Level Of Social Functioning Research Articles

Effect of Mental Health on Level of Injury and Life Satisfaction among Young Elite Athletes-A Barrier or Augment: An Observational Study

Introduction: Sports injuries can have long-term psychological and physical ramifications. For instance, concussions can affect a person's quality of life by causing a variety of cognitive problems and emotional swings. Joint injuries can also make athletes more susceptible to musculoskeletal issues in the future, which could limit their capacity to exercise and lower their level of enjoyment and general well-being. Gaining a thorough grasp of the mental health and psychological well-being unique to top athletes may help to improve models of treatment and management for this group, which might ultimately lead to improved performance, lower risk of injuries and improve quality of life. Sport professionals, such as coaches, medical personnel, and sport psychologists, need to have this understanding in order to help elite athletes improve their mental wellness by helping them build coping mechanisms. Methods: The study was performed in NIMS University, in 2024. The survey contained information about the purpose and objectives of the study, informed consent, sociodemographic questions, questions related to mental health, life satisfaction and level of injury questionnaires concerning various aspects of well-being (stress level, depression, anxiety, satisfaction, and physical health, level of physical, mental and social functioning). Result: In this study, a total of 258 participants were included in the analysis. The average age of the participants was 19.5 years, with 52.7% of the sample being women and 47.3% men. Conclusion: A distinct set of pressures that elite athletes face might make them more susceptible to mental illness. Important elements include coping with continuous performance pressure from competition, the psychological effects of injuries, life satisfaction, overtraining, and burnout, and intensive public and media scrutiny.

Collaborative outcomes study on health and functioning during infection times (COH-FIT): Insights on modifiable and non-modifiable risk and protective factors for wellbeing and mental health during the COVID-19 pandemic from multivariable and network analyses

There is no multi-country/multi-language study testing a-priori multivariable associations between non-modifiable/modifiable factors and validated wellbeing/multidimensional mental health outcomes before/during the COVID-19 pandemic. Moreover, studies during COVID-19 pandemic generally do not report on representative/weighted non-probability samples. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is a multi-country/multi-language survey conducting multivariable/LASSO-regularized regression models and network analyses to identify modifiable/non-modifiable factors associated with wellbeing (WHO-5)/composite psychopathology (P-score) change. It enrolled general population-representative/weighted-non-probability samples (26/04/2020-19/06/2022). Participants included 121,066 adults (age=42±15.9 years, females=64 %, representative sample=29 %) WHO-5/P-score worsened (SMD=0.53/SMD=0.74), especially initially during the pandemic. We identified 15 modifiable/nine non-modifiable risk and 13 modifiable/three non-modifiable protective factors for WHO-5, 16 modifiable/11 non-modifiable risk and 10 modifiable/six non-modifiable protective factors for P-score. The 12 shared risk/protective factors with highest centrality (network-analysis) were, for non-modifiable factors, country income, ethnicity, age, gender, education, mental disorder history, COVID-19-related restrictions, urbanicity, physical disorder history, household room numbers and green space, and socioeconomic status. For modifiable factors, we identified medications, learning, internet, pet-ownership, working and religion as coping strategies, plus pre-pandemic levels of stress, fear, TV, social media or reading time, and COVID-19 information. In multivariable models, for WHO-5, additional non-modifiable factors with |B|>1 were income loss, COVID-19 deaths. For modifiable factors we identified pre-pandemic levels of social functioning, hobbies, frustration and loneliness, and social interactions as coping strategy. For P-scores, additional non-modifiable/modifiable factors were income loss, pre-pandemic infection fear, and social interactions as coping strategy. COH-FIT identified vulnerable sub-populations and actionable individual/environmental factors to protect well-being/mental health during crisis times. Results inform public health policies, and clinical practice.

The Effect of Art Therapy by Painting Technique on Social Function Level in Schizophrenia Patients at Menur Mental Hospital, Surabaya City, East Java, Indonesia

The Effect of Art Therapy by Painting Technique on Social Function Level in Schizophrenia Patients at Menur Mental Hospital, Surabaya City, East Java, Indonesia

Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.

