Manual Of Mental Disorders-Fifth Edition Research Articles

Psychometric properties of the PTSD checklist for DSM-5 in treatment-seeking Black veterans.

Despite widespread use of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-fifth edition (PCL-5) across various trauma-exposed populations, little is known about the psychometric properties of the instrument in certain ethnic minority groups with increased risk of trauma exposure, including Black veterans. To this end, the current study examined the internal consistency of the PCL-5, convergent validity using correlations between the PCL-5 and another measure of PTSD, and discriminant validity using correlations between the PCL-5 and other commonly occurring psychiatric symptoms, including depression as well as alcohol and substance misuse. The sample was composed of 327 Black veterans (84% male, Mage = 51.87, SD = 13.72) presenting to a PTSD specialty clinic at a large Veterans Affairs hospital in the Midwest United States to receive psychological services. In addition to a diagnostic interview, veterans were asked to complete a brief battery of self-report questionnaires to assist with diagnostic clarification and treatment planning. The PCL-5 demonstrated excellent internal consistency. Furthermore, the PCL-5 was significantly and positively correlated with PTSD diagnostic status, suggesting evidence of convergent validity. Finally, the PCL-5 was strongly correlated with symptoms of depression and moderately correlated with alcohol and substance misuse. Findings suggest that the PCL-5 is a psychometrically sound measure to assess PTSD symptoms among Black veterans. Considering the brevity of PCL-5 administration, clinicians should consider utilizing this and other psychometric tests in clinical care to reduce disparities in health equity among Black patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The interaction of RELN-DNMT genes involving in neurotrophin signaling pathway contributes to schizophrenia susceptibility.

Schizophrenia belongs to a severe mental illness with complicated clinical presentations, an ill-defined pathogenesis, and no known cause. Many genetic studies imply that polygenic interaction is important in the development of schizophrenia. The main mechanism of the RELN-BDNF-CREB-DNMT signaling pathway in neurodevelopment involves RELN, brain-derived neurotrophic factor (BDNF), transcription factor cyclic adenosine monophosphate response element binding protein (CREB), DNA methyltransferase 1 (DNMT1), as well as DNA methyltransferase 3B (DNMT3B). An early case-control research on 15 polymorphisms in the RELN, CREB, BDNF, DNMT1, and DNMT3B genes was done. A single gene variation has little effect on the pathogenesis of schizophrenia, but the combination of intergenic variation loci has a bigger impact because schizophrenia is a complex polygenic disorder. The objective of the current study sought to explore the impact of genetic interactions between RELN, BDNF, CREB, DNMT1, and DNMT3B on schizophrenia in order to further highlight the genetic factors influencing the risk of schizophrenia. Taking the case-control study design, with the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to be the evaluation norm, 134 individuals suffering from schizophrenia hospitalized in the Third People's Hospital of Zhongshan City within January 2018 to April 2020 (case group) were selected, and 64 healthy individuals (control group) from the same geographical area had been chosen as well. MassArray identified DNMT1 gene single nucleotide polymorphisms (rs2114724 and rs2228611) and DNMT3B gene SNPs (rs2424932, rs1569686, rs6119954, and rs2424908). Using the generalized multifactor dimensionality reduction (GMDR), the RELN-BDNF-CREB-DNMT pathway's gene interactions were examined for their impact on schizophrenia. GMDR analysis showed that the three-order interaction model RELN (rs2073559, rs2229864)-DNMT3B (rs2424908) was the optimal model (p = 0.001), with the consistency of cross-validation of 10/10 and the test accuracy of 0.8711. The interaction between the RELN (rs2073559, rs2229864)-DNMT3B (rs2424908) may be related to schizophrenia, and large sample sizes should be verified in different population.

