Comprehensive psychiatry最新文献

{"title":"Trends in the dose-response relationship between adverse childhood experiences and maladaptive metacognitive beliefs: A cross-sectional study","authors":"Dorottya Horváth,&nbsp;Beáta Kovács-Tóth,&nbsp;Barnabás Oláh,&nbsp;Zita Fekete","doi":"10.1016/j.comppsych.2024.152489","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152489","url":null,"abstract":"<div><h3>Background</h3><p>Since the publication of the major research on adverse childhood experiences (ACE) at the turn of the millennium, our knowledge about the prevalence and physical and mental consequences of childhood adversities has increased substantially. In parallel, research on metacognition, which plays an important role in understanding our mental functioning, has also been on the rise. Although the adverse effects of ACEs on mental processes and the role of metacognitive deficits in the development of mental disorders are widely known, hardly any research into the interaction between these two areas has been conducted; this is what triggered our investigation.</p></div><div><h3>Methods</h3><p>Our research was carried out as a cross-sectional study on a sample of 304 members of the general population. We measured ACEs with the 10-item Adverse Childhood Experiences Questionnaire and maladaptive metacognitions—positive and negative metacognitive beliefs, cognitive confidence, cognitive self-consciousness, and need to control thoughts— using the Meta-Cognitions Questionnaire.</p><p>The closeness of the relationship between the ACE score and metacognitions was measured using Pearson's linear correlation coefficient, while the association of ACE accumulation with metacognitive beliefs was assessed using generalized linear models.</p></div><div><h3>Results</h3><p>The most common ACE in our sample turned out to be emotional neglect (44.74%). All the examined maladaptive metacognitive beliefs correlate mildly to moderately with the number of suffered ACEs (<em>r</em> = 0.13–0.34), with an increase in the ACE score leading to a rise in the salience of maladaptive metacognitive beliefs. Moreover, a dose-response relationship was seen between increases in ACE scores and the overall values of metacognition, negative metacognitive beliefs, and the maladaptive metacognitive belief of the need to control thoughts.</p></div><div><h3>Conclusions</h3><p>Our results suggest that the more ACEs were experienced in childhood, the more pronounced the dysfunctional metacognitive beliefs are. Therefore, our findings emphasize the importance of further research into the topic.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152489"},"PeriodicalIF":7.3,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000403/pdfft?md5=7d8a8af3864728fa7d156e78ee9d3804&pid=1-s2.0-S0010440X24000403-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140637887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and validation study of the Indonesian version of the Global Psychotrauma Screen in an undergraduate student population","authors":"Indira Primasari ,&nbsp;Chris M. Hoeboer ,&nbsp;Anne Bakker ,&nbsp;Miranda Olff","doi":"10.1016/j.comppsych.2024.152485","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152485","url":null,"abstract":"<div><h3>Background</h3><p>The high incidence of potentially traumatic events (PTEs) in Indonesia warrants early identification of those with probable trauma-related disorders in order to tailor prevention and intervention for trauma-related symptoms.</p></div><div><h3>Objectives</h3><p>This study aims to adapt and validate a novel brief transdiagnostic screener, the Global Psychotrauma Screen (GPS), in Indonesian undergraduate students.</p></div><div><h3>Methods</h3><p>An online survey was administered among Indonesian undergraduate students (<em>N</em> = 322). Exploratory factor analysis, reliability analyses, clinical validity analyses, and correlational analyses were performed to evaluate the construct validity, reliability, clinical validity, and convergent-divergent validity of the Indonesian GPS. Hierarchical multiple regression was conducted to assess the relationship between risk factors and trauma-related symptoms. The relationship between four categories of trauma-related symptom severity and social/work functioning was measured using Analysis of Covariance.</p></div><div><h3>Results</h3><p>Exploratory factor analysis yielded a single-factor solution. The Indonesian GPS demonstrated good internal consistency, test-retest correlation, and absolute agreement, indicating good reliability. The Indonesian GPS also had an acceptable area under the curve, sensitivity, and specificity for a probable diagnosis of Post-Traumatic Stress Disorder (PTSD), Complex-PTSD (CPTSD), depression, and generalized anxiety disorder (GAD). We also established evidence for the convergent and divergent validity of GPS. The GPS risk factors (low psychological resilience, other stressful events, history of mental illness, and low social support) contributed to predicting trauma-related symptoms after controlling for gender, age, employment status, and faculty background. Additionally, in comparison to participants from the mild and low categories of GPS symptoms scores, participants from the severe and moderate category reported impaired lowered social/work functioning.