnostics extended with imaging tests and gynecological examination revealed the connective tissue-covered cap of a popular multivitamin supplement in patient's vagina. During the following deepened interview, she admitted that in fact 6 months ago a piece had gotten stuck while masturbating. However due to the sense of shame and subjective lack of disturbing symptoms she had left it unsaid. One month after the evacuation of the foreign body she has been discharged from the hospital remaining the full remission. The presented case shows that inflammation in the body can complicate catatonia and NMS, causing a non-specific course and difficulties in diagnosis and treatment. In some patients, the inflammatory process may be caused by a foreign body located in various natural orifices in the body. It appears significant in the group of psychiatric patients. Once again it highlights the tremendous role of meticulously conducted interview including the patient's autoerotic life.

Telemedicine treatment of patients with mental disorders during and after the first COVID-19 pandemic lockdown in Germany – an observational study on feasibility and patient satisfaction

IntroductionIn response to the COVID-19 pandemic, a general lockdown was enacted across Germany in March 2020. As a consequence, patients with mental health conditions received limited or no treatment in day hospitals and outpatient settings. To ensure continuity of care, the necessary technological preparations were made to enable the implementation of telemedical care via telephone or video conferencing, and this option was then used as much as possible. The aim of this study was to investigate the satisfaction and acceptance with telemedical care in a heterogeneous patient group of psychiatric outpatients in Germany during the first COVID-19 lockdown.MethodsIn this observational study, patients in ongoing or newly initiated outpatient psychiatric therapy as well as those who had to be discharged from the day clinic ahead of schedule received telemedical treatment via telephone. Data collection to assess the patients’ and therapists’ satisfaction with and acceptance of the telemedical care was adjusted to the treatment setting.ResultsOf 60 recruited patients, 57 could be included in the analysis. 51.6% of the patients and 52.3% of their therapists reported that the discussion of problems and needs worked just as well over the phone as in face-to-face consultations. In the subgroup of patients who were new to therapy due to being discharged from hospital early, acceptance was higher and telemedicine was rated as equally good in 87.5% of contacts. Both patients and therapists felt that telemedicine care during lockdown was an alternative for usual therapy in the outpatient clinic and that the option of telemedicine care should continue for the duration of the coronavirus pandemic.DiscussionThe results show a clear trend towards satisfaction with and acceptance of telemedicine care in a heterogeneous group of unselected psychiatric patients. Although the number of patients is small, the results indicate that the mostly positive results of telemedicine concepts in research projects can probably be transferred to real healthcare settings.ConclusionsTelemedicine can be employed in healthcare for psychiatric patients either an alternative treatment option to maintain continuity of care or as a potential addition to regular care.

Offenders and non-offenders with schizophrenia spectrum disorders: the crime-preventive potential of sufficient embedment in the mental healthcare and support system.

Suffering from schizophrenia spectrum disorder (SSD) has been well-established as a risk factor for offending. However, the majority of patients with an SSD do not show aggressive or criminal behavior. Yet, there is little research on clinical key features distinguishing offender from non-offender patients. Previous results point to poorer impulse control, higher levels of excitement, tension, and hostility, and worse overall cognitive functioning in offender populations. This study aimed to detect the most indicative distinguishing clinical features between forensic and general psychiatric patients with SSD based on the course of illness and the referenced hospitalization in order to facilitate a better understanding of the relationship between violent and non-violent offenses and SSD. Our study population consisted of forensic psychiatric patients (FPPs) with a diagnosis of F2x (ICD-10) or 295.x (ICD-9) and a control group of general psychiatric patients (GPPs) with the same diagnosis, totaling 740 patients. Patients were evaluated regarding their medical (and, if applicable, criminal) history and the referenced psychiatric hospitalization. Supervised machine learning (ML) was used to exploratively evaluate predictor variables and their interplay and rank them in accordance with their discriminative power. Out of 194 possible predictor variables, the following 6 turned out to have the highest influence on the model: olanzapine equivalent at discharge from the referenced hospitalization, a history of antipsychotic prescription, a history of antidepressant, benzodiazepine or mood stabilizer prescription, medication compliance, outpatient treatment(s) in the past, and the necessity of compulsory measures. Out of the seven algorithms applied, gradient boosting emerged as the most suitable, with an AUC of 0.86 and a balanced accuracy of 77.5%. Our study aimed to identify the most influential illness-related predictors, distinguishing between FPP and GPP with SSD, thus shedding light on key differences between the two groups. To our knowledge, this is the first study to compare a homogenous sample of FPP and GPP with SSD regarding their symptom severity and course of illness using highly sophisticated statistical approaches with the possibility of evaluating the interplay of all factors at play.

