Frontiers in Psychiatry最新文献

{"title":"Modified cognitive behavioral therapy approach reduces loudness discomfort levels for an autistic child with hyperacusis: case report.","authors":"Tana B Carson, Lisa A Guerrero, Monica Niebles, Cindi G F Gayle","doi":"10.3389/fpsyt.2024.1440624","DOIUrl":"10.3389/fpsyt.2024.1440624","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperacusis is common among the autistic population, with a lifetime prevalence estimated at up to 60% compared to 17.1% in those without autism. For autistic children, avoidance behaviors and distress associated with hyperacusis significantly disrupt participation in everyday routines including academic, social and leisure activities. Although hyperacusis is a significant problem for children with autism and their families, there is little research on effective interventions. This report describes the clinical case of an 11-year-old boy with autism who received a modified cognitive behavioral therapy (CBT) approach to address symptoms of hyperacusis.</p><p><strong>Case presentation: </strong>Patient A is an 11-year-old boy with autism and hyperacusis. He and his parents report difficulties tolerating loud or high-pitched sounds including whistling, fireworks, traffic and high-pitched musical instruments (e.g., the ocarina and flute). When hearing these sounds during everyday activities (e.g., celebrations and social events) he will often ask strangers to stop, cover his ears, or avoid/run away from the source of sound. A modified CBT approach was combined with exposure therapy, and sensory-based self-regulation strategies to improve tolerance and decrease distress when hearing whistling. Treatment outcomes include improved loudness discomfort levels in audiology evaluations, improved auditory domain scores on the Sensory Profile questionnaires, lower self-reported subjective units of distress scale (SUDS) ratings in response to bothersome sounds, and decreased use of noise canceling headphones during daily activities. The client and his parents also reported generalization of these improvements with other sounds (e.g., fireworks).</p><p><strong>Conclusion: </strong>The patient described in this case report showed measurable improvements in his ability to tolerate whistling, a bothersome sound encountered regularly in his daily life. Considering the high prevalence rate of hyperacusis in autism and its impact on children and family routines, stress and daily living, the development and testing of an effective treatment approach for hyperacusis is needed. The treatment plan for this case arose from the collaboration between professionals in occupational therapy, applied behavior analysis, audiology, and clinical psychology. Future studies are encouraged to determine the efficacy of this combined approach for other children with autism and hyperacusis.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful pilot implementation of mailing lethal means safety devices to veterans calling the Veterans Crisis Line.","authors":"Sara J Landes, Jolie E Bourgeois, Nyssa D Curtis, Jennifer E Thropp, Ethan R Panal, Elizabeth G Spitzer, Susan M Jegley, MaryGrace Lauver","doi":"10.3389/fpsyt.2024.1447639","DOIUrl":"10.3389/fpsyt.2024.1447639","url":null,"abstract":"<p><strong>Introduction: </strong>Veterans are at greater risk for suicide than non-veterans; veterans who call the Veterans Crisis Line are at even higher risk. Firearms and poisoning are among the most common methods by which people die by suicide in the United States and access to those lethal means are risk factors for suicide. The United States Department of Veterans Affairs' Veterans Crisis Line conducted a six-month pilot to enhance lethal means safety counseling conversations by mailing lethal means safety devices (cable gun locks and/or medication takeback envelopes) to veteran callers.</p><p><strong>Materials and methods: </strong>Veterans Crisis Line responders were selected based on quality assurance ratings, received training, and passed a knowledge check prior to participating. Veterans were eligible if they were calling for themselves and had access to firearms and/or surplus medications. The pilot was assessed using operational data and qualitative interviews with responders to assess their experience, barriers and facilitators, and suggestions for improvement.</p><p><strong>Results: </strong>Responders documented 8,323 calls from 7,005 unique phone numbers; 10.8% were eligible for cable gun locks and 8.7% were eligible for medication takeback envelopes. Responders offered cable gun locks to 652 veterans and medication takeback envelopes to 522 veterans. A total of 465 cable gun locks and 567 medication takeback envelopes were mailed to 307 veterans. Operationally, there was little impact of the pilot on call handle time. Five responders participated in qualitative interviews. They reported feeling comfortable incorporating mailing devices into their work and reported that response from veterans was positive. Their most frequent suggestion for improvement was additional training.