The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF). The clinical outcomes were assessed, and intraoperative data and complications were collected. Numeric Rating Scale (NRS) scores for low back pain and leg pain, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores for evaluating functions of the lumbar spine and health-related quality of life, and the modified MacNab standard for assessing satisfaction were analyzed. Radiographic outcomes included disc space height, segmental lordosis, interbody fusion assessment, and the rate of muscle atrophy of the multifidus and the erector spinae muscles. Among the three groups, the SPSW group exhibited the shortest operation and drain retention time, lowest intraoperative blood loss, and minimal postoperative blood loss. Notably, the SPSW group displayed the highest level of social life function based on the JOABPEQ, and the highest level of patient satisfaction according to the modified MacNab Criteria, along with the lowest rate of muscle atrophy. All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.

Investigation of the quality of life, mental status in patients with gynecological cancer and its influencing factors.

Having a gynecological tumor or undergoing treatment can be a traumatic experience for women, as it affects their self-image and sexual relationships and can lead to psychological reactions. Psychological adjustment following cancer occurrence remains a key issue among the survivors. To examine the current status of quality of life (QoL), anxiety, and depression in patients with gynecological cancer and to analyze the factors associated with it. Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively. Patients' QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire. Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale. The associated factors of anxiety and depression were analyzed. The overall QoL score of the patients 6 months after surgery was 76.39 ± 3.63 points. This included low levels of social and emotional function and severe fatigue and pain. The scores for physiological, functional, emotional, social, and family well-being exhibited an upward trend following surgery compared with those before surgery. One month after surgery, some patients experienced anxiety and depression, with an incidence of 18.75% and 18.13%, respectively. Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors, whereas physical pain was a risk factor. Patients with gynecological malignancies often experience anxiety and depression. By analyzing the factors that affect patients' QoL, effective nursing measures can be administered.

Differential diagnosis and nosology issues of disorders with affective and psychotic symptoms: a clinical case report

Based on the results of large-scale genomic studies, the psychotic continuum hypothesis suggests considering disorders characterized by primary psychotic symptoms as part of a single spectrum of neurodevelopmental disorders and implies the existence of a gradient of severity between affective disorders and schizophrenia, with increasing severity of psychotic episodes and deficits. The continuum hypothesis explains the existence of the previously controversial diagnosis of schizoaffective disorder (SAD), which combines clinical manifestations of both schizophrenia and bipolar affective disorder: according to this hypothesis, schizoaffective disorder is assigned an intermediate position in the continuum. The common leading clinical criteria and genetic commonality on the one hand, and the absence of objective disease markers on the other significantly complicate the diagnostic search between the disorders with affective and psychotic symptoms, raising questions not only about their nosological relationships but also about the problem of finding methods of differentiation at early stages of disorder development. Promising tools for differential diagnosis include multifactorial analysis of parameters (genetic, clinical, and socio-demographic parameters, level of social functioning, response to prescribed psychopharmacotherapy), molecular phenotyping of profiles, and the search for laboratory, neuroimaging, and neurobiological markers of diseases. As of today, the main reliable approach in the differential diagnosis of these disorders remains the follow-up approach. The article presents a clinical case describing a 19-year follow-up of a patient with clinically heterogeneous episodes of affective-delusional symptomatology combined with alcoholism and demonstrating the difficulty of diagnosing disorders with affective and psychotic manifestations, as well as the need for further research in this area.