Transdiagnostic psychiatry: Symptom profiles and their direct and indirect relationship with well-being

BackgroundHeterogeneity and comorbidity in psychiatric disorders are common, however, little is known about the impact on well-being and the role of functional limitations. We aimed to identify transdiagnostic psychiatric symptom profiles and to study their association with well-being and the mediating role of functional limitations in a naturalistic psychiatric patient group. MethodsWe used four disorder-specific questionnaires to assess symptom severity within a sample of 448 psychiatric patients with stress-related and/or neurodevelopmental disorders and 101 healthy controls. Using both exploratory and confirmatory factor analyses we identified transdiagnostic symptom profiles, which we entered into a linear regression analysis to assess their association with well-being and the mediating role of functional limitations in this association. ResultsWe identified eight transdiagnostic symptom profiles, covering mood, self-image, anxiety, agitation, empathy, non-social interest, hyperactivity and cognitive focus. Mood and self-image showed the strongest association with well-being in both patients and controls, while self-image also showed the highest transdiagnostic value. Functional limitations were significantly associated with well-being and fully mediated the relationship between cognitive focus and well-being. LimitationsThe participant sample consisted of a naturalistic group of out-patients. While this strengthens the ecological validity and transdiagnostic perspective of this study, the patients with a single neurodevelopmental disorder were underrepresented. ConclusionTransdiagnostic symptom profiles are valuable in understanding what reduces well-being in psychiatric populations, thereby opening new avenues for functionally meaningful interventions.

Criminal behaviors and substance abuse in psychiatric patients

IntroductionPeople with mental illness are overrepresented throughout the criminal justice system. In Italy, an ongoing process of deinstitutionalization has been enacted: the Judicial Psychiatric Hospitals are now on the edge of their closure in favor of small-scale therapeutic facilities (Residenze per l’Esecuzione delle Misure di Sicurezza - REMS). Law 81/2014 prescribes that a patient cannot stay in a REMS for a period longer than a prison sentence for the same index offense. Therefore, when patients end their duty for criminal behaviors, their clinical management moves back to outpatient psychiatric centers. Elevated risks of violent behavior are not equally shared across the spectrum of psychiatric disorders. In the past several years, multiple studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse.ObjectivesIn order to broaden the research in this area, we analyzed sociodemographic, clinical and forensic variables of a group of psychiatric patients with a history of criminal behaviors, attending an outpatient psychiatric service in Milan, with a focus on substance abuse.MethodsThis is a cross-sectional single center study, conducted in 2020. Seventy-six subjects with a history of criminal behaviors aged 18 years or more and attending an outpatient psychiatric service were included. Demographic and clinical variables collected during clinical interviews with patients were retrospectively retrieved from patients’ medical records. Appropriate statistical analyses for categorical and continuous variables were conducted.ResultsData were available for 76 patients, 51,3% of them had lifetime substance abuse. Lifetime substance abuse was significantly more common in patients with long-acting injectable antipsychotics therapy, &gt;3 psychiatric hospitalizations, history of previous crimes and economic crime (Table 1). Additionally, this last potential correlation was confirmed by logistic regression.Table 1.Lifetime substance abusers (N=39)Non-lifetime substance abusers (N=37)Proportion DifferenceP-valueN%N%Depot administrationYes11(28,9%)0(0%)28,9%0,02HospitalizationsFour or more25(64,1%)5(33,3%)30,8%0,04Economic crimeYes15(40,5%)1(6,7%)33,8%0,02Previous crimesYes17(51,4%)2(13,3%)38,1%0,02ConclusionsData emerging from this survey provide new information about offenders in an Italian mental health service with a focus on lifetime substance abuse in these patients. Our preliminary results should be confirmed in larger sample sizes.Disclosure of InterestNone Declared