Intellectual status and factors influencing the intelligence in children with attention deficit and hyperactive disorder

To study the intellectual level and the factors influencing the intelligence in children aged 6-16 years with attention deficit hyperactivity disorder (ADHD). A retrospective study was conducted on 2 861 children who were diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition between October 2014 and September 2022 at Henan Children's Hospital. The Wechsler Intelligence Scale for Children-Fourth Edition was used to assess the intellectual levels of the ADHD children. Based on intelligence quotient (IQ) scores, the intellectual levels were classified into five categories: borderline (70-79), low average (80-89), average (90-109), high average (110-119), and superior (≥120). The intellectual levels among the children of different genders, grades, and parental education levels were compared. Among the 2 861 ADHD children, 569 (19.89%) were classified as borderline, 846 (29.57%) as low average, 1 304 (45.58%) as average, 111 (3.88%) as high average, and 31 (1.08%) as superior. The boys had lower scores in working memory, processing speed, and overall IQ than the girls (P<0.05). There were significant differences in perceptual reasoning, working memory, processing speed, and overall IQ scores among different grade groups (P<0.05). The scores in language comprehension, perceptual reasoning, working memory, processing speed, and overall IQ were found to be associated with parental education level in ADHD children (P<0.05). The proportion of ADHD children with low average and borderline intellectual levels is relatively high. The IQ level of ADHD children is influenced by gender, grade level and parental education level.

3EDANFIS: Three Channel EEG-Based Depression Detection Technique with Hybrid Adaptive Neuro Fuzzy Inference System

Background: Depression is a mental disorder that often negatively impacts the actions and feelings of the affected person. No laboratory tests are available to detect and properly diagnose depression. Presently, the detection of depression is done based on standardized questionnaires like Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-V) and Hamilton Depression Rating Scale (HAM-D) which is subjective in nature. Objective: The purpose of the study is to propose a framework for more accurate detection of depression from EEG signals using only three channels, which makes the system portable as well as efficient. Methods: In this study, we propose a classification model using EEG signal with the help of Adaptive Neuro Fuzzy Inference System optimized by nature-inspired algorithm. The proposed model is efficient, accurate, and portable as the features are extracted from only three channels, namely, Fp1, Fp2, and Fz. The three Data Channel (3EDANFIS) Adaptive Neuro Fuzzy Inference System (ANFIS) for detection of depression as well as three variants of Hybrid ANFIS – Adaptive Neuro Fuzzy Inference System-Genetic Algorithm (ANFIS-GA), Adaptive Neuro Fuzzy Inference System- Particle Swam Optimization (ANFIS-PSO) and Adaptive Neuro Fuzzy Inference System- Firefly Algorithm (ANFIS-FA) has been analyzed in this study. The features extracted are delta, theta, alpha, and beta and their corresponding sub-bands delta1, delta2, theta1, theta2, alpha1, alpha2, beta1, and beta2. Genetic Algorithm (GA), Particle Swam Optimization (PSO), and Firefly Algorithm (FA) are all nature-inspired metaheuristic algorithms which are used to optimize ANFIS by adapting the premise and consequent parameters. Results: The analysis showed that the GA and FA perform equally well in optimizing ANFIS with the highest accuracy of 83.33 % using delta1 power as well as delta power. Overall accuracy of the ANFIS-GA is found to be higher than that of the ANFIS-PSO, ANFIS-FA, and ANFIS. It was also found that the sub-band classification accuracy is higher than that of the band itself for delta, theta, and alpha bands. In case of the ANFIS, ANFIS-GA, ANFIS-PSO, and ANFIS-FA, delta1 was found to be having higher accuracy than delta power, theta1 was found to be having higher accuracy than theta power, and both alpha1 and alpha2 showed higher accuracy than alpha power. Conclusion: The use of only three EEG channels for data recording makes our technique to be more feasible, portable, convenient, and faster and hence can act as an adjunct tool for psychiatrists in the future.

Assessment of emotional distress in palliative care: Edmonton Symptom Assessment System-revised (ESAS-r) vs Distress Thermometer.