Adjuvant Psychotherapies to Prevent Relapse in Bipolar Disorder

Several psychotherapy protocols have been evaluated as adjuncts to pharmacotherapy for patients with bipolar disorder (BD). Little is known about their comparative effectiveness. To compare the effectiveness of 2 types of group psychotherapy, skill-oriented, material-based cognitive behavioral therapy (SEKT) and supportive, patient-centered, emotion-focused therapy (FEST), to prevent relapse in patients with euthymic BD. This was a large, observer-blind, randomized clinical trial conducted over 18 months (posttreatment after 6 months; follow-up at 12 and 18 months). In addition to psychiatric care as usual (including mood-stabilizing medication), each participant at 9 clinical outpatient units in Germany received 24 hours of group psychotherapy over 4, full-day sessions spread over 5 months. Patients with euthymic BD type 1 (BD 1) or BD type 2 (BD 2) between the ages of 18 and 50 years were randomly assigned to 1 of 2 forms of psychotherapy, SEKT or FEST. Independent clinicians blinded to patient grouping performed assessments using structured interviews (Structured Clinical Interview for DSM Disorders and Longitudinal Interval Follow-Up Evaluation) and self-rating and clinician rating for inclusion criteria and outcome. Kaplan-Meier survival curves were calculated for time to relapse. Cox proportional hazards statistics and propensity score matching were calculated for the multivariate analysis. Study data were analyzed from March 2020 to September 2022. SEKT intervention is a structured cognitive behavioral therapy integrating elements of interpersonal social rhythm therapy, and of mindfulness-based cognitive therapy. FEST psychotherapy has its roots in emotion-focused, supportive, and nondirective therapy. Recurrence of a new affective episode assessed by blinded interviewer with the LIFE interview. In addition, self-rating and clinician rating of depressive and mania symptoms as well as level of social functioning were assessed. Of 348 screened referrals, 305 patients (median [IQR] age, 34 [18-50] years; 162 male [53%]) with euthymic BD 1 or BD 2 were included in the study. A total of 207 patients (68%) had BD 1, 98 (32%) had BD 2, and 278 (91%) received psychiatric care. Both therapies were equally effective in preventing recurrence of a new episode. Outcome (higher rate of new episodes) was not predicted by kind of treatment (SEKT: 69 [49%] relapse; FEST: 63 [46%] relapse) but was predicted by BD 2, comorbidity, attending all sessions, and the interaction of type of treatment by BD 1 or 2. Patients with BD 2 had the highest rate of relapse (60 [61%] relapse), in particular, when treated by SEKT (39 [70%] relapse). Results of this randomized clinical trial revealed that a structured, skill-oriented, material-based cognitive behavioral therapy (SEKT) and a supportive, patient-centered, emotion-focused therapy (FEST) were equally effective in preventing relapse of affective episodes when delivered in a new, intensive group format. Additionally, there were baseline factors, in particular BD 2, that influenced outcomes. ClinicalTrials.gov Identifier: NCT02506322.

Differential diagnosis and issues of nosology of disorders with affective and psychotic symptoms: clinical observation

Based on the results of large-scale genomic studies, the psychotic continuum hypothesis suggests considering disorders characterized by primary psychotic symptoms as part of a single spectrum of neurodevelopmental disorders and implies the existence of a gradient of severity between affective disorders and schizophrenia, with increasing severity of psychotic epsodes and deficits. The continuum hypothesis explains the existence of the previously controversial diagnosis of schizoaffectivedisorder (SAD), which combines clinical manifestations of both schizophrenia and bipolar affective disorder: according to this hypothesis, schizoaffective disorder is assigned an intermediate position in the continuum. The common leading clinical criteria and genetic commonality on the one hand, and the absence of objective disease markers on the other significantly complicate the diagnostic search between the disorders with affective and psychotic symptoms, raising questions not only about their nosological relationships but also about the problem of finding methods of differentiation at early stages of disorder development. Promising tools for differential diagnosis include multifactorial analysis of parameters (genetic, clinical, and socio-demographic parameters, level of social functioning, response to prescribed psychopharmacotherapy), molecular phenotyping of profiles, and the search for laboratory, neuroimaging, and neurobiological markers of diseases. As of today, the main reliable approach in the differential diagnosis of these disorders remains the follow-up approach. The article presents a clinical case describing a 19‑year follow-up of a patient with clinically heterogeneous episodes of affective-delusional symptomatology combined with alcoholism and demonstrating the difficulty of diagnosing disorders with affective and psychotic manifestations, as well as the need for further research in this area.

The effects of psychosocial interventions applied to forensic psychiatry patients on social functioning and anger level: a meta-analysis study

ABSTRACT This study was conducted to determine the effects of psychosocial interventions on social functioning and anger levels in forensic psychiatry patients. Data for this meta-analysis study were gathered by searching databases such as PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center, without any year restriction, from September to December 2023. After a thorough review, 12 studies were deemed appropriate for the analysis. The findings of this meta-analysis indicate that psychosocial treatments administered to forensic psychiatry patients led to an increase in their level of social functioning (SMD: 0.513, 95% CI: 0.072 – 0.995; Z = 2.280; p < .05) and a decrease in their level of anger (SMD: −0.701, 95% CI: −1.301 to −0.100;Z = −2.287; p < .05). It was also observed that the effectiveness of the psychosocial intervention was not influenced by the type of psychotherapy, the country where the study was conducted, or the duration of the treatment. Psychosocial interventions for forensic psychiatry patients positively affect the mental health of individuals.

