Relevant Psychological Distress Research Articles

The psychological distress of gastrointestinal cancer patients and its association with quality of life among different genders

BackgroundPsychological distress is a prevalent unpleasant experience faced by many cancer patients. However, the psychological distress among gastrointestinal (GI) cancer patients is scarcely explored. Moreover, the association between psychological distress and quality of life in different genders has yet to be explored.AimsTo explore the psychological distress among GI cancer patients and examine its association with quality of life among different genders.MethodsThis study was a cross-sectional study. A total of 237 gastrointestinal cancer patients completed the distress thermometer and the Functional Assessment of Chronic Illness Therapy-General.ResultsThe mean score of psychological distress of the participants was 3.04 (SD = 2.90). A greater proportion of female gastrointestinal cancer patients (52.8%) had clinically relevant psychological distress compared to males (35.9%). The quality of life was negatively associated with their psychological distress (B = − 1.502, 95%CI: − 2.759 to − 0.245, p = 0.019) among gastrointestinal cancer patients. Such association was stronger among males compared to females in gastrointestinal cancer patients (Interaction term, B = − 1.713, 95%CI: − 3.123 to − 0.303, p = 0.017).ConclusionsThese findings suggest that healthcare providers should attach their attention to gastrointestinal cancer patients’ psychological distress, especially females. Longitudinal studies could adopted to track the changes in psychological distress and its association with quality of life over time among different genders. In future intervention studies, the focus of psychological interventions needs to be gender-specific.

The impact of COVID-19 workload on psychological distress amongst Canadian intensive care unit healthcare workers during the 1st wave of the COVID-19 pandemic: A longitudinal cohort study.

Intensive care unit healthcare workers (ICU HCW) are at risk of mental health disorders during emerging disease outbreaks. Numerous cross-sectional studies have reported psychological distress, anxiety, and depression amongst ICU HCW during the COVID-19 pandemic. However, few studies have followed HCW longitudinally, and none of these have examined the association between COVID-19 workload and mental health. We conducted a longitudinal cohort study of 309 Canadian ICU HCW from April 2020 to August 2020, during the 1st wave of the COVID-19 pandemic. Psychological distress was assessed using the General Health Questionnaire 12-item scale (GHQ-12) at 3 timepoints: during the acceleration phase of the 1st wave (T1), the deceleration phase of the 1st wave (T2), and after the 1st wave had passed (T3). Clinically relevant psychological distress, defined as a GHQ-12 score ≥ 3, was identified in 64.7% of participants at T1, 41.0% at T2, and 34.6% at T3. Psychological distress was not associated with COVID-19 workload at T1. At T2, psychological distress was associated with the number of COVID-19 patients in the ICU (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.00, 1.13) while at T3, when COVID-19 patient numbers were low, it was associated with the number of weekly hospital shifts with COVID-19 exposure (OR: 1.33, 95% CI: 1.09, 1.64). When analyzed longitudinally in a mixed effects model, pandemic timepoint was a stronger predictor of psychological distress (OR: 0.24, 95% CI: 0.15, 0.40 for T2 and OR: 0.16, 95% CI: 0.09, 0.27 for T3) than COVID-19 workload. Participants who showed persistent psychological distress at T3 were compared with those who showed recovery at T3. Persistent psychological distress was associated with a higher number of weekly shifts with COVID-19 exposure (OR: 1.97, 95% CI:1.33, 3.09) but not with a higher number of COVID-19 patients in the ICU (OR: 0.86, 95% CI: 0.76, 0.95). In summary, clinically relevant psychological distress was observed in a majority of ICU HCW during the acceleration phase of the 1st wave of the COVID-19 pandemic but decreased rapidly as the 1st wave progressed. Persistent psychological distress was associated with working more weekly shifts with COVID-19 exposure but not with higher numbers of COVID-19 patients in the ICU. In future emerging disease outbreaks, minimizing shifts with direct disease exposure may help alleviate symptoms for individuals with persistent psychological distress.

Global Prevalence of Psychological Distress and Comorbidity With Disorders of Gut-Brain Interactions.

