Anxiety Disorders

Background: Comorbidity of dependence on single and multiple drugs with psychiatric syndromes was examined in national samples from the National Household Survey on Drug Abuse (NHSDA). Methods: Subjects are adults from the l994, l995 and l996 NHSDA surveys. Proxy measures of drug dependence in the last year were constructed from five dependence symptoms that approximated DSM-IV criteria. Measures of patterns of concurrent dependence on cigarettes, alcohol and illicit drugs were constructed. Fallible indicators of a major depressive episode and any anxiety disorder (generalized anxiety disorder, agoraphobia and panic attack) were based on scales measuring symptoms during the last year. Comorbidity was estimated by adjusted odds ratios. Results: Probable drug dependent individuals have higher rates of psychiatric syndromes. Rates of psychiatric syndromes were similar for those uniquely dependent on alcohol, cigarettes or illicit drugs (adjusted odds ratios : 2.0). Rates almost doubled for those dependent on both an illicit and a licit drug. Conclusions: Individuals uniquely dependent on a single drug class experience similar rates of psychiatric morbidity. All those dependent on illicit drugs experience higher rates of psychiatric syndromes. This reflects the additive association of dependence on legal and illegal drugs with psychiatric disorders and the increased rates of dependence on a legal drug among those dependent on an illicit drug. Individuals with multiple dependencies on legal and illegal drugs have the highest need for mental health services.

This study examined gender differences in posttraumatic stress disorder (PTSD) symptoms and symptom factors in the total U.S. active duty force. Data were drawn from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel including 17,939 men and 6751 women from all services. The results indicated that women expressed more distress than men across almost all the symptoms on the PTSD Checklist except for hypervigilance. Women also scored significantly higher on all four factors examined: Re-experiencing, Avoidance, Emotionally Numb, Hyperarousal. More women than men were distressed by combat experiences that involved some type of violence, such as being wounded, witnessing or engaging in acts of cruelty, engaging in hand-to-hand combat, and, to a lesser extent, handling dead bodies. Men who had been sexually abused had a greater number of symptoms and were consistently more distressed than women on individual symptoms and symptom factors.

The aim of this study is to determine functioning of adults with Autism Spectrum Disorders (ASDs) diagnosed in childhood and also depression and burnout levels among their parents. 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported “good” or “very good” outcome. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/ hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD.

This paper investigates the phenomenological dimensions of aggressive emotions and dysphoric states specifically within schizophrenia, emphasizing distinctive psychopathological alterations of emotional experience. From a phenomenological standpoint, emotions are embodied, intentional, spatially structured, and relational experiences. Schizophrenia significantly disrupts these emotional structures, resulting in fragmented, reactive aggression intertwined with dysphoric states such as irritability, anxiety, and pervasive emotional discomfort. By systematically reviewing phenomenological, clinical, and psychiatric literature, we highlight critical disruptions in emotional intentionality, embodiment, and normative context. Such understanding enhances clinical precision in diagnosis, informs therapeutic interventions, and provides ethical and legal clarity on issues of autonomy and responsibility. We propose that phenomenological insights into aggression and dysphoria in schizophrenia are crucial for developing targeted, ethically sound psychiatric interventions and legal assessments.

Objective To compare the cost effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. Design Prospective, controlled trial with randomised and patient preference allocation arms. Setting General practices in London and greater Manchester. Participants 464 of 627 patients presenting with depression or mixed anxiety and depression were suitable for inclusion. Interventions Usual general practitioner care or up to 12 sessions of non-directive counselling or cognitive-behaviour therapy provided by therapists. Main outcome measures Beck depression inventory scores, EuroQol measure of health related quality of life, direct treatment and non-treatment costs, and cost of lost production. Results 197 patients were randomly assigned to treatment, 137 chose their treatment, and 130 were randomised only between the two psychological therapies. At four months, both non-directive counselling and cognitive-behaviour therapy reduced depressive symptoms to a significantly greater extent than usual general practitioner care. There was no significant difference in outcome between treatments at 12 months. There were no significant differences in direct costs, production losses, or societal costs between the three treatments at either four or 12 months. Sensitivity analyses did not suggest that the results depended on particular assumptions in the statistical analysis. Conclusions Within the constraints of available power, the data suggest that both brief psychological therapies may be significantly more cost effective than usual care in the short term, as benefit was gained with no significant difference in cost. There are no significant differences between treatments in either outcomes or costs at 12 months.

We assessed comorbid associations of 12-month DSM-IV mood/any anxiety disorders with chronic physical conditions within the São Paulo (SP) Megacity Mental Health cross-sectional survey of 5037 participants and explored whether strength of comorbid associations were modified when controlling for demographics. Chi-square tests and logistic regressions were used to examine comorbid associations of DSM-IV mood/anxiety disorders as measured by the WHO Composite International Diagnostic Interview (CIDI 3.0), and self-reported chronic physical conditions among adults from the SP Megacity Mental Health Survey. Among those with any mood or anxiety disorder, chronic pain disorder was the most common physical condition (48.9% and 44.9%, respectively). Significant unadjusted odds ratios (OR) of comorbidity were found between diagnosis of two or more physical conditions and any mood disorders (3.08, 95% CI: 2.27-4.17), and any anxiety disorders (2.49, 95% CI: 1.95-3.17). Comorbidities remained s...