</p><p><strong>Discussion: </strong>Results demonstrate that mailing these devices to veterans was feasible and acceptable. Call handle time results show that the Veterans Crisis Line would not need additional personnel to manage changes in call handle time associated with offering devices to all veteran callers. Full implementation of this program will require updates to procedures and policies, training, documentation system changes, additional logistical support for mailing, and a plan for ongoing evaluation.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clock is ticking on schizophrenia: a study protocol for a translational study integrating phenotypic, genomic, microbiome and biomolecular data to overcome disability.","authors":"Giacomo Mercuriali, Lorenzo Lodde, Pasquale Paribello, Jacopo Sapienza, Alice Corona, Chiara Ave, Delia Pacini, Daniela Nocera, Carolina Corrias, Sabrina El Kacemi, Michele D'Incalci, Ilaria Frau, Elena Monzani, Flavia Valtorta, Donatella Congiu, Anna Meloni, Maria Scherma, Paola Fadda, Simona Dedoni, Carlotta Siddi, Stefania Sut, Stefano Dall'Acqua, Sofia Nasini, Benedetta Barzon, Alessio Squassina, Roberto Cavallaro, Mirko Manchia, Claudia Pisanu, Marta Bosia, Stefano Comai","doi":"10.3389/fpsyt.2024.1451678","DOIUrl":"10.3389/fpsyt.2024.1451678","url":null,"abstract":"<p><strong>Background: </strong>Shared biological factors may play a role in both the cognitive deficits and the increased prevalence of metabolic syndrome observed in individuals with Schizophrenia (SCZ). These factors could entail disturbances in tryptophan (Trp) to both melatonin (MLT) and kynurenine (Kyn) metabolic pathways, as well as inflammation and alterations in the gut microbiome composition.</p><p><strong>Methods: </strong>The present research project aims to investigate this hypothesis by recruiting 170 SCZ patients from two different recruitment sites, assessing their cognitive functions and screening for the presence of metabolic syndrome. Additionally, we plan to assess the impact of a 3-month cognitive remediation therapy on 30 of these patients. We will analyze clinical data alongside serum biomarkers and gene expression related to the Trp- to MLT and Kyn metabolic pathways, markers of inflammatory and composition of the gut microbiome. The association between Trp-MLT-Kyn levels, expression levels of selected genes, inflammatory markers and clinical phenotypes will be analyses in the context of general linear models.</p><p><strong>Discussion: </strong>This project has the potential to identify some typical SCZ symptomatic clusters that will be more stringently associated with variations in the Trp-MLT-Kyn/inflammatory system and with a better response to cognitive remediation therapy. Moreover, in a future perspective, it may highlight a group of patients who may benefit from a pharmacological treatment aiming at reinstating the physiological Trp to MLT and Kyn system. Therefore, it has the potential to move research toward a personalized approach for SCZ management.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of cognitive remediation therapy in anorexia nervosa: a systematic review and meta-analysis.","authors":"Anas R Alserihi, Wejdan A Hubayni, Solaf Hilal Alotaibi, Sadeem Bahkali, Shatha Alqurashi, Muhannad Sadakah Abualola, Ahmad Mohammed Alsaleh","doi":"10.3389/fpsyt.2024.1484457","DOIUrl":"10.3389/fpsyt.2024.1484457","url":null,"abstract":"<p><strong>Background: </strong>Anorexia nervosa (AN) can significantly affect cognitive well-being. Cognitive remediation therapy (CRT) is regarded as one of the effective treatments for cognitive impairment in some mental illnesses such as schizophrenia, bipolar disorder, and attention deficit. For this reason, this systematic review and meta-analysis aim to assess the effectiveness of CRT in patients with AN.</p><p><strong>Methods: </strong>We conducted a search of Medline, ClinicalTrials.gov, and the Cochrane Database of Systematic Reviews from the inception of each database through April 8, 2023. Randomized clinical trials evaluating the effectiveness of CRT in comparison to placebo or other psychological treatments in patients with AN were included. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool. For meta-analysis, effect sizes were measured using mean difference (MD) utilizing the random-effects model and inverse variance (IV) technique. To evaluate the certainty of the evidence, we applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. The study was registered in PROSPERO, ID: CRD42023411784.</p><p><strong>Results: </strong>In the systematic review, six studies were included, of which four underwent meta-analysis. Among these, three trials encompassing 413 participants showed that CRT was associated with improved cognitive flexibility compared to control at the end of treatment (MD = -0.21, 95% CI [-0.44, 0.02], P=0.81, I² = 0%). In two trials with 143 patients, those who received CRT showed similar effects on the severity of AN symptoms compared to the control group in the self-reporting questionnaires: EDE-Q (MD = -0.25, 95% CI [-0.76, 0.27], P=0.77, I² = 0%) and EDEQOL (MD = -0.19, 95% CI [-0.41, 0.03], P=0.84, I² = 0%).