Essential Regulatory Update for Implementation of Clinical Decision Support Software in the Psychiatric Field

Decision-making in the field of psychiatry, including diagnosis, is highly complex and is hindered by use of a dichotomous categorical classification system that is ill-suited to mental disorders which are multi-factorial behavioral conditions. In addition, traditional use of results from randomized controlled trials to guide medical device regulation in the field of psychiatry is also problematic, as marked heterogeneity exists within psychiatric patient groups, which precludes results from these trials being projected onto the general patient population. In the past 20 years, clinical decision support software (CDSS) has been found to improve decision-making abilities, but the traditional regulatory approach based on the categorical classification system and randomized controlled trials does not allow the necessary flexibility for CDSS-based decision-making in psychiatry. In this article, we will use Major Depressive Disorder as an example and will discuss regulatory considerations for CDSS, including artificial intelligence, in psychiatry. We will also provide an adjusted life-cycle framework for CDSS in psychiatry, given that the particular complexity of psychiatric disorders demands new and innovative decision support tools. We suggest that any new software would need to perform at least as well as the standard-of-care, which in psychiatry is an unfortunate trial-and-error process. This would be demonstrated during the pre-market validation stage using clinical data from back-end testing of the CDSS. We propose that pre-market evidence of CDSS efficacy should be based on parameters that are used to measure the software success rate, with evidence of safety including demonstration of the low risk of CDSS due to human involvement in the decision-making process. In the post-market stage, CDSS would be used by doctors to generate real-world data that would allow ongoing evaluation and improvement of the algorithms. Furthermore, CDSS would collect data beyond the initial intended-use patient population, allowing the CDSS to learn about related indications. These data would inform the pre-market phase, during which the CDSS could be updated with an expanded patient population. We anticipate that such changes would support effective use of CDSS in psychiatry and improved patient care, which is particularly important given the trial-and-process that comprises the current standard-of-care in the field.

Patients with affective disorders profit most from telemedical treatment: Evidence from a naturalistic patient cohort during the COVID-19 pandemic.

During the COVID-19 pandemic telemedicine became essential in maintaining diagnostic procedures and treatment in psychiatry. However, it is still an open question if telemedicine is a feasible treatment option for all groups of psychiatric patients alike. This prospective monocentric observational trial was conducted to assess the general applicability of telemedical treatment in a naturalistic psychiatric outpatient cohort and to identify groups of disorders and clusters of psychopathology that respond particularly well to telemedical treatment considering sociodemographic characteristics and patients' perspectives. Patients were recruited April 2020-April 2021 and asked to fill out the WHO-5 and the SCL-90R at baseline, after 4-6 and 8-12 weeks and a feedback-survey. Additionally, medical records, psychopathology, psychosocial functioning, and socio-demographic data were analyzed. Primary outcomes were well-being, psychopathology and functioning during treatment. Secondly, diagnostic groups and psychopathology linked to a superior treatment-response were determined with respect to patients' subjective experiences. Out of 1.385 patients, 254-mostly with hyperkinetic (35.3%) and depressive disorders (24.6%)-took part. Well-being and SCL-90R total scores improved substantially (both p < 0.001). CGI and GAF scores were worse in depressed subjects (both p < 0.05). Improvement was mainly seen in depressed patients; chronic disorders experienced a decline in well-being. Sociodemographic characteristics could not explain this difference. Particularly female (r = 0.413) patients found telepsychiatry equivalent to conventional treatment. The more virtual sessions participants attended the more likely they were to find telepsychiatry equal to conventional treatment (r = 0.231). Telemedicine is an effective treatment for patients with depression under naturalistic conditions. Telemedical consultations are a simple and reliable way of monitoring symptom severity and directing treatment choices during the treatment of depressive disorders. Patients with depression benefited more from telemedical treatment compared to participants with chronic non-episodic psychiatric disorders. Future research needs to concentrate on improving telemedical treatment options suited for the latter conditions. Psychiatric telemedicine yielded overall high degrees of satisfaction among users.

