Increase In Psychological Symptoms Research Articles

Increases in Sleep Difficulties and Psychological Symptoms are Associated With the Increase of Chronic Back Pain in Adolescents: The HBSC Study 2002 to 2018

Cross-national research using data from the Health Behavior in School-aged Children (HBSC) survey showed an increase in the prevalence of chronic back pain from 2002 to 2014. However, it is unknown if this trend has persisted beyond 2014. The aims of this study were to 1) determine if the prevalence of chronic back pain in girls and boys aged 11, 13, and 15 continued to increase from 2014 to 2018 and if this was the case, 2) examine whether this increase in the prevalence of chronic back pain between 2002 and 2018 was explained indirectly by increases in sleep difficulties and psychological symptoms. Data from 7,89,596 adolescents retrieved from 5 waves of the HBSC survey conducted in 2002, 2006, 2010, 2014, and 2018 in 32 countries/regions were used. Logistic regressions and path analyses were conducted. Results showed an overall increase of .5% in the prevalence of chronic back pain between 2014 and 2018, ranging from .4% for 15-year-old girls to 1.3% for 11-year-old boys, indicating a continued overall increase in chronic back pain in adolescents beyond 2014. For 13-year-old girls and for 15-year-old girls and boys, the increase in the prevalence of chronic back pain between 2002 and 2018 was partially mediated by increases in sleep difficulties, which in turn were associated with increases in psychological symptoms. The findings provide important information that may aid stakeholders in enhancing public health initiatives to prevent or reduce the increasing trend in the prevalence of chronic back pain in adolescents. PerspectiveThis study shows that chronic back pain prevalence continues to increase among adolescents, with sleep difficulties and psychological symptoms contributing significantly to this trend. The findings provide insights that may inform strategies to prevent or reduce the increasing trend of chronic back pain in adolescents.

Personality predicts pre-COVID-19 to COVID-19 trajectories of transdiagnostic anxiety and depression symptoms.

This study aimed to characterize within-person pre-COVID-19 and coronavirus pandemic (COVID-19) transdiagnostic anxiety and depression symptom trajectories in emerging adults and determine the roles of neuroticism and behavioral activation in predicting these COVID-19-related changes. We recruited a sample of 342 emerging adults (aged 18-19 at baseline) who were screened on neuroticism and behavioral activation and completed symptom questionnaires on multiple occasions before and after the start of the pandemic. We examined estimates of the symptom factors of General Distress, Anhedonia-Apprehension, and Fears at each wave. The stress amplification model predicts a multiplicative neuroticism-adversity interaction with those high on neuroticism showing the greatest symptom increases to the pandemic. The stably elevated negative affect model is an additive model and predicts that persons high on neuroticism will display elevated symptoms at every wave. General Distress and Anhedonia-Apprehension showed large increases from the pre-COVID-19 to COVID-19 transition then decreased thereafter. The increase brought the average General Distress score to clinical levels at the first COVID-19 wave. There was a small decrease in Fears from the pre-COVID-19 to COVID-19 transition followed by a large increase. Thus, COVID-19 was associated with both increases in psychological symptoms and some resilience. Neuroticism positively predicted the pre-COVID-19 to COVID-19 transition change in Fears but was associated with a dampening of increases in General Distress and Anhedonia-Apprehension. The results disconfirmed the stress amplification model of neuroticism but partially supported the stably elevated negative affect model. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trend of Correlations between Psychological Symptoms and Socioeconomic Inequalities among Italian Adolescents: Cross-Sectional Study from 2006 to 2018 in Tuscany Region.