This study focused on defining the global prevalence of clinically relevant levels of psychological distress and somatic symptoms and the prevalence of coexistence between these symptoms and disorders of gut-brain interaction (DGBI). We also analyzed how clinically relevant psychological distress and somatic symptoms and coexistent DGBI are associated with health-related outcomes. We included a representative sample of 54,127 adult participants (49.1% women; mean age of 44.3 years) from 26 countries worldwide. Participants completed an Internet survey (the Rome Foundation Global Epidemiology Study) with validated self-report questionnaires. Clinically relevant psychological distress and/or somatic symptom severity was reported by 37.5% of the sample. These participants had 4.45 times higher odds to have at least one DGBI than individuals without psychological distress and/or somatic symptoms. Compared with participants with psychological distress and/or somatic symptoms with vs without DGBI, participants with a DGBI reported increased healthcare and medication utilization (with OR from 1.6 to 2.8). Coexistent DGBI in participants with psychological distress and/or somatic symptoms was the variable most strongly associated with reduced mental (β = -0.77; confidence interval [-0.86 to -0.68]) and physical (β = -1.17; confidence interval [-1.24 to -1.10]) quality of life. This global study shows that psychological distress, somatic symptoms, and DGBI are very common and frequently overlap. The coexistence between psychological distress/somatic symptoms and DGBI seems to be especially detrimental to quality of life and healthcare utilization. Individuals with psychological distress/somatic symptoms and DGBI coexistence seem to be a group vulnerable to psychosocial problems that should be studied further and would likely benefit from psychological/psychiatric interventions.

Parent Psychological Distress Is Associated with Symptom Burden and Health-Related Quality of Life in Children and Adolescents Undergoing Stem Cell Transplantation or Chimeric Antigen Receptor T Cell Therapy

Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor T cell therapy (CAR-T) are potentially curative treatment options for children with life-threatening conditions but can result in a high symptom burden, poor health-related quality of life (HRQoL), and parent psychological distress. In this study we investigated the associations over time between parent psychological distress and symptom burden and HRQoL in children undergoing HSCT or CAR-T. This multisite study used a longitudinal, repeated-measures design. English- and Spanish-speaking parents and their children age 2 to 18 years with planned HSCT or CAR-T therapy were eligible. Parents completed self-report measures of psychological distress (Beck Anxiety and Depression Inventories and Perceived Stress Scale) at 4 time points: before cell infusion and days +30, +60, and +90 after cell infusion. The Memorial Symptom Assessment Scale and PedsQL Cancer Module were administered to children (parent proxy for younger children) at corresponding time points. A symptom cluster called parent distress was created from each parent outcome using exploratory factor analysis. Longitudinal parallel process modeling was used to study the relationship between parent distress and child symptoms and HRQoL over time. A total of 140 child-parent dyads (280 participants) were enrolled across 4 sites. The mean age of the children was 8.4 ± 5 years, 56.4% were male, and most had an underlying diagnosis of malignancy (72.9%). The parents had a mean age of 39 ± 8.1 years, and the majority were mothers (80.7%),. Parent distress was consistently higher than normative means generated from nonclinical samples of adults. A high frequency of suicidal ideation was reported by parents (38.5% at baseline, 37% at day +30, 27.4% at day +60, and 33.6% at day +90). A significant relationship between parent distress and child HRQoL and symptoms was observed at baseline and through day +90. Our findings suggest that parents experience clinically relevant psychological distress throughout their child's HSCT or CAR-T therapy, and that this parent distress is associated with child HRQoL and symptom scores. Increased psychoeducational support tailored to address parental psychological distress is needed and has the potential to positively impact the child's HRQoL and symptoms.