The study aims to investigate the adaptation of Turkish version of Oxford COVID-19 Confidence and Complacency Scale that determine the COVID-19 vaccine trust and compliance, and the psychometric properties. The sample of the study conducted in methodological type included 554 individuals. The data were collected "Socio-Demographic Information Form" and "Oxford COVID-19 Vaccine Confidence & Complacency Scale". Collaborative translation and back translation techniques were used for Turkish language adaptation of the scale, and the expert opinion method was used for content validity. For reliability calculation, Cronbach Alpha values and split-half testing consistency were used, and for construct validity, Explanatory Factor Analysis and Confirmatory Factor Analysis were performed. Results: As a result of EFA and CFA, the scale consisted of onedimensions and 12 items in Turkish culture. The factor loads of the items in the scale vary between .37 and .73, respectively. The Cronbach Alpha values of the scale are .84. The emerging structure can explain 38.7% of confidence and complacency for the COVID-19 vaccine. Conclusion: Based on the results, it was concluded that the Oxford COVID-19 Vaccine Confidence & Complacency Scale is a valid and reliable measurement tool for the Turkish sample. It is recommended that the scale be used in determining the attitudes of the society towards COVID-19 vaccines in our country.

Recently the UK Government announced an unprecedented, large-scale initiative for Improving Access to Psychological Therapies (IAPT) for depression and anxiety disorders. Prior to this development, the Department of Health established two pilot projects that aimed to collect valuable information to inform the national roll-out. Doncaster and Newham received additional funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles, when appropriate. This article reports an evaluation of the new services (termed 'demonstration sites') during their first thirteen months of operation. A session-by-session outcome monitoring system achieved unusually high levels of pre to post-treatment data completeness. Large numbers of patients were treated, with low-intensity interventions (such as guided self-help) being particularly helpful for achieving high throughput. Clinical outcomes were broadly in line with expectation. 55-56% of patients who had attended at least twice (including the assessment interview) were classified as recovered when they left the services and 5% had improved their employment status. Treatment gains were largely maintained at 10 month follow-up. Opening the services to self-referral appeared to facilitate access for some groups that tend to be underrepresented in general practice referrals. Outcomes were comparable for the different ethnic groups who access the services. Issues for the further development of IAPT are discussed.

Psychiatric surveys conducted in prison populations find high prevalence rates, but diagnoses may be difficult in this particular context. None of these surveys have been conducted in France. 800 incarcerated male were sampled at random. Each prisoner was interviewed by a group of 2 clinicians, at least one of them being a senior psychiatrist. One of the clinicians used a structured clinical interview which generated DSM IV diagnosis (MINI plus); the second completed the procedure with an open clinical interview. Prevalence rates for a diagnosis given independently by both clinicians and for a consensual diagnosis were respectively: 3.8% (6.2%) for schizophrenia, 17.9% (24%) for major depressive disorder, 12.0% (17.7%) for generalized anxiety and 10.8% (14.6%) for drug dependence. Psychiatric diagnosis can be difficult to interpret in prison, especially using traditional standardized interviews. The approach proposed here, with good reliability and closer to a day-to-day clinical pr...

Celem badań była analiza psychometrycznych właściwości polskiej wersji Oldenburskiego Kwestionariusza Wypalenia Zawodowego (Oldenburg Burnout Inventory -OLBI) -jego struktury czynnikowej, rzetelności, trafności teoretycznej i normalizacji. Kwestionariusz mierzy 2 kluczowe komponenty wypalenia zawodowego -wyczerpanie oraz zdystansowanie wobec pracy. Materiał i metody: Badania przeprowadzono w 3 niezależnych próbach -liczących 1804 osoby, 366 osób i 46 osób -pracujących w zawodach służb społecznych i zawodach usługowych. Budowę czynnikową narzędzia sprawdzono za pomocą eksploracyjnej analizy czynnikowej. Jego rzetelność obliczono 2 metodami -przy użyciu miary α Cronbacha (zgodność wewnętrzna) i testu-retestu (stabilność czasowa) -z 6-tygodniową przerwą w pomiarze. Trafność teoretyczną kwestionariusza oszacowano za pomocą analizy korelacji, w której zmiennymi kryterialnymi były stres spostrzegany i zaangażowanie w pracy. Normy obliczono w skali staninowej. Wyniki: Analiza czynnikowa wykazała 2-czynnikową strukturę kwestionariusza, która zawierała pytania sformułowane pozytywnie i negatywnie. To zadecydowało o przeprowadzeniu oddzielnych analiz dla 2 podskal teoretycznych -wyczerpania i zdystansowania wobec pracy. Podskale okazały się spójne i obejmowały po 2 czynniki stwierdzeń sformułowanych pozytywnie i negatywnie. Wyczerpanie i zdystansowanie wobec pracy były ze sobą umiarkowanie współzależne. Rzetelność narzędzia była satysfakcjonująca. Zgodnie z przewidywaniem wyczerpanie i zdystansowanie wobec pracy dodatnio wiązały się ze stresem spostrzeganym i ujemnie z zaangażowaniem w pracy oraz z 3 jego komponentami -wigorem, oddaniem się pracy i pochłonięciem przez pracę. Wnioski: Mimo pewnych ograniczeń polska wersja Oldenburskiego Kwestionariusz Wypalenia Zawodowego jest narzędziem o dobrych właściwościach psychometrycznych, które może być polecane jako alternatywna metoda pomiaru wypalenia zawodowego.