</p></div><div><h3>Conclusion</h3><p>The current findings indicate that the Indonesian GPS is a valid and reliable transdiagnostic trauma screener for Indonesian undergraduate students. This first comprehensive validation of the GPS in Indonesia calls for more research in Lower-middle Income Countries (LMICs) as a way towards prevention and early intervention for trauma-related symptoms.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152485"},"PeriodicalIF":7.3,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000361/pdfft?md5=7b7b0aa55eda17a5fd29cc15a3e95eee&pid=1-s2.0-S0010440X24000361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140631700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive vagus nerve stimulation conditions increased invigoration and wanting in depression","authors":"Magdalena Ferstl ,&nbsp;Anne Kühnel ,&nbsp;Johannes Klaus ,&nbsp;Wy Ming Lin ,&nbsp;Nils B. Kroemer","doi":"10.1016/j.comppsych.2024.152488","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152488","url":null,"abstract":"<div><h3>Background</h3><p>Major depressive disorder (MDD) is often marked by impaired motivation and reward processing, known as anhedonia. Many patients do not respond to first-line treatments, and improvements in motivation can be slow, creating an urgent need for rapid interventions. Recently, we demonstrated that transcutaneous auricular vagus nerve stimulation (taVNS) acutely boosts effort invigoration in healthy participants, but its effects on depression remain unclear.</p></div><div><h3>Objective</h3><p>To assess the impact of taVNS on effort invigoration and maintenance in a sample that includes patients with MDD, evaluating the generalizability of our findings.</p></div><div><h3>Methods</h3><p>We used a single-blind, randomized crossover design in 30 patients with MDD and 29 matched (age, sex, and BMI) healthy control participants (HCP).</p></div><div><h3>Results</h3><p>Consistent with prior findings, taVNS increased effort invigoration for rewards in both groups during Session 1 (<em>p</em> = .040), particularly for less wanted rewards in HCP (<em>p</em>_boot &lt; 0.001). However, invigoration remained elevated in all participants, and no acute changes were observed in Session 2 (Δinvigoration = 3.3, <em>p</em> = .12). Crucially, throughout Session 1, we found taVNS-induced increases in effort invigoration (<em>p</em>_boot = 0.008) and wanting (<em>p</em>_boot = 0.010) in patients with MDD, with gains in wanting maintained across sessions (Δwanting = 0.06, <em>p</em> = .97).</p></div><div><h3>Conclusions</h3><p>Our study replicates the invigorating effects of taVNS in Session 1 and reveals its generalizability to depression. Furthermore, we expand upon previous research by showing taVNS-induced conditioning effects on invigoration and wanting within Session 1 in patients that were largely sustained. While enduring motivational improvements present challenges for crossover designs, they are highly desirable in interventions and warrant further follow-up research.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152488"},"PeriodicalIF":7.3,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000397/pdfft?md5=dab522568a8237cb70938ae6e85f5fed&pid=1-s2.0-S0010440X24000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-label higher doses of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder: Safety and tolerability","authors":"Daniel Minkin Levy ,&nbsp;Oded Ben Arush ,&nbsp;Lior Carmi ,&nbsp;Alzbeta Juven Wetzler ,&nbsp;Joseph Zohar","doi":"10.1016/j.comppsych.2024.152486","DOIUrl":"10.1016/j.comppsych.2024.152486","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the long-term safety and tolerability of off-label high-dose serotonin reuptake inhibitors (OLHD-SRIs) in the treatment of obsessive-compulsive disorder (OCD).</p></div><div><h3>Methods</h3><p>A retrospective longitudinal study was performed on 105 randomly selected outpatients diagnosed with OCD and were treated with OLHD-SRIs for at least 6 months. Patients received sertraline &gt;200 mg/day, escitalopram &gt;20 mg/day, fluvoxamine &gt;300 mg/day, and fluoxetine &gt;60 mg/day, combined with exposure and response prevention therapy. Patients were divided into three dosing groups: sertraline equivalent dose (SED) ≤ 200 mg/day (<em>n</em> = 26, 24.7%), 201–400 mg/day (<em>n</em> = 51, 48.5%) and 401–650 mg/day (<em>n</em> = 28, 26.6%). Safety and tolerability were assessed with an electrocardiogram, blood biochemistry, complete blood count, and side-effects monitoring.