To evaluate the sensitivity and specificity of the Distress Thermometer (DT) as a screening tool for emotional distress in oncological palliative care patients and to compare the DT with the Edmonton Symptom Assessment System-revised (ESAS-r) and the gold standard to determine the most appropriate assessment method in palliative psychological care. Data were collected from psychological screening tests (ESAS-r and DT), and clinical interviews (gold standard) were conducted by a clinical psychologist specialist in palliative oncology from January 2021 to January 2022 in an oncology palliative care service. The sample consisted of 356 first-time patients with a diagnosis of advanced cancer in palliative care. The most frequently reported oncological diagnoses were gastrointestinal tract (49.3%) and breast (18.3%). Most patients were female (n=206; 57.9%), 60.4% were married/with a partner, 55.4% had between 6 and 9years of schooling, and a median age of 57 (range, 46-65) years. The cutoff of the DT was 5, with a sensitivity of 75.88% and specificity of 54.3%. Emotional problems (sadness and nervousness) had a greater area under the curve (AUC) when measured using the DT than the ESAS-r; however, only in the case of the comparative sadness and discouragement was the difference between the AUC marginally significant. The use of the DT as a screening tool in oncological palliative care is more effective in the evaluation of psychological needs than the ESAS-r. The DT, in addition to evaluation by an expert psychologist, allows for a more comprehensive identification of signs and symptoms to yield an accurate mental health diagnosis based on the International Classification of Diseases-11th Revision and/or Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.

DNMT1 SNPs (rs2114724 and rs2228611) associated with positive symptoms in Chinese patients with schizophrenia

ObjectiveSchizophrenia is a serious mental disorder with complex clinical manifestations, while its pathophysiological mechanism is not fully understood. Accumulated evidence suggested the alteration in epigenetic pathway was associated with clinical features and brain dysfunctions in schizophrenia. DNA methyltransferases (DNMTs), a key enzyme for DNA methylation, are related to the development of schizophrenia, whereas the current research evidence is not sufficient. The aim of study was to explore the effects of gene polymorphisms of DNMTs on the susceptibility and symptoms of schizophrenia.MethodsThe study was case–control study that designed and employed the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) as the diagnostic standard. 134 hospitalized patients with schizophrenia in the Third People's Hospital of Zhongshan City from January 2018 to April 2020 (Case group) as well as 64 healthy controls (Control group) from the same region were involved. Single nucleotide polymorphisms (SNPs) of DNMT1 genes (r s2114724 and rs 2228611) and DNMT3B genes (rs 2424932, rs 1569686, rs 6119954 and rs 2424908) were determined with massARRAY. Linkage disequilibrium analysis and haplotype analysis were performed, and genotype and allele frequencies were compared. The Hardy–Weinberg equilibrium was tested by the Chi-square test in SPSS software (version 20.0, SPSS Inc., USA). The severity of clinical symptoms was assessed by the Positive and Negative Syndrome Scale (PANSS). The correlation between DNMT1 genes (rs 2114724 and rs 2228611) and DNMT3B genes (rs2424932, rs1569686, rs6119954 and rs2424908) and clinical features was analyzed.ResultsThere were no significant differences in genotype, allele frequency and haplotype of DNMT1 genes (rs 2114724 and rs 2228611) and DNMT3B genes (rs 2424932, rs 1569686, rs 6119954 and rs 2424908) between the case and healthy control group. There were significant differences in the PANSS total positive symptom scores, P3 (hallucinatory behavior), P6 (suspicious/persecution), G7 (motor retardation), and G15 (preoccupation) in patients with different DNMT1 gene rs 2114724 and rs 2228611 genotypes. The linkage disequilibrium analysis of gene polymorphic loci revealed that rs 2114724–rs 2228611 was complete linkage disequilibrium, and rs 1569686–rs 2424908, rs 2424932–rs 1569696 and rs 2424932–rs 2424908 were strongly linkage disequilibrium.ConclusionThe polymorphisms alteration in genetic pathway may be associated with development of specific clinical features in schizophrenia.

Autism Spectrum Disorder and the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5): The Experience of 10 Years.

Autism Spectrum Disorder and the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5): The Experience of 10 Years.

Agomelatine augmentation of sertraline in the treatment of moderate to severe obsessive-compulsive disorder: a randomized double-blinded placebo-controlled clinical trial