</p><p><strong>Conclusion: </strong>CRT did not show a statistically significant difference compared to the control group in improving abstract thinking skills and quality of life in individuals with AN. That indicates that CRT's efficacy remains inconclusive. Further research with larger, more diverse samples is needed to determine its long-term effects and potential benefits.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier CRD42023411784.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massed treatment of posttraumatic stress disorder, traumatic brain injury, and co-occurring conditions: the Home Base intensive outpatient program for military veterans and service members.","authors":"Laura K Harward, René M Lento, Andrew Teer, Stephanie Samph, Megan E Parmenter, Joseph Bonvie, Charlotte Magee, Lauren Brenner, Kaitlin Picard, Wesley Sanders, William Joseph Tinney, Cyrielle Andrew, Jessica Covitz, Katrina Echevarria, Ryan Vanderweit, Nicolette S Maggiolo, Kaloyan S Tanev","doi":"10.3389/fpsyt.2024.1387186","DOIUrl":"10.3389/fpsyt.2024.1387186","url":null,"abstract":"<p><p>The two-week Home Base Intensive Clinical Program (ICP) provides treatment to veterans and active duty service members suffering from primary diagnoses of posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), anxiety, or depression. First launched in 2015, this paper provides a programmatic update, including new treatment components implemented since inception, and examines outcomes for all participants who entered the program from September 2015 to July 2024 (<i>n</i> = 2561). The Home Base ICP provides a massed care approach through daily individual Prolonged Exposure, Cognitive Processing Therapy, Unified Protocol, or cognitive rehabilitation, along with groups targeting coping skills. Participants entering the program are provided with core group programming, as well as individualized therapy sessions tailored to their unique needs and symptom presentation. Supplemental dual recovery support is also available for all participants with co-occurring substance use or behavioral addiction concerns. Participants' support people receive education, support, and case management services. Participants have a multidisciplinary team comprising therapists, psychopharmacology providers, case managers, nurses, and wellness providers. Results demonstrate that program participants exhibited statistically significant reductions in PTSD symptoms (Cohen's <i>d</i> = 0.80), depression (<i>d</i> = 0.68), post-concussion symptoms (<i>d</i> = 0.71), and increased satisfaction in social roles <i>(d</i> = -0.65). Completion rate was 94.60% (<i>n</i> = 2422), suggesting that the Home Base ICP is a well-received and effective model of care for veterans and service members.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and associated factors among patients with type 2 diabetic mellitus in Ethiopia: a cross sectional study.","authors":"Amanuel Dukato, Abera Beyamo, Aklilu Habte Hailegebireal, Wegayehu Zeneb Teklehaimanot, Abatwoy Ayfokru, Metages Alemnew, Daniel Birhanu Abate, Worku Abemie, Bethlehem Taye Mengistu, Yihenew Ayehu Dessie, Leweyehu Alemaw Mengstie, Bekahegn Girma","doi":"10.3389/fpsyt.2024.1454087","DOIUrl":"10.3389/fpsyt.2024.1454087","url":null,"abstract":"<p><strong>Background: </strong>Depression is a significant public health concern in both developed and developing countries. The burden of depression is particularly high among patients with chronic illnesses in developing countries, creating a dual challenge for both patients and the community. However, depression goes undiagnosed in 50%-75% of patients with chronic conditions such as diabetes mellitus. Additionally, there is limited information about the prevalence of depression among diabetic patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among type 2 diabetic patients in Ethiopia.</p><p><strong>Method: </strong>An institution-based cross-sectional study was conducted on 376 randomly selected type 2 diabetic patients. Data were collected through face-to-face interviews and from patients' follow-up records. The data were entered into EpiData version 4.6 and analyzed using STATA 14. Bivariable and multivariate logistic regression analyses were employed to identify associated factors. Variables with a p-value of less than 0.25 in the bivariable analysis were selected for multivariate logistic regression. Model fitness was assessed using Hosmer-Lemeshow's test, and associations were reported using adjusted odds ratios with 95% confidence intervals.</p><p><strong>Results: </strong>In this study, the prevalence of depression among type 2 diabetic patients was found to be 69.72% (95% CI: 64.75, 74.27). Three factors were significantly associated with depression in these patients: the duration of diabetes mellitus since diagnosis [AOR: 1.17; 95% CI (1.02, 1.34)], glycaemic control [AOR: 1.8; 95% CI (1.09, 3.01)] and cigarette smoking [AOR: 2.18; 95% CI (1.07, 4.46)].