</p></div><div><h3>Results</h3><p>SED ranged from 100 to 650 mg/day and the mean duration of OLHD-SRI treatment was 20.8 months. The most common side-effects reported were sexual dysfunction (<em>n</em> = 36, 34%), weight gain (<em>n</em> = 28, 27%), sedation (<em>n</em> = 27, 26%), hyperhidrosis (<em>n</em> = 20, 19%), and tremor (<em>n</em> = 11, 10%). Abnormal ECG was documented in one patient, and another patient experienced a first-time seizure, whereas elevated liver enzymes were seen in 4.8% of the sample (<em>n</em> = 5). None of the patients had serotonin syndrome or drug-induced liver injury. Side-effects did not differ among the three dosing groups.</p></div><div><h3>Conclusion</h3><p>OLHD-SRIs appear to be safe and well tolerated in OCD patients in SED ≤ 650 mg/day doses and the side-effects did not differ between the three dosing groups.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"133 ","pages":"Article 152486"},"PeriodicalIF":7.3,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000373/pdfft?md5=a86a67b93e201a4aba0b19f96f874e72&pid=1-s2.0-S0010440X24000373-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an intervention program to improve mental health and epilepsy care in Madagascar","authors":"Sedera Mioramalala ,&nbsp;Lara Mroueh ,&nbsp;Pierre-Emile Bruand ,&nbsp;Mbolatiana Michèle Raharinivo ,&nbsp;Roger Marie Rafanomezantsoa ,&nbsp;Daniel Gérard ,&nbsp;Arsène Ratsimbasoa ,&nbsp;Pierre-Marie Preux ,&nbsp;Farid Boumédiène","doi":"10.1016/j.comppsych.2024.152484","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152484","url":null,"abstract":"<div><h3>Background</h3><p>Despite the high prevalence of mental disorders and epilepsy in low- and middle-income countries, nearly 80% of patients are not treated. In Madagascar, initiatives to improve access to epilepsy and mental health care, including public awareness and training of general practitioners (GPs), were carried out between 2013 and 2018. Our study's main objective was to assess the effectiveness of these initiatives, two to five years post-intervention.</p></div><div><h3>Methods</h3><p>This quasi-experimental study (intervention vs. control areas) included five surveys assessing: general population's Knowledge Attitudes and Practices (KAP), GPs' KAP , number of epilepsy and mental health consultations at different levels of the healthcare system, diagnostic accuracy, and treatments' availability.</p></div><div><h3>Outcomes</h3><p>In the general population, KAP scores were higher in intervention areas for epilepsy (11.4/20 vs. 10.3/20; <em>p</em> = 0.003). For mental disorders, regardless of the area, KAP scores were low, especially for schizophrenia (1.1/20 and 0.1/20). Among GPs, KAP scores were higher in intervention areas for schizophrenia (6.0/10 vs. 4.5/10; <em>p</em> = 0.008) and epilepsy (6.9/10 vs. 6.2/10; <em>p</em> = 0.044). Overall, there was a greater proportion of mental health and epilepsy consultations in intervention areas (4.5% vs 2.3%). Although low, concordance between GPs' and psychiatrists' diagnoses was higher in intervention areas. There was a greater variety of anti-epileptic and psychotropic medications available in intervention areas.</p></div><div><h3>Interpretation</h3><p>This research has helped to better understand the effectiveness of initiatives implemented in Madagascar to improve epilepsy and mental health care and to identify barriers which will need to be addressed.</p></div><div><h3>Funding</h3><p>Sanofi Global Health, as part of the Fight Against STigma Program.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152484"},"PeriodicalIF":7.3,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X2400035X/pdfft?md5=251948c98a2fa6ac9067c28633a02c97&pid=1-s2.0-S0010440X2400035X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140552194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress and compulsive buying-shopping disorder: A scoping review","authors":"Tobias A. Thomas ,&nbsp;Anna M. Schmid ,&nbsp;Annica Kessling ,&nbsp;Oliver T. Wolf ,&nbsp;Matthias Brand ,&nbsp;Sabine Steins-Loeber ,&nbsp;Astrid Müller","doi":"10.1016/j.comppsych.2024.152482","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152482","url":null,"abstract":"<div><h3>Introduction</h3><p>Theoretical frameworks of behavioral addictions mostly acknowledge the role of stress in the development and maintenance of these disorders, models of compulsive buying-shopping disorder (CBSD) however rarely incorporated stress. The association between stress and CBSD has not been reviewed yet.</p></div><div><h3>Methods</h3><p>A scoping review was conducted to evaluate empirical results on the association between stress and CBSD. A comprehensive search string was employed in three databases.</p></div><div><h3>Results</h3><p>16 studies were included. Correlative studies suggested significant correlations between general perceived stress and CBSD symptom severity. Studies involving mean comparisons found higher general perceived stress levels in persons with problematic buying-shopping behavior/CBSD compared to control participants (large effects). Mixed results were found in studies involving regression/structural equation models and ecological momentary assessments. One study with a stress/negative mood induction observed more CBSD symptoms in a high stress group compared to a low stress group.