BackgroundAs 40–60% of the patients with obsessive-compulsive disorder (OCD) do not adequately respond to the first-line treatment, finding an effective second-line treatment is required. Our aim was to assess the efficacy and safety of agomelatine (a selective melatonin receptor agonist and a 5-hydroxytryptamine (HT)2 C antagonist) augmentation of sertraline in the treatment of patients with moderate to severe OCD.MethodsIn this 12-week randomized, double-blinded, placebo-controlled, parallel-group clinical trial, 65 patients with moderate to severe OCD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM–5) criteria and a Yale-Brown obsessive compulsive scale (Y-BOCS) score of over 21, were included. They were assigned with sertraline (100 mg/day for the first 4 weeks and 200 mg/day for the next 8 weeks) and either agomelatine (25 mg/day) or placebo. The primary outcome was OCD symptoms measured by the Y-BOCS.ResultsFifty patients (24 in agomelatine group and 26 in placebo group) completed the trial. The Y-BOCS scores in total (MD (95% CI) = 12.25 (11.00, 13.49) (P < 0.001) vs. MD (95% CI) = 12.46 (6.65, 15.74) (P < 0.001)), the obsession subscale (MD (95% CI) = 5.04 (4.19, 5.88) (P < 0.001) vs. MD (95% CI) = 5.00 (3.84, 6.16) (P = 0.0001)), and compulsion subscale (MD (95% CI) = 7.21 (6.34, 8.07) (P < 0.001) vs. MD (95% CI) = 7.460 (6.50, 8.42) (P < 0.001)) significantly decreased in both groups. Although, at the end of the trial, no significant difference was observed between the scores of the two groups in total (MD (95% CI) = 0.480 (-1.23, 2.19) (P = 0.78)), the obsession subscale (MD (95% CI) = 1.020 (-0.15, 2.19) (P = 0.38)), and the compulsion subscale (MD (95% CI) = 0.540 (-0.34, 1.42) (P = 0.54)). No major adverse effects were recorded, and the frequency of side effects was not significantly different between the groups.ConclusionAgomelatine in augmentation with sertraline is safe and tolerable in patients with moderate to severe OCD. However, our study does not support its efficacy in improving OCD symptoms, compared to placebo.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials on 14/07/2020 (www.irct.ir; IRCT ID: IRCT20170123032145N5).

Investigating the DSM-5 and the ICD-11 PTSD symptoms using network analysis across two distinct samples.

Posttraumatic stress disorder (PTSD) has long been debated with a recent focus on the consequences of having two different diagnostic descriptions of PTSD (i.e., the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition [DSM-5] and the International Classification of Diseases-11th Edition [ICD-11]). Research has modeled PTSD as a network of interacting symptoms according to both diagnostic systems, but the relations between the two systems remain unclear regarding which symptoms are more central or interconnected. To answer this question, the present study is the first study to investigate the combined network structure of PTSD symptoms according to both systems using validated measurements (i.e., the International Trauma Questionnaire [ITQ] and the Posttraumatic Stress Disorder Checklist 5 [PCL-5] across two distinct trauma samples [a community sample, N = 2,367], and a military sample, N = 657). We estimated two Gaussian Graphical Models of the combined ICD-11 and DSM-5 PTSD symptoms across the two samples. Five of the six most central symptoms were the same across both samples. The results underline that a combination of five symptoms representing both diagnostic systems may hold central positions and potentially be important for treatment. However, the implications depend on if the different diagnostic descriptions can be reconciled in an indexical rather than constitutive perspective. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multinational evaluation of the measurement invariance of the Level of Personality Functioning Scale-brief form 2.0: Comparison of student and community samples across seven countries.

The Diagnostic and Statistical Manual of Mental Disorders-fifth Edition's (DSM-5) Level of Personality Functioning Scale (LPFS) was introduced as a dimensional rating of impairments in self- and interpersonal functioning, and the LPFS-Brief Form (LPFS-BF) was the first published corresponding self-report. The updated LPFS-BF 2.0 has been translated into several languages and international research supports many of the instrument's psychometric properties; however, its measurement invariance has only been evaluated across a few countries. This study expands previous studies as an introductory step in a global evaluation of the LPFS-BF 2.0s measurement invariance. Archival data (N = 5,618, 57% female) from seven countries (Canada, Chile, Denmark, Germany, Italy, United Arab Emirates, United States of America) were used for this study. Participants were recruited from both community (n = 4,677) and student (n = 941) populations. After confirming adequate model fit separately in the community and student samples, we evaluated a series of increasingly stringent model comparisons to test three aspects of measurement invariance (configural, metric, scalar) and then examined latent mean differences across countries. Full scalar invariance was supported in the community sample and partial scalar invariance was supported in the student sample. Evaluation of latent mean differences revealed multiple significant differences. Overall, the LPFS-BF 2.0 appears to assess self- and interpersonal functioning impairment similarly across the included countries. Findings are discussed through the lenses of the cultures from which participants were recruited, as well as in the context of alternative explanations. Limitations, plans for future research, and implications for both research and clinical practice are offered. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relationship between nocturnal enuresis and sleep in children and adolescents.

