Psychosocial Functioning Research Articles

Demographic and Experiential Characteristics of Asexual Individuals and Associations with Well-Being.

The visibility and number of people identifying as asexual-those with little to no sexual attraction-have been increasing in recent years. In the current study, we examined variation in experiential and developmental milestones and psychosocial functioning in 1,726 individuals on the asexual spectrum (61.2% women, 15.0% non-binary, 14.2% men, 9.0% other gender). A lack of sexual attraction was a lifelong orientation-most (i.e., often half to two-thirds) asexual individuals reported never experiencing sexual attraction or acting on it. Identity formation processes and romantic feelings tended to be most salient in adolescence. People are identifying as asexual more recently, such that 18-22-year-olds did so recently in adolescence (ages 13-17), 23-29 year-olds did so recently in young adulthood (ages 18-24), and 30 + year-olds did so recently in adulthood (ages 25-34). This may be consistent with the visibility of asexuality increasing in recent years, providing a useful label for people. Asexual people were more out to other members of the LGBTQIA+ community but less to family, coworkers, and the heterosexual community. Being out and lower levels of internalized acephobia were associated with higher life satisfaction. We discuss these findings in the context of identity development and the mechanisms linking individual and relational characteristics to well-being in asexual populations.

Sex differences in pain, suicidal ideation, and suicide attempts in patients with migraine.

To examine sex-specific associations between non-cephalic pain and suicidal ideation and suicide attempts in patients with migraine, controlling for depression and other risk factors for suicide. In patients with migraine, co-occurring pain conditions are common and are associated with worse physical and psychosocial function, but the association with suicide has not been determined. In this cross-sectional analysis, we included 10,690 patients with migraine who were consecutively recruited from headache clinics. All participants provided information on sociodemographic status, headache, Widespread Pain Index (WPI), suicidal ideation, and suicide attempts. Relative risks (RRs and 95% confidence intervals [CIs]) for factors associated with suicidal ideation and suicide attempts were calculated. In this migraine cohort, more females reported non-cephalic pain than males (78.7% [6511/8271] vs. 66.7%, [1613/2419]; p < 0.001). The prevalences of suicidal ideation and suicide attempts were higher in female patients than male patients in those aged 20-59 years (p < 0.001), and the differences diminished after the age of 60 years. In female patients, a WPI ≥4 was associated with increased suicidal ideation and suicide attempts, and dysmenorrhea was associated with suicidal ideation (RR 1.27, 95% CI 1.12-1.43), while lower back pain was associated with both suicidal ideation (RR1.35, 95% CI 1.18-1.55) and suicide attempts (RR 1.48, 95% CI 1.19-1.84). In male patients, a WPI ≥2 was associated with increased suicidal ideation, and no individual pain site was associated with suicidal ideation or suicide attempts. In both sexes, there was a dose-response association between the number of pain sites and suicidal ideation and suicide attempts; and pain that had lasted for 2 years and extreme pain intensity were associated with suicide attempts. Non-cephalic pain was associated with suicidal ideation and suicide attempts, with observed differences in pain threshold and individual pain sites found between sexes. Patients with migraine and co-occurring pain conditions, chronic pain, or extreme pain are distinct subgroups of patients at risk of suicide who require sex-specific and integrated risk assessment by multidisciplinary teams.

Investigating the associations between personality functioning, cognitive biases, and (non-)perceptive clinical high-risk symptoms of psychosis in the community.

Beyond psychosis prediction, clinical high-risk (CHR-P) symptoms show clinical relevance by their association with functional impairments and psychopathology, including personality pathology. Impaired personality functioning is prioritized in recent dimensional personality disorder models (DSM-5, ICD-11), yet underexplored in CHR-P, as are associations with cognitive biases, which early studies indicate as possibly linking CHR-P-symptoms and personality pathology. A community sample (N=444, 17-60years, 61.8% female) was assessed via clinical telephone interview and online questionnaires. Using zero-inflated Poisson models, we explored associations of personality functioning, cognitive biases, current psychopathology, and psychosocial functioning with likelihood and severity of overall CHR-P, as well as perceptive (per-) and non-perceptive (nonper-)CHR-P-symptoms distinctly. Higher nonper-CHR-P-symptom likelihood was associated with more impaired personality functioning and psychosocial functioning, while more severe cognitive biases were associated with higher CHR-P- and per-CHR-P-symptom likelihood, alongside higher CHR-P- and nonper-CHR-P-symptom severity. Further, more axis-I diagnoses were linked to higher CHR-P-, per-CHR-P-, and nonper-CHR-P-symptom likelihood, and younger age to higher CHR-P- and per-CHR-P-symptom severity, with CHR-P-symptom severity appearing higher in females. In an exploratory analysis, personality functioning elements identity and self-direction, and cognitive biases dichotomous thinking, emotional reasoning, and catastrophizing, respectively, showed multifaceted associations with nonper-CHR-P-symptom likelihood and overall CHR-P-symptom expression. Our study supports the association of CHR-P-symptoms with multiple mental health factors. Findings suggest intricate associations between personality functioning impairments and cognitive biases with CHR-P-symptom expression in non-help-seeking populations, possibly contributing to different per-CHR-P- and nonper-CHR-P-symptom expression patterns. Therefore, they should be targeted in future longitudinal studies, aiming at better understanding CHR-P-manifestations to inform preventive intervention.

