Occurrence Of Psychopathology Research Articles

Development of depression in patients hospitalized for COVID-19 infection

IntroductionCoronavirus pandemic (COVID-19) has caused a great psychological impact all over the world. With this research, we want to discover the incidence and associated risk factors for depressive symptoms among hospitalized patients. The objective is to investigate patients with criteria of a severe clinical picture and expressed systemic inflammatory response to SARS-CoV-2 coronavirus infection and if they develop mental disorders- depression, measured by Depression, anxiety and stress scale- DASS-21 scale. With this research, we also calculate the index of the immune-inflammatory response SII and test the hypothesis that people with higher SII will develop mental disorders more often. Demographic variables, comorbidities, COVID-19 severity criteria, and the intensity of the organism’s inflammatory response have also been examined. Psychiatric questionnaires were for the first time applied directly to patients with coronavirus infection during hospitalization.ObjectivesTo identify possible risk factors for depression and to investigate the association between disease severity and the occurrence of psychopathology among COVID-19 hospitalized patients.MethodsThe subjects are patients suffering from COVID-19, older than 18 years who were hospitalized in the respiratory center KB Dubrava. After an interview and informed consent, demographic data was taken and two psychological questionnaires had been applied. Variables: patient characteristics -demographic data, experience of vulnerability, information on whether they have been previously treated psychiatrically, symptoms of anxiety, depression, stress, somatic comorbidities Intensity of systemic inflammation Severity of COVID-19.ResultsA total of 169 patients hospitalized were analyzed. The median age of the patients was 65. There were (62.1%) men and (37.9%) women. On admission, most patients had a severe (134, 79.3%) or critical (17, 10.1%) form of COVID-19. The median Charlson comorbidity index was 3 points. Arterial hypertension was present in 101 (59.8%), diabetes mellitus 42 (24.9%), hyperlipoproteinemia 30 (17.8%), obesity 61 (36.1%), malignant disease 17 (10.1%) patients. 11 (6.5%) smoked and 7 (4.1%) patients consumed alcohol. The median CRPa was 72.75 mg /L. Median SII was 1741. During hospitalization, the median DASS21 score for depression was 14, for anxiety 8, and for stress 6. Regarding depression, it was absent in 49 (29%), mild in 27 (16%), moderate in 47 (27.8%), severe in 18 (10.7%) and extremely severe in 28 (16.6%) patients during hospitalization.ConclusionsPatients with symptoms of depression during hospitalization felt statistically significantly more likely to be in danger of life due to COVID-19, had a more pronounced intensity of symptoms of COVID-19 upon admission. Additionally, patients with higher DASS 21 scores for depression were significantly more likely to be female, had COPD and required oxygen supplementation at higher flows.Disclosure of InterestNone Declared

Delirium and long-term psychopathology following surgery in older adults

ObjectiveTo describe the risk of postoperative delirium and long-term psychopathology (depression, anxiety or post-traumatic stress syndrome (PTSS)) in older adults. Methods255 elderly patients (≥ 65 years) undergoing major surgery (planned surgical time > 60 min) in a tertiary hospital were compared to 76 non-surgical controls from general practice. Patients were assessed twice daily for postoperative delirium using the Confusion Assessment Method (CAM(-ICU)), nursing delirium screening scale (NuDESC) and validated chart review. Before surgery and 3 and 12 months thereafter, the participants filled in the Hospital Anxiety and Depression Scale (HADS), the Geriatric Depression Scale (GDS-15) and the Post-Traumatic Stress Syndrome-14-Questions Inventory (PTSS-14). Non-surgical controls filled in the same questionnaires with similar follow-up. ResultsPatients were more often male, had higher American Society of Anesthesiologists scores and more often had a spouse compared to controls (p < 0.005). Forty-three patients (18%) developed postoperative delirium, who were significantly older, had higher ASA scores and lower estimated IQ scores compared to the patients who did not develop delirium (p < 0.05). There were no differences in psychopathology at baseline and 3-month follow-up between patients and controls. At 12-months, surgical patients less frequently scored positive for depression (7% versus 16%) and anxiety (2% versus 10%) compared to nonsurgical controls (p < 0.05). We did not observe differences in occurrence of psychopathology between patients who had and had not developed postoperative delirium. ConclusionOur results suggest that the older surgical population, with or without postoperative delirium, does not appear to be at greater risk of developing psychopathology. Why does this paper matter?The older surgical population does not appear to be at greater risk of developing psychopathology, neither seems this risk influenced by the occurrence of postoperative delirium

