Psychiatric Diagnosis Research Articles

Young and adult patients with gaming disorder: Psychiatric co-morbidities and progression of problematic gaming

BackgroundPrevious research suggests age-dependent differences in the progression of addiction, and evidence is accumulating, showing that an early initiation of gaming increases the risk for addiction. With the recent introduction of gaming disorder (GD) as a psychiatric diagnosis, there is a need to extend the knowledge of the clinical characteristics of patients seeking treatment for GD of all age groups. Compared to adolescents and young adults, less is known about treatment-seeking adults. This study aimed to investigate whether there are clinically relevant age-dependent differences among patients seeking treatment for GD.MethodParticipants were recruited among patients seeking treatment and fulfilling diagnosis for GD at an outpatient clinic specialized in the treatment of GD. During the study period, 142 patients went through assessment for GD at the clinic, 37 did not fulfill the diagnosis for GD, and 36 declined participation, leaving a sample of 69 patients (age range = 15–56) for analysis. The sample (men, n = 66; women, n = 3) was divided in two age groups: adolescents and young adults (25 years or younger) and adults (26 years or older). Gaming-related data and information about psychiatric co-morbidity was collected through structured clinical interviews and questionnaires.ResultsThe adolescents and young adults (AYAs) reported a more rapid progression into problematic gaming than the adult group. The younger group developed problematic gaming four years faster than the adults. We also observed comparable clinical profiles in both groups. Both age groups had similar levels of GD as well as symptoms of psychiatric co-morbidities including possible attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD) and problematic gambling. We also noticed that half of our study population consisted of adults.ConclusionWith the increasing prevalence of gaming in all age groups, it is unknown how the occurrence of GD will develop in different stages of life. We conclude that the adolescents and young adults had almost double as fast progression to problematic gaming than the adult group, highlighting the need for preventive strategies. The similarity in clinical profiles indicates that treatments with the same type of interventions could be offered to both age groups.

Contribution of rare chromosome 22q11.2 copy number variants to non-syndromic bicuspid aortic valve

BackgroundBicuspid aortic valve (BAV) is the most common congenital heart defect in adults, often leading to complications such as thoracic aortic aneurysms and aortic stenosis. While BAV is frequently associated...

Magnetic Seizure Therapy in Refractory Psychiatric Disorders: A Systematic Review and Meta-Analysis: La thérapie par convulsions magnétiques pour la prise en charge des troubles psychiatriques réfractaires : revue systématique et méta-analyse.

To qualitatively and quantitatively synthesize the literature on the efficacy and safety of magnetic seizure therapy (MST) in psychiatric disorders. A literature search was conducted of the OVID Medline, OVID EMBASE, PsychINFO, CINAHL, Web of Science and Cochrane databases from inception to 14 January 2024, using subject headings and key words for "magnetic seizure therapy." Randomized controlled trials (RCTs), post-hoc analyses of RCTs, open-label trials, or case series investigating MST in adults with a verified psychiatric diagnosis and reporting on two possible primary outcomes (1) psychiatric symptom reduction (as measured by validated rating scale) or (2) neurocognitive outcomes (as measured by standardized testing), were included. Abstracts, individual case reports, reviews and editorials were excluded. Extracted data included: (1) basic study details; (2) study design; (3) sample size; (4) baseline demographics; (5) outcome data (including secondary outcomes of suicidal ideation and adverse events); and (6) stimulation parameters. Cochrane's risk of bias tool was applied. A quantitative analysis was conducted for the depression studies, using Hedge's g effect sizes. A total of 24 studies (n = 377) were eligible for inclusion. Seventeen studies in depression (including three RCTs), four studies in schizophrenia (including one RCT), one study in bipolar disorder, one study in obsessive-compulsive disorder and one study in borderline personality disorder were summarized. We found no significant difference in depressive symptom reduction between MST and electroconvulsive therapy (ECT) in randomized, controlled trials (g = 0.207 towards ECT, 95% confidence interval (CI) -0.132 to 0.545, P = 0.232). We found a significant reduction in depressive symptoms overall with MST in the pooled RCT and open-label analysis (g = 1.749, CI 1.219 to 2.279, P < 0.005). It is suggested that MST has modest cognitive side effects. Large-scale RCTs are necessary to confirm early signals of MST as an effective intervention in psychiatric disorders with a cognitive profile that is potentially more favourable than ECT.