Association Between Oral Health Status and DMFT Index with Cognitive Dysfunction in Community-Dwelling Older Adults with Type 2 Diabetes: A Cross-Sectional Study

ABSTRACT Objective Cognitive dysfunction is a significant issue in old age and can cause many problems in older adults, especially those with diabetes. This study aimed to investigate the association between oral health status and DMFT index with cognitive dysfunction in community-dwelling older adults with T2D (type 2 diabetes). Methods This was a cross-sectional study that included 245 older people aged 60 years and older with T2D, visiting healthcare centers in north of Iran, using the cluster sampling method. Data collection tools included clinical-demographic questionnaire, the Geriatric Oral Health Assessment Index (GOHAI) and the Mini-Mental State Examination (MMSE) questionnaire. A P-value <.05 was considered significant. Results The mean age of older adults in this study was 64.86 ± 3.99 years. The mean and standard deviation for the DMFT index, GOHAI index and MMSE scale were 9.39 ± 3.83, 34.29 ± 17.93 and 15.18 ± 10.04 respectively. The results showed statistically significant relationship between poor oral health status and the cognitive status of older adults with T2D (p < .001). Additionally, the relationship between oral health index domains (physical function, psychosocial function and pain) and cognitive status in older adults was significant (p < .001). Another finding indicated an inverse and significant relationship between the DMFT index and cognitive dysfunction in older adults (p < .001). Conclusion Poor oral health was associated with cognitive dysfunction among the community-dwelling older adults with T2D. Given the high prevalence of T2D in older adults and the critical importance of oral and dental health for cognition, it is necessary to develop interventions to improve oral health in older adults with T2D.

Emotional and psychosocial functioning in youngsters with a congenital heart disease (CHD) in comparison to healthy controls.

Due to their medical vulnerability, youngsters with congenital heart disease (CHD) may experience more overwhelming emotions than healthy peers. This multi-informant-based study aims to examine differences between these youngsters and their peers in psychosocial functioning, attachment and emotion regulation. 217 youngsters (8-18years) with CHD (53.9% boys, 46.1% girls) were compared to 232 healthy controls (52.6% boys, 47.4% girls) matched for gender, age and education. Participants and parents completed online self-report questionnaires assessing psychosocial functioning (SDQ), attachment (ECR-RC), and maladaptive Emotion Regulation Strategies (ERS; FEEL-KJ). Based on child's self-reports MANOVA's showed no significant differences between the groups in psychosocial functioning. However, based on parent reports, differences were found between the groups in psychosocial functioning for the total scales and overarching subscales. No differences were found between the groups for insecure attachment to either parent. However, youngsters with CHD and their fathers reported more use of self-devaluation compared to controls (p=.03). Other maladaptive ERS (giving up, withdrawal, rumination, aggressive actions) showed no differences. Care interventions for children with CHD should address medical, emotional, and social needs, with a focus on multi-informant evaluations to support emotional well-being. Nurses are important partners in detecting psychosocial difficulties and providing family support. Patient- and family-centered care involves patients, parents and caregivers in the care plan, recognizing their key role, especially as youngsters often perceive their psychosocial health differently than their parents. Although differences were noted compared to the control group, the study's cross-sectional design limits conclusions on evolution with time.

A randomised double-blind, placebo-controlled trial of pramipexole in addition to mood stabilisers for patients with treatment-resistant bipolar depression (the PAX-BD study).