Nocturnal enuresis (NE) is a multifactorial and complex condition. One less understood factor in its pathophysiology is the enuretic inability to wake up when the bladder is full (impaired arousal). We aimed to investigate the relationship between sleep and NE in children and adolescents. A systematic review was performed following the PRISMA guidelines, and the electronic databases MEDLINE (via PubMed) and SCOPUS were searched until March 2022. Eligibility criteria were studies that recruited patients aged five-17years with a diagnosis of NE according to the International Child Continence Society (ICCS), Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), or International Classification Criteria of Sleep Disorders-Third edition (ICSD-3) who had their sleep assessed using validated questionnaires and/or polysomnography. The tool used to analyze the risk of bias in the included studies was the risk of bias in non-randomized studies of exposure. Of 1582 citations screened, nine were included, giving 1685 participants, 581 with NE. All studies were observational and half had a low risk of bias. Four studies evaluated sleep by questionnaires only; two used questionnaires and polysomnography; two used only polysomnography, and one used sleep logs and actigraphy. Sleep questionnaires showed that children with enuresis had more sleep problems than controls, especially parasomnias, breathing disorders, and daytime sleepiness. Among the polysomnography parameters, the sleep stage architecture and periodic limb movements during sleep had conflicting data between the two studies. The studies evaluated sleep through heterogeneous tools. They used different questionnaires; even those considered by polysomnography did not record the same channels. It seems that enuretic children and adolescents sleep differently from those who are non-enuretic. More studies are needed to clarify the best way to assess sleep and better understand this relationship. The review protocol was registered with PROSPERO, CRD42021266338. There was no funding.

Preoperative anxiety as an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation.

Anxiety is common in older patients suffering from lumbar disc herniation. Postoperative delirium is related to poor prognosis. But the relationship between preoperative anxiety and postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation is not clear. The study aimed to investigate if preoperative anxiety is an independent risk factor of postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation. The medical records of 1290 patients undergoing elective surgery for lumbar disc herniation at a single institution from 2016 through 2021 were reviewed. Of 863 eligible patients, 225 (26.1%) patients had been diagnosed with anxiety by a board-certified psychiatrist and constituted the Anxiety group; the remaining 638 patients constituted the no-anxiety group. The demographics, baseline, operative variable and postoperative complications were collected and compared between the two groups. The primary outcome of this study was the incidence of delirium, according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, during a hospital stay after surgery for lumbar disc herniation. The relationship between anxiety and postoperative delirium was determined through multivariate logistic regression analysis. The demographics and comorbidity were similar between the two groups, except for age, sex, alcohol use and cerebrovascular disease. The operative variables were different between the two groups. The incidence of postoperative complications other than postoperative delirium was also similar between the two groups. In total, 86 patients (9.97%) had an episode of postoperative delirium, with anxiety group patients experiencing approximately a twofold higher rate (15.6% vs 7.99%). In a multivariate logistic regression analysis, anxiety was an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation (OR 2.228, 95% CI 1.494-3.416, p = 0.009). This study suggests that anxiety is an independent risk factor of postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation. Preoperative anxiety assessment can help to identify older patients at high risk of postoperative delirium and facilitate perioperative management of older patients undergoing elective surgery for lumbar disc herniation.

Dynamic changes in brain structure in patients with post-traumatic stress disorder after motor vehicle accident: A voxel-based morphometry-based follow-up study.