Abstract PO2-10-09: Professional Support for Eating and Nutrition among Women Living with Breast Cancer: Implications for Mental Health and Quality of Life

Abstract Background: Within oncology, nutrition and eating behaviors are often tied to cancer prevention, incidence rates, progression, and healthy survivorship, as well as symptom and side effect management. While many nutrition-related resources and guidelines focus on physical health outcomes, support around nutrition and eating behaviors can have critical implications for mental health and quality of life outcomes among breast cancer patients and survivors. Methods: 232 women with breast cancer enrolled in the online Cancer Experience Registry and provided sociodemographic and clinical characteristics, answered questions about their eating and nutrition experiences, including utilization of a Registered Dietitian for professional eating and nutrition support since being diagnosed with cancer, and completed the Patient-Reported Outcomes Measurement Information System (PROMIS-29v2.0 + 2-item Cognitive Function Short Form). Frequencies were calculated and group differences among those who wanted professional support for eating and nutrition but either did or did not receive it were assessed using independent-samples t-tests. Results: The sample was 81% Non-Hispanic (NH) White, 9% NH Black. Participants varied in age (mean=61 yrs; SD=9.2), time since diagnosis (median=7 yrs, range: &amp;lt; 1-39) and socioeconomic status (16% household income &amp;lt; $40K; 32% employer-provided insurance coverage). 44% were currently receiving treatment, with 70% in remission, 12% with metastatic disease, and 21% with history of recurrence. Over one-third (36%) received professional support for eating and nutrition from a Registered Dietitian since being diagnosed with cancer, including 12% receiving that support in the last 6 months. Participants wanted professional support for eating and nutrition during active treatment (51%), after treatment (44%), at initial diagnosis (23%), before treatment (18%), before being diagnosed with cancer (11%) . The most commonly reported eating and nutrition needs driving the desire for professional support included weight-related support (54%; maintenance, gain, or loss), achieving healthy eating patterns (52%), increasing energy level (46%) and physical fitness/strength (45%). However, experiences with professional support for eating and nutrition varied: 54% wanted eating and nutrition support since being diagnosed with cancer, but only 68% of those who wanted this support were able to access care. Irrespective of access to professional eating and nutrition support, participants report changing their eating patterns to manage SSEs (50%) or improve long-term health (57%). Among those who desired professional support for eating and nutrition since being diagnosed with cancer (n=102), those who did not get the desired support (n=34) compared to those who did (n=68) reported higher levels of anxiety, depression, sleep disturbance, and pain, as well as lower levels of physical and cognitive function (all ps &amp;lt; .05). Levels of fatigue and social function were not significantly different between groups. Conclusion: While there is a strong desire for professional support surrounding eating and nutrition among women with breast cancer, when that support is needed and what it aims to address varies greatly. Among those interested in receiving professional support for eating and nutrition, those who accessed professional support reported greater mental health and quality of life. Further research is needed to understand barriers to accessing eating and nutrition support among those who are not able to obtain it. Community-based advocacy organizations that offer access to professional support services for eating and nutrition are critical for addressing unmet needs in this area to improve health and well-being among women with breast cancer. Citation Format: Victoria Morris, Melissa Miller, Susan Weldon, Gail Kelly. Professional Support for Eating and Nutrition among Women Living with Breast Cancer: Implications for Mental Health and Quality of Life [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-09.

Examining the Longitudinal Bi-Directional Associations of Friend Engagement, Social Functioning, and Depression.