Options for 'treatment-resistant bipolar depression' (TRBD) are limited. Two small, short-term, trials of pramipexole suggest it might be an option. To evaluate the clinical effectiveness and safety of pramipexole in the management of TRBD. A multi-centre randomised, double-blind controlled trial including participants ⩾18 years old with TRBD (failure to respond, tolerate or clinical contraindication/patient refusal of ⩾2 of quetiapine, olanzapine, lamotrigine or lurasidone) randomised 1:1 to pramipexole (max 2.5 mg/day salt weight) or placebo added to ongoing mood stabiliser (n = 39). Primary outcome: Quick Inventory of Depressive Symptoms, Self-rated (QIDS-SR) at 12 weeks. Up to 48 weeks follow-up. Pramipexole (n = 18) was associated with a greater reduction in QIDS-SR score at 12 weeks versus placebo (n = 21, 4.4 (4.8) vs 2.1 (5.1)): a medium sized (d = -0.72) but not statistically significant difference (95% CI: -0.4 to 6.3, p = 0.087). Similarly, there was a non-significant approximate 2-point (d = -0.76) improvement in pleasure at 6 weeks (95% CI: -0.11 to 4.20). Significant advantages of pramipexole on QIDS-SR score (6.28 points: 95% CI: 1.85-10.71) and psychosocial function (5.36 points: 95% CI: 0.38-10.35) were seen at 36 weeks post-randomisation, and on the response (46% vs 6%; p = 0.026) and remission (31% vs 0%; p = 0.030) rates at trial exit (48 weeks or last available data after 16 weeks for those affected by the early study closure). Hypomania ratings were significantly higher at 12 weeks. Otherwise, pramipexole was well tolerated. Clinically large, but statistically non-significant, effects of pramipexole on depression at 12 weeks, with significant longer-term benefits on mood and function were observed. Pramipexole use was complicated by dose titration and increased hypomanic symptoms. The small sample size limits interpretation. Furthermore, larger randomised placebo-controlled trials are warranted.

Examining eating pathology and psychosocial functioning across subjective eating disorder recovery stages in sexual and gender minority individuals

ABSTRACT Subjective eating disorder (ED) recovery has important clinical relevance. However, studies have focused on the perspectives of cisgender heterosexual individuals, which is notable given that sexual and gender minority (SGM) people often describe feelings misrepresented by prevailing ED conceptualizations. We examined eating pathology and psychosocial functioning across subjective recovery stages in SGM individuals (N = 196). Analyses of variance tested differences between active ED (n = 106, 54.1%), partial recovery (n = 82, 41.8%), and full recovery (n = 8, 4.1%) groups. Groups differed in body dissatisfaction, binge eating, restricting, clinical impairment, autonomy, environmental mastery, and self-acceptance. Most differences were observed between the full recovery and active ED groups and the full recovery and partial recovery groups, such that subjectively higher levels of ED recovery were generally associated with lower transdiagnostic ED symptoms and better psychosocial functioning. Clinical profiles appear similar between SGM and cisgender heterosexual individuals across subjective ED recovery stages.

Caregiver food allergy self-efficacy explains the relationship between perceived food allergy severity and burden.

Caregiver perceived food allergy severity is associated with food allergy burden, while caregiver food allergy self-efficacy has been linked to improved quality of life for caregivers. This study examined the mediating effect of caregiver food allergy self-efficacy on the relationship between perceived food allergy severity and caregiver food allergy burden. Caregivers of children diagnosed with IgE-mediated food allergy were recruited from pediatric allergy clinics to complete demographic and medical questionnaires, the Food Allergy Independent Measure-Parent Form, the Food Allergy Self-Efficacy Scale for Parents, and the Food Allergy Quality of Life-Parental Burden. Hayes' PROCESS was utilized to test mediation analysis. The TREND checklist is available in the Supplementary Materials section. Analyses consisted of 94 caregivers of children (Mage = 11.72 years, 52.7% male, 34.0% Black). Caregiver food allergy self-efficacy mediated the relationship between perceived food allergy severity and caregiver food allergy burden, B = 0.16, SE = 0.07, CI (0.04-0.33). Caregiver food allergy self-efficacy may play an important role in food allergy psychosocial functioning. Interventions targeting self-efficacy could reduce caregiver food allergy burden. Future research should explore additional psychosocial and medical factors to better tailor food allergy interventions to the family's unique needs.

Sleep quality and physical fitness as modifiable contributors of fatigue in childhood cancer survivors.