Assessing Psychiatric Symptomatology in Adults with Intellectual Disabilities: Psychometric Properties of German Versions of the PAS-ADD Checklist and the Mini PAS-ADD

ABSTRACT Introduction Adults with intellectual disabilities (ID) face a high risk of developing psychiatric disorders, yet there is a lack of valid instruments measuring psychopathology in this population. Two existing instruments are the PAS-ADD Checklist questionnaire and the Mini PAS-ADD interview, two third-party assessments that can be used for the purpose of screening. Methods German versions of the PAS-ADD Checklist and the Mini PAS-ADD were performed on 78 and 55 adults with ID, respectively. Internal consistency, sensitivity, and specificity were calculated for both instruments and the convergent validity of the two tools was tested. Results Cronbach’s alphas of the Checklist’s scales and the total score were questionable (alpha over 0.6), except for a very low alpha for Organic Condition (0.34). For the scales of the Mini PAS-ADD, Cronbach’s alpha varied between 0.34 (Unspecified Disorder) and 0.72 (Psychosis). Using current clinical diagnoses as a reference, sensitivity was rather poor in both instruments, with a case identification of 52% each. Specificity was 70% for the Checklist and 100% for the Mini PAS-ADD. The correlation between the tools was low to moderate (Spearman’s ρ = 0.32, Kendall’s τ = 0.22). Applying the available thresholds, the instruments resulted in the same conclusion about the possible occurrence of psychopathology in only 52.7% of the cases. Discussion The PAS-ADD Checklist and the Mini PAS-ADD are feasible third-party instruments for the assessment of psychiatric disorders in people with ID. Professionals must be aware of the low sensitivity of both tools, meaning that a referral to further assessment should not be based on the thresholds alone. More research is needed as to the adjustment of the thresholds, the suitability of the unusual scoring system and the additional development of self-report instruments.

Stress-related psychopathology after cardiac surgery and intensive care treatment

• Cardiac surgery patients are at risk for post-traumatic stress disorder (PTSD) and depression, which might hamper recovery. • Factors associated with the development of PTSD and depression are variable. • Linear backwards regression identified higher trait anxiety to affect the occurrence of PTSD and depression significantly. • In this setting, female patients potentially benefit from intraoperative dexamethasone administration. Cardiac surgery patients are at risk for psychopathology. Symptoms of post-traumatic stress disorder (PTSD) and depression occur in 10–20% of these patients and affect their quality of life. The aim of this study was to assess factors associated with psychopathology after cardiac surgery. We followed participants of the multi-center randomized clinical trial Dexamethasone for Cardiac Surgery (DECS), on a single, intravenous dose of dexamethasone (1 mg/kg) or placebo during cardiac surgery, using validated questionnaires to assess PTSD and depressive symptoms after 1.5 to 4 years, as well as childhood trauma, trait anxiety, pre-existing psychopathology, and substance use. Saliva was used for genotyping of the hypothalamic-pituitary-adrenal-axis (HPA axis) glucocorticoid receptor gene. Linear backward regression analysis was performed with these factors, including pre-specified interaction terms of dexamethasone with sex and genotype. Complete data was available for 90% of cases ( n = 1111). The model including trait anxiety and the [dexamethasone x female sex] interaction explained 57% of variance in PTSD symptoms (Model fit F (2;4.817)=643.043, p <.001; R 2 =0 0.57). Similar explained variance was seen for depressive symptoms, where age, trait anxiety and the [dexamethasone x female sex] interaction provided the optimal model (Model fit F (3;4.261)=435,960, p <.001; R 2 =0.58). In this study psychopathology was assessed through validated questionnaires. Variability in data collection detail was present. This study suggests that the occurrence of psychopathology after cardiac surgery is influenced by higher trait anxiety. Female cardiac surgery patients may benefit from intra-operative dexamethasone administration.