The contributions of genetic and both positive and negative environmental factors were tested in the prediction of alcohol abuse/dependence among 300 adult adoptees. No direct effects for either genetic or environmental factors were significant in the prediction of adoptee alcohol abuse/dependence. However, among women, early-life family conflict and psychopathology in the adoptive family interacted with a biological background of alcoholism. Among women with at B OTH GENETIC and environmental factors have been implicated in the etiology of alcohol abuse. The current investigation was designed to investigate the individual and interactive contributions of biological predisposition (i.e., alcoholic biological parent) and the environment in the etiology of alcoholism. All participants were adopted away from their biological homes soon after birth, thus allowing separation of genetic and environmental factors. We assessed not only adverse circumstances that might interact with biological predisposition to increase the probability of alcohol abuse (e.g., substance abuse or psychopathology in adoptive family member, conflict among adoptive family members), we also assessed positive factors in the environment that might decrease the probability that the biological predisposition would be expressed (cohesive adoptive family environment). Although lifetime prevalence rates for alcohol dependence and/or abuse remain significantly lower among women (4.2% to 4.8%) than among men (19.1% to 28.9%),' rates of alcoholism among women have been increasing. Much of the research on alcohol abuse has focused exclusively on men. Thus, there is a need for research on risk factors for alcohol abuse and dependence among women. This need is especially pressing, since there is some evidence that different factors are most influential in the etiology of alcoholism for men and women.2-3 Results have been inconsistent in studies that have contrasted concordance rates for monozygotic versus dizygotic twins to estimate the least one alcoholic biological parent, conflict or psychopathology in the adoptive family increased the probability of alcohol abuse and/or dependence. Among men, no significant interactions were found between a biological background of alcoholism and environmental variables. Results suggest a pattern of geneenvironment interaction among women.

This paper explores the multifaceted problems associated with anger in humans, examining its psychological, physiological, and social impacts. Through a comprehensive literature review, we identify the prevalence of anger-related issues, their correlation with various mental health disorders, and the physical health consequences of chronic anger. Additionally, we discuss effective anger management strategies and interventions based on current research. Our findings underscore the importance of addressing anger not only for individual well-being but also for societal health.

Essential oils are bioactive ingredients extracted from aromatic plants by distillation. The terpene derivatives present or extracted from these essential oils are considered in a double way, on the one hand as a support for pharmacological activities demonstrated from essential oils, on the other hand as natural biomolecules with high therapeutic potential. These are therefore natural substances or molecules, which have an important reservoir for preventing or treating many organic and functional disorders. We looked at one of these terpene derivatives, linalool, to identify and analyze the bibliographic data available and establish a balance sheet on the therapeutic, nutritional, cosmetic and environmental interests and benefit of this natural biomolecule.

Background The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention. Method A pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants with coronary heart disease risk (CHD, 1559, 72%), mild to moderate depression, anxiety or stress (79, 4%) or both (522, 24%) randomised to receive (1) NERS or (2) normal care and brief written information. Outcome measures at 12 months included the 7-day physical activity recall, the hospital anxiety and depression scale. Results Ordinal regression identified increased physical activity among those randomised to NERS compared with those receiving normal care in all participants (OR 1.19, 95% CI 0.99 to 1.43), and among those referred for CHD only (OR 1.29, 95% CI 1.04 to 1.60). For those referred for mental health reason alone, or in combination with CHD, there were significantly lower levels of anxiety (OR À1.56, 95% CI À2.75 to À0.38) and depression (OR À1.39, 95% CI À2.60 to À0.18), but no effect on physical activity. The base-case incremental cost-effectiveness ratio was £12 111 per quality adjusted life year, falling to £9741 if participants were to contribute £2 per session. Conclusions NERS was effective in increasing physical activity among those referred for CHD risk only. Among mental health referrals, NERS did not influence physical activity but was associated with reduced anxiety and depression. Effects were dependent on adherence. NERS is likely to be cost effective with respect to prevailing payer thresholds. Trial registration Current Controlled Trials ISRCTN47680448.