Advances in cancer treatment have increased childhood cancer patient's survival rates. However, many childhood cancer survivors (CCS) face long-term effects such as fatigue. This study assessed fatigue in CCS and healthy controls (HCs), its contributors, and associated outcomes. This cross-sectional study included 90 CCS and 55 age and sex-matched HCs. Fatigue was measured using the Pediatric Quality of Life Multidimensional Fatigue Scale, and modifiable contributors included sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and physical fitness (VO2 peak during a treadmill test). Quality of life (QoL) and emotional and cognitive functioning were evaluated using the Pediatric Quality of Life Inventory, Beck Depression Inventory II, Cognitive Failure Questionnaire, and the Impact of Event Scale-Revised. Stepwise linear regressions identified predictors of general, sleep/rest, cognitive, and total fatigue. General, cognitive, and total fatigue were significantly higher in CCS compared to HCs (44.7% vs. 23%, p < .001; cognitive: 64.7% vs. 29.3%, p < .001; total fatigue: 56.5% vs. 25%, p < .001). Sex, PSQI, PSQI × sex, and PSQI × VO₂ were significant predictors for general fatigue, PSQI and PSQI × VO₂ for cognitive fatigue, and PSQI for sleep/rest and total fatigue. Cognitive and total fatigue correlated most strongly with cognitive and work-related functioning, whereas general and sleep/rest fatigue were more related to psychosocial functioning. Fatigue is highly prevalent among CCS, with distinct factors influencing general, sleep/rest, cognitive, and total fatigue. Female survivors, those with poorer sleep quality and lower physical fitness, are at risk. This study underscores the need for tailored interventions for each type of fatigue. Improving sleep quality, physical fitness, and psychological well-being may contribute to reducing fatigue and enhancing overall quality of life in CCS.

Loneliness in Middle-Aged and Older Adults: Effects of Social Environments.

Loneliness is a common subjective condition that is associated with distress and negative outcomes for psychosocial functioning and well-being, and it is grounded in destructive or inadequate social functioning. Social interactions are considered one of the key factors determining loneliness, and similarly to social interactions, loneliness can occur in different domains. While a solid body of research is focused on loneliness as a general condition, there are few studies that investigate loneliness from a multidimensional perspective, particularly combining general and domain-specific loneliness. In the present study, we conceptualized loneliness as a complex phenomenon. We focused on the associations between different types of loneliness and the characteristics of social environments. The participants were 140 adults aged 45-73 (58.9% females). The methods involved the Multidimensional Inventory of Loneliness Experience, the Social and Emotional Loneliness Scale (SELSA-S), the "Sociotropy-Self-Sufficiency" Questionnaire, and the assessment of demographic characteristics (age and sex). To test our hypothesis, we applied regression path modeling. The results showed that general loneliness predicted both family and non-family loneliness. We also found that general loneliness increased experiences of social uncertainty, while non-family loneliness decreased positive relations with others. No age effects were found. An effect of sex was found for social uncertainty and positive relations with others.

The role of psychosocial factors in mediating the treatment response of epidural steroid injections for low back pain with or without lumbosacral radiculopathy: A scoping review.

Epidural steroid injections (ESIs) are often used to treat low back pain (LBP) due to lumbosacral radiculopathy as well as LBP without a clear component of radiculopathy, in some cases. While it is increasingly recognized that psychosocial factors are associated with pain outcomes, few studies have assessed the contribution of these factors to common pain interventions like ESIs. This study aimed to summarize the scope and nature of how psychosocial factors are accounted for in research on ESIs for the treatment of LBP with or without lumbosacral radiculopathy and to identify gaps and recommendations for future research. A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Review Extension framework was conducted. Publications dated before September 2023 were searched in PubMed, CINAHL, Scopus, PsycINFO, and Google Scholar. Of the 544 records identified through database searching, a total of 51 studies cumulatively totaling 10,447 participants were included. Sample sizes ranged from 12 to 5,104 participants. Of the 51 included studies, only 10 (20%) analyzed and reported the relationship between at least one psychosocial variable and post-injection pain at any follow-up timepoint. The other 41 (80%) included no analyses examining ESI response as a function of psychosocial variables. Based on the studies that included analysis by psychosocial variables, poor psychosocial functioning appears to be associated with inferior treatments outcomes following ESI for back pain with or without lumbosacral radiculopathy. Relative to the vast body of literature on ESIs for LBP and lumbosacral radiculopathy, minimal attention has been directed to the influence of psychosocial factors on ESI treatment outcomes. Future research evaluating predictors of the effect of ESI on pain relief should include development of more comprehensive models containing modifiable psychosocial variables as predictors of ESI response.