EVALUATION OF THE INCEST CASES WHO APPLIED TO MERSİN UNIVERSITY MEDICAL FACULTY DEPARTMENT OF FORENSIC MEDICINE IN 2019

Incest relationship, which has many different definitions, is a form of sexual abuse that is more difficult to manifest and its effects on the victim are much more severe. In our study, it was aimed to develop solutions by evaluating the sociodemographic and forensic medical characteristics of the incest victims who were sent to Mersin University Forensic Medicine Department. Method: The forensic investigation documents and medical reports of 34 incest cases that were sent to us for forensic reports with the allegation of sexual assault between January 2019 and January 2020 were analyzed retrospectively. Findings: It was found that most of the cases (85.3%, n: 29) were women, average age being 15.41, with the majority (41.2%, n: 14) between the ages of 6-12. It was observed that in 44.1% of the cases (n: 15) the defendant was the victim's biological father, in 47.1% (n: 16) of the cases the incident took place in the shared house where the victim and the defendant lived. In 32.4% of the cases (n: 11), the incident was reported by school counselors, the person to whom the victim told the event first was most frequently their mother (35.3%, n: 12). In 70.6% of the cases (n: 24), the first person to whom the victim told the incident supported the forensic reporting process. Biological evidence was detected in 8.8% (n: 3) of the cases, the victim's mental health deteriorated in 61.8% (n: 21) of the cases, most common psychopathology being Post Traumatic Stress Disorder (41.2%, n: 14). Conclusion: Our study reveals the importance of schools, where children can communicate with others, in the emergence of incest. On that account, it should be ensured that children continue their education and benefit from guidance services. All teachers, especially counselors, should be made aware on the matter of sexual abuse of children. In addition, "systematic sexual education" for children should be included in the curriculum. Since incest cases are mostly reported late, more often than not biological evidence cannot be obtained. The occurrence of psychopathology in most of the victims shows the importance of mental evaluation. In addition, it should be ensured that all procedures, including clinical treatment, are carried out in centers where multidisciplinary approach can be provided, to prevent secondary suffering due to reinterrogations and examinations of the victim in the judicial process.

MMPI-2Dx restructured clinical scale-based psychopathology among opioid dependence inmates in class IIA correctional facility Denpasar

Substance users, especially those with dependence, have been demonstrated to have a high rate of mental disorder comorbidities. The substance used might have significant effects on the occurrence of psychopathology. This research aimed at decribing opioid users psychopathology based on the MMPI-2 Dx restructured clinical (RC) scale and its correlation with dependence among inmates of Class IIA Correctional Facility Denpasar. An analytic observational research with a cross sectional design was conducted. A number of 70 inmates presented to the Class IIA Correctional Facility clinic who met the inclusion criteria were enrolled in this study. They were screened with MMPI-2Dx. Chi Square test was conducted to determine the correlation and the amount of psychopathology in the opioid dependent and non-dependent groups. Significant difference was set at P of <0.05. Significant opioid dependence was found to correlate with psychopathology as revealed by MMPI-2Dx restructured clinical scale, and this included the subscales RC4 (p 0.00), RC7 (p 0.002), RC8 (p 0.0014), RC9 (p 0.026) dan RCd (p 0.037). No significant correlation was found for other subscales such as RC1 (p 0.339), RC2 (p 0.393), RC3 (p 0.216) and RC6 (p 0.127). Opioid dependent subjects had 7.6 times higher chance (OR 7,667) of having psychopathology compared to nondependent ones. These psychopathologies included demoralization, antisocial behavior, aberrant experiences, dysfunctional negative emotions dan hypomanic activation.