Sumnzaq.-As breast reconstruction is an important adjunct after mastectomy to regain physical integrity and also to improve affect, the present aim was to evaluate patients' subjective perceptions of body image during the whole breast reconstruction period and to assess the importance of their psychological reaction in terms of negative affectivity. Participants were 62 women, 43 women (A4 age=46.4, SD=9.8) who had had mastectomies and 19 healthy women ( M age=39.9, .YD= 13.99). Patients were admitted for surgery at the Hospital S. Orsola in Bologna. Healthy subjects were relatives of the wornen and students, all with no history of breast pathology. The Body Satisfaction Scale and thc State Anxiety Inventory-Y were administered to the two groups before, post, and 6 mo. after surgery. Analysis of scores indicated that during the period of the study, the women with mastectomies reported higher anxiety and also greater dissatisfaction with their body image than the healthy group, even when the breast had been reconstructed. This unexpected finding suggests patients' unrealistic expectations of the breast reconstruction and the surgical outcome.

The study investigated the relationship between recognition of emotional facial expressions and trait anxiety. A nonclinical sample of 19 participants with high-trait anxiety was selected, using the trait version of the State-Trait Anxiety Inventory, and compared with a sample of 20 participants with low-trait anxiety on a facial expression recognition task. Visual stimuli were 42 faces, representing seven emotional expressions: anger, sadness, happiness, fear, surprise, disgust and neutral. Participants had to identify the emotion portrayed by each face. Results showed that participants with high-trait anxiety recognized fear faces significantly better while the two groups did not differ in recognition of other facial expressions.

Posttraumatic stress, depression, and anxiety symptoms are common outcomes following earthquakes, and may persist for months and years. This study systematically examined the impact of neighborhood damage exposure and average household income on psychological distress and functioning in 600 residents of Christchurch, New Zealand, 4-6 months after the fatal February, 2011 earthquake. Participants were from highly affected and relatively unaffected suburbs in low, medium and high average household income areas. The assessment battery included the Acute Stress Disorder Scale, the depression module of the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7), along with single item measures of substance use, earthquake damage and impact, and disruptions in daily life and relationship functioning. Controlling for age, gender and social isolation, participants from low income areas were more likely to meet diagnostic cut-offs for depression and anxiety, and have more severe anxiety symptoms. Higher probability of acute stress, depression and anxiety diagnoses was evident in affected versus unaffected areas, and those in affected areas had more severe acute stress, depression and anxiety symptoms. An interaction between income and earthquake effect was found for depression, with those from the low and medium income affected suburbs more depressed. Those from low income areas were more likely post-earthquake to start psychiatric medication and increase smoking. There was a uniform increase in alcohol use across participants. Those from the low income affected suburb had greater general and relationship disruption post-quake. Average household income and damage exposure make unique contributions to earthquakerelated distress and dysfunction.

There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities, women were more likely to have a diagnosis of mood disorder and sexual abuse history; men were more likely to have a substance abuse diagnosis, legal issues, and past destructive behavior. Gender difference patterns found for individuals with intellectual disabilities were similar to those of persons without intellectual disabilities, with the exception of eating disorder and psychotic disorder diagnoses. Gender issues should receive greater attention in intellectual disabilities inpatient care.

Aims: Most research on return-to-work (RTW) has focused on musculoskeletal disorders. To study RTW in employees sick-listed with common mental disorders (CMD), e.g., stress, depression, and anxiety, the National Research Centre for the Working Environment initiated a study on ‘‘Common Mental Disorders, Return-to-work, and Long-term Sickness Absence’’ (CORSA). The aim of the study is (1) to identify predictors of RTW from the environmental, the individual, and the health-related domain and (2) to explore the RTW process based on study participants’ experiences. The purpose of this paper is to present the study design and the characteristics of the participants, including analyses on non-response and the prevalence of major depression. Methods: CORSA is a mixed-method follow-up study encompassing quantitative and qualitative analyses in a cohort of employees sick-listed with CMD. Participants were all employees who suffered from CMD and whose applications for sickness absence benefits...

It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitof...

Objective: To investigate the prosodic aspects of therapists' empathic communication. Method: 70 audio-recorded sessions of cognitive psychotherapy and psychoanalysis were analysed using conversation analysis. Results: Two interactional trajectories where the therapists either validated the clients' emotions or challenged them were identified. The difference between these trajectories was not evident in the lexical composition of the therapists' formulations that initiated the trajectory. However, the prosodic features of the formulation already anticipated the direction of the trajectory. The formulations leading up to the validating trajectory were characterized by prosodic continuity and formulations leading up to the challenging trajectory by prosodic disjuncture. The choice between continuous and disjunctive prosody was a key resource for therapists in the construction of formulations as either validating or challenging. The present article emphasizes the relational aspects of psychotherapy communication by considering the prosodic features of the therapist's talk in relation to the prosody of the client.

