High Levels Of Emotional Distress Research Articles

Minimizing Ambulatory Setting Pediatric Healthcare-Induced Anxiety: A Case Review

It is no longer a rare phenomenon for pediatric patients to experience moderate to high levels of emotional distress, including anxiety, during preventive care office visits with healthcare providers. This distress can be attributed to multiple factors, including being in an unfamiliar setting with unknown people, and unclear expectations. Further compounding the anguish, children are often aware of the potential for, or likelihood of, physical discomfort, or pain during the office visit. These combined variables often result in unwelcome behavioral demonstrations of protest to healthcare workers and the child’s caregivers. Some children may scream, cry, pinch, bite, hit, or even refuse to engage in the examination or procedure. When these behavioral protests impede necessary care, expedient interventions must be considered. The following case review aims to demonstrate that attuning to a child’s emotional needs and providing developmentally appropriate power and control during an outpatient office visit in a healthcare setting, can aid in offering emotional safety and reduce the potential for long-term psychological harm

Group eye movement desensitization and reprocessing (EMDR) in chronic pain patients.

The prevalence of chronic pain is increasing, and conventional pain therapies often have limited efficacy in individuals with high levels of psychological distress and a history of trauma. In this context, the use of Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based psychotherapy approach for the treatment of posttraumatic stress disorder, is becoming increasingly important. EMDR shows promising results, particularly for patients with pain and high levels of emotional distress. Although group therapy is becoming increasingly popular in pain management, EMDR has mainly been studied as an individual treatment. However, a systematic review suggests that group therapy can be an effective tool for improving mental health outcomes, especially when trauma is addressed together. Based on these findings, an outpatient EMDR group program was developed for patients with chronic pain. The program consists of a total of four treatment days with 5-5.5 h therapy sessions each day and provides patients with a supportive environment in which they can learn effective pain management strategies and interact with other patients with similar experiences. Initial pilot evaluations indicate high efficacy and adequate safety for patients with chronic pain.

The association among executive functions, academic motivation, anxiety and depression: a comparison between students with specific learning disabilities and undiagnosed peers

ABSTRACT Since COVID-19 pandemic started, schools had to face environmental changes, one was shifting from a face-to-face educational approach to online learning. It represented an unfavourable learning environment, especially for children with Specific Learning Disabilities (SpLD). Following the Self Determination Theory (SDT) framework, the current study investigated the differences in cognitive, emotional, and motivational domains between students with SpLD and undiagnosed peers, and the relations between executive functioning, emotional distress, and academic motivation. Participants included 97 Italian students, 47 with SpLD (average age of 10.9 years, SD = 1.35), and 50 undiagnosed peers (average age of 10.7 years, SD = 1.58) attending OL lectures during COVID-19. Results displayed lower executive functions (EFs), higher levels of emotional distress in students with SpLD. Furthermore, students with SpLD showed lower levels of identified and intrinsic motivation but higher levels of introjected motivation.

Teachers’ perceptions of the psycho-social effects of COVID-19 on learners’ well-being in South African schools

The lockdown the South African government implemented in 2020 to contain the COVID-19 pandemic resulted in school closures. During this time, and also when learners were allowed to attend school again, the focus was on the physical health and safety of the learners. However, in the process, schools might have neglected the psycho-social and mental well-being of learners, which is a state in which learners are able to manage stress and function optimally. This paper reports on a study that investigated teachers’ views on how learners’ psycho-social and mental well-being was affected by the COVID-19 pandemic. This qualitative study used semi-structured interviews to gather data from 17 teachers from five schools in two districts of the North-West Province in South Africa. The school mental health theoretical framework was used for the study because of its focus on the psycho-social mental health of learners and the role of institutions in supporting mental health. The findings indicate that learners experienced a higher level of emotional distress during the lockdown. This was caused by an increase in fear, stress, anxiety, uncertainty, frustration, anger and aggression during the pandemic. Although learners from all the schools were negatively affected by COVID-19, learners from low-income schools that had limited access to resources were affected more due to the limited professional psycho-social support they received. This highlights the need for Education Departments to build the capacity of all South African schools to address the emotional and psycho-social well-being of their learners. It is vital that schools commit themselves to enabling learners to develop a high level of resilience and antifragility at all times, not just during major crises such as the COVID-19 pandemic.