The Importance of Memory Specificity and Memory Coherence for the Self: Linking Two Characteristics of Autobiographical Memory.

Autobiographical memory forms a network of memories about personal experiences that defines and supports well-being and effective functioning of the self in various ways. During the last three decades, there have been two characteristics of autobiographical memory that have received special interest regarding their role in psychological well-being and psychopathology, namely memory specificity and memory coherence. Memory specificity refers to the extent to which retrieved autobiographical memories are specific (i.e., memories about a particular experience that happened on a particular day). Difficulty retrieving specific memories interferes with effective functioning of the self and is related to depression and post-traumatic stress disorder. Memory coherence refers to the narrative expression of the overall structure of autobiographical memories. It has likewise been related to psychological well-being and the occurrence of psychopathology. Research on memory specificity and memory coherence has developed as two largely independent research domains, even though they show much overlap. This raises some important theoretical questions. How do these two characteristics of autobiographical memory relate to each other, both theoretically and empirically? Additionally, how can the integration of these two facilitate our understanding of the importance of autobiographical memory for the self? In this article, we give a critical overview of memory specificity and memory coherence and their relation to the self. We link both features of autobiographical memory by describing some important similarities and by formulating hypotheses about how they might relate to each other. By situating both memory specificity and memory coherence within Conway and Pleydell-Pearce’s Self-Memory System, we make a first attempt at a theoretical integration. Finally, we suggest some new and exciting research possibilities and explain how both research fields could benefit from integration in future research.

Study of Psychiatry Morbidity Following Traumatic Long Bone Injury

Background: Limb fractures due to traumatic injury cause pain, prolonged discomfort, loss of function and immobility and are expected to produce adverse psychological effects. However, there is paucity of work regarding psychopathology following bone trauma in India. Aim: To evaluate the psychiatric morbidity amongst patients with Traumatic long bone injury (fracture). Design: Cross sectional study Setting: Dr Vasantrao Pawar Medical College, Nashik-Maharashtra. Method: The study was carried out amongst 100 randomly selected patients in the age group of 18- 65 yrs who had sustained long bone injury (fracture). Patients were evaluated 4-6 weeks after the trauma over a period of 18 months. All patients were screened using Mini International Neuropsychiatric Interview version 6.0.0. Statistical Analysis was done using the EPI-INFO software. Result: Long bone fracture patients had a high prevalence of Major depressive disorder (23%). Axis I psychiatric diagnosis shows significant association with age, marital status and education (p<0.05). The commonest cause of injury was road traffic accidents among males (n=58) and it was statistically significant. (p<0.05). Axis I psychiatric diagnosis was found more in road traffic accidents 18 (54.5%) and individuals with closed and lower limb fracture 26 (78.78%). Conclusion: In view of occurrence of psychopathology following long bone trauma. Orthopaedic surgeons need to be aware of these conditions so that they should refer patients for psychiatric evaluation and appropriate treatment.

Psychopathology in Police Custody: The Role of Importation, Deprivation and Interaction Models

People experiencing mental illness are over-represented among police cell detainees, however limited work has sought to investigate the occurrence of psychopathology in police custody. The present study sought to examine the predictive power of personal factors (e.g., history of psychiatric hospitalisation), situational factors (e.g., police cell conditions), and their interactive effects to explain the occurrence of psychopathology in police custody. A total of 150 detainees were recruited from two metropolitan police stations in Melbourne, Australia. Personal factors were significantly associated with psychiatric symptomatology, with situational factors and interaction terms yielding no association. Detainees with preexisting vulnerabilities and those unsatisfied with police cell conditions demonstrated the highest levels of psychopathology. While all detainees experience some difficulties in police cells, it is those with pre-existing vulnerabilities that suffer the most. This may be due to the exacerbation of vulnerabilities by police cell conditions. The implications of these findings for provision of health care services in police cells are discussed.