Various components of social functioning predict depression and these associations can vary by gender. Bi-directional associations may be important to consider as social factors may influence depressive symptoms while depressive symptoms may impact social factors. Most previous longitudinal research examining bi-directional effects has traditionally used the cross-lagged panel model (CLPM), which has some inherent weaknesses. This study sought to apply a more comprehensive analysis to examine bi-directional associations between friend engagement, social functioning, and depressive symptoms. Random intercept cross-lagged panel models (RI-CLPM) were tested on three waves from the Wisconsin Longitudinal Study (N = 5890). Average levels of social functioning were positively associated with friend engagement and negatively associated with depression. Fluctuations in social functioning and friend engagement were negatively associated with same-wave depressive symptoms. Lastly, depression was predicted by previous fluctuations in social functioning, although the findings varied by gender. This study showed that the relationships between social factors and depression are apparent within and across large time intervals, even while controlling for between-person associations. These findings add further support to the need to attend to social life as a predictor of depression in older adults. Future research could improve upon this research by examining the characteristics of the friendship interactions and including more diverse samples.

The Impact of an Effective Rehabilitation System on the Academic Performance of Special needs persons

This study looked at how well functioning rehabilitation programme affect special needs students’ academic performance in Federal College of Education (Special), Oyo. A descriptive research design was employed for the study. The population of the study consisted of all the Academic staff from the School of Special Education, Federal College of Education (Special), Oyo. The sample size for the study was fifty (50) academic staff randomly selected from various departments in special education. A Self-developed questionnaire titled: Impact of an Effective Rehabilitation System on the Academic Performance of Special Needs Persons (IERSAPSP) was used by the researcher for data collection. The instrument was validated and the reliability coefficient 0f 0.86 was realized which implies that the instrument was reliable. Three research questions guided the study. The data collected were organized and analyzed using descriptive statistics frequency count and percentage. The findings showed that persons with special needs find it very difficult to adapt to school life and show signs of inappropriate or what might be considered immature behavior, but with effective rehabilitation system this will enable them to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. It was recommended among others that the Government at all levels should ensure that a reasonable percentage of the Education Trust Fund Allocation is made available for the education of students with disabilities.

Social activity mediates locus coeruleus tangle-related cognition in older adults

The locus coeruleus-noradrenaline system regulates brain-wide neural activity involved in cognition and behavior. Integrity of this subcortical neuromodulatory system is proposed to be a substrate of cognitive reserve that may be strengthened by lifetime cognitive and social activity. Conversely, accumulation of tau tangles in the brainstem locus coeruleus nuclei is recently studied as a very early marker of Alzheimer’s disease (AD) pathogenesis and cognitive vulnerability, even among older adults without cognitive impairment or significant cerebral AD pathologies. This clinical-pathologic study examined whether locus coeruleus tangle density was cross-sectionally associated with lower antemortem cognitive performance and social activity among 142 cognitively unimpaired and impaired older adults and whether social activity, a putative reserve factor, mediated the association of tangle density and cognition. We found that greater locus coeruleus tangle density was associated with lower social activity for the whole sample and in the cognitively unimpaired group alone and these associations were independent of age, sex, education, depressive symptoms, and burden of cerebral amyloid and tau. The association of locus coeruleus tangle density with lower cognitive performance was partially mediated by level of social activity. These findings implicate the locus coeruleus-noradrenaline system in late-life social function and support that locus coeruleus tangle pathology is associated with lower levels of social activity, independent of cerebral AD pathologies, and specifically among older adults who are cognitively unimpaired. Early brainstem pathology may impact social function, and level of social function, in turn, influences cognition, prior to canonical stages of AD.

20-year neurocognitive development following a schizophrenia spectrum disorder and associations with symptom severity and functional outcomes.

Cognitive deficits are a core feature of schizophrenia and are closely associated with poor functional outcomes. It remains unclear if cognitive deficits progress over time or remain stable. Determining patients at increased risk of progressive worsening might help targeted neurocognitive remediation approaches. This 20-year follow-up study examined neurocognitive outcomes of 156 participants from the OPUS I trial. Neurocognition was assessed using the brief assessment of cognition in schizophrenia at the 10- and 20-year follow-up, allowing us to examine changes in neurocognition over ten years. We found that 30.5% of patients had a declining course of neurocognition, 49.2% had a stable course of neurocognition and 20.3% experienced improvements in neurocognition. Good cognitive functioning at the 20-year follow-up was significantly associated with higher levels of social functioning (B 6.86, CI 4.71-9.02, p < 0.001) while increasing experiential negative symptoms were significantly correlated to cognitive worsening (PC-0.231, p = 0.029). Younger age at inclusion (B: 0.23 per 10-years, CI 0.00-0.045, p = 0.047) and low level of education (below ten years) (mean difference: -0.346, CI -0.616 to -0.076, p = 0.012) predicted declining neurocognition. Our findings support the notion of different schizophrenia subtypes with varying trajectories. Neurocognitive impairment at the 20-year follow-up was associated with other poor outcomes, highlighting the importance of treatments aimed at improving neurocognition in patients with schizophrenia spectrum disorders.