</p><p><strong>Conclusion: </strong>The prevalence of depression among type 2 diabetic patients was high. The Federal Ministry of Health, stakeholders, and the Ethiopian Diabetes Association should collaborate to reduce this burden. Mental health assessment and treatment should be integrated into chronic care follow-up services. Additionally, healthcare providers should closely monitor and counsel patients who smoke and those with poor glycemic control.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual management in transgender and gender diverse individuals: psychiatric and psychosocial considerations.","authors":"Arslaan Arshed, Sharon Madanes, Stephanie Pottinger, Marra G Ackerman, Allison B Deutch","doi":"10.3389/fpsyt.2024.1422333","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1422333","url":null,"abstract":"<p><p>Transgender and gender-diverse (TGD) menstruators are individuals assigned female at birth (AFAB)*, who retain the capacity to menstruate and have a gender identity that differs from their natal sex. Reports indicate up to 1.6 million individuals in the US identify as TGD. Until recently, the mainstream menstrual discourse has failed to capture the experience of transmenstruators. However, a better understanding of the menstrual experiences of TGD-AFAB will allow for more individualized patient-centered care. In this review, we provide the relevant data necessary to inform the psychiatric management of menstruation in TGD-AFAB individuals, including experiences of menstruation, preferences for menstrual management, and the impact on mental health. Our review indicates that menstrual care in TGD patients must be tailored to the individual; clinicians should remain open-minded to the unique experience of transmenstruators; gender-affirming menstrual care is necessary to reduce psychological burden. It should not be assumed that TGD-AFAB menstruators are utilizing appropriate contraceptive methods and should receive contraceptive and fertility preservation counseling. We highlight the importance of having these conversations early in the reproductive arch, even before puberty onset. Keeping in mind the gender minority stress model, in the upcoming sections, we discuss the limited body of literature on mood disorders in TGD-AFAB individuals who menstruate, undergo menstrual suppression, or continue to ovulate. The psychological impact of hormonal therapies is also reviewed.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current perspectives and trends in acupuncture for sleep disorders: a bibliometric analysis.","authors":"Yi Huang, Xihan Ying, Jieqi Zhang, Rong Hu, Yi Chen, Lei Wu, Bowen Chen, Kai Zhang, Kelin He, Ruijie Ma","doi":"10.3389/fpsyt.2024.1338455","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1338455","url":null,"abstract":"<p><strong>Background: </strong>Limitations of conventional treatment methods for sleep disorders have driven the use and development of complementary and alternative therapies such as acupuncture. However, despite the surge in related studies, there is still a lack of visual analysis and detailed elaboration regarding the current status, international collaborations, and research hotspots of acupuncture for sleep disorders.</p><p><strong>Methods: </strong>We conducted a bibliometric analysis of publications on acupuncture for sleep disorders using the Web of Science Core Collection database from 2004 to 2023. We utilized the R package \"bibliometrix\" to count publications and citations, VOSviewer to create an inter-institutional referencing network, and CiteSpace to identify references and keywords with the highest citation bursts. Additionally, we employed a bibliometric online analysis platform designed for analyzing national partnerships.</p><p><strong>Results: </strong>A total of 432 pertinent papers were retrieved, with China being the most prolific contributor, accounting for 61.6% of the publications, followed by the United States and South Korea. Despite China's high output, its average article citation rate and proportion of international collaborations were notably lower than those of the United States. Key research institutions such as the University of Hong Kong, Shanghai University of Traditional Chinese Medicine, Memorial Sloan Kettering Cancer Center, and Guangzhou University of Chinese Medicine have played significant roles in this field. Among authors, Ka-Fai Chung from the University of Hong Kong stood out as the most productive. In terms of journals, MEDICINE was the most active, while SLEEP was considered the most authoritative. The clinical effects of acupuncture for insomnia have garnered significant attention in recent years, with electroacupuncture emerging as the prevailing technique for addressing sleep disorders.</p><p><strong>Conclusion: </strong>This bibliometric study effectively outlines the basic framework of knowledge surrounding acupuncture for sleep disorders over the past two decades, covering publications, countries, institutions, authors, and sources. It highlights promising clinical effects and underlying mechanisms of acupuncture, particularly for secondary insomnia and specific sleep disorders like restless legs syndrome. Moving forward, the focus and challenge for future research lie in the development of standardized study protocols and harmonization of efficacy assessment metrics.