Adolescence is a critical moment in life; people become individuals, create new relationships, develop social skills and learn behaviours that they will use for the rest of their lives. During this phase, adolescents establish patterns of behaviour that can protect their health. This study aims to 1. assess the presence of psychological disorders in adolescents of both genders, 2. determine their relation to socio-economic differences based on the Family Affluence Scale (FAS), and 3. assess trends from 2006 to 2018. Data were collected from the Italian Health Behaviour in School-aged Children survey given to a representative sample of Tuscan adolescents aged 11-15 years. Participants (n. 12,550) filled out questionnaires to assess whether psychological symptoms such as feeling low, irritability, nervousness, or sleeping difficulties manifested weekly or more often over the past six months. For the study we utilized a cross-sectional survey method and linear regression to examine the association between psychological symptoms (dependent variable measured on an interval scale (0-16)), gender and FAS. We conducted similar analyses using logistic regressions for each of the four symptoms. An increase in psychological symptoms in both genders was revealed between 2006 and 2018, with a statistically significant presence in females: 0.29 (95% Confidence Interval [CI], 0.17 to 0.41), 1.43 (95% CI, 1.37 to 1.48) and 1.43 (95% CI, 1.34 to 1.52) in low-, medium- and high-affluence families, respectively; whereas males presented 0.14 (95% CI, 0.01 to 0.27), 0.71 (95% CI, 0.65 to 0.77) and 0.31 (95% CI, 0.22 to 0.39), respectively. The probability of a predictive episode of psychological symptoms (feeling low, irritability, nervousness, sleeping difficulties) occurring weekly, or more, often was greatly increased in females of all socioeconomic classes. These findings suggest that the increase in psychological disorders in adolescents should be considered a public health problem and further investigated through longitudinal studies and continuous monitoring of health trends.

Psychopathology of Former GDR Competitive Athletes in Comparison to The General Population

The knowledge about the consequences of state doping in the GDR is limited. It is assumed that the precarious training conditions had a great influence on the mental health of the former competitive athletes. The aim of this study was to assess the psychological symptoms of former GDR competitive athletes. A case-control study was conducted using questionnaires on psychological symptoms and possible risk or protective factors. Significant differences were found on scales. The major part of the affected athletes showed a clinically relevant psychological stress. Exemplary for this is a pronounced depressive symptomatology in 65,19% of the probands. Presumably, the negative experiences in competitive sports led to an increase in psychological symptoms and vulnerability.

Add-On Selective Estrogen Receptor Modulators for Methadone Maintenance Treatment.

Methadone maintenance treatment (MMT) remains the cornerstone for the management of opiate abuse. However, MMT can be associated with complex factors, including complications during the tolerance phase, the inability of some patients to maintain treatment effects during the tapering or abstinence phases, and the development of methadone dependence. Previous studies have revealed a sex disparity in MMT efficacy, showing that women undergoing MMT experiencing an increase in psychological symptoms compared with men and suggesting a link between disparate responses and the effects of estrogen signaling on methadone metabolism. More specifically, estradiol levels are positively associated with MMT dosing, and the expression of a single-nucleotide polymorphism (SNP) associated with estrogen receptor (ER) regulation is also associated with MMT dosing. In addition to performing mechanistic dissections of estrogen signaling in the presence of methadone, past studies have also proposed the targeting of estrogen signaling during MMT. The present report provides an overview of the relevant literature regarding sex effects, including differences in sex hormones and their potential impacts on MMT regimens. Moreover, this article provides a pharmacological perspective on the targeting of estrogen signals through the use of selective ER modulators (SERMs) during MMT. Preliminary preclinical experiments were also performed to evaluate the potential effects of targeting estrogen signaling with tamoxifen on methadone metabolism.

Increases in Stressors Prior to-Versus During the COVID-19 Pandemic in the United States Are Associated With Depression Among Middle-Aged Mothers.

Working parents in are struggling to balance the demands of their occupation with those of childcare and homeschooling during the COVID-19 pandemic. Moreover, studies show that women are shouldering more of the burden and reporting greater levels of psychological distress, anxiety, and depression relative to men. However, research has yet to show that increases in psychological symptoms are linked to changes in stress during the pandemic. Herein, we conduct a small-N study to explore the associations between stress and psychological symptoms during the pandemic among mothers using structural equation modeling, namely latent change score models. Thirty-three mothers completed questionnaires reporting current anxious and depressive symptoms (Beck Anxiety and Depression Index, respectively), as well as stressful life experiences prior to-versus during the pandemic (Social Readjustment Rating Scale). Women endorsed significantly more stressful events during the pandemic, relative to the pre-pandemic period. Additionally, 58% of mothers scored as moderate-to-high risk for developing a stress-related physical illness in the near future because of their pandemic-level stress. Depressive symptoms were associated with the degree of change in life stress, whereas anxiety symptoms were more related to pre-pandemic levels of stress. The present study preliminarily sheds light on the nuanced antecedents to mothers’ experiences of anxious and depressive symptoms during the COVID-19 pandemic. Although further work is needed in larger, more diverse samples of mothers, this study highlights the potential need for appropriate policies, and prevention and intervention programs to ameliorate the effects of pandemics on mothers’ mental health.

