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Abstract

Objectives

To conduct a pilot study on the lived experiences of people affected by the COVID-19 pandemic, and the mental health impacts of the COVID-19 pandemic on affected people.

Methods

This mixed methods study used random and snowball techniques to recruit 91 respondents (age range 18–58 years) from 14 countries. Accessing patients with COVID-19 was restricted because of the nature of the disease and the treatment they were receiving which limited their access to being selected for our pilot study. Therefore, our respondents were members of the general population who were directly or indirectly affected by the pandemic. Respondents completed online surveys consisting of the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9) and open-ended questions. Collected data were subjected to IBM SPSS statistics software (v. 22.0) and thematic analysis.

Results

Both quantitative and qualitative instruments reported very high feasibility, which is suggestive of an excellent feasibility of our mixed methods design. Second, we identified financial and time resources as major barriers to the recruitment process, and how to avert these in the main study was discussed. Third, COVID-19 pandemic had more anxious than depressive impacts on our respondents. We also found that more than half (58, 63.7%) of the total respondents showed high knowledge level of COVID-19, and the major sources from which they gained knowledge were television, radio, and online academic papers. Our qualitative insight showed five themes from the lived experiences of respondents from the COVID-19 pandemic. These themes were; changes in lifestyles, disruption of schooling activities, impact on options for health services, disruption of works and economy, and anxious and worrisome impacts, in that order.

Conclusion

Main study is feasible with minor addition required on our protocol. Given other findings, we recommend the need for adaptive coping skill training, and appropriate information sharing during pandemics. There is also the need for psychosocial preparation due to the uncertainty of pandemics. In addition, averting the likely adverse economic impacts from pandemics should be of concern to governments and other stakeholders during pandemics. Finally, we recommend that governments and other stakeholders should be cautious about the likelihood of limited health service options for the general public during pandemics.

Abstract

Objective

The primary objective of this paper is to present a short measure of perceptions on the impact of the COVID-19 pandemic on quality of life, along with analysis of its reliability and validity in non-clinical and clinical samples.

Methods

The scale was named The COV19 – Impact on Quality of Life (COV19-QoL) and it consists of six items presented in the form of a 5-point Likert scale. The items (i.e. statements) cover main areas of quality of life with regard to mental health. The scale was administered to 1346 participants from the general population in Croatia (the non-clinical sample) and 201 patients with severe mental illness recruited from four European countries (Bosnia and Herzegovina, Montenegro, North Macedonia and Serbia), constituting the clinical sample. The clinical sample was part of the randomised controlled trial IMPULSE funded by the European Commission. Data on age and gender were collected for both samples, along with psychiatric diagnoses collected for the clinical sample.

Results

Main findings included a high internal consistency of the scale and a moderate to strong positive correlation among participants’ scores on different items. Principal component analysis yielded one latent component. The correlation between participants’ age and their results on COV19-QoL was negligible. Participants’ perceived quality of life was the most impacted domain, whereas mental health, personal safety and levels of depression were the least impacted domains by the pandemic.

Discussion

The COV19-QoL is a reliable and valid scale which can be used to explore the impact of COVID-19 on quality of life. The scale can be successfully used by researchers and clinicians interested in the impact of the pandemic on people experiencing various pre-existing mental health issues (e.g. anxiety, mood and personality disorders) as well as those without such issues.

Abstract

Objectives:

The measurement and assessment of the emergent symptoms in various psychotic disorders is essential to the delivery of efficacious, patient centred mental health care. Despite the existence of several instruments that can measure these factors, their applicability within a global context remains undetermined. This paper aims to provide evidence for a factor structure in Clinical Assessment Interview for Negative Symptoms (CAINS), tailored for use in the Albanian language.

Methods:

We recruited 106 patients with psychosis (68% male), who were aged 16 to 40 years old (M = 22, SD = 1.75), and treated in community services in Kosovo. We adapted, translated, and back-translated CAINS and the Brief Symptom Inventory (BSI) before these measures were administered in interviews with the participants. According to Kaiser-Guttman’s criterion (i.e., eigen-value >1), four components were extracted from the original measure of CAINS.

Results:

Using Principal Component Analysis, CAINS was found to be a valid means of measurement of motivation and pleasure in various life domains (social, recreational, and work/school). Intercorrelation existed not only between the BSI scale and the CAINS scales, but within the CAINS scales themselves.

Conclusions:

In contrast to the previous studies that found Expression and Motivation and Pleasure as two major factors, our results revealed four components. Thus, it may be that the culture plays a substantial role in the factor structure of CAINS, and it might be related to different appraisal of emotional situations, which are influenced by different socio-cultural practices. These results have global implications for clinical practice and future research.

Abstract

Objectives

The general objective of this research was to see if academic achievement significantly relates with social anxiety of high school students. There were other specific and auxiliary objectives also. One among these was to gather prevalence data of social anxiety among adolescents of Kathmandu.