The validity of the distress thermometer in patients with musculoskeletal tumors

BackgroundVisits to an outpatient cancer clinic represent a challenging situation for patients, which can trigger anxiety and helplessness in those affected. It is important to identify patients with high psychological distress as early as possible in order to provide them with supportive psychological interventions. The aim of this study was to validate the Distress Thermometer (DT), a widely used screening for distress,in a cohort of patients with musculoskeletal tumors and to explore associations between distress, treatment satisfaction and health literacy. MethodsAll patients presenting to a University outpatient clinic for musculoskeletal cancers were asked to complete a set of questionnaires including the DT), the Hospital Anxiety and Depression Scale (HADS) as a comparison scale, the Patient Satisfaction with Comprehensive Cancer Care (SCCC) and European Health Literacy Survey Questionnaire (HLS-EU-Q16).To assess the sensitivity and specificity of the DT in a cohort of patients with musculoskeletal tumors, we compare the performance of the DT in relation to an established screener for anxiety and depression using receiver operating characteristics (ROC) analyses. ResultsA total of 120 patients (age 58 ± 18, 51% female) were analyzed. Patients reported a mean DT of 5.0 (SD 2.3, range, 0 to 10). Eighty-six patients (71.7 %) had a DT score ≥ 5 indicating moderate or severe psychological distress.The mean total HADS score (scale 0 to42 points) was 11.7 (SD 7.6, range, 0 to 32) with a HADS score of ≥ 15 in 29.2% of patients. The DT correlated moderately with anxiety and depression (HADS total r = 0.48, p < 0.001), while the correlation with depression (HADS-D, r = 0.47, p < 0.001) was stronger than with anxiety (HADS-A, r = 0.38, p < 0.001).For a DT score ≥ 5, ROC analysis yielded a sensitivity of 71.4% and a specificity of 75.3% for detecting moderate or severe psychological distress (HADS ≥ 15, AUC 0.782).The REPERES-G, collected from a subgroup (n = 49), showed high treatment satisfaction with a median score of 132 (min 90, max 163). Especially the “satisfaction with medical aspects of treatment” (REPERES-G medical aspects) showed a moderate correlation with the DT (r = 0.51, p < 0.001) a strong correlation with anxiety and depression (HADS total, r = 0.69, p < 0.001). ConclusionAbout three in four patients with musculoskeletal tumors have relevant psychological distress. A visual analogue scale can only be a rough guide for identifying patients in need of psychological support, with a sensitivity of 71.4 % and a specificity of 75.3 %. A strong relationship between patient and care team was associated with lower patient psychological distress.Consequently, screening tools cannot replace detailed discussion and personal contact, especially in the treatment of malignant diseases.

Psychopathology among Emerging Adults with Learning Disabilities in Canada

Individuals with learning disabilities (LDs) are more likely to have a mental illness, yet few studies explore this association in emerging adulthood, a developmental period with an increased risk for mental illness. The purpose of the current study was to investigate psychological distress in emerging adults (15–29 years) with and without LDs. The 2012 Canadian Community Health Survey—Mental Health was used (n = 5630), and multiple and logistic regression models with survey weights were computed. Adjusting for demographic, psychosocial, and health covariates, there was no evidence for significant differences in psychological distress among emerging adults with vs. without LDs. However, age and sex were significant effect modifiers. Among emerging adults with LDs, both males (OR = 2.39 [1.01, 5.67]) and those aged 25–29 years (OR = 3.87 [1.05, 14.30]) had an increased odds of clinically relevant psychological distress in comparison to those without LDs. These findings suggest a need for improved awareness and support for prevention of psychological distress among emerging adults with LDs, especially for males and those in later emerging adulthood.

Addiction in the time of COVID-19: Longitudinal course of substance use, psychological distress, and loneliness among a transnational Tyrolean sample with substance use disorders.