Acute mental health presentations before and during the COVID-19 pandemic.

A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum. We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic. We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020. There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown. UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

Psychosocial Effects of Corona Measures on Patients With Dementia, Mild Cognitive Impairment and Subjective Cognitive Decline.

Background: The recent COVID-19 pandemic is not only a major healthcare problem in itself, but also poses enormous social challenges. Though nursing homes increasingly receive attention, the majority of people with cognitive decline and dementia live at home. We aimed to explore the psychosocial effects of corona measures in memory clinic (pre-)dementia patients and their caregivers.Methods: Between April 28th and July 13th 2020, n = 389 patients of Alzheimer center Amsterdam [n = 121 symptomatic (age = 69 ± 6, 33%F, MMSE = 23 ± 5), n = 268 cognitively normal (age = 66 ± 8, 40% F, MMSE = 29 ± 1)] completed a survey on psychosocial effects of the corona measures. Questions related to social isolation, worries for faster cognitive decline, behavioral problems and discontinuation of care. In addition, n = 147 caregivers of symptomatic patients completed a similar survey with additional questions on caregiver burden.Results: Social isolation was experienced by n = 42 (35%) symptomatic and n = 67 (25%) cognitively normal patients and two third of patients [n = 129 (66%); n = 58 (75%) symptomatic, n = 71 (61%) cognitively normal] reported that care was discontinued. Worries for faster cognitive decline were existed in symptomatic patients [n = 44 (44%)] and caregivers [n = 73 (53%)], but were also reported by a subgroup of cognitively normal patients [n = 27 (14%)]. Both patients [n = 56 (46%) symptomatic, n = 102 (38%) cognitively normal] and caregivers [n = 72 (48%)] reported an increase in psychological symptoms. More than three quarter of caregivers [n = 111(76%)] reported an increase in patients' behavioral problems. A higher caregiver burden was experienced by n = 69 (56%) of caregivers and n = 43 (29%) of them reported that a need for more support. Discontinuation of care (OR = 3.3 [1.3–7.9]), psychological (OR = 4.0 [1.6–9.9]) and behavioral problems (OR = 3.0 [1.0–9.0]) strongly related to experiencing a higher caregiver burden. Lastly, social isolation (OR = 3.2 [1.2–8.1]) and psychological symptoms (OR = 8.1 [2.8–23.7]) were red flags for worries for faster cognitive decline.Conclusion: Not only symptomatic patients, but also cognitively normal patients express worries for faster cognitive decline and psychological symptoms. Moreover, we identified patients who are at risk of adverse outcomes of the corona measures, i.e., discontinued care, social isolation, psychological and behavioral problems. This underlines the need for health care professionals to provide ways to warrant the continuation of care and support (informal) networks surrounding patients and caregivers to mitigate the higher risk of negative psychosocial effects.

Die Lebenssituation von Menschen mit Demenz und pflegenden Angehörigen während der Coronavirus-Pandemie Eine qualitative Studie.

This study aims to describe the current life situation of family carers and people with dementia. For this purpose, 21 telephone interviews with both family carers and people with dementia have been conducted twice during the spring of 2020 and were subsequently evaluated by a content analysis. The interviewees experienced the situation differently. Especially the social isolation, the higher amount of care, the uncertainty of the situation and the increase in psychological symptoms are described as being stressful. With regard to coping with the situation, discussions are taking place about the support from the social environment, alternative ways of communication, experiences with comparable crises, the stability of formal care and the handling of information. Family carers and people with dementia feel stressed due to the coronavirus pandemic, but many of them have coping strategies for this special situation. Informal support is a particularly important support mechanism.