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interconnected mental health symptoms: network analysis of depression, anxiety, stress, and burnout among psychiatric nurses in the context of the COVID-19 pandemic.","authors":"Rui Tao, Song Wang, Qingfang Lu, Yunxiao Liu, Lei Xia, Daming Mo, Feng Geng, Tingfang Liu, Yuanli Liu, Feng Jiang, Huan-Zhong Liu, Yi-Lang Tang","doi":"10.3389/fpsyt.2024.1485726","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1485726","url":null,"abstract":"<p><strong>Background: </strong>Mental health symptoms such as anxiety, depression, stress, and burnout are common among healthcare workers. However, the interconnections among them remain under-explored. This study aimed to address the interrelationships among these symptoms in psychiatric nurses.</p><p><strong>Methods: </strong>We conducted a nationwide survey in the early stage of the COVID-19 pandemic (January to March 2021) to investigate the interconnectedness of depression, anxiety, stress, and burnout among psychiatric nurses. Using network analysis, we identified central symptoms, important bridge symptoms, and the correlations among these central symptoms.</p><p><strong>Results: </strong>Of the 9,224 psychiatric nurses (79.2% female) included in the statistical analyses, 27.6% reported clinically significant depression, 31.2% anxiety, 14.5% stress, and 23.8% burnout. Network analysis revealed that stress had the highest expected influence (EI) value (0.920) and the highest strength among all nodes. The node for depression scored the highest in both closeness and betweenness. Emotional exhaustion (EE) had the highest bridge expected influence (BEI) of 0.340, with the strongest intergroup association between EE and depression. No significant differences were found in gender or frontline work experience (all p > 0.05).</p><p><strong>Conclusions: </strong>Burnout, depression, anxiety, and stress are relatively common among psychiatric nurses in the context of the COVID-19 pandemic. While anxiety was the most prevalent, stress emerged as the core symptom, and depression as an important bridging node. Interventions targeting the core symptoms and bridging nodes may improve the mental health of psychiatric nurses.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dutch practice of euthanasia and assisted suicide in patients suffering from psychiatric disorders: a qualitative case review study.","authors":"Fenne Bosma, Kelly Romana Mink, Johannes Jozef Marten van Delden, Agnes van der Heide, Suzanne van de Vathorst, Ghislaine Jose Madeleine Wilhelmien van Thiel","doi":"10.3389/fpsyt.2024.1452835","DOIUrl":"https://doi.org/10.3389/fpsyt.2024.1452835","url":null,"abstract":"<p><strong>Importance: </strong>Euthanasia or assisted suicide (EAS) in patients suffering from a psychiatric disorder (PD) is a controversial topic worldwide. In the Netherlands, this practice is regulated by law. All cases of EAS have to be reported and are assessed by the Regional Euthanasia Review Committees (RTEs), who publish a selection of all cases on their website.</p><p><strong>Objective: </strong>To provide insight into the Dutch practice of EAS in patients suffering from a psychiatric disorder.</p><p><strong>Design setting and participants: </strong>We performed a retrospective case review study in which all published cases of EAS in patients suffering from a PD between 2017 and 2022 were analyzed.</p><p><strong>Interventions or exposures: </strong>Not applicable.</p><p><strong>Main outcomes and measures: </strong>Characteristics of patients who died by EAS because of suffering from a PD, characteristics of the reporting physician and consultant(s) and the RTEs assessment of published cases.</p><p><strong>Results: </strong>Of the 72 cases studied, the majority of patients were female (n=48, 67%), suffered from 3 or more conditions (n=38, 53%) and died by euthanasia instead of assistance in suicide (n=56, 78%). In 63% of cases (n=45), the life termination was performed by a physician from the Euthanasia Expertise center (EE). The RTEs' judgement that the case did not meet the due care criteria (n=11) was in all cases related to issues regarding the (advice of the) independent physician or psychiatric expert.</p><p><strong>Conclusion and relevance: </strong>This qualitative study shows that the RTEs attach great importance to a careful evaluation procedure of physicians handling EAS requests and to the physician demonstrating ability to reflect on his views, especially when the independent consultant evaluates the case different than the physician. Training for physicians and more transparency in the assessment of EAS requests in patients with a PD may lower the threshold for physicians to handle requests of these patients themselves.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}