IntroductionNext to an increased use of alcohol, the current pandemic has been associated with increased psychological distress among the general population. Research on its effects on individuals suffering from substance use disorders (SUD) is scarce. This study aimed at expanding the existing literature on this topic with a focus on the impact of loneliness and perceived social support.MethodsSixty-eight people diagnosed with SUD according to ICD-10 from the Austrian state of Tyrol and from the Italian Province of South Tyrol who had been treated in a psychiatric hospital in 2019 and one hundred and thirty-six matched reference subjects of the same regional background participated in an online survey. Sociodemographic variables and scores on the Brief Symptom Checklist, the Three-Item Loneliness Scale, and the Multidimensional Scale of Perceived Social Support were collected at baseline and 5 months thereafter. Baseline took place after the first wave, while follow-up largely coincided with the second wave of the pandemic.ResultsAmong both patients and the matched reference group, substance use as a means to feel better facing the pandemic rose and predicted higher levels of psychological distress. Patients were less likely to receive specific care at follow-up than at baseline and presented with a significantly higher prevalence of clinically relevant psychological distress and loneliness than the matched reference group at both assessment times. Among both groups, psychological burden remained unchanged over time. Perceived social support was generally significantly higher in the matched reference group than in patients. Loneliness and, to a lesser degree, low perceived social support predicted psychological distress.ConclusionThese findings emphasize the need of preventive and educational measures regarding substance use behavior for both individuals suffering from SUD and those without mental health disorders.

Prevalence and predictors of psychological distress among patients with thyroid cancer during transitional period in China: a cross-sectional study.

This study aimed to explore the psychological distress and its predictors among Chinese patients with thyroid cancer during their transitional period from hospital to home. A cross-sectional study was conducted in a cancer hospital in Tianjin, China. A total of three hundred patients with thyroid cancer completed the Chinese version of the National Comprehensive Cancer Network Distress Thermometer (DT), Cancer Fatigue Scale, and the Brief Illness Perception Questionnaire. Logistic regression was used to obtain the model of predictors of psychological distress among patients with thyroid cancer during the transitional period. The DT score of 300 patients with thyroid cancer ranged from 0 to 10, and the median DT score was 2 [1-4]. The prevalence of clinically relevant psychological distress (DT score ≥ 4) in Chinese patients with thyroid cancer during their transitional period was 29.33% (88/300). The results of logistic regression analysis showed that gender (OR = 2.505, P = 0.036), fatigue (OR = 1.086, P = 0.005), and illness perception (OR = 1.137,P < 0.001) were significantly related to psychological distress in patients with thyroid cancer. The psychological distress of patients with thyroid cancer during the transitional period is medium level. Patients with thyroid cancer who are female, easily fatigued, and have worse illness perceptions are more likely to experience psychological distress. Therefore, clinical attention should be paid to female patients and potential interventions aimed at improving fatigue and illness perception. It may reduce the prevalence of psychological distress during the transitional period.

Physician's Burnout and the COVID-19 Pandemic-A Nationwide Cross-Sectional Study in Austria.

Background: The current study assesses the prevalence of burnout and psychological distress among general practitioners and physicians of various specialities, who are not working in a hospital, during the COVID-19 pandemic. Additionally in this context, contributing factors are registered.Materials and Methods: Burnout and psychological distress were assessed with the Copenhagen Burnout Inventory (CBI) and the Brief Symptom Inventory (BSI-18). A newly developed self-reporting questionnaire was used to evaluate demographic data and pandemic-associated stress factors.Results: 252 general practitioners and 229 private practice physicians provided sufficient responses to the outcome variables for analysis. The prevalence of clinically relevant psychological distress was comparable between groups (12.4 vs. 9.2%). A larger proportion of general practitioners than specialists had intermediate (43.8 vs. 39.9%) or high burnout (26.9 vs. 22.0%) without reaching statistical significance for either category. When combining study participants with intermediate and high levels of burnout, the group difference attained significance (70.7 % vs. 61.9%).Conclusion: Our findings provide evidence that practicing physicians are at high risk of burnout in the context of the pandemic. Being single (standardized beta = 0.134), financial problems (beta = 0.136), and facing violence in patient care (beta = 0.135) were identified as significant predictors for psychological distress. Burnout was predicted by being single (beta = 0.112), financial problems (beta= 0.136), facing violence in patient care (beta = 0.093), stigmatization because of treatment of SARS-CoV-2-positive patients (beta = 0.150), and longer working hours during the pandemic (beta = 0.098).