Aims: This study aimed to explore the lived experiences of test anxiety among pre-service teachers, considering its broader implications for Sustainable Development Goal (SDG) 4. It investigated the manifestations, determinants, and coping mechanisms associated with test anxiety in this population of future educators who undergo critical evaluations that shape their professional abilities.

We have demonstrated that the atypical antipsychotic drugs prevent cell death in PC12 cells induced by various cytotoxins and have protective effects on methamphetamine-induced neurotoxcity in rats. The present study was designed to examine the possible effects of chronic administration of quetiapine, an atypical antipsychotic drug, on the anxiety-like behavioural consequences of a neurotoxic regimen of dl-amphetamine. Rats were treated with quetiapine (10 mg/kg/day; i.p.) for 33 days. During days 15-19 of this period, the animals were given dl-amphetamine (20 mg/kg/day; s.c.) 1 h after the administration of quetiapine. The repeated administration of dl-amphetamine resulted in a decrease of tyrosine hydroxylase (TH) immunostaining in the caudate putamen, hyperthermia, and anxiety-like behavioural changes. The behavioural changes were indicated by a significant increase in the time spent in the light box in the light/dark box test, an increase in the ratios of ambulation distance inside the inner circle over the total ambulation distance and rearings inside the inner circle over the total rearings in the open field test, and an increase in the time spent in open arms in the elevated plus-maze test. Chronic administration of quetiapine significantly attenuated the dl-amphetamine-induced hyperthermia, and the anxiety-like behavioural changes in the light/dark box and in the open field tests. These results suggest that quetiapine can normalize the dl-amphetamine-induced anxiety-like behavioural changes, and might be helpful in the treatment for amphetamine-induced emotional changes.

The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population. Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations. Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population. As in the case with classi...

A double-blind, randomized, active placebo-controlled pilot study was conducted to examine safety and efficacy of lysergic acid diethylamide (LSD)-assisted psychotherapy in 12 patients with anxiety associated with lifethreatening diseases. Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart. The participants received either 200 Kg of LSD (n = 8) or 20 Kg of LSD with an open-label crossover to 200 Kg of LSD after the initial blinded treatment was unmasked (n = 4). At the 2-month follow-up, positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety ( p = 0.033) with an effect size of 1.1, and state anxiety was significantly reduced ( p = 0.021) with an effect size of 1.2, with no acute or chronic adverse effects persisting beyond 1 day after treatment or treatment-related serious adverse events. STAI reductions were sustained for 12 months. These results indicate that when administered safely in a methodologically rigorous medically supervised psychotherapeutic setting, LSD can reduce anxiety, suggesting that larger controlled studies are warranted.

This condition is common in chronic conditions like cancer, cardiovascular, metabolic, inflammatory, and neurological problems, that ultimately results in suicide according to Korkmaz et al. 3 There is a significant prevalence of (80%) depression among the chronic medical conditions reported by Belsiyal et al. 4 Development of depression and suicide in these chronic conditions can be of various reasons like hereditary similarities, convergence of biochemical pathways, social factors, health-related behaviors, and psychological factors. 3 Gold et al also reported medications used as a ABSTRACT Background: Depression and suicide occur as a comorbidity in chronic medical illness. The poor knowledge and attitude of staff nurses in general practice greatly impacts the identification and treatment of these patients. Training nurses on this will reduce the mortality related to this. The current study identified the effectiveness of a structured educational program in improving the knowledge and attitude of nursing personnel. Method: A true experimental study was performed on 120 staff nurses working in different medical units of a hospital in Saudi Arabia. The samples were randomly selected and allotted 60 in experimental and 60 in control group by randomization. Pretest posttest control group design was adopted, and a video assisted structured planned training program was provided for the interventional group and the mean difference was compared. Results: The knowledge of nurses on caring for patients with depression increased from preprogram to post program. (M =3.90 to 5.17 (t= 6.469, p<.001 and for suicide, from (M =2.13 to 2.53. The attitude towards depression increased from 24.60 to 27.03 and for suicide from (M =20.83, SD = 3.75) to (M =23.37, SD = 3.85); t =5.443, p <0.001. The mean post-test knowledge was higher in experimental group for all measures except for attitude on depression with a slight increase in control group. Conclusion: Our findings suggest PTP was effective in developing knowledge and attitude for nurses on managing depression and suicide in chronic medical areas.