Pharmacogenomics in Psychiatry Practice: The Value and the Challenges.

The activity of cytochrome P450 enzymes is influenced by genetic and nongenetic factors; hence, the metabolism of exogenous psychotropic medications and potentially some endogenous neuropeptides is variably affected among different ethnic groups of psychiatric patients. The aim of this review is to highlight the most common cytochrome P450 isoenzymes associated with the metabolism of psychotropic medications (antidepressants, antipsychotics, and mood stabilizers), their variations among different populations, their impact on endogenous neurotransmitters (dopamine and serotonin), and the effect of nongenetic factors, particularly smoking, age, and pregnancy, on their metabolic activity. Furthermore, the adverse effects of psychiatric medications may be associated with certain human leukocytic antigen (HLA) genotypes. We also highlight the gene variants that may potentially increase susceptibility to obesity and metabolic syndrome, as the adverse effects of some psychiatry medications. Collectively, the literature revealed that variation of CYP450 activity is mostly investigated in relation to genetic polymorphism, and is directly correlated with individualized clinical outcomes; whereas adverse effects are associated with HLA variants, projecting the value of pharmacogenetics implementation in psychiatry clinics. Only a few previous studies have discussed the impact of such genetic variations on the metabolism of endogenous neuropeptides. In this review, we also report on the prevalence of key variants in different ethnicities, by demonstrating publicly available data from the 1000 Genomes Project and others. Finally, we highlight the future direction of further investigations to enhance the predictability of the individual gene variants to achieve precision therapies for psychiatric patients.

Fear of COVID-19, anxiety, depression and suicide among elderly patients with chronic physical or mental diseases

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9. According to the results, older chronic disease patients showed higher levels of fear, whereas anxiety and depressive symptoms were present mainly in the group of older psychiatric patients. Suicidality was reported from a subtotal of 25.4% that was composed of 7.8% chronic disease patients and 17.6% psychiatric patients. Chronic physical disease and higher anxiety predicted more severe COVID-19-related fear.

3.38 COVID-19 and Patients With ASD, Symptoms of Depression and Anxiety, and Use of Media

This study compares symptoms of anxiety and depression as well as use of electronic media in acute psychiatric patients with ASD with a group of psychiatric patients without ASD to determine what symptoms were most significantly experienced by patients with ASD during the COVID-19 pandemic.

How do Patients Diagnosed with Dissociative Identity Disorder Experience Conflict? A Qualitative Study

ABSTRACT The role and nature of conflict in the development and manifestation of dissociative identity disorder (DID) remains underexplored beyond theoretical deduction. In this qualitative instrumental case study, we explored the subjective experience and nature of conflict in a group of adult psychiatric patients diagnosed with DID. We purposively selected typed transcriptions of 28 previously recorded in-depth individual interviews with 15 patients, their audio recordings and associated field notes. The data were thematically analyzed and constant comparison was applied. Two main themes emerged from the transcriptions, namely, participants’ experiences of having one or more incompatible and conflicting worldviews about their DID, and the type and nature of conflict that arises between dissociative identities, i.e., conflict of information in awareness, conflicting actions or behaviors, conflicting emotions, conflicting goals, conflicting values, and a battle of wills. Patients with DID have contextually and culturally variable comprehension of the origin of their DID. Conflict between dissociative identities was pervasive, multifaceted, and exacerbated by a lack of awareness between identities. The study provides insight into the complexities of conflict between dissociative identities, as well as highlights the role of inter-identity awareness in conflict.