Effects of a Brief Mindfulness-Based Intervention on Depression, Anxiety, and Stress in Senior Students

Senior students are subject to several demands relative to the transition from the academic to professional environment. This pressure can lead to an increase in psychological symptoms. The aim of this study was to identify the possible effects of a brief mindfulness-based intervention on depression, anxiety, and stress in senior students. Another objective was to evaluate whether there was an association between the amount of meditative practices performed by the participants and the possible effects of the intervention. The study had a pre-experimental design, with pre- and post-intervention test and comparative and correlational measures. The intervention of six weekly meetings was attended by 34 participants and held in a university located in the south of Brazil. The results revealed a significant reduction in the three dimensions analyzed, according to the DASS-21 instrument. The scores showed a significant decrease in the level of depression with a large effect size, as well as a decrease in anxiety and stress levels with medium effect sizes. No associations were found between the amount of meditative practices performed by the undergraduates and the effects of the variables. It was concluded that a brief mindfulness intervention is capable of promoting mental health in academic contexts.

The Mediating Role of Inflated Sense of Self and Impulsivity in the Relationship Between Helicopter Parenting and Psychological Symptoms.

Helicopter parenting is characterised as a parenting style that take too much care and intervention to their children, take decisions instead of them, solve the problems they face and try to be overprotective. There is a growing interest in the negative aspects of helicopter parenting. This type of parenting attitude is thought to affect psychological problems. The aim of this study is to investigate the mediating effect of impulsivity and inflated self-sense of self in the relationship between helicopter parenting and psychological symptoms. The sample of the study consists of 337 university students. Perceived helicopter parenting was evaluated by Perceived Helicopter Parenting Attitude Scale, psychological symptoms by Brief Symptom Inventory, impulsivity levels by Barratt Impulsivity Scale, and inflated sense of self levels by using the Inflated Sense of Self Scale. As the helicopter parenting level perceived from the mother increased, psychological symptoms, impulsivity and inflated sense of self increased. There was no relationship between helicopter parenting perceived from the father and other variables. In the relationship between mother-perceived helicopter parenting and psychological symptoms, the inflated self-sense of self and impulsivity have a mediating effect; it was also found that impulsivity has a partial mediating effect on the relationship between inflated sense of self and psychological symptoms. In addition, inflated self-sense of self has a full mediating effect in the relationship between impulsivity and mother-perceived helicopter parenting. The results of the study show that there is a difference between perceived helicopter parenting from mother and father. Perceived helicopter parenting is associated with an increase in psychological symptoms. In addition, in this relationship, helicopter parenting can affect psychological symptoms by causing an increase in impulsivity and inflated sense of self.

Psychological changes during faith exit: A three-year prospective study.

This prospective study explored psychological changes during faith exit and attempted to identify individual characteristics of believers who would within a 3-year time frame become disengaged from their faith. Data were collected from 632 Chinese Protestant Christians, of whom 188 left their faith within 3 years after the 1st survey. The faith exiters' subsequent changes in personality, beliefs, and values, if any, were not any different from what were observed among other Christians. The only exceptions were that fate control belief and stimulation value increased more and religiosity social axiom declined more among the exiters than among those who stayed in faith. Latent growth mixture modeling indicated that about half of the faith exiters would initially experience an improvement in psychological symptoms, and the other half a deterioration. Poor quality of life at baseline was a risk factor for increase in psychological symptoms postexit. Besides being more likely to be a university student, the would-be exiters had a beliefs and values profile that was more similar to that of the nonbelievers than of the believers in other studies. However, with the exception of low emotional stability, the Big Five did not predict exit. The findings strongly suggest that changes in beliefs and values might have begun long before the actual faith exit, whereas personality change, if any, might take a long time after the transition. Changes in psychological symptoms after faith exit can be multitrajectory.