Sažetak U radu je ispitana percepcija važnosti i zadovoljstvo s različitim aspektima posla kod visokoškolskih nastavnika iz privatne i javne ustanove. Primijenjene su dvije mjere zadovoljstva poslom, jedna temeljena na globalnom, druga na analitičkom pristupu. Na prvom upitniku nastavnici ukupno najvažnijim procjenjuju zanimljivost posla, s kojom su i najzadovoljniji. Najmanje važnim vide mogućnost odlučivanja, s čime su i najmanje zadovoljni. Na drugom upitniku, najveće zadovoljstvo iskazano je samim poslom, a najmanje plaćom. Među nastavnicima dvije ustanove generalno je više sličnosti nego razlika, no na prvom upitniku pronađene su razlike u procjeni važnosti radnih uvjeta (važnije u javnom sektoru) i u procjeni zadovoljstva s kolegama (zadovoljniji u privatnom sektoru). Nalazi potvrđuju hipoteze o važnosti i zadovoljstvu intrinzičnih faktora zadovoljstva poslom kod visokoškolskih nastavnika. Ključne riječi: aspekti zadovoljstva poslom, percepcija važnosti posla, privatni i javni...

Background: Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents. Methods: A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale. Results: The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001). Conclusions: This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.

Background: Dissociation is understood as one of coping mechanism to deal with intense stressors. Individuals vary widely in their subjective response to a similar stressful event depending on number of factors including their family and social support system. So, authors tried to study the expressed emotion in patients of dissociative disorder along with other socio-demographic factors and its relation with perceived stress.Methods: This cross-sectional descriptive study was done on 100 patients with primary diagnosis of dissociative disorder. Hamilton depression rating scale (HAM-D) was used to assess comorbid Depressive symptoms and Hamilton anxiety rating scale (HAM-A) was used to asses comorbid anxiety symptoms. Perceived stress scale (PSS) was used to assess the perception of stress. Family emotional involvement and criticism scale (FEICS) was used to measure perceived criticism (PC) and intensity of emotional involvement (EI).Results: Mean perceived stress in this study was 2...

Background: Depression and suicide occur as a comorbidity in chronic medical illness. The poor knowledge and attitude of staff nurses in general practice greatly impacts the identification and treatment of these patients. Training nurses on this will reduce the mortality related to this. The current study identified the effectiveness of a structured educational program in improving the knowledge and attitude of nursing personnel.
Method: A true experimental study was performed on 120 staff nurses working in different medical units of a hospital in Saudi Arabia. The samples were randomly selected and allotted 60 in experimental and 60 in control group by randomization. Pretest posttest control group design was adopted, and a video assisted structured planned training program was provided for the interventional group and the mean difference was compared.
Results: The knowledge of nurses on caring for patients with depression increased from preprogram to post program. (M =3.90 to 5.17 (t= 6.469, p<.001 and for suicide, from (M =2.13 to 2.53. The attitude towards depression increased from 24.60 to 27.03 and for suicide from (M =20.83, SD = 3.75) to (M =23.37, SD = 3.85); t =5.443, p <0.001. The mean post-test knowledge was higher in experimental group for all measures except for attitude on depression with a slight increase in control group. 
Conclusion: Our findings suggest PTP was effective in developing knowledge and attitude for nurses on managing depression and suicide in chronic medical areas.

The human hippocampal formation can be divided into a set of cytoarchitecturally and functionally distinct subregions, involved in different aspects of memory formation. Neuroanatomical disruptions within these subregions are associated with several debilitating brain disorders including Alzheimer&#39;s disease, major depression, schizophrenia, and bipolar disorder. Multi-center brain imaging consortia, such as the Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) consortium, are interested in studying disease effects on these subregions, and in the genetic factors that affect them. For large-scale studies, automated extraction and subsequent genomic association studies of these hippocampal subregion measures may provide additional insight. Here, we evaluated the test-retest reliability and transplatform reliability (1.5T versus 3T) of the subregion segmentation module in the FreeSurfer software package using three independent cohorts of healthy adults, one young (Quee...