</p></div><div><h3>Discussion</h3><p>The studies are heterogeneous concerning design, samples and measures. Only very few studies surpass the level of cross-sectional correlative data which limits the ability to draw clear conclusions. Future research should study the impact of experimentally induced stress on CBSD symptoms, examine the relationship between stress and CBSD longitudinally and assess objective stress markers.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152482"},"PeriodicalIF":7.3,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000336/pdfft?md5=48bbb428f4213d91228e3b88dc19b6d6&pid=1-s2.0-S0010440X24000336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140542848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenting and family interventions in lower and middle-income countries for child and adolescent mental health: A systematic review","authors":"Tania Bosqui ,&nbsp;Anas Mayya ,&nbsp;Sally Farah ,&nbsp;Zahraa Shaito ,&nbsp;Mark J.D. Jordans ,&nbsp;Gloria Pedersen ,&nbsp;Theresa S. Betancourt ,&nbsp;Alan Carr ,&nbsp;Michael Donnelly ,&nbsp;Felicity L. Brown","doi":"10.1016/j.comppsych.2024.152483","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152483","url":null,"abstract":"<div><h3>Background</h3><p>Given the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential.</p></div><div><h3>Method</h3><p>This systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0–24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes.</p></div><div><h3>Main findings</h3><p>We found a total of 80 studies (<em>n</em> = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs.</p></div><div><h3>Preliminary conclusions</h3><p>Despite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152483"},"PeriodicalIF":7.3,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000348/pdfft?md5=eacb376a7c9e30c110c12ef31fe16b44&pid=1-s2.0-S0010440X24000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140558230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of F-18 FDG PET-CT in neuropsychiatric systemic lupus erythematosus","authors":"Bianca D. Berndorfler ,&nbsp;James M. Warwick ,&nbsp;Alex G.G. Doruyter","doi":"10.1016/j.comppsych.2024.152480","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152480","url":null,"abstract":"<div><h3>Background</h3><p>Neuropsychiatric systemic lupus erythematosus (NPSLE) is a major contributor to morbidity and mortality in systemic lupus erythematosus (SLE) patients. To date no single clinical, laboratory or imaging test has proven accurate for NPSLE diagnosis which is a testament to the intricate and multifactorial pathophysiological mechanisms suspected to exist. Functional imaging with FDG PET-CT has shown promise in NPSLE diagnosis, detecting abnormalities prior to changes evident on anatomical imaging. Research indicates that NPSLE may be more aggressive in people of African descent with higher mortality rates, making rapid and correct diagnosis even more important in the African context.</p></div><div><h3>Methods</h3><p>In this narrative review, we provide a thorough appraisal of the current literature on the role of FDG PET-CT in NPSLE. Large, well-known databases were searched using appropriate search terms. Manual searches of references of retrieved literature were also included.</p></div><div><h3>Findings</h3><p>A total of 73 article abstracts were assessed, yielding 26 papers that were directly relevant to the topic of FDG PET-CT in NPSLE. Results suggest that FDG PET-CT is a sensitive imaging test for NPSLE diagnosis and may play a role in assessing treatment response. It is complementary to routine anatomical imaging, particularly in diffuse manifestations of the disease. Newer quantitative analyses are commonly used for interpretation and can detect even subtle abnormalities, missed on visual inspection. Findings of group-wise analyses of FDG PET-CT scans in NPSLE patients are important in furthering our understanding of the complicated pathophysiological mechanisms involved. Limitations of FDG PET-CT include its lack of specificity, high cost and poor access.</p></div><div><h3>Conclusion</h3><p>FDG PET-CT is a sensitive test for NPSLE diagnosis but is hampered by lack of specificity. It is a valuable tool for clinicians managing SLE patients, particularly when anatomical imaging is negative. Its exact application will depend on the local context and clinical scenario.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152480"},"PeriodicalIF":7.