Mental health and quality of life of elderly people in the Bethlehem district: a cross-sectional study

BackgroundThe focus of this study was quality of life and mental health in elderly people living in the Bethlehem district. The aim of this study was to identify the most prevalent mental health problems and how they affect quality of life. MethodsThis cross-sectional study was done in June and July, 2010. We recruited a convenience sample of elderly people (aged 65 years and older) living in the Bethlehem district of occupied Palestinian territory. Using a structured questionnaire, we assessed quality of life with the WHOQOL-BREF and current psychological status and distress with the Brief Symptom Inventor. Verbal consent form was obtained from all participants before their interview. Findings291 (97%) of 300 elderly people approached for this study completed the questionnaire. 101 (35%) participants described severe or very severe levels of somatisation. 39 (14%) participants reported severe or very severe obsessive compulsive symptoms, 27 (9%) complained of severe or very severe anxiety symptoms, and 37 (13%) had severe or very severe depression. 135 (46%) participants rated their quality of life as good or very good, but the physical health domain of the WHOQOL-BREF scale had the lowest scores (mean 50·9 [SD 21·4]) of all the domains. 103 (36%) participants perceived their physical health as being good or very good, whereas 95 (33%) participants rated their social life as good or very good. 117 (40%) participants were satisfied or very satisfied with their environment, and 119 (41%) participants evaluated their psychological health as good or very good. A stepwise regression analysis of variables indicated that an increase in psychological symptoms was independently associated with lack of education, living in a rural area, being economically dependent on others, and living with chronic disease. Poor quality of life was independently associated with increased age, lack of education, living in the home of sons, and being economically dependent on others. InterpretationIn view of the high prevalence of chronic diseases and their negative effect on psychological health and quality of life, we recommend the provision of better health care for elderly people, especially those living in rural areas. Our findings also show the importance of special education programmes for the physical and psychological health of elderly people. FundingNone.

The Effect of Workplace Bullying Perception on Psychological Symptoms: A Structural Equation Approach.

BackgroundThe aims of this study were to determine the extent of workplace bullying perceptions among the employees of a Faculty of Medicine, evaluating the variables considered to be associated, and determining the effect of workplace bullying perceptions on their psychological symptoms evaluated by the Brief Symptom Inventory (BSI).MethodsThis cross-sectional study was performed involving 355 (88.75%) employees.ResultsLevels of perceived workplace bullying were found to increase with the increasing scores for BSI and BSI sub-dimensions of anxiety, depression, negative self, somatization, and hostility (all p < 0.001). One point increase in the workplace bullying perception score was associated with a 0.47 point increase in psychological symptoms evaluated by BSI. Moreover, the workplace bullying perception scores were most strongly affected by the scores of anxiety, negative self, depression, hostility, and somatization (all p < 0.05).ConclusionThe present results revealed that young individuals, divorced individuals, faculty members, and individuals with a chronic disease had the greatest workplace bullying perceptions with our study population. Additionally, the BSI, anxiety, depression, negative self, somatization, and hostility scores of the individuals with high levels of workplace bullying perceptions were also high.

N01 - The psychological consequences after adjuvant aromatase inhibitor therapy in breast cancer women

Aromatase inhibitors (AIs) are standard hormone therapy for the adjuvant treatment of postmenopausal endocrine-sensitive early breast cancer. AIs therapy has been shown to be associated with increased survival, decreased risk of recurrence, and lower risk of contralateral breast cancer compared to tamoxifen but cross-trial and direct comparisons have demonstrated that AIs are also associated with several toxicities (musculoskeletal/menopausal symptoms). While physical side-effects have been studied, the presences of pain, insomnia, fatigue, cognitive dysfunction, and mood disorders were not well documented and it is not clear the potential effect of AIs on psychological aspects. This study aimed at evaluate the QOL and the presence of a pattern of psychological symptoms in breast cancer patients undergoing AIs therapy. A longitudinal study was conducted with a group of postmenopausal breast cancer women. Data were collected with a questionnaire at three time points: T0 when the AIs therapy was started, T1 after 3 month and T2 after six months. FACT-G, FACT-B and FACT-ES were used to assess the QOL; psychological symptoms were assessed using the SCL-90. Women characteristics were collected at T0 and clinical aspect were measured at each time point. 43 women were enrolled in the study, 37 completed T1 evaluation and 29 T2. A general decrease in FACT-G, FACT-ES and FACT-B scores resulted from T0 to T1/T2 evaluations; the most relevant and statistically significant decreases were: FACT-G (T1-T0 = -3.1, p = 0.0456; T2-T0 = -4.8, p = 0.0296); Physical well-being subscale (T2-T0 = -1.7, p = 0.0128), Emotional well-being subscale (T2-T0 = -1.5, p = 0.0059), FACT-ES (T1-T0 = -2.4, p = 0.0058; T2-T0 = -3.3, p = 0.0009), FACT-B (T2-T1 = -1.6, p = 0.0471). The scores of the SCL-90 scale showed a positive trend for most of the patients from T0 to T1/T2 (mainly between T1/T2). Using a data clustering with Heatmap Analysis, items 1, 2, 10, 11, 26, 31, 32, 44, 55, 57, 64, 66, 79 were the most associated with trend. Our study showed a general deterioration in the QOL and an increase in psychological symptoms in women undergoing AIs therapy. The presence of a specific pattern of symptoms is clinically relevant in a small subsample, since these symptoms compromised treatment's compliance. The limited sample size did not allow a broad generalizability of results, future studies are needed to better understand the psychological consequences in AIs therapy.