Psychological burden in patients with COVID-19 and their relatives 90 days after hospitalization: A prospective observational cohort study

ObjectiveCOVID-19 causes psychological distress for patients and their relatives at short term. However, little research addressed the longer-term psychological outcomes in this population. Therefore, we aimed to prospectively assess clinically relevant psychological distress in hospitalized patients with COVID-19 and their relatives 90 days after hospital discharge. MethodsThis exploratory, prospective, observational cohort study included consecutive adult patients hospitalized in two Swiss tertiary-care hospitals between March and June 2020 for confirmed COVID-19 and their relatives. The primary outcome was psychological distress defined as clinically relevant symptoms of anxiety and/or depression measured with the Hospital Anxiety and Depression Scale (HADS) 90 days after discharge. ResultsClinically relevant psychological distress 90 days after hospital discharge was present in 23/108 patients (21.3%) and 22/120 relatives (18.3%). For patients, risk and protective factors associated with clinically relevant psychological distress included sociodemographic, illness-related, psychosocial, and hospital-related factors. A model including these factors showed good discrimination, with an area under the receiver-operating characteristic curve (AUC) of 0.84. For relatives, relevant risk factors were illness-related, psychosocial, and hospital-related factors. Resilience was negatively associated with anxiety and depression in both patients and relatives and regarding PTSD in relatives only. ConclusionCOVID-19 is linked to clinically relevant psychological distress in a subgroup of patients and their relatives 90 days after hospitalization. If confirmed in an independent and larger patient cohort, knowledge about these potential risk and protective factors might help to develop preventive strategies.

Psychosocial Dimensions in Hemodialysis Patients on Kidney Transplant Waiting List: Preliminary Data

Although the donation rate for deceased and living kidneys has been increasing, the donor organ availability meets only the 30% of kidney needs in Italy. Consequently, hemodialysis patients stay for a long time, an average of 3.2 years, on a waiting list for a kidney transplant with consequent relevant psychological distress or even full-fledged psychiatric disorders, as diagnosed with traditional psychiatric nosological systems. Recent studies report, however, a higher prevalence of other psychosocial syndromes, as diagnosed by using the Diagnostic Criteria for Psychosomatic Research (DCPR) in medically ill and kidney transplant patients. Nevertheless, no data regarding DCPR prevalence are available in patients waitlisted for a renal transplant (WKTs). Thus, the primary aim of this study was to identify sub-threshold or undetected syndromes by using the DCPR and, secondly, to analyze its relationship with physical and psychological symptoms and daily-life problems in WKTs. A total of 30 consecutive WKTs were assessed using the DCPR Interview and the MINI International Neuropsychiatric Interview 6.0. The Edmonton Symptom Assessment System (ESAS) and the Canadian Problem Checklist were used to assess physical and psychological distress symptoms and daily-life problems. A total of 60% of patients met the criteria for at least one DCPR diagnosis; of them, 20% received one DCPR diagnosis (DCPR = 1), and 40% more than one (DCPR &gt; 1), especially the irritability cluster (46.7%), Abnormal Illness Behavior (AIB) cluster (23.3%) and somatization cluster (23.3%). Fifteen patients met the criteria for an ICD diagnosis. Among patients without an ICD-10 diagnosis, 77.8% had at least one DCPR syndrome (p &lt; 0.05). Higher scores on ESAS symptoms (i.e., tiredness, nausea, depression, anxiety, feeling of a lack of well-being and distress), ESAS-Physical, ESAS-Psychological, and ESAS-Total were found among DCPR cases than DCPR non-cases. In conclusion, a high prevalence of DCPR diagnoses was found in WKTs, including those who resulted to be ICD-10 non-cases. The joint use of DCPR and other screening tools (e.g., ESAS) should be evaluated in future research as part of a correct psychosocial assessment of WKTs.