Investigating the relationship between FRailty And Quality of LIfe in patients with heart faiLure and CKD (FRAIL study).

Patients with chronic kidney disease (CKD) or heart failure (HF) are disproportionally affected by frailty, an independent predictor of morbidity. The prevalence of frailty and its impact on quality of life (QoL) in a unique population of patients with both CKD and HF (CKD-HF) is unclear. The aim of this study was to investigate the association between frailty and QoL in patients with CKD-HF. Patients were identified from a tertiary care cardiorenal clinic. Eligible patients had CKD-HF with a stable estimated glomerular filtration rate of <60mL/min/1.732. Data were collected from each participant at one point in time using surveys delivered by study personnel between 14 July 2022 and 31 March 2023. Frailty was defined as Modified Frailty Phenotype (MFP) score ≥3. The Medical Outcomes Study 36-item Short Form Health Survey (SF-36) was used to assess QoL. Demographic data were retrospectively collected from electronic patient records. Demographics and QoL were compared between frail and non-frail cohorts using Pearson's R and Student's t-test (two-tailed, alpha-priori=0.05). One hundred five participants consented, and 103 completed the questionnaires in full. Amongst the 103 participants, 49.5% (n=51) were frail. Frailty was related to sex (P=0.021) and medication count (P=0.007), however not to other clinical measures, including estimated glomerular filtration rate (P=0.437) and ejection fraction (P=0.911). Frail patients reported poorer QoL across physical functioning (P<0.001), general health (P<0.001), bodily pain (P=0.004), social functioning (P<0.001), and energy levels (P<0.001), however not emotional wellbeing (P=0.058); 51.5% cited 'better quality of life' as their healthcare priority, over longer survival (23.3%) or avoiding hospital admissions (22.3%). This was consistent across frail and non-frail groups. A large proportion of CKD-HF patients are frail, regardless of disease severity, and more susceptible to significantly poorer QoL across physical and social domains. Improving QoL is the priority of patients across both frail and non-frail cohorts, further emphasizing the need for prompt recognition of frailty as well as possible intervention and prevention.

Associations of gut microbiota alterations with clinical, metabolic, and immune-inflammatory characteristics of chronic schizophrenia

The present study had the following aims: 1) to compare gut microbiota composition in patients with schizophrenia and controls and 2) to investigate the association of differentially abundant bacterial taxa with markers of inflammation, intestinal permeability, lipid metabolism, and glucose homeostasis as well as clinical manifestation. A total of 115 patients with schizophrenia during remission of positive and disorganization symptoms, and 119 controls were enrolled. Altogether, 32 peripheral blood markers were assessed. A higher abundance of Eisenbergiella, Family XIII AD3011 group, Eggerthella, Hungatella, Lactobacillus, Olsenella, Coprobacillus, Methanobrevibacter, Ligilactobacillus, Eubacterium fissicatena group, and Clostridium innocuum group in patients with schizophrenia was found. The abundance of Paraprevotella and Bacteroides was decreased in patients with schizophrenia. Differentially abundant genera were associated with altered levels of immune-inflammatory markers, zonulin, lipid profile components, and insulin resistance. Moreover, several correlations of differentially abundant genera with cognitive impairment, higher severity of negative symptoms, and worse social functioning were observed. The association of Methanobrevibacter abundance with the level of negative symptoms, cognition, and social functioning appeared to be mediated by the levels of interleukin-6 and RANTES. In turn, the association of Hungatella with the performance of attention was mediated by the levels of zonulin. The findings indicate that compositional alterations of gut microbiota observed in patients with schizophrenia correspond with clinical manifestation, intestinal permeability, subclinical inflammation, lipid profile alterations, and impaired glucose homeostasis. Subclinical inflammation and impaired gut permeability might mediate the association of gut microbiota alterations with psychopathological symptoms and cognitive impairment.