Predicting mental health after living kidney donation: The importance of psychological factors.

Living donor kidney transplantation offers advantages to the patient, however involves risks to the donor. To optimize donors' mental health after donation, we studied the influence of psychological factors on this outcome. Potential predictors were based on models of Lazarus () and Ursin and Eriksen () that describe predictors of mental health mediated by stress. Prospective design. Living kidney donors (n=151) were interviewed before donation and completed questionnaires 2.5months before and 3 and 12months post-donation. Using multilevel regression models, we examined whether appraisals, expectations, knowledge, social support, coping, life events, and sociodemographic characteristics predicted psychological symptoms and well-being and whether these relationships were mediated by stress. A greater increase in psychological symptoms over time was found among donors without a partner. Younger age, lack of social support, expectations of interpersonal benefit, lower appraisals of manageability, and an avoidant coping style were related to more psychological symptoms at all time points. The latter three were mediated by stress. No religious affiliation, unemployment, history of psychological problems, less social support, expectations of negative health consequences, and less positive appraisals were related to lower well-being at all time points. This study identified indicators of a lower mental health status among living kidney donors. Professionals should examine this profile before donation and the need for extra psychological support in relation to the number and magnitude of the identified indicators. Interventions should be focused on the changeable factors (e.g., expectations), decreasing stress/psychological symptoms, and/or increasing well-being. Statement of contribution What is already known on this subject? Until now, research on psychological outcomes after living kidney donation revealed that mental health remained the same for the majority of living kidney donors, while mental health improved or deteriorated for a minority after donation. In reaction to these findings, many psychosocial screening guidelines have been developed for potential donors; however, the components of these guidelines are based on professional opinions and experience rather than on longitudinal empirical data. There is a lack of research that identifies pre-donation donor characteristics that are related to a lower mental health among donors. Such studies are essential in order to tailor psychosocial support during the donation process. What does this study add? Components that are mostly included in psychosocial screening guidelines for potential living kidney donors are not predictive of deterioration, nor increase, in mental health after donation, except for the lack of a partner. Therefore, there is little evidence on the necessity of rejecting potential donors based on these psychological criteria. The following psychological risk factors are predictive of the absolute level of donors' mental health during the donation process: A history of psychological problems, expectations of interpersonal benefit and negative health outcomes, an avoidant coping style, lack of social support, appraisals of the donation process as an unmanageable and/or negative event, a younger age, no religious affiliation, and unemployment. We argue that potential donors should not be rejected for donation based on these factors, but the indicators should be used to identify donors who might be in need for more psychological support.

The Effects of Declining Functional Abilities in Dementia Patients and Increases in Psychological Distress on Caregiver Burden Over a One-Year Period

The degree to which changes in caregiver burden over a one-year period can be predicted by functioning of dementia patients and caregiver psychological stress was examined. The Direct Assessment of Functional Status (DAFS) was administered to 44 patients and the Caregiver Burden Inventory and the Brief Symptom Inventory were administered to their next-of-kin caregivers. All patients and caregivers were assessed at baseline and again in approximately one year with the same measures. Hierarchical regression revealed that baseline patient functioning predicted overall changes in caregiver burden, but that increases in psychological symptoms of caregivers such as depression, anxiety, and hostility were the best predictors for specific types of increased caregiver burden, such as social, developmental, or physical burden. These results suggest that interventions should target reduction of particular psychological symptoms in order to reduce caregiver burden over time.