Eating Disorders, Co-Morbid Disorders and Early Risk Factors Amongst Post-9/11 Veteran Men and Women.

To assess, by interview, the rates of eating disorders in a nationally representative sample of recent veterans, describe their DSM-5 eating disorder diagnoses and the occurrence of comorbid psychiatric disorders. To conduct an exploratory case-control analysis of previously documented and additional specific military risk factors before eating disorder onset to inform studies of prospective risk. Using a two-stage design, probable cases and controls were identified by screening questionnaires from a sample of 1494 veterans who completed a survey study and interviewed to establish case status and confirm probable co-morbid psychiatric diagnoses. Previously documented risk factors and military risk factors occurring before disorder onset were investigated. Ninety-one cases and 51 controls were confirmed. Weighted prevalence for any eating disorder was 5.2%, with estimates for anorexia nervosa, bulimia nervosa, binge eating disorder and other specified eating disorder being 0.01%, 0.6%, 1.4%, and 1.6%, respectively. Seventy-nine (86.8%) confirmed cases had a diagnosis of one or more co-morbid psychiatric disorders. Previously documented risk factors were associated with subsequent case status, while in this sample, military risk factors were not. Rates of eating disorder and co-occurring psychiatric disorders in recent veterans were comparable to those reported for non-veterans, with levels of posttraumatic stress disorder likely higher. As co-occurring psychiatric disorders, particularly posttraumatic stress disorder, may complicate achieving good outcomes with existing evidence-based treatments, there is an urgent need to adapt them where necessary to improve outcomes. Military risk factors may maintain or exacerbate pre-existing problems and need to be investigated alongside other maintaining factors in longitudinal studies. Rates of eating disorder and co-occurring psychiatric disorders in recent veterans were comparable to those reported for non-veterans, highlighting a need to detect eating problems and address unmet treatment need. Co-occurring psychiatric disorders may complicate achieving good outcomes with existing treatments, emphasising a need to adapt them to improve outcomes. Investigating maintaining factors, including military factors in longitudinal studies will likely aid treatment development.

AI depictions of psychiatric diagnoses: a preliminary study of generative image outputs in Midjourney V.6 and DALL-E 3

ObjectiveThis paper investigates how state-of-the-art generative artificial intelligence (AI) image models represent common psychiatric diagnoses. We offer key lessons derived from these representations to inform clinicians, researchers, generative AI companies,...

Psychiatric Disorders and Their Impact on Herpes Zoster Incidence: Five Years of Data from Turkiye

Background/Objectives: This study investigates the relationship between psychiatric disorders and herpes zoster (HZ). Emergency and outpatient admissions to Kırşehir Education and Research Hospital between 2019 and 2023 were examined. Psychiatric disorders are known in the literature as one of the factors that weaken the immune system, thereby increasing the risk of infection. Methods: In our study, the past diagnoses and sociodemographic data of all individuals over the age of 18 who applied to the Kırşehir Education and Research Hospital between 2019 and 2023 were obtained from hospital system records. Patients receiving immunosuppressive treatment or those with diseases that could affect immune system function were excluded from the study. The sample was divided into two groups: those with and without psychiatric disorders diagnosed with HZ. Sociodemographic features, change of HZ frequency over the years, and differences among psychiatric diagnosis subgroups were examined between the groups. Results: Individuals with psychiatric diseases had a significantly higher frequency of HZ compared to those without psychiatric diseases (0.0040% vs. 0.0016%, p &lt; 0.001). No significant difference was found in the frequency of HZ among different types of psychiatric disorders (p = 0.60). Additionally, no statistically significant difference was found in the median age between the groups (p = 0.11). In terms of gender distribution, it was determined that women were more frequently diagnosed with HZ compared to men. Conclusions: The frequency of HZ was found to be higher in individuals with psychiatric disorders. However, further research is needed to explore the association between specific psychiatric diagnoses and HZ frequency.

The Relationship Between Psychopathology, Personality Traits, and a History of Traumatic Brain Injury.