Our Hungarian cross-sectional study highlights the crucial mediating role that adult attachment styles play in the relationship between early traumas and suicidal behaviour, shaping how individuals process and respond to traumatic experiences. Early traumas, such as abuse or neglect, often disrupt the development of secure attachment, leading to insecure styles in adulthood-such as anxious or avoidant attachment. These insecure attachment styles influence emotional regulation, interpersonal relationships, and coping mechanisms, thereby exacerbating feelings of isolation and despair. For instance, anxious attachment can intensify fear of abandonment and hypersensitivity to rejection, increasing emotional instability and suicidal ideation. Conversely, avoidant attachment may lead to emotional suppression and reluctance to seek support, amplifying feelings of hopelessness. Psychopathological symptoms resulting from early trauma-such as depression and PTSD-are often filtered through these attachment patterns, shaping how distress is experienced and managed. In our research, we analysed the role of adult attachment styles and early traumas in suicidal behaviour. We also examined the mediating effect of attachment style in the relationship between early traumas and suicidal behaviour. A total of 357 subjects between the ages of 18 and 85 (mean = 37.02, SD = 12.86) were included in the analysis; 33.6% were male and 66.4% female. The sample consisted of 146 individuals with a history of suicide, 154 clinical participants without a history of suicide, and 57 from a non-clinical population. The adult attachment scale (AAS) and the childhood trauma questionnaire (CTQ) were used as assessment tools. To model the relationships between variables, logistic regression, generalized linear models, and mediation analyses were conducted. All models were adjusted for basic demographic variables. Our results showed that the severity of emotional abuse (adjusted OR 1.064, p = 0.004), emotional neglect (adjusted OR 1.064, p = 0.007), and overall traumatization measured by the CTQ (adjusted OR 1.021, p = 0.006) significantly predicted a higher risk of suicidal behaviour. In contrast, higher levels of secure attachment style predicted a lower risk of suicide attempt (adjusted OR-0.091, p = 0.004). Additionally, secure attachment style significantly mediated part of the total effect of early traumatization severity on suicidal behaviour (indirect effect = 0.0032, p < 0.05; Pm = 16.5%). We also examined the relationship between early traumas and attachment style and found multiple significant associations. For avoidant attachment, significant associations were observed with the total traumatization score (B = 0.086, p < 0.001) and specific adversities, including emotional abuse, emotional neglect, and physical neglect (B = 0.244-0.319, all p < 0.001). Anxious-ambivalent attachment was associated with the total CTQ score (B = 0.088, p < 0.001), as well as emotional abuse (B = 0.298, p < 0.001), emotional neglect (B = 0.254, p < 0.001), physical abuse (B = 0.248, p < 0.001), and physical neglect (B = 0.261, p = 0.010). A lower level of secure attachment was linked to the overall traumatization score (B =-0.039, p = 0.004), as well as emotional abuse, emotional neglect, and sexual abuse (B =-0.101 to-0.163, all p < 0.05). By mediating the relationship between trauma and suicidal behaviour, adult attachment styles can either perpetuate maladaptive coping strategies or hinder recovery. Understanding this mediating role is crucial for developing interventions that address attachment insecurities while promoting resilience and emotional healing. Therapeutic approaches aimed at fostering secure attachment patterns can help mitigate the effects of early trauma and reduce the risk of suicidal behaviour. These findings underscore the importance of incorporating attachment-focused strategies into trauma-informed care.

The unified protocol for the transdiagnostic treatment of emotional disorders is a promising treatment approach that could be applicable to a broad range of mental disorders, including depressive, anxiety, trauma-related, and obsessive-compulsive disorders. However, no randomized controlled trial has been conducted to verify the efficacy of the unified protocol on the heterogeneous clinical population with depressive and anxiety disorders. The trial was designed as a single-center, assessor-blinded, randomized, 20-week, parallel-group superiority study in order to compare the efficacy of the combination of unified protocol and treatment-as-usual versus waiting-list with treatment-as-usual for patients with depressive and/or anxiety disorders. The primary outcome was depression at 21 weeks, assessed by the 17-item version of the GRID-Hamilton Rating Scale for Depression. Estimated minimum sample size was 27 participants in each group. We will also examine the treatment mechanisms, tr...

Background-Assessment of suicide plans is standard in acute psychiatric care, but there is a limited evidence base to guide this routine clinical practice. The purpose of this study was to investigate clinical correlates of suicide planning in depressed patients. Methods-151 patients with major depressive disorder and a lifetime history of suicide attempt were studied. Subjects received a comprehensive evaluation including structured diagnostic interview for Axis I and II disorders, current symptoms, impulsivity, and systematic assessment of suicide planning prior to the most recent suicide attempt. Results-Seriousness of suicide attempt planning correlated with lethality of suicidal acts. Comorbid anxiety disorder and anxiety correlated with less suicide planning. Specifically, this negative correlation was with comorbid panic disorder. Planning did not correlate with severity of depression or aggressive/impulsive traits. Limitations-Cross-sectional design, retrospective recall of suicide planning data, limited applicability to completed suicide or other psychiatric disorders. Conclusions-In major depression, comorbid panic disorder appears protective against more carefully planned, higher lethality suicide attempts. Surprisingly, severity of depression and aggressive impulsive traits do not predict planning or lethality of suicide attempts. We have previously reported that anxiety severity protects against the probability of a suicide attempt and now extend that observation to show there is protection against lethality of a suicide attempt. Treatment of anxiety without directly treating major depression may place patients at greater risk of suicidal behavior.

Objective -To provide an update on recent research on depression and anxiety in obstructive sleep apnea syndrome (OSAS). Methods -A review was carried out on reports drawn from MEDLINE and PSYCHLIT (January 1995-June 2006) and identified from their list of references. The selection criteria were met by 55 articles. Results -Sample sizes in the reviewed studies varied widely and consisted mainly of working age men. Depression and anxiety were mostly evaluated with commonly used mood scales; only a few studies provided a psychiatric diagnosis. Prevalence figures fluctuated considerably for both depression (7-63%) and anxiety (11-70%). The effect of the continuous positive airway pressure (CPAP) on mood was inconsistent. Conclusions -Variations in the prevalence of depression and anxiety are affected by patient characteristics, mood assessment methods, and overlap between mood alterations and OSAS-related symptoms. CPAP might improve mood alterations but more long-term follow-up studies are needed to verify the effectiveness.