Metacognitive Training for Subjects with Bipolar Disorder: A Randomized Controlled Trial

Introduction: Impairments in social cognition in bipolar disorder (BD) have been extensively described in the last decade but few treatment strategies have been studied to address this issue. This study presents findings from a randomized controlled trial (RCT) investigating the efficacy of metacognitive training for bipolar disorder (MCT-BD) compared to Treatment as Usual (TAU) among individuals with BD in remission. The aim was to determine whether MCT-BD could improve social cognition and overall functioning in this population. Methods: Participants (N = 56) were recruited via social media and an internal database at the University of São Paulo Medical School. Inclusion criteria included a confirmed BD diagnosis, current state of remission, and the presence of social functioning impairments. Exclusion criteria included any impairments that could hinder neuropsychological testing. Patients were randomly assigned to either MCT-BD or TAU, with assessments conducted at baseline and follow-up. The MCT-BD program consisted of nine sessions. Results: The overall attendance rate across all MCT-BD intervention sessions was 96.6%. The MCT-BD program demonstrated added value in improving social cognition, specifically in emotion recognition reaction time. However, no significant changes were found in theory of mind, psychosocial functioning, or quality of life. Conclusion: This RCT provides preliminary evidence for the efficacy of MCT-BD in improving emotion recognition latency, emphasizing the importance of targeted interventions in social cognition outcomes for individuals with BD. The study’s strengths include high completion rates and comprehensive cognitive assessments. Future studies should explore long-term effects and personalized treatment approaches aiming to improve social-cognitive deficits in this population.

Prostate Cancer and Suicide Risk: A Systematic Review and Meta-Analysis.

Suicide is a substantial public health concern, and there are a variety of contributing factors. Prostate cancer is known to be a disease at high risk of suicide regardless of country and age. Nonetheless, comprehensive information about associated risk levels and underlying determinants remains limited. To systematically evaluate the suicide risk in prostate cancer patients compared to control by systematic review and meta-analysis. PubMed, Embase, and the Cochrane Library were searched from the earliest available indexing date through May 2024. The criteria for selecting the subjects were as follows: (1) studies including patients who had prostate cancer, (2) intervention was not specified, (3) comparison was made with people without prostate cancer selected as the control group, and (4) outcomes were measured as standardized mortality ratio (SMR) or relative risk (RR), or hazard ratio (HR) of suicide in prostate cancer. Random-effects model were used to estimate pooled effect sizes. Meta-regression analyses were conducted to identify the potential moderator effects between prostate cancer and the risk of suicide. A systematic review and meta-analysis of these 25 studies that included a total of 4,987,941 participants were performed. The pooled SMR for overall suicide risk in prostate cancer compared with control groups was 1.251 (95% confidence interval [95% CI]: 1.120-1.383). The pooled RR or HR was 1.712 (95% CI: 1.306-2.243). The suicide risk of prostate cancer patients showed statistically significant in all cases of SMR and RR or HR. The suicide risk was also significantly higher in most subgroup analyses according to age and research follow-up period. The findings of this systematic review and meta-analysis support the association between prostate cancer and increased risk of suicidal tendencies. Follow-up for prostate cancer patients should be highly integrated with psychiatric and psychological care to improve the psychosocial function of patients.

Psychosocial Function in Mild Cognitive Impairment: Social Participation is Associated With Cognitive Performance in Multiple Domains.

Psychosocial function is associated with cognitive performance cross-sectionally and cognitive decline over time. Using data from the COMPASS-ND study, we examined associations between psychosocial and cognitive function in 126 individuals with mild cognitive impairment, an at-risk group for Alzheimer's disease (AD). Psychosocial function was measured using questionnaires about mental health, social support, and social engagement. Composite scores for five cognitive domains were derived using principal component analysis. Multiple linear regression models were used to test the effects of various psychosocial factors on cognitive performance, controlling for age, sex, education, MoCA scores, and living circumstances. We found that low current participation in one's social networks, over other psychosocial factors, was associated with worse verbal fluency and processing speed scores than those endorsing normal or high social participation. Our findings provide groundwork for further psychosocial-cognitive analyses in individuals at-risk for AD to better understand the role of poor social engagement in cognitive decline.