Expressed emotions, early caregiver–child interaction, and disorders

AbstractIn addition to the socio-relational framework of expressive behaviors (SRFB), we recommend integrating theoretical and empirical findings based on attachment theory. We advocate a dynamic interpretation of early caregiver–child interaction. The consequences of models from developmental psychology for the occurrence of psychopathology are demonstrated from a clinical perspective.

The Effects of MMPI-A T-Score Elevation on Classification Accuracy for Normal and Clinical Adolescent Samples

In this investigation we examined the ability of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) to classify accurately both clinical and normal adolescents using 2 different T-score elevation ranges, T *ge; 60 and T *ge; 65, and using 2 different clinical base rates for the occurrence of psychopathology. A clinical base rate of 50% and 20%, respectively, were created by comparing a clinical sample of 203 adolescent inpatients with cooccurring substance abuse and psychiatric disorders with 2 subsamples from the MMPI-A normative group. These subsamples consisted of 203 adolescents matched for sex and age, and a larger subsample of 1,015 adolescents proportionately matched for sex and age, with the clinical group. Classification accuracy analyses revealed that although clinical base rate did affect the accurate classification of cases, a T-score cutoff of 65 resulted in higher levels of accurate classification overall while minimizing the misclassification of both clinical and normal cases. Implications of these findings for the recommended use of the MMPI-A "gray zone" are presented, and the relative areas of strength and weakness of the MMPI-A are reviewed in the identification and description of psychopathology.

Adjustment in conditions with short stature: a conceptual framework.

A major justification of extended indications for GH therapy in conditions with short stature is based on the objective of preventing or alleviating suspected psychosocial maladjustment. Despite more sophisticated research, results are still controversial concerning the actual seriousness of adjustment difficulties in various conditions with short stature, thus making it difficult to determine a patient's need for treatment. This paper discusses different concepts and assessment strategies of "adjustment" as a major source of the apparent heterogeneity among study findings, conclusions and treatment recommendations. A concise framework is developed that identifies and differentiates three hierarchical levels of research on adjustment in conditions with growth retardation: (1) stress exposure due to short stature, (2) quality of coping responses, and (3) occurrence of psychopathology. Choosing a particular research level and its corresponding measures may imply whether a high, medium or very low impact of short stature on adjustment is found, and the need for treatment that is inferred. The integration of these different research approaches within an integrative model may help to resolve apparent inconsistencies among empirical studies and reveal sources of confoundation due to other, short stature independent risk factors associated with the particular underlying growth disorder. The key terms of the suggested model are transformed into a clinical guideline for psychological assessment in patients with growth retardation and into three key criteria for the decision making process on extended indications for GH treatment with respect to the improvement of psychosocial adjustment.

Vascular depression--a new concise concept?

Many studies pointed out that in the elderly depression is underdiagnosed, probably due to the uncharacteristic psychopathologic symptoms. Often elder people complain about somatic disorders and cognitive impairment, sometimes covering the psychopathologic symptoms and hampering diagnostic classification. Cerebrovascular disorders has been considered to be one major cause for depressive mood in the elderly. In a recent paper Alexopoulos et al. (1997) proposed the concept of vascular depression (VD) which is different from that of post-stroke depression established by the group of Robinson and Starkstein. The new concept is critically reviewed with regard of its clinical feasibility. In contrast to the ICD-10 guidelines the vascular depression concept requires no connection between the occurrence of psychopathology and of cerebrovascular disorder. Therefore it appears to be more feasible in clinical practice. However, a differentiation of vascular depression into two subtypes according to the CT/MRI findings seems to be more promising: type I (macroangiopathy) is similar to post-stroke-depression, while type II is characterized by microangiopathy and its clinical description resembles that for vascular depression of Alexopoulos et al. Up to now possible therapeutic consequences have not been investigated. Moreover, the concept of vascular depression basing only on two clinical studies needs further confirmation.