Identify the Level of Emotional Stress Factors for Workload, Lack of Resources, Administrative Management, Time Constraints and Negative Student Behavior and Disciplinary Problems Among Teachers at Sekolah Menengah Kebangsaan Pangkal Meleret, Machang, Kelantan

A very challenging form of social services is the teaching profession. A teacher’s profession has a high level of emotional distress. The problem of emotional stress among teachers is of concern to the public both inside and outside the educational organization. This study was done to find out the extent of the emotional stress that teachers experienced at Sekolah Menengah Kebangsaan Pangkal Meleret. The study aims are to see the extent of the level of the emotional stress of the teacher's workload, lack of resources, administrative management, time constraints, and negative student behavior and disciplinary problems. To achieve the purpose of the research, quantitative methods have been used. This study was conducted at Sekolah Menengah Kebangsaan Pangkal Meleret, Machang, Kelantan. A total of 44 teachers were selected as sample size to represent 54 respondents. Frequency and descriptive statistical tests covering frequency, percentage, mean and standard deviation have been used to describe demographic profiles and descriptive analysis. Cronbach's Alpha reliability value is 0.806 also good for pilot study. The findings showed that the highest levels of teacher emotional stress were teacher’s workload (M=4.37, SP=.459), followed by lack of resources (M=4.07, SP=.524), and administrative management (M=4.05, SP=.599), while time constraints were at moderate levels (M=3.54, SP=.862), followed by negative student behavior and disciplinary problems (M=3.21, SP=.855). The results of this study prove that these five factors influence the level of the emotional stress of the teacher. The results of this study contribute as reference material and guidance to the school to overcome the problem of emotional stress among teachers to improve the quality of teacher services.

Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool.

Cancer patients may experience significant distress. The "Emotion Thermometers" (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items-sadness, depression, sleep and breathing-were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.

The Interconnection Between Social Support and Emotional Distress Among Individuals with Chronic Pain: A Narrative Review.

Chronic pain is a public health concern affecting over 100 million U.S. adults. Because chronic pain is multifactorial, it requires a biopsychosocial approach to understand how biological, psychological, and social factors contribute to both the development and maintenance of pain. On average, individuals with chronic pain report higher levels of emotional distress compared to pain-free individuals. Research has demonstrated that social support is associated with better pain outcomes and less emotional distress. It has been proposed that social support may improve pain outcomes by reducing the influence of stressors. However, the majority of research exploring the relationships between social support and pain-related outcomes has focused on the direct relationship between these variables, largely overlooking the process by which social support has a positive influence on pain. This narrative review synthesizes research on how chronic pain, emotional distress, and social support are highly interconnected, yet research investigating chronic pain and emotional distress within a social context is limited. We then highlight disparities in chronic pain, such that the burden of chronic pain is unequal between demographic groups. Next, we discuss existing evidence for the use of group-based interventions to address pain-related outcomes. Lastly, we summarize limitations of prior research studies and highlight gaps in the current literature. Overall, longitudinal research comprehensively investigating the distinct nuances in the measurement of social support and how these nuances relate to emotional distress and pain outcomes is needed and may provide insight into the unique needs of individuals or subgroups. Further, demographically diverse randomized controlled trials are needed to identify the process by which group-based interventions improve pain outcomes and whether these interventions are more effective for particular groups in order to personalize treatment approaches and address inequities in pain care.

The Longitudinal Mediating Effect of Distress Tolerance in a Mindfulness-Based Intervention: A Randomized Controlled Trial

"Objective: The present study aimed to investigate the intermediary role of distress tolerance in Mindfulness-Based Intervention (MBI) with respect to self-perceived stress reduction. Method: One hundred and twenty-nine adults with a high level of emotional distress were randomized into MBI groups or a waiting-list group. Levels of mindfulness skills, self-perceived stress, and distress tolerance (tolerance, appraisal, absorption, and regulation) were measured four times: pre-test, week 3, week 6, and post-test. Results: The developmental trajectories modeled by the univariate latent growth curve showed that the factor intervention significantly predicted the slope of observing, non-reactivity, overall mindfulness, and distress appraisal during first six weeks. Bivariate latent growth curve models demonstrated a significant association between increases in the growth rate of distress appraisal and non-reactivity in participants receiving mindfulness training. Such an association was not observed among those who did not receive an MBI. Longitudinal mediation analyses further revealed that the effect of MBI on non-reactivity and self-perceived stress at week 6 was fully mediated by distress appraisal at week 3, respectively."