The impact of a caregiver's chronic illness on childhood psychosocial functioning.

Prolonged activation of the body's stress response from chronic exposure to adverse stressors may have a significant impact on lifelong psychosocial functioning. Screening for the impact of prolonged adversity in childhood has become an integral component of pediatric care. While past research has separately explored the impact of caregiver chronic illness and caregiver toxic stress on children, the relationship between caregiver chronic illness disability burden, caregiver parental toxic stress, and their child's psychosocial functioning is not well understood. This study aimed to investigate how caregiver chronic illness disability burden and caregiver toxic stress impact childhood psychosocial dysfunction (CPD). This pilot study was conducted at two free family medicine clinics in Inland Southern California between August and December 2022. It surveyed caregivers with chronic illness of any age or functional capacity who are full-time caretakers of children aged 4-17 years old. Validated screening tools assessed caregiver disability burden (World Health Organization Disability Assessment Schedule 2.0-12), parental toxic stress (Functional Impact of Toxic Stress for Parents), and pediatric psychosocial functioning (Pediatric Symptom Checklist-17). Regression analysis tested if caregiver scores on these measures predicted CPD. Twenty-nine participants completed the survey. High caregiver chronic illness disability burden and toxic stress together significantly predicted CPD. Caregiver toxic stress alone predicted CPD, whereas chronic illness disability burden alone did not. This study highlights the relationship between caregiver chronic illness disability burden, caregiver toxic stress, and childhood psychosocial dysfunction, and may contribute to providing holistic care to children and their caregivers. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

From breast cancer diagnosis to survivorship: analyzing perioperative biopsychosocial phenotypes and their relationship to pain on long term.

Persistent breast cancer treatment-related pain affects up to 40% of patients, decreasing their quality of life (QoL). While current research typically utilizes correlation and regression analysis to identify biopsychosocial phenotypes contributing to this pain, this study employs cluster analysis to identify qualitatively different phenotypes based on somatosensory and psychosocial characteristics both before and one week post-breast cancer surgery. Further, it investigates how these phenotypes are related to pain intensity one year post-surgery and examines the evolution of phenotype membership from pre- to post-surgery. Somatosensory and psychosocial functioning was evaluated pre- and post-surgery in 184 women undergoing unilateral breast cancer surgery. Eight different quantitative sensory testing (QST) methods including mechanical detection and pain thresholds, pressure pain thresholds, thermal detection and pain thresholds, and conditioned pain modulation were performed at the surgical area (trunk, arm, major pectoral muscle) and a distant location (quadriceps muscle). Psychosocial functioning was assessed using the Central Sensitization Inventory, Pain Catastrophizing Scale, Depression Anxiety Stress Scale-21, and the McGill Quality of Life Questionnaire. Pain intensity was evaluated one year post-breast cancer surgery using the Visual Analogue Scale. Latent class analysis identified five distinct phenotypes before and post-surgery, characterized by differences in mechanical and pain thresholds alongside psychosocial factors. Moreover, higher psychosocial distress and lower QoL correlated with elevated pain intensity one year post-surgery. These findings underscore the importance of addressing breast cancer patients' mental health perioperatively. Therefore, future research should explore whether psychological interventions perioperatively can reduce long-term pain intensity. PerspectiveThis secondary analysis, utilizing cluster analysis, reveals five distinct phenotype based on somatosensory and psychosocial characteristics both before and post breast cancer surgery. Higher psychosocial distress and lower quality of life correlated with elevated pain intensity one year post-surgery, emphasizing the need to address patients' mental health perioperatively. Trial registrationclinicaltrials.gov (NCT03351075)

Comparing Parent Perception of Neurodevelopment after Primary versus Staged Repair of Neonatal Symptomatic Tetralogy of Fallot