Spinal cord injury and psychological response

Psychological adjustment and psychopathological morbidity issues during rehabilitation of patients with spinal cord injury, have been documented in international literature. However, most authors are faced with methodological difficulties, and results are contradictory. In this prospective study, the first to be made in the Portuguese population, a sample of 65 patients being treated in a rehabilitation unit during the years of 1993, 1994 and 1995, was obtained. The authors study the type of psychological response, when it does occur, which personality traits point to less suffering, which coping mechanisms are used by the better adjusted patients and the differences between the scores of paraplegic and quadriplegic patients. Two assessments were made. The following assessment instruments were used: an anamnestic data questionnaire, the SCL-90-R (Derogatis, 1983), the EPI (Eysenck & Eysenck, 1984), the Coping Styles Evaluation Scale (Figueira, 1990). The second assessments were carried out with the SCL-90-R only. The findings indicate that psychopathological scores consistent with depression occurred in 60% of patients if we consider any evaluation. Sleep disturbances, suicide ideation and guilt occurred in the same proportion. In 33% of them, we found persistent depressive scores in the two assessments. The authors find a highly significant positive correlation between psychopathology and neuroticism. On the contrary, the extroversion dimensions of EPI seem to be a good prognosis predictive factor as far as the occurrence of psychopathology is concerned. No differences in the psychopathological response were found concerning the paraplegic-quadriplegic situation.

Psychomotor and Mental Development from Birth to Age of Four Years; Sex Differences and Their Relation to Home Environment Children in a New Stockholm Suburb Results from a Longitudinal Prospective Study Starting at the Beginning of Pregnancy

Five hundred and thirty-two pregnant women were interviewed about their psychosocial health at the beginning of pregnancy. According to various factors including alcoholism, mental disease and criminality among the women and their husbands the families were divided in three groups of different degrees according to psychosocial stress. The pregnancies, deliveries and the 497 live-born children in these families have been investigated with prospective methods. Data concerning the psychological development and psychiatric health of the child were attained by interviewing the mother and evaluating the child during visits to home (age 1 and 4). The physical health and development of the children has been followed by prospective data achieved from the child welfare centers. At one year of age 452 of the children (226 boys, 226 girls) and at four-five years of age 412 of the children (202 boys, 210 girls) were evaluated by the Griffith's Development Scales. Findings from these evaluations can now be related to a number of factors concerning the psychosocial situation, pediatric riskfactors etc. With the prospective, longitudinal methods used in this project interesting results concerning sex differences related to the mental development have been found. At one year of age girls had higher scores than boys on the Griffiths-subscale measuring hearing-and-speech abilities. At four years of age several significant differences between the sexes were found. Girls had more "even" Griffiths-profiles and scored higher than boys in several Griffiths-subscales. The greatest differences at four years of age were found concerning personal-social function and eye-hand-coordination. Boys seem to be specially vulnerable to the psychosocial situation in their homes as the Griffiths-results at four years of age are lower among boys from homes with psychosocial stress compared to other boys. It should be very interesting to follow and study what these sex differences mean concerning future development, the occurrence of psychopathology school difficulties.

Family variables and child mental disorders in a Third World urban area (Bahia, Brazil).

The relationship between family support variables and child mental disorders was assessed through a prevalence study conducted in an urban neighborhood of Bahia, Brazil. From a representative sample of 828 children, aged between 5 and 14 years, 23.3% were diagnosed as having varying degrees of psychological symptoms. Diagnoses were based on psychiatric interviews, following screening using the Questionario de Morbidade Psiquiatrica Infantil (QMPI). Results supported the hypotheses that: (a) children from smaller families exhibit a higher prevalence than those from larger families; (b) prevalence of neurotic and psychosomatic disorders is lower for children from larger families than for those from smaller ones. The data failed to confirm the hypothesis that family type is associated with the occurrence of psychopathology in children. Controlled analyses indicated that these relationships were not confounded by the age or sex of the child, the social class, type or size of the family.