ObjectivesTo investigate the dynamic changes of emotional and memory-related brain regions in post-traumatic stress disorder (PTSD) patients and trauma-exposed subjects, who experienced motor vehicle accident (MVA).Materials and methodsFunctional Magnetic Resonance imaging (fMRI) and general data were collected from trauma victims who had experienced MVA within 2 days, and their social support and coping style were evaluated. The PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) is used for screening and diagnosis. Subsequently, 17 PTSD patients and 23 car accident trauma-exposed individuals completed a second fMRI scan at 2 months. Data were analyzed by using voxel-based morphometry (VBM) to examine the volume changes of relevant brain regions. Correlation analysis was used to assess the correlation between the regions of interest (ROIs) and the total scores on the clinical scales. Subsequently, the relationship between the total PCL-5 scores and the individual dimensions of the Simplified Coping Style Questionnaire (SCSQ) and the Social Support Rate Scale (SSRS) was studied.ResultsIn comparison with the control group, the results showed a reduction in right SFG volume in the PTSD group at 2 months. Similarly, a comparison within the PTSD group revealed a reduction in the left STG volume at 2 months. Compared with the control group, PTSD patients showed a more negative coping style and worse performance in objective and subjective support. In addition, the total PCL-5 scores were negatively associated with positive coping, objective support, and subjective support.ConclusionThe occurrence of PTSD may be related to reduced volume of the right SFG and left STG, and that patients with PTSD receive less social support and tend to cope in a negative manner in the face of stressful events. These results suggest that within 2 months of the MVA, changes in gray matter volume have occurred in some brain regions of those suffering from PTSD. We believe the results of our study will provide useful insights into the neuropsychological mechanisms underlying PTSD.

Optimized Informed Consent for Psychotherapy: Protocol for a Randomized Controlled Trial.

BackgroundInformed consent is a legal and ethical prerequisite for psychotherapy. However, in clinical practice, consistent strategies to obtain informed consent are scarce. Inconsistencies exist regarding the overall validity of informed consent for psychotherapy as well as the disclosure of potential mechanisms and negative effects, the latter posing a moral dilemma between patient autonomy and nonmaleficence.ObjectiveThis protocol describes a randomized controlled web-based trial aiming to investigate the efficacy of a one-session optimized informed consent consultation.MethodsThe optimized informed consent consultation was developed to provide information on the setting, efficacy, mechanisms, and negative effects via expectation management and shared decision-making techniques. A total of 122 participants with an indication for psychotherapy will be recruited. Participants will take part in a baseline assessment, including a structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) disorders. Eligible participants will be randomly assigned either to a control group receiving an information brochure about psychotherapy as treatment as usual (n=61) or to an intervention group receiving treatment as usual and the optimized informed consent consultation (n=61). Potential treatment effects will be measured after the treatment via interview and patient self-report and at 2 weeks and 3 months follow-up via web-based questionnaires. Treatment expectation is the primary outcome. Secondary outcomes include the capacity to consent, decisional conflict, autonomous treatment motivation, adherence intention, and side-effect expectations.ResultsThis trial received a positive ethics vote by the local ethics committee of the Center for Psychosocial Medicine, University-Medical Center Hamburg-Eppendorf, Hamburg, Germany on April 1, 2021, and was prospectively registered on June 17, 2021. The first participant was enrolled in the study on August 5, 2021. We expect to complete data collection in December 2022. After data analysis within the first quarter of 2023, the results will be submitted for publication in peer-reviewed journals in summer 2023.ConclusionsIf effective, the optimized informed consent consultation might not only constitute an innovative clinical tool to meet the ethical and legal obligations of informed consent but also strengthen the contributing factors of psychotherapy outcome, while minimizing nocebo effects and fostering shared decision-making.Trial RegistrationPsychArchives; http://dx.doi.org/10.23668/psycharchives.4929International Registered Report Identifier (IRRID)DERR1-10.2196/39843

Anxiety disorders, depression and incontinence in preschool children-A population-based study.