Method

A survey was conducted among 696 high school students of Kathmandu to see if academic achievement was associated with their social phobia. Convenient sample from a high school was used. Social Phobia Inventory (SPIN), a self-report test, was used to measure social anxiety disorder of adolescent students. Some demographic data were also collected. Data were organized in MS Excel and analysed in SPSS.

Results

The prevalence of ‘very severe’ social phobia among boys was 2.01% and girls had that of 1.71%. One-way ANOVA showed that academic achievement did not have a relationship with social phobia, F (2, 613) = 1.74, p > 0.05.

Conclusions

Academic achievement was not associated with social phobia among students of a high school in Kathmandu. Boys have more prevalence of severe forms of social anxiety than girls when they are in adolescence.

Abstract

Objectives

In Sub-Saharan Africa, Nigeria is currently home to many people living with HIV/AIDS (PLWHA), and suicidal ideation is amongst the common early problems of newly diagnosed PLWHA. This reflects the importance of including psychotherapy in HIV care. In this regard, compassion-focused therapy (CFT) is the one that has not been a point of study for reducing suicidal risks in newly diagnosed PLWHA despite the relevance of CFT to the treatment/management of persons living with self-criticism or self-harm. To bridge this gap, we examined the use of CFT as an intervention against suicidal ideation in newly diagnosed PLWHA receiving antiretroviral therapy at the Adeoyo Maternity Teaching Hospital in Ibadan, Oyo state, Nigeria.

Methods

Twenty-two participants (mean age = 40 ± 5.6 years) with less than 1-month-old clinical diagnosis of HIV who have recently thought about suicide because of the new HIV-positive diagnosis were purposively sampled and randomly assigned into the intervention and control groups. The CFT module and scale for suicide ideation were the research instruments. All data collected were analysed using SPSS (v.22.0), and statistical significance was determined at P<0.05.

Results

The findings established that after administering CFT to the intervention group, the mean score for suicidal ideation was significantly lower in the intervention group compared with that in the control group.

Conclusion

The results suggest that CFT has the potential to reduce suicidal ideation in newly diagnosed PLWHA; therefore, in addition to the antiretroviral therapy, the administration of CFT should be included in the early stage of HIV care, to reduce the risk of suicide that is associated with newly living with HIV/AIDS.

Abstract

Objectives

Rhodiola rosea is an adaptogen herb from the Crassulaceae family, which has been vastly used in the Russian and Chinese medicine. The herb is used against depression, anxiety, mental and physical fatigue and to promote overall health. In this systematic review, we examined the effects of R. rosea on depression, anxiety and mood, as these are the most relevant to mental health.

Methods

Literature searches were made in PubMed using the term ‘Rhodiola rosea’. Inclusion criteria were: Randomized controlled trials using interventions of R. rosea on any type of participants, while focusing on the effects of the intervention on depression, anxiety or mood. Mixed interventions of R. rosea with other herbs were excluded. Studies not published in English or Greek were excluded.

Results

A total of 39 randomized controlled trials were identified and their abstract was screened. After screening, a total of 17 papers were excluded because they were focusing on irrelevant outcomes. The full text of the remaining 22 papers was read and an additional 17 papers were excluded. These papers were excluded because they were eventually not focusing on our main outcome or they were using R. rosea interventions with other herbs. In the end, a total of 5 papers (n = 327 participants) were found eligible for our systematic review. In these studies, R. rosea seems to improve the symptoms of mild to moderate depression, symptoms of mild anxiety and to enhance mood. The last date of our search was October 13, 2019.

Conclusion

Rhodiola rosea supplementation may alleviate symptoms of mild to moderate depression and mild anxiety, while it may also enhance mood. The findings of our review are not definite due to the lack of available experimental data. Randomized controlled trials with a low risk of bias are needed to further study the herb.

Abstract

Objectives

Psychotic disorders have large treatment gap in low- and middle-income countries (LMICs) in South-Eastern Europe, where up to 45% of affected people do not receive care for their condition. This study will assess the implementation of a generic psychosocial intervention called DIALOG+ in mental health care services and its effectiveness at improving patients’ clinical and social outcomes.