To determine whether history of traumatic brain injury (TBI) is associated with psychopathology, and, in particular, substance use disorder (SUD) in young adults with a history of athletic participation. Observational study. University in the northeastern United States. A large (n = 534) and mixed sex (57% female) sample of varsity and club sport athletes older than 18 years. None. The Ohio State University Traumatic Brain Injury ID assessment and the Structured Clinical Interview for the diagnostic and statistical manual of mental disorders, fifth edition. Twenty-five percent of participants reported no history of head injuries, 32% reported 1 head injury, and 43% reported more than 1 head injury. Thirty-eight percent of participants had been diagnosed with 1 or more concussions. Twenty-eight percent of participants had a current psychiatric diagnosis and 49% had at least 1 lifetime diagnosis. Head injuries and concussions were significantly associated with the presence of lifetime psychiatric diagnosis and symptoms or diagnosis of alcohol or SUD. More head injuries were associated with symptoms of post-traumatic stress disorder. Higher number of self-reported head injuries and diagnosed concussions were associated with a lifetime history of psychopathology, and specifically, with alcohol and substance use disorders. These relationships are similar to those seen in the general population of adults. The relationships also raise several interesting questions about recovery from head injuries in young adult athletes.

Phenome-wide diagnostic comparison among suicide deaths and living individuals with chronic pain diagnoses

BackgroundChronic pain, regardless of its type, is a significant risk factor for suicide. However, not all individuals with chronic pain also experience suicidal thoughts and behaviors. Better characterization of clinical risk profiles and comorbidities across the medical spectrum among people with chronic pain who die by suicide is urgently needed to aid treatment and prevention strategies.MethodsThis case–control study leverages population-based data from the Utah Suicide Mortality Risk Study. Specifically, we identify clinical phenotypes from diagnostic data that differentiate between individuals that died by suicide with chronic pain diagnoses (N = 1,410) and living control individuals who also had chronic pain diagnoses (N = 4,664). Medical diagnostic codes were aggregated via phecodes to perform a phenotype-based phenome-wide association study. Using multivariable logistic regression analysis adjusting for covariates and multiple testing, differences in 1,727 common clinical phenotypes (phecodes) were assessed between suicide deaths and controls with chronic pain diagnoses. Models were also stratified by sex.ResultsChronic pain diagnoses were nearly three times more prevalent in individuals who died by suicide compared with those who did not. Sixty-five phecodes were significantly overrepresented among suicide deaths with chronic pain diagnoses compared with controls with chronic pain diagnoses. Utah suicide deaths with chronic pain had significantly more psychiatric diagnoses (mood disorders, anxiety disorders, attention deficit hyperactivity disorder, posttraumatic stress disorder, personality disorders, schizophrenia/psychosis, substance use related traits and prior overdoses, and diagnoses related to previous suicidal thoughts and behaviors) in addition to insomnia and specific pain related diagnoses compared to Utah controls with chronic pain (odds ratios ranged from 1.40–7.10). Twenty-five phecodes were overrepresented in controls with chronic pain compared to suicides. These were related to preventative care, cancer, obesity and other conditions (odds ratios ranged from 0.16–0.73). Sex-specific analyses largely replicated the combined analyses, yet the strength of the association was stronger for women with phecodes related to prior self-harm.ConclusionsResults identified multiple clinical comorbidities with chronic pain that differentiate suicide deaths from living control individuals with a history of diagnosed chronic pain. Our findings may help discern individuals with chronic pain who may be at greater risk for suicide death.

Incidence rate of suicidal behavior stratified by diagnosis among high-risk patients

BackgroundPsychiatric diagnoses are known to increase suicide risk, but whether this risk varies across specific disorders remains unclear. Previous studies have often relied on retrospective designs or population-based databases, limiting comparability due to heterogeneous methodologies and follow-up periods. AimsThis study aimed to compare the incidence rates of unfavorable events (suicide or suicide attempts) among high-risk patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia over a 24-month follow-up period. MethodsThis secondary analysis was conducted as part of a multicenter prospective cohort study involving 324 patients admitted to emergency departments for suicidal ideation or a recent suicide attempt. Clinical evaluations were performed at baseline and every six months to assess for unfavorable events. Additionally, Kaplan-Meier curves were estimated for each diagnosis, and Cox regression models were used to evaluate whether the diagnosis is associated with unfavorable events, adjusted for covariates such as age, history of childhood sexual abuse, and number of previous suicide attempts. ResultsThe incidence rates of suicide attempts were 27,000, 20,400, and 21,100 per 100,000 person-years for patients with MDD, BD, and Schizophrenia, respectively, while suicide rates were 1,600 per 100,000 person-years across all groups. No statistically significant differences were found in the risk of unfavorable events among diagnostic groups (p = 0.653), as confirmed by Kaplan-Meier survival analysis and Cox regression models. ConclusionsOver a 2-year follow-up, psychiatric diagnosis alone did not predict significant differences in unfavorable events rates. Comprehensive suicide risk assessments should prioritize individual risk profiles over diagnostic categories. These findings underscore the importance of integrating biopsychosocial factors in suicide prevention strategies for high-risk psychiatric populations.