Evaluation of psychiatrist&amp;#8217;s communication with psychosis patients

Evaluation of the physician-patient relationship is very important in determining priorities in medical practice and medicine. For this purpose, in this study the psychiatrist’s communication with psychotic patients as a sensitive group was evaluated. A questionnaire was administered to 210 patients in a psychiatric clinic of Inonu University Hospital in Turkey to determine how the examination is performed in the facility for outpatients in the psychosis unit. According to the study conducted, it was observed that the evaluation score of the psychiatrist’s communication with psychotic patients increased positively with increasing consultation duration. Our work is particularly noteworthy because it deals with a sensitive area, such as a group of psychiatric patients. The scores were obtained based on data from the evaluation of the questionnaires, which showed that the communication between the psychiatrist and the psychotic patient was conducted in a sensitive and careful manner, and without ethical problems.

Cannabidiol (CBD) in the Self-Treatment of Depression-Exploratory Study and a New Phenomenon of Concern for Psychiatrists.

Cannabis sativa, whose flowers are also known as marijuana or marihuana, is a recreational plant that contains many chemicals that are constantly being studied by scientists around the world. One of these substances is cannabidiol (CBD), which has gained widespread popularity on the internet as a cure for mental health problems, leading many people to use CBD to self-treat depression and anxiety. This article presents an exploratory cohort study (n = 90) of a group of people aged 16–69 using CBD to self-heal depression symptoms. The survey included basic sociodemographic questionnaire and validated Hospital Depression and Anxiety Scale. And was distributed via the Internet. The results were statistically analyzed. High school degree was the most commonly held education (46%), large city was the most popular place of living (33%) and majority of the respondents have a full-time job (53%). Only 19% of the respondents consult their doctor or pharmacists about taking CBD. On the group of psychiatric patients, only 49% of respondents tell their psychiatrist about using the compound. Psychiatrists should be aware of CBD use in their patients during their daily practice, as CBD use can be found within people from all walks of life, and due to public interest, there is a need for education and research on the efficacy and safety of CBD use for mental disorders.

The Relationship Between and Correlates of Problematic Sexual Behavior and Major Mental Illness.

While research has consistently found that general distress and psychopathology are not predictive of sexual recidivism, examination of specific syndromes and their relationship to offending has revealed a potentially more complicated relationship. One proposed mechanism for the mixed findings with respect to major mental illness and sexual offending may be the confound of neurological injury. As identified in Mann et al. (2010) work on psychologically meaningful risk factors, mental illness represents an area in need of more study given the indirect influence it may exert on risk. To this end, the current paper summarizes the study of the relationship between neurological injury, psychosis and problematic sexual behavior among two Canadian samples of forensic and civil psychiatric patients. In the first study we observed higher than expected rates of sexually-themed psychotic symptoms (45%) and problematic sexual behavior (PSB; 40%) among a combined group of forensic and civil psychiatric patients (n = 109). Indeed 70 percent of those individuals who engaged in PSB endorsed sexually-themed psychotic symptoms. While comorbidity is common amongst this group, brain injury appeared to represent a specific liability. Compared to those who did not engage in PSB, those who did were almost 4x (OR = 3.83) more likely to have a documented history of brain injury (e.g., traumatic and acquired brain injury, including fetal alcohol syndrome). In the second study we sought to replicate this finding in a larger forensic sample of 1,240. However, the recorded rates of brain injury were significantly less, such that no relationship to PSB was observed. Based on the mixed findings to date, including our own data, questions remain about the nature of a potential shared vulnerability for psychosis and PSB previously postulated. Among psychiatrically complex individuals who engage in PSB, understanding etiology and links to risk are helpful, but perhaps more importantly is attention to the mechanisms through which symptoms confer risk (e.g., problem solving, sexual disinhibition, social/intimacy deficits) and how best to treat and manage them.