Objective -To provide an update on recent research on depression and anxiety in obstructive sleep apnea syndrome (OSAS). Methods -A review was carried out on reports drawn from MEDLINE and PSYCHLIT (January 1995-June 2006) and identified from their list of references. The selection criteria were met by 55 articles. Results -Sample sizes in the reviewed studies varied widely and consisted mainly of working age men. Depression and anxiety were mostly evaluated with commonly used mood scales; only a few studies provided a psychiatric diagnosis. Prevalence figures fluctuated considerably for both depression (7-63%) and anxiety (11-70%). The effect of the continuous positive airway pressure (CPAP) on mood was inconsistent. Conclusions -Variations in the prevalence of depression and anxiety are affected by patient characteristics, mood assessment methods, and overlap between mood alterations and OSAS-related symptoms. CPAP might improve mood alterations but more long-term follow-up studies are needed to verify the effectiveness.

Background-Cognitive-behavioural therapy (CBT) has proven to be effective for anxietybased school refusal, but it is still unknown how CBT for school refusal works, or through which mechanisms. Aims-Innovative statistical approaches for analyzing small uncontrolled samples were used to investigate the role of self-efficacy in mediating CBT outcomes for anxiety-based school refusal. Method-Participants were 19 adolescents (12 to 17 years) who completed a manual-based cognitive-behavioural treatment. Primary outcomes (school attendance; school-related fear; anxiety) and secondary outcomes (depression; internalizing problems) were assessed at posttreatment and 2-month follow-up. Results-Post-treatment increases in school attendance and decreases in fear about attending school the next day were found to be mediated by self-efficacy. Mediating effects were not observed at 2-month follow-up. Conclusions-These findings provide partial support for the role of self-efficacy in mediating the outcome of CBT for school refusal. They contribute to a small body of literature suggesting that cognitive change enhances CBT outcomes for young people with internalizing problems. Regarding methodology, the product of coefficient test appears to be a valuable way to study mediation in outcome studies involving small samples.

Background-Cognitive-behavioural therapy (CBT) has proven to be effective for anxietybased school refusal, but it is still unknown how CBT for school refusal works, or through which mechanisms. Aims-Innovative statistical approaches for analyzing small uncontrolled samples were used to investigate the role of self-efficacy in mediating CBT outcomes for anxiety-based school refusal. Method-Participants were 19 adolescents (12 to 17 years) who completed a manual-based cognitive-behavioural treatment. Primary outcomes (school attendance; school-related fear; anxiety) and secondary outcomes (depression; internalizing problems) were assessed at posttreatment and 2-month follow-up. Results-Post-treatment increases in school attendance and decreases in fear about attending school the next day were found to be mediated by self-efficacy. Mediating effects were not observed at 2-month follow-up. Conclusions-These findings provide partial support for the role of self-efficacy in mediating the outcome of CBT for school refusal. They contribute to a small body of literature suggesting that cognitive change enhances CBT outcomes for young people with internalizing problems. Regarding methodology, the product of coefficient test appears to be a valuable way to study mediation in outcome studies involving small samples.

Multiple sclerosis (MS) can become a significant challenge due to its high comorbidity with mood and anxiety disorders. Despite extensive research on psychological symptoms in MS, the role of transdiagnostic protective factors, demographic variables, and the interplay between these factors have received less attention. This study aimed to investigate the interaction between psychological symptoms, transdiagnostic factors, and demographic variables in patients with MS. Methods: Data were collected and analyzed from 154 patients with MS. The participants completed the demographic data form, Yale-Brown obsessive-compulsive scale, Beck depression inventory-II (BDI-II), generalized anxiety disorder-7 scale, the difficulties in emotion regulation scale, and Connor-Davidson resilience scale (CDRS). Path analyses were performed using the lavaan package in R software. Results: The findings indicate that a higher age at MS onset and longer disease duration are directly associated with increased depression and obsessive-compulsive disorder (OCD) symptoms, as well as patients' perception of disability (PDS). Additionally, resilience negatively and difficulties in emotion regulation positively contributed to more severe symptoms of depression OCD and anxiety. Through the mediating role of depression, resilience and difficulties in emotion regulation are indirectly associated with a milder and more severe PDS, respectively. Conclusion: The results highlight the importance of demographic characteristics, particularly the role of disease duration in the development of depression, as well as the impact of depression on patients' PDS. Moreover, the protective role of resilience and the detrimental role of difficulties in emotion regulation underscores the need for targeted psychological interventions in MS rehabilitation.