Lived experiences of mothers: A longitudinal study of impacts and adjustment following adolescent psychiatric hospitalization for suicide attempts or other reasons.

Parents play crucial roles in monitoring and supporting youth who have been hospitalized after suicide attempts, but their adjustment in the period following hospitalization has been understudied. This study assessed the adjustment and impacts on mothers during the year following hospitalization. Participants included 135 mothers of suicidal adolescents and 117 mothers of adolescents hospitalized for other reasons. The Structured Clinical Interview for DSM (SCID) and the Child and Adolescent Impact Assessment were used to assess psychiatric diagnoses of Major Depressive Disorder [MDD], Generalized Anxiety Disorder [GAD], and Post-Traumatic Stress Disorder [PTSD], and impacts on caregivers at one, three, six, and 12 months after hospitalization. Higher rates of MDD, GAD, and PTSD, and greater impacts were evidenced closer in time to the hospitalization. There were few overall differences between mothers of youth with and without suicidal behavior. However, family history of suicidal behavior was related to higher rates of MDD and PTSD, and greater severity of youth suicidal thoughts and behavior over the follow-up was related to greater impact upon mothers of suicidal youth. This study highlights the mental health struggles of mothers of suicidal and other hospitalized youth and underscores the importance of support for caregivers.

Examining the Relationship Among Parental-Reported Problems, Self-Reported Problems, and Psychiatric Diagnosis in Children and Adolescents

The study aims to investigate the relationship among psychiatric diagnosis, parental reported problems, and the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) results of children. The sample of the study consisted of 78 children and adolescents (36 girls and 42 boys), and statistical analyses were made using the chi-square test and Fisher’s exact test. Relationships identified between the following pairs: worry problems with Generalized Anxiety Disorder (GAD), distraction problems with Attention Deficit and Hyperactivity Disorder (ADHD), hyperactivity problems with Tic and Tourette's Syndrome, obsession problems with Obsessive-Compulsive Disorder (OCD), unhappiness with Major Depressive Disorder or dysthymia, and avoidance of communication with autism spectrum disorder. Furthermore, when examining the relationship between psychiatric diagnoses and diagnoses according to the RCADS-CV, we found other connections, such as the psychiatric diagnosis of separation anxiety and RCADS-CV separation anxiety, as well as the psychiatric diagnosis of separation anxiety and RCADS-CV social phobia. Lastly, when investigating the relationship between parentally reported problems and RCADS-CV diagnoses, several associations emerged, including the connection between obsession problems and RCADS-CV OCD diagnosis, relationship problems and RCADS-CV’s OCD diagnosis, unhappiness problems, and RCADS-CV’s depression diagnosis. In conclusion, our findings demonstrate a substantial overlap among parentally reported problems, psychiatric diagnoses, and diagnoses based on RCADS-CV.

The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations.

Catatonia is a neuropsychiatric disorder marked by significant disturbances in motor, cognitive, and affective functioning and that is frequently under-diagnosed. To enhance clinical detection of catatonia, this study aimed to develop a rapid, sensitive Catatonia Quick Screen (CQS) using a reduced set of catatonic signs to facilitate screening in adult and pediatric patients. Data were derived from two retrospective cohorts totaling 446 patients (254 adults, 192 children) who screened positive for catatonia using the Bush Francis Catatonia Screening Instrument (BFCSI). Sensitivity analyses were performed for all combinations of BFCSI signs, with sensitivity defined as the proportion of patients identified by each subset relative to the full BFCSI. The CQS was developed by selecting signs from the BFCSI based on sensitivity, ease of assessment, and relevance to diverse catatonia presentations. Screening for the presence of any one of four signs-excitement, mutism, staring, or posturing-using the CQS yielded a theoretical sensitivity of 97% (95% CI: 95 to 98%) relative to the full BFCSI (which requires two signs out of 14). The CQS demonstrated 97% sensitivity across both pediatric and adult subsets. The Catatonia Quick Screen provides a rapid screening alternative to the BFCSI with high sensitivity, potentially improving early detection of catatonia in clinical settings. Future prospective studies are necessary to validate the CQS's sensitivity and to determine its specificity in clinical populations. The Catatonia Quick Scale (CQS) is a newly developed rapid screen for catatonia.Assessment for any one of four signs-excitement, mutism, staring, and posturing-has 97% sensitivity for detecting catatonia relative to the BFCSI.This screening is sensitive in both adult and pediatric populations. The study relies on retrospective data.Only patients who initially screened positive for catatonia were included, so the specificity of the CQS could not be assessed.Most of the sample has a primary psychiatric diagnosis so the generalizability to patients with primary medical disorders is unclear.