Contents and Characteristics of Mental Imagery and their Association with Emotional Intensity in Adolescents: A Pilot Study

The contents and characteristics of mental imagery (MI) have been investigated with respect to a few mental disorders, but not yet in healthy samples. In adults, it was found that characteristics like the vividness and perspective of MI might be associated with emotions and emotional distress, a matter which needs to be examined in youths. A sample of 80 adolescents (14–20 years; 75.3% female) completed a web-based quasi-experimental design about the contents, and characteristics (frequency, vividness, perspective, controllability) of spontaneous positive and negative MI and emotional distress and emotions, as well as the Beck Depression Inventory and the Social Phobia Inventory. Adolescents described mental images primarily about social themes and those participants experiencing images about social conflicts reported higher levels of emotional distress. Participants reported perceiving images in a combination of field- and observer perspective also stated a higher score of anxiety. A higher frequency, vividness and less control over negative images were significantly linked to a higher intensity of emotional distress and anxiety. A higher frequency, vividness and a higher level of control over positive images were significantly linked to a higher intensity of joy. Small sample size and high social status of participants limits generalizability. Findings indicate that encouraging young people to create vivid positive images and to use a training to increase control over MI might be useful to increase mental health. The results do not permit causal conclusions to be drawn, but raise questions about previous studies comparing each imagery perspective individually.

A test of the dyadic associations between ineffective arguing, emotional distress, and violence perpetration and victimization among couples seeking therapy.

Researchers have tested associations between ineffective arguing and emotional distress among couples without relationship violence. Moreover, studies have demonstrated associations between physical violence perpetration and victimization in the aftermath of emotional distress. However, there is a paucity of research examining linkages between ineffective arguing, emotional distress, and physical violence perpetration or victimization. Dyadic data from 231 married, heterosexual couples seeking therapy were used to test a model examining pathways between ineffective arguing and physical violence perpetration and victimization through emotional distress. The hypothesized model was compared to two plausible alternative models. Results revealed higher levels of men's ineffective arguing were positively associated with men's physical violence perpetration, both directly and indirectly, through higher levels of emotional distress. Higher levels of men's ineffective arguing were associated with lower men's physical violence perpetration through higher levels of women's emotional distress. Results can inform the clinical treatment of interpersonal violence by targeting ineffective arguing and emotional distress.

Effect of a digital biopsychometric risk profile of patients with cancer on the delivery of risk-stratified personalised prehabilitation.

e13636 Background: Cancer symptoms and treatment consequences such as fatigue, nausea, distress and breathlessness contribute to inactivity, malnutrition, sarcopenia and ultimately poor clinical outcomes. Multimodal prehabilitation, with a focus on physical activity, nutrition and emotional well-being, is associated with improved treatment outcomes. However, prehabilitation needs to be personalised to maximise adherence and impact. Digital solutions offer an opportunity to collect and consolidate health data to facilitate the personalisation of prehabilitation programmes. Methods: Patients were referred from the NHS to an independent digital prehabilitation provider, Onkohealth Ltd. Baseline health metrics were collected via validated survey tools and wearable technology to develop a biopsychometric profile including the following modifiable factors. Multi-morbidity risk (MMR) was represented as a score from 0-14. Frailty estimation was based on walking speed. Diet quality was based on the World Cancer Research Fund diet score with higher score for better quality food items (range 0-3). Psychological wellbeing was measured via an emotional distress scale (range 0-10) and self-efficacy (range 0-40). Exercise metrics included 1 minute heart rate recovery (1m HRR) and 30 second Sit to Stand test (30sSTS). Risk-stratification was undertaken using the validated thresholds for each of these 9 modifiable risk metrics, including BMI. EuroQoL EQ5D5L was used to report quality of life as health utility (EQ-HU). Results: 303 patients with a range of cancer diagnosis [gastrointestinal (41%), biliopancreatic (10%) gynaecological (16%) and breast (20%) were included. 72% of patients had at least one high-risk metric and 30% had >3 high risk metrics. 42% of patients were obese, 34% had a high MMR and 25% had a slow walking speed. There were strong correlations between age and MMR (rho=0.53; p<0.001) and walking speed (rho=0.33; p=0.004). 16% had a low HRR and 17% had a low STS. STS had significant correlation with walking speed [rho=0.47; p<0.001) and BMI (rho=0.34; p<0.001). 42% of patients reported a low quality diet. High levels of anxiety were recorded in 21% of patients and high levels of depression in 26% of patients. Higher levels of anxiety (rho-0.24; p=0.002) and distress (rho=0.29; p<0.001) and lower levels of self-efficacy (rho= 0.25, p<0.001) were associated with lower EQ HU. Conclusions: This study demonstrated that 7 in 10 cancer patients have at least one risk factor and 1 in 4 patients have more than 3 predictors of poor treatment outcomes. Bio-psychometric profiling highlights modifiable risk factors and provides a focus for prehabilitation to be personalised. The findings also highlighted the importance of psychological wellbeing as high levels of emotional distress were associated with lower reported quality of life.