Walking capacity and its association with quality of life among children with down syndrome in Saudi Arabia

BackgroundWalking ability, which has been connected to better health and independence, is one of the daily activities that is negatively impacted by Down syndrome. Thus, the objective of this study was to examine the walking capacity and its association with the quality of life of children who have Down syndrome compared to those who do not have Down syndrome in Saudi Arabia.MethodsFor this cross-sectional study, we recruited 68 Arabic-speaking children aged 6 to 12 using a convenience sampling method from August to November 2021. Children were divided into two groups: those who do not have Down syndrome (n = 38) and those who have Down syndrome (n = 30). Children in the Riyadh region of Saudi Arabia who do not have Down syndrome were chosen randomly from two schools. Children who have Down syndrome were selected from multiple associations and centers in the same region. A 6-minute walk test was used to measure the child’s walking capacity. The Arabic version of the Pediatric Quality of Life Inventory scale was used to assess the child’s or parent’s perceptions of the child’s quality of life and its physical, emotional, social, and school functioning domains.ResultsThe difference in the mean 6-minute walk test scores between children who have and who do not have Down syndrome was statistically significant, with a mean difference = 105.6, 95% confidence limit = 57.2—154.0, p < .0001. The linear regression analysis after adjusting for age, height, weight, and body mass index revealed that walking capacity was found to be significantly associated with the worst score on the Pediatric Quality of Life Inventory scale (β = −2.71, SE = 0.49, p < .0001) and its domains of physical, social, and school functioning (β = −2.29, SE = 0.54, p < .0001; β = −2.40, SE = 0.58; p = .001; β = −3.71, SE = 0.56, p = .002, respectively) in children who have Down syndrome, but they had better emotional functioning than children who do not have Down syndrome.ConclusionsChildren who have Down syndrome were less able to walk and were highly associated with the worst possible quality of life, which included the lowest levels of physical, social, and school functioning. Early interventions with techniques must be developed to improve the quality of life for these children.

Severe COVID anxiety among adults in the United Kingdom: cohort study and nested feasibility trial

BackgroundPeople with severe COVID anxiety have poor mental health and impaired functioning, but the course of severe COVID anxiety is unknown and the quality of evidence on the acceptability and impact of psychological interventions is low.MethodsA quantitative cohort study with a nested feasibility trial. Potential participants aged 18 and over, living in the UK with severe COVID anxiety, were recruited online and from primary care services. We examined levels of COVID anxiety in the six months after recruitment, and factors that influenced this, using linear regression. Those scoring above 20 on the short Health Anxiety Inventory were invited to participate in a feasibility trial of remotely delivered Cognitive Behavioural Therapy for Health Anxiety (CBT-HA). Exclusion criteria were recent COVID-19, current self-isolation, or current receipt of psychological treatment. Key outcomes for the feasibility trial were the level of uptake of CBT-HA and the rate of follow-up.Results204 (70.2%) of 285 people who took part in the cohort study completed the six month follow-up, for whom levels of COVID anxiety fell from 12.4 at baseline to 6.8 at six months (difference = -5.5, 95% CI = -6.0 to -4.9). Reductions in COVID anxiety were lower among older people, those living with a vulnerable person, those with lower baseline COVID anxiety, and those with higher levels of generalised anxiety and health anxiety at baseline. 36 (90%) of 40 participants enrolled in the nested feasibility trial were followed up at six months. 17 (80.9%) of 21 people in the active arm of the trial received four or more sessions of CBT-HA. We found improved mental health and social functioning among those in the active, but not the control arm of the trial (Mean difference in total score on the Work and Social Adjustment Scale between baseline and follow up, was 9.7 (95% CI = 5.8–13.6) among those in the active, and 1.0 (95% C.I. = -4.6 to 6.6) among those in the control arm of the trial.ConclusionsWhile the mental health of people with severe COVID anxiety appears to improve over time, many continue to experience high levels of anxiety and poor social functioning. Health anxiety is highly prevalent among people with severe COVID anxiety and may provide a target for psychological treatment.Trial registrationRetrospectively registered at ISRCTN14973494 on 09/09/2021.

The Effects of Family Functioning on Gross Motor Function, Activity, and Participation in Children with Cerebral Palsy.