The aim was to examine associations of specific anxiety disorders, depressive symptoms, and incontinence in a representative, population-based sample of preschool children. All preschool children of a defined geographical area examined before school-entry were included. Parents completed a questionnaire including the Preschool Feelings Checklist (PFC), eight questions referring to nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI) and constipation, and 30 items regarding Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) diagnostic criteria of separation anxiety disorder (SAD), social phobia (SOC), specific phobia (PHOB), and generalized anxiety disorder (GAD). Data of 1206 children (mean age = 5.7 years; 53.5% boys) are presented. 34.6% of incontinent children had an anxiety disorder based on DSM-5 criteria and 13.3% had clinically relevant depressive symptoms (measured by the PFC). Rates of incontinence overall were 14.1% (11.9% NE, 3.1% DUI, and 1.8% FI) and 6.3% for constipation. Rates of SOC and PHOB were increased in NE (20.8% and 25.4%), DUI (39.3% and 34.5%) and FI (35.3% and 50.0%) compared to continent children (13.5% and 17.2%). Children with constipation had higher rates of SOC, PHOB, and GAD than those without. Compared to continent children (9.7%), depressive symptoms were more frequent in children with NE (26.8%), DUI (50.0%), and FI (61.9%). Anxiety disorders and depressive symptoms are common in children with incontinence. The most specific DSM-5 disorders associated with incontinence are SOC and PHOB, which can be incapacitating and may require treatment. Due to the high rates of anxiety disorders, it is important to screen all children with incontinence, for example, with specific questionnaires.

Sexual dysfunction in women suffering from major depressive disorder: A cross-sectional study

Abstract Background: Compared to a healthy population, sexual dysfunction is higher in major depressive disorder (MDD). Identification and management of sexual dysfunction profoundly impact marital satisfaction, quality of life, and compliance with treatment in patients with depression. Aims and Objectives: The primary objective was to determine the proportion of sexual dysfunction among women suffering from MDD attending the psychiatry department of a tertiary care center. The secondary objectives were (1) to study the correlation between the severity of depression and sexual dysfunction in women with MDD and (2) to study the relationship between sociodemographic and clinical variables with sexual dysfunction. Settings and Design: This was a cross-sectional study carried out among 40 women diagnosed with MDD attending the psychiatry department of our tertiary care institute. Materials and Methods: After taking informed consent, relevant sociodemographic details and clinical variables were recorded using a semi-structured questionnaire. MDD was diagnosed according to the Diagnostic Statistical Manual of Mental Disorders-Fifth Edition, and its severity was assessed using Hamilton rating scale for depression. Sexual dysfunction was measured using the Arizona sexual experience scale. Statistical Analysis: Spearman’s correlation coefficient was used to assess the correlation between the severity of depression and sexual dysfunction. The Chi-square test was used to test the relationship between categorical variables. Analysis of data was done using appropriate statistical software. Results: The proportion of sexual dysfunction among women with MDD was 65%. The most common sexual dysfunction was low sexual desire (57.5%). There was a positive correlation between the severity of depression and the presence of sexual dysfunction, with Spearman’s correlation coefficient (rho = 0.765, P = 0.000). Age, attainment of menopause, history of alcohol and tobacco use in the spouse, and severity of depression were significant with sexual dysfunction using the Chi-square test. Conclusions: The proportion of sexual dysfunction was high among women suffering from MDD. The severity of depression and the presence of sexual dysfunction are positively correlated.

Diagnostic accuracy of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) within a civilian primary care sample.

This study aims to evaluate the diagnostic accuracy of the Primary Care Posttraumatic Stress Disorder (PTSD) Screen for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) (PC-PTSD-5) as a screening tool for the identification of PTSD among a civilian sample receiving behavioral health treatment within a primary care setting. Validation within a civilian sample will increase the generalizability of the PC-PTSD-5 as a brief screening measure to identify PTSD within primary care practices. The present study is a retrospective review of data (N = 198) collected as part of a patient registry for an integrated behavioral health consultation service within a primary care clinic. The PC-PTSD-5 was administered as part of a standardized set of brief screening measures and a standard clinical interview. Diagnostic validation was accomplished via a consensus model between a board-certified family medicine physician and a licensed psychologist along with medical/psychology trainees. Fifty-two participants (26.26%) out of 198 who completed the PC-PTSD-5 were diagnosed with PTSD. The PC-PTSD-5 demonstrated excellent diagnostic accuracy (area under the curve = 0.933, 95% confidence interval [CI]: 0.901-0.965). A cutoff score of 4 maximized sensitivity (sensitivity% = 100) while maintaining acceptable specificity (specificity% = 85.2). This score also maximized efficiency (κ[0.5] = 0.77, SE = 0.05, 95% CI: 0.67-0.86) and maintained a good (≥0.60) quality index for specificity (κ[0] = 0.61). The PC-PTSD-5 maintained strong diagnostic accuracy within a civilian primary care sample.