Psychometric evidence of the adaptation to the Brazilian context of the Childhood Mania Rating Scale - Parent/Guardian Version (CMRS-P).

To carry out the process of cross-cultural adaptation of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context. Statistical procedures were carried out, based on the analysis of the validity of the internal structure of the scale, as well as its relationship with external variables. 224 parents/guardians of children/adolescents aged between five and 18 years participated in the study. The data collection form included instruments for assessing (hypo)manic symptoms, irritability, inattention, hyperactivity, emotional symptoms and behavioral problems. Data were collected in person, at a public school and at a Psychosocial Care Center, and online (via Google forms). Exploratory and confirmatory factor analyses, measurement invariance analyses, reliability analyzes were performed, as well as convergent and concurrent validity analyses. The one-dimensional model was investigated, showing satisfactory results, similar to those of the original scale. A reduced version was proposed with the ten most robust items from this study. Validity analyzes based on hypotheses indicated higher scores among those subjects with more clinical problems, such as the previous existence of a psychiatric diagnosis. Statistically significant and positive correlations, of low and moderate magnitudes, were observed with the scores of the other instruments used. The results indicated that the adapted versions of the CMRS-P (full scale and reduced form) are promising instruments for use in the country.

Use of antipsychotic drugs during radiotherapy in adult cancer patients in Korea: a nationwide retrospective cohort study based on the national health insurance service database

BackgroundAntipsychotic drugs (APDs) are used for treating mental illnesses and are also used by cancer patients. This study aimed to evaluate APD use in adult cancer patients who received radiotherapy (RT) in South Korea and assess the effects of APD use during RT on survival.MethodsThis retrospective cohort study utilized the National Health Insurance Service database database of Korea. We included adult cancer patients who underwent RT or chemotherapy (CTx, cisplatin, or 5-Fluorouracil) between 2010 and 2020. The APDs included in the analysis were aripiprazole, quetiapine, olanzapine, risperidone, haloperidol, and chlorpromazine.ResultsOverall, 725,897 patients received RT, and 115,500 received concomitant chemo-radiotherapy (CCRT). Of them, 41,118 (5.6%) took APDs during RT, and 8,129 (7%) took APDs during CCRT. Overall, 27,789 (67.58%) patients who took APDs during RT were men, and 28,004 (68.2%) were aged ≥ 60 years. The most frequently used APD during RT was quetiapine (64.93%). Patients who took APDs during RT and during CCRT had higher mortality rates (HR: 3.45 and 1.72, p < 0.0001, respectively) compared to the non-APD patients. Of the patients who used APDs during RT, patients accompanying psychiatric diagnosis, taking high-dose APD, and taking APD for more than 3 months had lower mortality than patients without psychiatric diagnosis, taking low-dose APD, and taking APD for less than 3 months, respectively (HR: 0.88, 0.87 and 0.80, respectively, p < 0.0001).ConclusionsOnly 5.6% of patients who underwent RT used APDs, and quetiapine was the most frequently prescribed APD during RT. The use of APD during RT may adversely affect survival. Further studies are required to elucidate the effects of APDs on cancer patients.Trial registrationThis study is retrospectively registered.

Effects of psychoplastogens on blood levels of brain-derived neurotrophic factor (BDNF) in humans: a systematic review and meta-analysis.