0150 Increased Prevalence of Clinical Depression in Late Teens with Sleep Complaints

Abstract Introduction Adolescent mental health is becoming clinical attention since suicide is one of the leading causes of death in late teens. Depression and sleep are interconnected, since depression affects sleep, vice versa. Clinical depression with symptoms of sleep disturbance were interviewed by a board certified psychiatrist following depression inventory. Age, sex matched adolescents were also accessed by depression inventory scales. Methods 71 adolescence aged from 16-18 ( M:F=1:1) who visited sleep disorders clinic for their complaints of daytime sleepiness, sleep initiation problems, snoring, frequent midnight awakenings. 29% of them diagnosed with narcolepsy, 21% delayed sleep phase syndrome, 19% obstructive sleep apnea syndrome, 15% of them had chronic insomnia. Some of them have multiple sleep disorders associated diagnosis like OSA + narcolepsy, OSA + insomnia, or DSPS + OSA. 21 aged, sex matched high school students were evaluated for their anxiety and depression symptoms. Results Patients with sleep complaints had higher level of emotional distress compared with healthy adolescents without sleep complaints. Among sleep disorders, patients with narcolepsy had higher level of depression. These explains why children or adolescents with narcolepsy are initially misdiagnosed with depression in clinical setting. Comorbid depression and narcolepsy should be differentiated in clinical field. Conclusion In adolescents, patients with sleep disorders especially with narcolepsy have higher level of depression. Misdiagnosis of narcolepsy as depression may delay narcolepsy diagnosis. Support (if any)

Exploring experiences of moral injury and distress among health care workers during the Covid-19 pandemic.

Health care workers have been exposed to a variety of practical and emotional challenges because of the Covid-19 pandemic, leaving them vulnerable to experiencing moral injury and distress. However, there is currently sparse research which directly explores such experiences. This study aimed to explore and characterise the experiences and impacts of moral injury and distress among health care workers during the pandemic. Twenty semi-structured interviews were conducted with health care workers employed across both mental and physical health care services. Interviews were analysed from a critical realist perspective using thematic analysis. Three key themes were identified: attitudes towards moral injury, experiences of moral injury and consequences of moral injury. Participants appeared to identify with the idea of acting against their morals to varying extents based on their job roles. Participants experienced a range of potentially morally injurious and distressing events throughout the pandemic and many ultimately felt that they provided sub-standard levels of care due to extreme pressures on services. Detrimental impacts upon wellbeing were commonly reported, including high levels of emotional distress and feelings of guilt and shame. Some reported a loss of enthusiasm for their job and a desire to leave the profession entirely. Moral injury and distress presents a real concern for staff wellbeing and retention within the profession. During and beyond the Covid-19 pandemic, there is an urgent need for health care providers to implement wider strategies to target moral injury and distress, and support staff within health care settings.

Effects of risk exposure on emotional distress among Chinese adults during the COVID-19 pandemic: The moderating role of disruption of life and perceived controllability.

COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress. This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak. This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress. This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress (B = 0.551, 95% CI: -0.019, 1.121; B = 2.161, 95% CI: 1.067, 3.255; B = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress (B = 0.217, 95% CI: 0.036, 0.398; B = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress (B = -0.180, 95% CI: -0.362, 0.002; B = -0.187, 95% CI: -0.404, 0.030). These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public's perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.

Emotional Distress in a Patients Following Polytrauma.