To assess the association between primary and staged repair of neonatal symptomatic tetralogy of Fallot (sTOF) and neurodevelopmental outcomes in preschool through school-age children. Multicenter cohort (n=9 sites) study of patients with sTOF who underwent neonatal intervention between 2005 and 2017. The neurodevelopmental outcomes measures included caregivers' ratings of executive function with the Behavior Rating Inventory of Executive Function, and psychosocial functioning with the Behavior Assessment System for Children - third Edition (BASC-3). Results were compared with normative data and by treatment strategy (primary repair vs staged repair). A parent survey assessed history of disabilities and access to services related to neurodevelopment. Although the majority of patients (median age 8.3years, IQR 5.7-11.2) had median Behavior Rating Inventory of Executive Function and BASC-3 scores within the normal range, a proportion had clinically elevated (abnormal) scores, especially in the school-age patient subgroup (Behavior Rating Inventory of Executive Function 24%-30% and BASC 20%-37%). There were no statistically significant differences based on treatment strategy for either the Behavior Rating Inventory of Executive Function or BASC-3. However, lower birth weight, genetic syndrome, and medical complexity were significantly associated with worse executive function, and lower maternal education was associated in school-age children with lower executive and psychosocial functioning. Ongoing disabilities were relatively common (learning disability 35%, speech delay 33%, developmental delay 31%), although up to 50% of children were not receiving educational or developmental services. Elevated executive and psychosocial concerns are present in the patient population with sTOF. Although initial treatment strategy appears unrelated to neurodevelopmental outcomes, lower birth weight, genetic syndrome, and medical complexity and lower maternal education are risk factors. Early recognition of neurodevelopmental concerns can facilitate access to appropriate neurodevelopmental services in this high-risk group.

Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety

Variations in pain, disability, and psychosocial functioning among non-specific chronic low back pain patients with and without anxiety

Machine learning prediction model of the treatment response in schizophrenia reveals the importance of metabolic and subjective characteristics.

Predicting early treatment response in schizophrenia is pivotal for selecting the best therapeutic approach. Utilizing machine learning (ML) technique, we aimed to formulate a model predicting antipsychotic treatment outcomes. Data were obtained from 299 patients with schizophrenia from three multicenter, open-label, non-comparative clinical trials. For prediction of treatment response at weeks 4, 8, and 24, psychopathology (both objective and subjective symptoms), sociodemographic and clinical factors, functional outcomes, attitude toward medication, and metabolic characteristics were evaluated. Various ML techniques were applied. The highest area under the curve (AUC) at weeks 4, 8 and 24 was 0.711, 0.664 and 0.678 with extreme gradient boosting, respectively. Notably, our findings indicate that BMI and attitude toward medication play a pivotal role in predicting treatment responses at all-time points. Other salient features for weeks 4 and 8 included psychosocial functioning, negative symptoms, subjective symptoms like psychoticism and hostility, and the level of prolactin. For week 24, positive symptoms, depression, education level and duration of illness were also important. This study introduced a precise clinical model for predicting schizophrenia treatment outcomes using multiple readily accessible predictors. The findings underscore the significance of metabolic parameters and subjective traits.

Predictors of Psychosocial Functioning Among Long-stay Schizophrenia Patients in a Malaysian Mental Institution.

A considerable number of schizophrenia patients still require long-term hospital care despite psychiatric deinstitutionalisation, especially in developing nations. Prolonged hospitalisation is associated with greater impairment in psychosocial functioning. This study aimed to determine the level of psychosocial functioning and its predictors among long-stay schizophrenia patients in a Malaysian mental institution. This cross-sectional study included 138 patients selected through universal sampling. Data on socio-demographics, illness characteristics such as psychopathology and illness severity [measured using the Brief Psychiatric Rating Scale (BPRS)], and cognitive function [assessed using the Montreal Cognitive Assessment (MoCA)] were collected. The Personal and Social Performance (PSP) scale was used to evaluate psychosocial functioning. Pearson correlation coefficients and multiple linear regression analyses were applied to identify the correlates and predictors of psychosocial functioning. This study found that 47.8% and 16.7% of the patients had moderate and severe cognitive impairments, respectively. The mean PSP score was 69.68 (standard deviation (SD) = 15.48). Female gender, previous unemployment and more severe cognitive impairments were significantly associated with poorer psychosocial functioning. Meanwhile, negative symptoms and age of onset were negatively correlated with psychosocial functioning. By contrast, the duration of illness was positively correlated with psychosocial functioning. The regression model indicated that being female (β = -7.32, p < 0.001), previously unemployed (β = -3.67, p < 0.047), having negative symptoms (β = -4.18, p < 0.001), experiencing a longer illness duration (β = -0.60, p = 0.004), and the presence of severe cognitive impairment (β = -9.80, p < 0.001) significantly predicted poorer psychosocial functioning. Long-stay schizophrenia patients experience substantial difficulties in psychosocial functioning. Factors such as gender, last employment status, negative symptoms, illness duration, and cognitive function affect psychosocial functioning.