Peripheral levels of brain-derived neurotrophic factor (BDNF) are often used as a biomarker for the rapid plasticity-promoting effects of ketamine, psychedelics, and other psychoplastogens in humans. However, studies analyzing peripheral BDNF after psychoplastogen exposure show mixed results. In this meta-analysis, we aimed to test whether the rapid upregulation of neuroplasticity seen in preclinical studies is detectable using peripheral BDNF in humans. This analysis was pre-registered (PROSPERO ID: CRD42022333096) and funded by the University of Fribourg. We systematically searched PubMed, Web of Science, and PsycINFO to meta-analyze the effects of all available psychoplastogens on peripheral BDNF levels in humans, including ketamine, esketamine, LSD, psilocybin, ayahuasca, DMT, MDMA, scopolamine, and rapastinel. Risk of bias was assessed using Cochrane Risk of Bias Tools. Using meta-regressions and mixed effects models, we additionally analyzed the impact of several potential moderators. We included 29 studies and found no evidence that psychoplastogens elevate peripheral BDNF levels in humans (SMD = 0.024, p = 0.64). This result was not affected by drug, dose, blood fraction, participant age, or psychiatric diagnoses. In general, studies with better-controlled designs and fewer missing values reported smaller effect sizes. Later measurement timepoints showed minimally larger effects on BDNF. These data suggest that peripheral BDNF levels do not change after psychoplastogen administration in humans. It is possible that peripheral BDNF is not an informative marker of rapid changes in neuroplasticity, or that preclinical findings on psychoplastogens and neuroplasticity may not translate to human subjects. Limitations of this analysis include the reliability and validity of BDNF measurement and low variation in some potential moderators. More precise methods of measuring rapid changes in neuroplasticity, including neuroimaging and stimulation-based methods, are recommended for future studies attempting to translate preclinical findings to humans.

The Impact of Traffic Congestion on the Mental Health of Civil Servants: A Case Study of Ministry of Transportation Employees in the Greater Jakarta Area

This study aims to investigate the psychological effects of prolonged traffic congestion on civil servants working in the Ministry of Transportation in the Greater Jakarta Area. As one of the most densely populated regions in Indonesia, Greater Jakarta experiences severe daily traffic, which has the potential to exacerbate mental health issues. The research employed a quantitative approach through a structured survey distributed to 102 respondents. The respondents were classified into three categories of mental health disorders: high, moderate, and low, based on validated psychological scales. The results indicated that 51.20% of respondents experienced severe mental health disorders, while 39.21% reported moderate disorders, and 8.82% exhibited mild symptoms. Emotional regulation difficulties, anxiety, and mood disturbances were significantly related to traffic exposure. The study recommends implementing flexible work arrangements, improving public transportation infrastructure, and providing mental health support programs to mitigate the adverse effects of traffic congestion on civil servants. These findings highlight the need for urgent policy interventions to promote the well-being of public servants in urban settings, particularly those affected by chronic congestion.

Diagnosis of Mental Disorders Complicated by Rheumatoid Arthritis: A Study of the Validity of a Questionnaire Method and Diagnosis by the Psychiatrist.

Rheumatoid arthritis (RA) is associated with depression in approximately 15% of patients, most of whom have been studied using questionnaires. As the depression questionnaire includes questions about physical symptoms, caution should be exercised when interpreting the results due to an underlying disease. In addition, few studies have been conducted on other psychiatric disorders. Here, we examined the validity of diagnosing rheumatoid arthritis complicated by psychiatric disorders using a questionnaire. Forty-nine outpatients with RA who consented to participate in this study were included. The patient background information included age, sex, type of anti-rheumatic drug, prednisolone use, presence of diabetes, hypertension, dyslipidemia, and C-reactive protein. The Patient Health Questionnaire-9 (PHQ-9) and Center for Epidemiologic Studies Depression Scale (CES-D) questionnaires were used; scores of ≥10 on the PHQ-9 and ≥16 on the CES-D were considered the cut-off. The psychiatrist was blinded to the questionnaire results and arrived at a diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM) in a separate room. Additionally, the specificity and sensitivity of the PHQ-9 and CES-D were examined. Eleven patients had abnormal psychiatric diagnoses. The PHQ-9 had a specificity of 0.98, a sensitivity of 0.36, a positive predictive value of 0.80, and a negative predictive value of 0.89. The CES-D had a specificity of 0.87, a sensitivity of 0.91, a positive predictive value of 0.51, and a negative predictive value of 0.98. The PHQ-9 and CES-D may help screen for psychiatric disorders associated with RA.