Emotional affectivity can be described under two general dimensions: positive affectivity and negative affectivity. It is often assessed by means of questionnaires completed retrospectively by the subjects. The most common scales used are PANAS, DES, and PANA-X. All these scales are based on the concept of two dimensions, negative and positive affective emotions, respectively. Both dimensions mentioned, positive and negative affectivity, can be associated with a bipolar dimensional entity called pleasant-unpleasant. Specifically, a high level of positive emotions and a low level of negative emotions are associated with pleasant/positive feelings (happiness, well-being, satisfaction, cheerfulness, etc.), while a low level of positive emotions and a high level of negative emotions are associated with negative feelings (sadness, anger, nervousness, depression, anxiety, etc.). This study is an observational and cross-sectional study. The elements that led to the production of the final database were collected by means of a questionnaire, which included 43 items, 39 of which were specific questions found in the affective distress profile. The questionnaire was administered to 145 patients who had suffered polytrauma and were admitted to the Emergency Hospital of Galati in October 2022. The final centralizing tables included the characteristics of 145 patients, aged between 14 and 64 years. The aim of this study is to identify the level of emotional distress in patients who have suffered polytrauma, so the following scores were evaluated, obtained after the application of PDA: STD, ENF, END. The total distress score was obtained by summing all the negative items found in the PDA questionnaire. Men show a high level of emotional distress compared to women. Polytrauma has a negative effect on patients' emotional status, with a worrying prevalence of negative functional and dysfunctional emotions. The level of distress in polytrauma patients is high.

Psychological distress in a Portuguese sample of cancer patients during the COVID-19 pandemic: a cross-sectional study

Abstract Objective: Considering the lack of studies exploring the psychological impact of COVID-19 on patients living with and beyond cancer, this study aimed to explore the levels of emotional distress, anxiety, and depression in patients with cancer and survivors during the COVID-19 pandemic and to identify psychological risk factors. Methods: Data for this cross-sectional study were collected through an online questionnaire comprised a self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics and linear regression models were used to characterize the sample and identify the determinants of emotional distress, depression, and anxiety. Statistical analyses were performed using R, version 4.1.1. Results: The sample included 940 patients with cancer and survivors, mostly female (87.1%), with a mean age of 49.7 years. More than half of the patients were survivors (55.1%); 56.7% were diagnosed with breast cancer, and 35.0% had other chronic diseases. Most participants believed that they were more likely to be infected with COVID-19 (53.9%) and that they may have more complications if they were infected (76.7%). Approximately half of the participants revealed significant emotional distress (49.3%), 18.1% revealed significant depression, and 29.2% revealed significant anxiety. Female patients, participants with lower education levels, unemployed/lay-off, or in a medical leave with a chronic disease, taking care of someone with a chronic disease, or perceiving a higher risk of being infected with COVID-19 had higher levels of emotional distress, depression, and anxiety. Conclusions: This study provides useful information regarding the impact of the COVID-19 pandemic on the mental health of patients with cancer and survivors, showing that an increased number of patients experienced significant emotional distress during the pandemic.

Emotional Distress During COVID-19 by Mental Health Conditions and Economic Vulnerability: Retrospective Analysis of Survey-Linked Twitter Data With a Semisupervised Machine Learning Algorithm.

Monitoring the psychological conditions of social media users during rapidly developing public health crises, such as the COVID-19 pandemic, using their posts on social media has rapidly gained popularity as a relatively easy and cost-effective method. However, the characteristics of individuals who created these posts are largely unknown, making it difficult to identify groups of individuals most affected by such crises. In addition, large annotated data sets for mental health conditions are not easily available, and thus, supervised machine learning algorithms can be infeasible or too costly. This study proposes a machine learning framework for the real-time surveillance of mental health conditions that does not require extensive training data. Using survey-linked tweets, we tracked the level of emotional distress during the COVID-19 pandemic by the attributes and psychological conditions of social media users in Japan. We conducted online surveys of adults residing in Japan in May 2022 and collected their basic demographic information, socioeconomic status, and mental health conditions, along with their Twitter handles (N=2432). We computed emotional distress scores for all the tweets posted by the study participants between January 1, 2019, and May 30, 2022 (N=2,493,682) using a semisupervised algorithm called latent semantic scaling (LSS), with higher values indicating higher levels of emotional distress. After excluding users by age and other criteria, we examined 495,021 (19.85%) tweets generated by 560 (23.03%) individuals (age 18-49 years) in 2019 and 2020. We estimated fixed-effect regression models to examine their emotional distress levels in 2020 relative to the corresponding weeks in 2019 by the mental health conditions and characteristics of social media users. The estimated level of emotional distress of our study participants increased in the week when school closure started (March 2020), and it peaked at the beginning of the state of emergency (estimated coefficient=0.219, 95% CI 0.162-0.276) in early April 2020. Their level of emotional distress was unrelated to the number of COVID-19 cases. We found that the government-induced restrictions disproportionately affected the psychological conditions of vulnerable individuals, including those with low income, precarious employment, depressive symptoms, and suicidal ideation. This study establishes a framework to implement near-real-time monitoring of the emotional distress level of social media users, highlighting a great potential to continuously monitor their well-being using survey-linked social media posts as a complement to administrative and large-scale survey data. Given its flexibility and adaptability, the proposed framework is easily extendable for other purposes, such as detecting suicidality among social media users, and can be used on streaming data for continuous measurement of the conditions and sentiment of any group of interest.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Head and Neck Pain Drawing Area Correlates With Higher Psychosocial Burden But Not With Joint Dysfunction in Temporomandibular Disorders: A Cross-Sectional Study