Association of traumatic events with levels of psychological distress and depressive symptoms in male asylum seekers and refugees resettled in Italy

BackgroundIn recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, public health and mental health implications. The aim of this study is to (1) describe the level of psychological distress and frequency of psychiatric disorders in a sample of male asylum seekers and refugees across different ethnic groups resettled in Italy; (2) establish whether the number of traumatic events experienced before, during and after the migration process is associated with level of psychological distress and depressive symptoms.MethodsIn two large Italian catchment areas, over a period of 1 year a consecutive series of male asylum seekers and refugees, aged 18 or above and included in the Italian protection system, were screened for psychological distress and psychiatric disorders using validated questionnaires.ResultsDuring the study period, 252 male asylum seekers or refugees were recruited. More than one-third of the participants (34.5%) showed clinically relevant psychological distress, and one-fourth (22.2%), met the criteria for a psychiatric diagnosis, mainly Post Traumatic Stress Disorder and depressive disorders. The number of traumatic events turned out to be a risk factor for both clinically relevant psychological distress and depressive disorders. Receiving good social support emerged as a protective factor, while migrants with unclear status were at higher risk of psychological distress than those holding or awaiting a permission.DiscussionIn an unselected sample of male asylum seekers and refugees, after around 1 year of resettlement in Italy, the frequency of psychological distress and psychiatric disorders was substantial and clinically relevant. The association between traumatic events, especially post-migration problems, and mental health conditions suggests the need of developing services to assist refugees and asylum seekers to address the multi-faceted problems they experience, such as social support in host country, legal problems concerning permit status and asylum procedure, and family reunification, as well as addressing trauma and mental health issues.

The Impact of Parent Distress on Symptoms and Quality of Life Experienced By Children Undergoing Hematopoietic Stem Cell Transplantation or Chimeric Antigen Receptor T-Cell Therapy: An Argument for Increased Parent Support

<h3>Background</h3> Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor (CAR) T-cell therapy are potentially curative for children with life-threatening conditions but can result in a high symptom burden and poor quality of life (QoL). Parents can experience distress during their child's HSCT but the impact of parent psychological health on symptoms and QoL experienced by children is largely unknown. The purpose of this study is to describe, over time, the association of parent distress with symptom burden and QoL among children undergoing HSCT or CAR T-cell therapy. <h3>Methods</h3> This multisite study employed a longitudinal, repeated measures design. English and Spanish-speaking children ages 2-18 years with planned HSCT or CAR T-cell therapy were eligible. Parents completed self-report measures (Table 1) at 4 timepoints: pre-cell infusion, and day+30, +60, +90 post. The Memorial Symptom Assessment Scale, and PedsQL Cancer Module were administered to children (parent-proxy for younger children) at corresponding timepoints. A symptom cluster called parent distress was created with 5 parent outcomes (anxiety, depression, stress, sleep disturbance, and fatigue). A 1-factor representation of the data was then created using exploratory factor analysis. Longitudinal parallel processing was used to study the relationship between parent distress and child symptoms and QoL over time. <h3>Results</h3> To date, 139 child/parent dyads (278 participants) were enrolled across 4 sites. Child mean age was 8.3 years/SD=4.9, 57% were male, primarily with an underlying diagnosis of malignancy (68.9%). Most parents were mothers (79.1%), mean age of 38.9 years/SD=8.1. Parent distress (Table 1) was consistently higher than normative means generated from non-clinical samples of adults. Figure 1 represents the significant relationship between parent distress and child QoL at baseline and through day +90. There was no significant association between parent distress and child symptoms at baseline or over time (Figure 2). <h3>Conclusion</h3> Findings suggest that parents experience clinically relevant psychological distress throughout their child's HSCT or CAR T cell therapy and this parent distress is associated with child QoL, but not child symptom scores. Increased psychoeducational support tailored to address parental psychological distress is greatly needed and has potential to positively impact the child's QoL.

Possible association between photic sneeze syndrome and migraine and psychological distress.