Changes in cognitive‐emotional and physiological symptoms of depression following STN‐DBS for the treatment of Parkinson’s disease

Subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to have beneficial effects on the motor features of Parkinson's disease (PD), but its impact on non-motor symptoms, most notably mood, has not been fully explored. In the first study to independently compare the emotional-cognitive and somatic/physiological symptoms of depression, we examined mood differences in 17 bilateral STN-DBS and 22 matched non-surgical PD patients at baseline and 6 months. The STN-DBS group reported higher levels of depression at baseline with significant endorsement of physical symptomatology. Postoperatively, no significant between-group differences in physical symptoms of depression were found. In contrast, a significant group by time interaction for cognitive-emotional symptoms of depression was found, with the STN-DBS group reporting an increase in psychological symptoms of distress. The STN-DBS group also reported an increase in anxiety following surgery. The suicide rate of 5% found in our study is consistent with other postoperative studies in PD. The impact of changes in levodopa and psychotropic medication are also explored. Preliminary results suggest that the motor improvement often observed in patients with PD following bilateral STN-DBS may be partially offset by an increase in affective-cognitive symptoms of depression.

Longer-term psychiatric adjustment of children and parents after meningococcal disease

To ascertain whether increases in psychological symptoms in children and parents after meningococcal disease are sustained over time, and to examine the psychosocial and illness associations of 12-mo psychological outcome. A prospective, cohort study using repeated measures. Three pediatric intensive care units and 19 general pediatric wards across greater London. Fifty-six children, aged 3 to 16 yrs, admitted to hospital with meningococcal disease and their parents. Child and parent psychological symptoms were measured, using the Strengths and Difficulties Questionnaire (SDQ) and the General Health Questionnaire (GHQ) at three time points: before/during hospital admission, 3 mos, and 12 mos after discharge. The Impact of Event Scale (IES) was used at the two follow-up points. During the follow-up period, there were statistically significant increases over child pre-illness levels in parent-rated emotional, conduct, hyperactivity, and impact SDQ scores; the most significant change at 12-mo follow-up was an increase in impact on daily living scores. At 12 mos, five (11%) of 43 children were at risk for posttraumatic stress disorder. The strongest correlations of 12-mo child psychological symptoms (total SDQ scores)--in addition to premorbid total SDQ score--were illness-related changes in parenting, maternal IES and GHQ scores. At 12 mos, 13 (24%) of 54 mothers and six (15%) of 40 fathers scored at high risk for posttraumatic stress disorder. The strongest correlation of maternal posttraumatic stress disorder symptoms (IES scores) was paternal posttraumatic stress disorder symptoms. Admission to the hospital with meningococcal disease is followed by an increase in psychological symptoms in children at home, some of which are persistent and impairing, and by continuing posttraumatic stress symptoms in a proportion of children and parents. Psychosocial (pre- and postmorbid) factors predict problems at 12-mo follow-up.

Women in novel occupational roles: mental health trends in the UK Armed Forces

There is uncertainty about whether women in the military have more psychological symptoms than men and whether psychological symptoms have increased over time. The aims of this study were to assess changes in psychological symptoms in military women over time, to compare them with men, and assess the effect of deployment. Two cross-sectional studies based on random samples of the Armed Forces were used to assess the effects of deployment to the Gulf and Iraq Wars. We selected for the analyses all the women and a 20% random sample of men who completed a questionnaire stratified by rank. We assessed psychological distress, number of symptoms, post-traumatic stress reaction (PTSR), chronic fatigue and alcohol misuse. There has been an increase in psychological symptoms, including alcohol misuse, in those not deployed to the Gulf or Iraq Wars, especially in women. The odds ratios for PTSR [5.82 (95% CI: 1.27-26.71)], multiple symptoms [8.49 (1.97-36.65)] and alcohol misuse [6.20 (2.09-18.37)] were higher in women than in men in the non-deployed samples. Psychological distress and chronic fatigue was more common in women, and alcohol misuse, was more common in men. In women, psychological symptoms were positively associated with deployment in the Gulf War, but not the Iraq War. Psychological symptoms in the Armed Forces have increased over time regardless of gender, in those not deployed. The association between gender and psychological symptoms has not changed over time. The deployment effect in women is similar to that described in men.