Head and neck pain drawings have been introduced as part of the diagnostic gold standard for temporomandibular disorders (TMD). We aimed to quantify the spatial extent of pain in TMD patients and to analyze its association with further clinical findings. In a cross-sectional study, 90 patients (median age = 38 years; n women = 68) were diagnosed according to the DC/TMD. Intra-articular disorders were either confirmed or rejected by magnetic resonance imaging. The patients shaded all painful areas in a sketch of the left and right side of a face. A grid template was placed over the drawings and each region that contained markings was scored as painful. The correlation between the calculated area and the psychosocial variables (DC/TMD axis II) as well as the influence of pain lateralization were investigated using Spearman correlation, Mann-Whitney-U and chi-square tests. Pain affected all facial areas but concentrated on the regions of the temporomandibular joint and masseter origin. Thirty-nine percent reported purely unilateral pain, which was associated with structural TMJ findings in 77% of cases. Individuals with bilateral pain and those with greater spatial spread of pain had significantly higher scores on all axis II variables, except for functional limitation of the jaw. PerspectiveHead and neck pain drawings can contribute to a stratification of TMD patients. A greater extent of pain as well as pain bilateralization is associated with higher levels of emotional distress, pain chronicity and somatization, but not with functional impairment. Unilateral reporting of pain is associated with more intra-articular disorders.

COVID-19 PANDEMIC IN URUGUAY AND THE NEED FOR A PERSON AND SOCIAL CENTERED MEDICINE

Background: During the COVID-19 pandemic, the Uruguayan government decided to call for an attitude of responsible freedom of the population and created an Honorary Scientific Advisory Group (GACH). The intention was to report the scientific evidence available on the health situation with transparency and technical independence and to recommended interventions. This paper aims (1) to analyze the strategy to combat the COVID-19 pandemic used in Uruguay from the perspective and principles of person-centered medicine (PCM), (2) to report and examine from a broad perspective the policy regarding health authorities, scientific evidence and population, and (3) to discuss the importance of mental health and behavioral monitoring for identifying vulnerable groups that require special attention and care.
 Methods: Retrospective and narrative analysis of the creation of a socioeconomic and behavioral observatory [OSEC], critical evaluation of key data collection on population mental health, and assessment of the influence of OSEC in the context of the pandemic in Uruguay. T-test was used to assess mean differences of mental health trends in the general population using GHQ-12 panel data. The article presents the results obtained on the country’s mental health data through the analysis of a helpline consultations and a digital panel survey of a representative sample of the Uruguayan population. Screening instruments were used, which allowed for an identification of risk groups.
 Results: The evidence shows the impact of the pandemic on the emotional distress of the population, indicating that the population discomfort decreased significantly when the pandemic situation began to improve. In addition, differences according to socioeconomic status and age groups were observed, showing that the most disadvantaged had significantly higher levels of emotional distress than those of the middle and upper class, at all times of analysis.
 Conclusions: Apparently, it is possible to extend the principles of beneficence, autonomy, and justice applied at the individual level to the level of collective health policies. This is essential to achieve the active participation of the population in their self-care and to promote greater and more transparent communication with the health and scientific fields. It is also necessary to adopt a holistic, biopsychosocial perspective, which makes it possible to identify the vulnerable sectors of society and the areas in which special attention is required.