Methods

This is a protocol for a multi-country, pragmatic, hybrid effectiveness–implementation, cluster-randomised, clinical trial. The trial aims to recruit 80 clinicians and 400 patients across 5 South-Eastern European LMICs: Bosnia and Herzegovina, Kosovo*, Montenegro, Republic of North Macedonia and Serbia. Clusters are clinicians working with patients with psychosis, and each clinician will deliver the intervention to five patients. After patient baseline assessments, clinicians will be randomly assigned to either the DIALOG+ intervention or treatment as usual, with an allocation ratio of 1:1. The intervention will be delivered six times over 12 months during routine clinical meetings. TThe primary outcome measure is the quality of life at 12 months [Manchester Short Assessment of Quality of Life (MANSA)]; the secondary outcomes include mental health symptoms [Brief Psychiatric Rating Scale (BPRS), Clinical Assessment Interview for Negative Symptoms (CAINS), Brief Symptom Inventory (BSI)], satisfaction with services [Client Satisfaction Questionnaire (CSQ-8)] and economic costs at 12 months [based on Client Service Receipt Inventory (CSRI), EQ-5D-5L and Recovering Quality of Life (ReQOL-10)]. The study will assess the intervention fidelity and the experience of clinicians and patients’ about implementing DIALOG+ in real-life mental health care settings. In the health economic assessment, the incremental cost-effectiveness ratio is calculated with effectiveness measured by quality-adjusted life year. Data will also be collected on sustainability and reach to inform guidelines for potentially scaling up and implementing the intervention widely. Conclusion: The study is expected to generate new scientific knowledge on the treatment of people with psychosis in health care systems with limited resources. The learning from LMICs could potentially help other countries to expand the access to care and alleviate the suffering of patients with psychosis and their families.

Trial registration: ISRCTN 11913964

Abstract

Background

Major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) are the most common mental disorders following traumatic experiences. The aim of this study was to investigate the extent to which PTSD and depression co-occurred in Serbian general population at baseline and 1 year after the follow-up, as well as how this co-occurrence was associated with sociodemographic factors, personal distress, suicidality and quality of life.

Subjects and methods

The sample consisted of 159 subjects, who fulfilled the IES criteria for PTSD, and were taken from a larger sample of 640 participants, which was chosen by a random walk technique in five regions of the country affected by major trauma. The assessment was carried out by the following instruments: Mini International Neuropsychiatric Interview 5 (MINI 5), Life Stressor Checklist-Revised (BSC-R), Brief Symptom Inventory (BSI), Impact of Event Scale-Revised (IES-R) and Manchester Short Assessment of Quality of Life Scale (MANSA). The follow-up study was carried out 1 year after the baseline.

Results

In the initial phase, PTSD was found in 100 out of 159 participants (62.9%), while 81 (51%) fulfilled the diagnostic criteria for MDD. Comorbidity of PTSD and depression was identified in 65 (40.9%) subjects of the sample. After 1 year, PTSD was found in 56 (35.2%) and MDD in 73 (45.9%) participants. Comorbidity of PTSD and depression in the follow-up phase was identified in 41 (25.8%) subjects of the sample. The subjects with comorbidity had significantly higher level of post-traumatic stress symptoms, general psychological distress as well as suicide risk and lower level of quality of life than participants with either condition alone.

Conclusion

PTSD–depression comorbidity is a common post-traumatic condition. Complex psychopathology, severity of symptoms and their consequences, both at individual and community levels, require attention to be paid to early diagnostics and treatment of affected persons.

Abstract

Background

There is evidence of a progressive increase in the number of Randomized Controlled Trials (RCTs) in the area of psychiatry. However, some areas of psychiatry receive more attention from researchers potentially to the detriment of others.

Methods

Aiming to investigate main gaps for RCTs in psychiatry, the present bibliometric study analysed the bi-annual and five-year rates of RCTs in the main database of medical studies (Pubmed) over the 1999–2018 period (n = 3,449). This analysis was carried out using the ICD-10 mental and behavioural chapter. ICD-10, was the edition of the manual used throughout the above period.

Results

Overall, after 16 years of considerable increase in the bi-annual absolute number of RCTs, there has been a slowdown in the last 4 years, similar to other medical areas. Affective, organic and psychotic disorders, and depression, schizophrenia and dementia were the top studied groups and disorders respectively – ahead of other groups/diagnoses. For substance use disorders, there has been a decrease of RCT in the last 5 years, in line with the fall of alcohol use disorder in the ranking of most studied disorders. Delirium and mild cognitive disorder are both ascending in this ranking. Personality disorders and mental retardation stand out as the least studied groups over the whole assessment period.

Conclusion

Novel treatments, ease of access to patient populations, and ‘clinical vogue’, seem to be more important in guiding the undertaking of RCTs than the actual need as indicated by prevalence and/or burden of disorders and public health impact. Regarding specific disorders, acute/transient psychosis; mixed anxiety and depression; adjustment disorder; dissociative and conversion disorders; somatization; hypochondria; and neurasthenia, would deserve future RCTs. Clinical researchers and editors of scientific journals should give special attention to the less studied areas and disorders, when considering conducting and publishing RCT studies, respectively.

Abstract

As part of the intention to document the recent and current history of psychiatry, I was asked to present memories of my involvement in psychiatry over the past 50 years. Reviewers suggested that I should start this personal history of psychiatry with a summary of my curriculum vitae because this will make it easier to place the events I describe into their historical context. Here it goes, then.