The present study aimed to investigate whether family functioning (FF) could impact gross motor function, activity, and participation in children with cerebral palsy (CP). Sixty-seven children with spastic diplegic CP who were admitted to the Special Education and Rehabilitation Clinic were included in the study. The guidelines of the American Academy of Neurology were followed for the diagnosis of spastic diplegia. The type of home where the family lives, the family's average income, the child's age, gender, and number of siblings, and the age and educational level of the child's primary caregiver were recorded. The gross motor function capacity of children with CP was assessed with the Gross Motor Function Classification System (GMFCS). The Pediatric Evaluation of Disability Inventory (PEDI) was used to evaluate activity and participation performance. The children living in detached houses had statistically higher PEDI mobility levels than those living in apartments (p < 0.05). PEDI's social function and self-care levels were higher in 12 to 18-year-old children with two siblings (p < 0.05). The age and educational status of the primary caregiver were found to have an important impact on the PEDI scores. According to the results, social function and self-care levels were higher in children whose primary caregivers were 30 to 65 years old and had high levels of education above high school (p < 0.05 The effects of family income and gender on PEDI scores were statistically non-significant (p˃ 0.05). Variables related to family functioning had no statistically significant effect on GMFCS scores (p˃ 0.05). These factors can enable healthcare providers to collaborate with the families to develop more comprehensive intervention plans emphasizing family strengths and supporting their needs.

Порушення соціального функціонування у хворих з депресивними розладами в умовах стресу війни

The psychotraumatic factors that occurred during the war of 2022-2023 significantly affect the exacerbation / onset and manifestations of depressive syndrome (DS) in schizophrenia spectrum disorders (SSD) and neurotic depressive disorders (NDD), as well as worsen the level of social functioning (SF) of patients. Objective. To study the SF impairment in patients with DS in patients with SSD and NDD, and the relationship between the stress factors and the exacerbation of psychopathological symptoms and their severity in these patients. Methods and materials. There was conducted psychopathological examination of 92 patients with SSD (schizophrenia, Sch and schizoaffective disorder, SchAD) and neurotic DR (recurrent depression, RD and depressive reaction as adjustment disorders, AD) who experienced severe stress during the war. Results. In the research the largest number of patients were women (60.9% of cases). Among patients aged 18 - 25 years, majority of cases was the patients with AD (46.2%), in the group of 26 - 35 years - with SSD (50,0% with Sch and with SchAD). The vast majority of RD cases were presented among patients aged 36-50 years. Depressive syndrome significantly prevailed in patients with RD, and depressive-phobic syndrome in patients with AD. Whereas, depressive-delusional syndrome was most often diagnosed in patients with SSD. Among all examined patient’s reactive exacerbation of the main disease (in case of SSD and RD), as well as the development of RA occurred as a result of a significant impact of stress factors of different content, but related to the war in all cases.The most frequent of these were the feeling of "war fatigue", uncertainty and/or hopelessness about the future (in general 82% of patients with RD and RA); difficulties during evacuation, caused a strong increase in family conflicts, especially in patients with SSD (57.9% of cases in general) and RA; significant reduction of money for life. The impairment of SF in patients with various mental disorders and DS as a result of war-related stressors was mainly manifested in significant difficulty in daily professional and household duties (91.3% of all patients); the feeling of social support lacks and loneliness; frequent and/or prolonged interpersonal conflicts; as well as a strong financial problem. Other psychopathological features associated with DS that develop under the war stress influence and worsened the level of patients' SF were sleep disturbances (97.8% of cases) with a significant direct correlation with a significant difficulty in daily activities; self-disbelief and hopelessness, as well as the emergence or strong increasing of suicidal thoughts were noted by more than 80% of the examined patients (36.0% of patients with NDDs had suicide attempts or self-injurirs - most often in AD); constant fatigue (80.0% of patients with NDDs). Conclusion. Understanding the impact of war-related stressors on the manifestations of DS, and the features and level of SF impairment need the use of treatment and rehabilitation complex for patients with DS (with SSD and NDD) who have experienced a severe psychotraumatic situation. It will allow timely and effective treatment of reactive states (relapses of psychotic episodes), take to account into the severity and characteristics of DS, and the content and severity of stressful effects in order to achieve remission, restore social adaptation of patients, and reduce the risk of self-destructive or aggressive behavior of them.