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000312/pdfft?md5=5095c98641cb29c19f209ac205008b6c&pid=1-s2.0-S0010440X24000312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the surface: Understanding obsessive symptoms and body perceptions, from shape concerns to fear of blushing","authors":"S. Tempia Valenta ,&nbsp;G. Campanile ,&nbsp;U. Albert ,&nbsp;F. Marcolini ,&nbsp;G. Faedi ,&nbsp;D. De Ronchi ,&nbsp;A.R. Atti","doi":"10.1016/j.comppsych.2024.152481","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152481","url":null,"abstract":"<div><h3>Introduction</h3><p>Recent reclassifications have expanded the understanding of Obsessive-Compulsive Disorders (OCDs), now incorporated into a broader category known as Obsessive-Compulsive Disorder and Related Disorders (OCRDs). This study sought to assess obsessive-compulsive symptoms and body uneasiness among outpatients seeking treatment for Eating Disorders (ED). Additionally, we aimed to explore associations and potential mediation effects between obsessive-compulsive symptoms and body uneasiness. This investigation extended beyond concerns related solely to body shape and weight, encompassing fears associated with specific body components (such as facial features, abdominal region, and limbs) or functions (including sweating, blushing, emitting noises, and releasing odors).</p></div><div><h3>Methods</h3><p>Psychometric assessments included the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Body Uneasiness Test (BUT). Statistical analyses involved bivariate correlations, linear regression, and mediation analysis to explore the associations and potential mediation effects between obsessive-compulsive symptoms and different manifestations of body uneasiness.</p></div><div><h3>Results</h3><p>The sample (<em>N</em> = 210) demonstrated substantial obsessive-compulsive symptoms and notable body discomfort. OCI-R scores positively correlated with various dimensions of body dissatisfaction, including shape, weight, and specific body components or functions. Linear regression revealed significant associations between OCI-R scores and overall body uneasiness (BUT-A) as well as concerns about body components or functions (BUT<img>B). Mediation analysis indicated that BUT-A mediated the relationship between obsessive-compulsive symptoms and BUT<img>B.</p></div><div><h3>Conclusion</h3><p>This study offers new insights into the comprehensive landscape of OCRDs. It specifically emphasizes the association between obsessive-compulsive symptoms and body uneasiness, embracing not only concerns about body shape and weight but also extending to body components and functions.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152481"},"PeriodicalIF":7.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000324/pdfft?md5=34407f4a0e171253670bcfbe51f65b5d&pid=1-s2.0-S0010440X24000324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140321461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of the comparative efficacy of benzodiazepines and antidepressants for psychic versus somatic symptoms of generalized anxiety disorder","authors":"Chad Beyer ,&nbsp;Christopher B. Currin ,&nbsp;Taryn Williams ,&nbsp;Dan J. Stein","doi":"10.1016/j.comppsych.2024.152479","DOIUrl":"https://doi.org/10.1016/j.comppsych.2024.152479","url":null,"abstract":"<div><h3>Background</h3><p>Benzodiazepines and antidepressants are effective agents for the treatment of generalized anxiety disorder (GAD), with the HAM-A frequently used as a primary outcome measure. The GAD literature is inconsistent regarding which medications are more effective for somatic versus psychic symptoms of GAD, and treatment guidelines do not advocate for prescribing based on subtype. This meta-analysis aimed to determine whether benzodiazepines and antidepressants have a differential impact on the somatic versus psychic subscales of the HAM-A in GAD.</p></div><div><h3>Methods</h3><p>An electronic search was undertaken for randomized controlled trials of either benzodiazepines or antidepressants for GAD that reported treatment response using the HAM-A subscales. Data were extracted by independent reviewers. A random effects assessment of weighted mean difference with 95% confidence intervals and subgroup difference was applied. All analysis was done on SPSS 26. An assessment of bias, and of quality of evidence was performed.</p></div><div><h3>Results</h3><p>24 randomized controlled trials met the inclusion criteria: 18 antidepressant trials, 5 benzodiazepine trials and 1 of both. 14 studies were assessed as having between some and high risk of bias, while 10 were assessed as having low risk of bias. Benzodiazepines (WMD of 1.81 [CI 1.03, 2.58]) were significantly more effective than antidepressants (WMD of 0.83 [CI 0.64, 1.02]) for reducing somatic symptoms of GAD (Chi² = 5.81, <em>p</em> = 0.02), and were also more effective (WMD of 2.46 [CI 1.83, 3.09]) in reducing psychic symptoms than antidepressants (WMD of 1.83 [CI 1.55, 2.10]), although this comparison did not reach statistical significance (Chi² = 3.31, <em>p</em> = 0.07).</p></div><div><h3>Conclusion</h3><p>The finding that benzodiazepines were significantly more effective than antidepressants for somatic symptoms needs to be weighed up against potential benefits of antidepressants over benzodiazepines. It may be useful for future treatment guidelines for GAD to explicitly consider symptom subtype.</p></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"132 ","pages":"Article 152479"},"PeriodicalIF":7.3,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010440X24000300/pdfft?md5=cc132f10aaaf4b34147d3bbeb980b53a&pid=1-s2.0-S0010440X24000300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}