BackgroundPhotic sneeze syndrome (PSS) is a condition that causes sneezing when the eye is exposed to sudden bright light. Because alterations in the parasympathetic and trigeminal nerve systems have been implicated in PSS, and such systems are involved in migraine and stress‐related disorders, we examined the possible associations of PSS with migraine and psychological distress.MethodsThe presence of PSS and migraine was examined in 11 840 participants from the general population using a self‐report questionnaire. Psychological distress was assessed by the 6‐item Kessler Psychological Distress Scale (K6).ResultsThe overall prevalence of PSS was 3.1%. Individuals with PSS were more likely to suffer from migraine (odds ratio = 1.97, P = 2.18 × 10–9), clinically relevant psychological distress (K6 score ≥ 5: odds ratio = 1.40, P = 0.00143), and severe psychological distress (K6 score ≥ 13: odds ratio = 1.49, P = 0.0486). Overall, K6 scores were significantly higher in those with PSS than in those without (P = 0.000013). Analysis controlling for sex and the presence of migraine showed that PSS was associated with higher K6 scores irrespective of sex or the presence of migraine.ConclusionsThe low prevalence of PSS identified in the present study may be due to the inadequate ability of the self‐report questionnaire to identify PSS. Despite such limitation, the present study suggests that individuals with PSS are more likely to suffer from migraine and psychological distress than those without PSS. PSS may be a potential target for the research of migraine and stress‐related disorders.

Prevalence and Correlates of Psychological Distress and Psychiatric Disorders in Asylum Seekers and Refugees Resettled in an Italian Catchment Area

In recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, humanitarian and public health implications. The aim of this study is to describe the frequency and correlates of psychological distress and psychiatric disorders in asylum seekers and refugees resettled in an Italian catchment area. In the catchment area of Verona, all male asylum seekers and refugees aged 18 or above included in the Italian protection system for asylum seekers and refugees during a period of 1year were screened for psychological distress and psychiatric disorders using validated questionnaires. During the study period, 109 asylum seekers or refugees were recruited. The frequency of traumatic events experienced was very high. More than one-third of the participants (36%) showed clinically relevant psychological distress, and one-fourth (25%), met the criteria for a psychiatric diagnosis, mainly PTSD and depressive disorders. In multivariate analyses, time after departure, length of stay in the host country and number of traumatic events were independent factors associated with psychological distress and psychiatric disorders. In an unselected sample of male asylum seekers and refugees, after around 1 year of resettlement in an Italian catchment area, the frequency of psychological distress and psychiatric disorders was substantial and clinically relevant. Health care systems should include a mental health component to recognise and effectively treat mental health conditions.

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete’s Risk of Cardiovascular events (MARC) study

BackgroundPsychological distress caused by cardiovascular pre-participation screening (PPS) may be a reason not to implement a PPS program. We assessed the psychological impact of PPS, including cardiac computed tomography (CT), in 318 asymptomatic sportsmen aged ≥45 years.MethodsCoronary artery disease (CAD) was defined as a coronary artery calcium score ≥100 Agatson units and/or ≥50% luminal stenosis on contrast-enhanced cardiac CT. Psychological impact was measured with the Impact of Event Scale (IES) (seven items) on a six-point scale (grade 0–5). A sum score ≥19 indicates clinically relevant psychological distress. A Likert scale was used to assess overall experiences and impact on sports and lifestyle.ResultsA total of 275 participants (86.5% response rate, 95% CI 83–90%) with a mean age of 54.5 ± 6.4 years completed the questionnaires, 48 (17.5%, 95% CI 13–22%) of whom had CAD. The median IES score was 1 (IQR 0–2, [0–23]). IES was slightly higher in those with CAD (mean rank 175 vs. 130, p < 0.001). One participant (with CAD) experienced clinically relevant psychological distress (IES = 23). Participants reported numerous benefits, including feeling safer exercising (58.6%, 95% CI 53–65%) and positive lifestyle changes, especially in those with CAD (17.2 vs. 52.1%, p < 0.001). The majority were satisfied with their participation (93.8%, 95% CI 91–97%).ConclusionCardiovascular PPS, including cardiac CT, causes no relevant psychological distress in older sportsmen. Psychological distress should not be a reason to forego screening in sportsmen.Electronic supplementary materialThe online version of this article (doi: 10.1007/s12471-017-0948-5) contains supplementary material, which is available to authorized users.

Coping With Diverse Sex Development: Treatment Experiences and Psychosocial Support During Childhood and Adolescence and Adult Well-Being.