Risk factors for ASD : Risk Factors for Autism Spectrum Disorder in Shanghai, China: A Population-based Case-control Study.

Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder that brings heavy burdens to families and the society. This case-control study explored risk factors for ASD based on 74,252 children aged 3-12 years who were recruited from general education kindergartens, primary schools, and special education schools in Shanghai, China. One hundred ninety-two children were identified with ASD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition. Male sex, the presence of anoxia or asphyxia at birth, artificial feeding, adverse maternal psychological status, complications during pregnancy and higher paternal education were associated with ASD even after controlling for age, residential district, family history of mental disorders, parental personality, and amount of daily TV viewing.

Pattern And Prevalence Of Psychiatry Morbidity Among Subjects Attended Psychiatric Outpatient Department In A Tertiary Care Hospital In Northern Telangana

Abstract Background: Mental health problem is a major public health issue all over the world including India. In India, mental disorders are the leading contributors to significant morbidity and disability amongst those affected. With changing health patterns among Indians, mental behavior and substance use disorders are coming to the forefront in health care delivery systems. Objective: This study was aimed to assess the diagnostic pattern of psychiatric morbidity among the patients attending psychiatric outpatient department in a private medical college. Methodology: This cross-sectional study was carried out in the Department of Psychiatry in Prathima Institute of Medical Sciences located at Karimnagar, Telangana, India. For this study, a total of 442 new subjects attending Psychiatry Outpatient Department (OPD) from August 2020 to July 2021 were taken. All the information including longitudinal histories of patients was recorded in files and the diagnosis was made following Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM 5). Socio-demographic parameters and family history of mental illness were collected from the record file of the individual patient. Results: In the present study, among the different age groups, the majority (28.05%) of the study subjects were of the age ranging from 21-30 years. The distribution according to gender was (62.89%) males and (37.10%) females. The majority of the study subjects belonged to the rural background (69.45%), educated up to 10th standard (28.73%), self-employed (29.86%), married (67.42%), belonged to Hindu religion (85.74%), and with a monthly family income of 5,000 to 10,000 (38.68%). The majority of the study subjects were diagnosed with Major depressive Disorders (28.05%), followed by anxiety disorders (17.87%) and Substance-Related and Addictive Disorders (16.96%). Conclusion: This study provides information about the prevalence of psychiatric morbidity among patients attending outpatient department in a private medical hospital in Northern Telangana. It helps in assessing the pattern of psychiatric problems and taking necessary steps to plan for better management of mental health care in the near future.

Prevalence of Bullying Behaviors Among Students From a National University in the United Arab Emirates: A Cross-Sectional Study

BackgroundThis study aims to investigate bullying behaviors among college students at one of the national universities in UAE, and also to examine the psychological characteristics of those who were exposed to, or have experienced bullying.MethodsA cross-sectional study was conducted on 839 undergraduate students at one of the national universities in the UAE. Students from all colleges participated in this study and were selected by using stratified random sampling. Participants completed a bullying survey designed for the study, in addition to three psychological measures [i.e., Aggression Questionnaire, Buss and Perry, 1992; The Primary Care Anxiety and Depression, El-Rufaie et al., 1997; and the Post Traumatic Stress Disorder (PTSD) for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5), Weathers et al., 2013].ResultsThe prevalence rate of students being exposed to or engaged in bullying was 26.3% (221 out of 839). Of those, 72 students (8.7%) reported being bullied, 29 (3.6%) reported bullying others, and 185 (22.8%) reported witnessing friends being bullied. The most common types of bullying reported were traditional bullying (e.g., face-to-face bullying, verbal, and physical). Cyberbullying was not very common. More females reported being bullied in comparison to males and most of the aggressors were peer students. Overall, moderate level of aggressive personality traits and low levels of symptoms of depression, anxiety, and PTSD were reported for the total sample. T-tests revealed significant differences in the three psychological measures between those who did not experience bullying and those who did. The mean scores on the Aggression Questionnaire for those who bullied others were significantly higher than those who did not experience bullying.ConclusionExperiences of bullying seem to impact college students’ mental health in the UAE. Therefore, efforts need to focus on developing preventive programs to increase students’ awareness of bullying and its negative impact on campus environment. Offering psychological help for those who were exposed to bullying would help them to deal effectively with this trauma.