A comparison of scalable routine clinical materials and observer ratings to assess CBT fidelity

Decades of research have demonstrated the efficacy of cognitive behavioral therapies (CBTs) for a wide variety of psychiatric diagnoses, resulting in the inclusion of CBT as a first-line evidence-based practice (EBP) in treatment guidelines for mood and anxiety disorders. However, some research suggests that many providers do not implement EBPs as intended. Ongoing quality monitoring is needed to support EBP implementation and sustainability, but “gold standard” fidelity monitoring (e.g. observer ratings) is time-consuming, requires extensive training, and may feel intrusive to providers and clients. In the current study, we aimed to develop a scalable method of assessing CBT fidelity that leverages information generated in routine clinical care (e.g. session worksheets and clinician checklists). Ratings of adherence based on worksheets were not correlated with ratings of adherence based on observer ratings. However, ratings of competence based on worksheets were significantly correlated with observer ratings of competence. Ratings of adherence based on clinician checklist ratings were also significantly correlated with observer-rated adherence. Results did not indicate a strong relationship between adherence or competence measured by worksheet ratings or observer and symptom change. However, adherence as measured by clinician checklists were associated with subsequent depression symptom change. Findings have a strong potential to impact fidelity monitoring strategies for a variety of CBTs. Given the limited resources and time to do full audio review in routine care settings, findings suggest that using routine materials generated in session to assess therapist competence may be a feasible alternative to the “gold standard” audio review. The trial is registered at ClinicalTrials.gov, number NCT03479398.

Identifying diagnosed major chronic diseases associated with recent housing instability among aging adults: data from the 'All of Us' research program.

Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults. Cross-sectional data on 147465 participants of the 'All of Us' Research Program (6 May 2018-1 July 2022), ≥50years of age at enrollment, were analyzed. Self-reported housing instability over the past 6 months was examined in relation to diagnosed conditions at age≥50years based on electronic health records. Multivariable logistic regression models sequentially adjusting for demographic and socioeconomic characteristics were constructed to estimate odds ratios (OR) with their 95% confidence intervals (CI). After adjusting for confounders, past 6 months housing instability was associated with lower odds of diagnosed cardiovascular disease (OR=0.89, 95% CI: 0.87, 0.93) and cancer (OR=0.82, 95% CI: 0.78, 0.86), higher odds of diagnosed psychiatric (OR=1.35, 95% CI: 1.30, 1.40) conditions, but was unrelated to diagnosed diabetes (OR=0.98, 95% CI: 0.94, 1.01). Recent housing instability among aging adults is positively associated with psychiatric diagnoses, but negatively associated with cardiovascular and cancer diagnoses, with implications for chronic disease prevention.

Delusion-proneness predicts COVID-19 vaccination behavior.

Vaccination-related conspiracy ideation is related to reduced compliance with public health advice globally. Such beliefs have previously been linked to the delusion-proneness trait. However, it is not known how this extends to getting vaccinated. Here, we examined how delusion-proneness, as assessed by Peters et al. Delusions Inventory (PDI), is associated with COVID-19 vaccination in a sample of 273 subjects. We also examined whether delusion-proneness predicted the time to get vaccinated, after the vaccine became available. Unvaccinated subjects were more delusion-prone than vaccinated subjects (W=2225.5, p<0.001, effect-size=0.27). Among vaccinated subjects, higher delusion-proneness was related to longer time to get vaccinated ( =0.27, p<0.001). These effects remained after adjusting for anxiety, ADHD, and ASD (Autism Spectrum Disorder) traits as well as for psychiatric diagnoses and sex. Path analyses indicated that the effect of delusion-proneness on vaccination rate was strongly mediated through COVID-19 conspiracy ideation, suggesting that delusion prone individuals first develop specific delusion-like ideas regarding vaccination, which then delays vaccination. An exploratory analysis of written text by subjects instructed to explain why they had vaccinated or not, revealed a difference in reasoning between the groups. Unvaccinated individuals were primarily motivated by concerns about personal safety and potential side effects, while vaccinated individuals stated a desire to protect themselves and others as the primary reasons to get vaccinated. Our results suggest that delusion-proneness is a key factor for attaining conspiracy beliefs, at least in relation to COVID-19 pandemic, and associated with lower vaccination rates as well as longer time to get vaccinated.