The purpose of this exploratory, retrospective, and correlational study was to examine the relationships between childhood treatment experiences, parental care, and social support, and outcome in adults with different diverse sex development (DSD). The data of 69 participants from an exploratory questionnaire were collected in a retrospective German study. The majority received medical treatment in relation to their DSD during childhood and adolescence. Seventy percent reported having had a best friend and 29% a confidant during childhood. Sixty-one percent showed clinically relevant psychological distress, and 45% reported suicidal thoughts at least at one point in their lives. Quality of parental care and having had a best friend correlated positively with adult outcome, whereas treatment experiences correlated with aspects of impaired adjustment. Social support and DSD-related treatment experiences appear to have an impact on adult well-being. Appropriate psychosocial care including peer-to-peer support should be made available to children with DSD and their families.

Multidisziplinärer Versorgungsbedarf psychisch belasteter Tumorpatienten an einem Comprehensive Cancer Center

Considering the prolonged life-expectancies and the resulting demands that are placed on cancer patients and their relatives, the importance of specific counseling and support services including psycho-oncology, social services, nutritional, and exercise counseling has profoundly increased. The main focus of the current study was to evaluate the multidisciplinary health care needs of emotionally distressed cancer patients whoe were treated in a Comprehensive Cancer Center. METHODS AND STUDYGROUP: 831 out-patients were evaluated with regard to their psychological distress level and their multidisciplinary health care needs for specialist services of psycho-oncology, social services, nutritional, and exercise counseling using a tablet-PC assisted screening questionnaire. Separate analyses were completed for patients with and without psychological distress. One third of the screened patients showed clinically relevant psychological distress. Health care needs for all specialist services were significantly greater among these patients compared to patients without psychological distress (all p-values < 0.005). The higher needs were foremost presented by the number of needed specialist services (p < 0.001): two thirds of the psychologically distressed patients demonstrated, besides the need for a psycho-oncological service, a need for two or three further specialist services, whereas among patients without psychological distress more than 70% showed a need for at most one specialist service. Multidisciplinary health care needs of psychologically distressed cancer patients should be systematically addressed in a Comprehensive Cancer Center, and patients should be offered a coordinated and integrated health care program.

Adequacy of the Simplified Version of the Tinnitus Handicap Inventory (THI-S) to Measure Tinnitus Handicap and Relevant Distress

Background and ObjectivesThe Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus.Subjects and MethodsA total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S.ResultsThe severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach's α=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (p<0.01) correlations of the THI-S with the THI (rs=0.95) as well as with the BEPSI, STAI, BDI questionnaires (rs=0.40-0.45) suggest that the THI-S questionnaire appeared to be useful to provide objective data of subjective tinnitus handicap as well as predict psychological distress. Three factors were extracted through factor analysis, which explained 73% of the total variance.ConclusionsDespite reducing the length of 25 items of THI to 10 items, the THI-S can be used as s a simple but reliable and valid tool for evaluating severity of tinnitus handicap as well as detecting its negative impact on psychological functioning.

Quality of life in patients with congenital vascular malformations.

To assess quality of life (QoL) in patients with congenital vascular malformations (CVMs) and to identify factors of CVMs associated with poor QoL, including high psychological and/or somatic (physical) distress. We evaluated 71 patients (mean age, 40± 16 years; 51% women) with arteriovenous (n= 10), venous/capillary (n= 34), lymphatic (n= 10), and combined (n= 17) malformations. All patients completed validated psychometric assessment tools, which were the 36-Item Short Form Health Survey, the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire-15, and the Pain Disability Index. Compared with population norms, the group of CVM patients as a whole showed lower 36-Item Short Form Health Survey Physical (46 vs 50) and Mental (46 vs 52) Component Summary scores, indicating impaired physical and mental health. In addition, 13% of patients with CVMs had clinically relevant psychological distress (Hospital Anxiety and Depression Scale total scores ≥17), and 15% had increased somatic distress (Patient Health Questionnaire-15 total scores ≥10). Greater levels of psychological and somatic distress were significantly associated with lower scores of virtually all of the eight 36-Item Short Form Health Survey subscales (P< .05). Our findings suggest that, compared witha normal population, CVM patients have a lower QoL that is accompanied by increased psychological and somatic distress. In treating patients with CVMs, it is important to be aware of the psychological impact of this rare illness and to offer appropriate support.