2.Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers.
Li ZHANG ; Lingjiang LI ; Wanhong ZHENG ; Yan ZHANG ; Xueping GAO ; Liwen TAN ; Xiaoping WANG ; Qiongni CHEN ; Junmei XU ; Juanjuan TANG ; Xingwei LUO ; Xudong CHEN ; Xiaocui ZHANG ; Li HE ; Jin LIU ; Peng CHENG ; Lizhi XU ; Yi TIAN ; Chuan WEN ; Weihui LI
Journal of Central South University(Medical Sciences) 2023;48(1):92-105
OBJECTIVES:
Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.
METHODS:
The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.
RESULTS:
The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful.
CONCLUSIONS
Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.
Humans
;
COVID-19
;
Sleep Initiation and Maintenance Disorders
;
Crisis Intervention
;
Psychosocial Intervention
;
SARS-CoV-2
;
Mental Health
;
Depression/epidemiology*
;
Health Personnel/psychology*
;
Anxiety/etiology*
3.Association of risky driving behavior with psychiatric disorders among Iranian drivers: A case-control study.
Kiana KHATAMI ; Yaser SARIKHANI ; Reza FEREIDOONI ; Mohammad SALEHI-MARZIJARANI ; Maryam AKABRI ; Leila KHABIR ; Arash MANI ; Mahsa YAGHIKOSH ; Afsaneh HAGHDEL ; Seyed Taghi HEYDARI ; Kamran Bagheri LANKARANI
Chinese Journal of Traumatology 2023;26(5):290-296
PURPOSE:
This study aimed to investigate the possible association between psychological disorders and risky driving behavior (RDB) in Iran.
METHODS:
This case-control study conducted in Shiraz, Iran in 2021. The case group included drivers with psychological disorders and the control group included those without any disorders. The inclusion criteria for selecting patients were: active driving at the time of the study, being 18 - 65 years old, having a driving license, having a psychological disorder including depression, bipolar disorder, anxiety spectrum disorder, or psychotic disorder spectrum confirmed by a psychiatrist, and completing an informed consent form. The exclusion criterion was the existence of conditions that interfered with answering and understanding the questions. The inclusion criteria for selecting the healthy cases were: active driving at the time of the study, being 18 - 65 years old, having a driving license, lack of any past or present history of psychiatric problems, and completing an informed consent form. The data were gathered using a researcher-made checklist and Manchester driving behavior questionnaire. First, partition around medoids method was used to extract clusters of RDB. Then, backward logistic regression was applied to investigate the association between the independent variables and the clusters of RDB.
RESULTS:
The sample comprised of 344 (153 with psychological disorder and 191 without confirmed psychological disorder) drivers. Backward elimination logistic regression on total data revealed that share of medical expenditure ≤ 10% of total household expenditure (OR = 3.27, 95% CI: 1.48 - 7.24), psychological disorder (OR = 3.08, 95% CI: 1.67 - 5.70), and substance abuse class (OR = 6.38, 95% CI: 3.55 - 11.48) were associated with high level of RDB.
CONCLUSION
Substance abuse, psychological illnesses, and share of medical costs from total household expenditure were found to be main predictors of RDB. Further investigations are necessary to explain the impact of different psychological illnesses on driving behavior.
Humans
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Automobile Driving
;
Iran
;
Case-Control Studies
;
Mental Disorders/epidemiology*
;
Surveys and Questionnaires
;
Risk-Taking
4.Changes in the prevalence of comorbidity of mental and physical disorders in Singapore between 2010 and 2016.
Edimansyah ABDIN ; Siow Ann CHONG ; Janhavi Ajit VAINGANKAR ; Saleha SHAFIE ; Darren SEAH ; Chun Ting CHAN ; Stefan MA ; Lyn JAMES ; Derrick HENG ; Mythily SUBRAMANIAM
Singapore medical journal 2022;63(4):196-202
INTRODUCTION:
Few studies have examined the changes in the prevalence of comorbidity of mental and physical disorders in recent years. The present study sought to examine whether the prevalence of comorbidity of mental and physical disorders in Singapore showed any changes between 2010 and 2016.
METHODS:
We extracted data from two repeated nationally representative cross-sectional surveys conducted among resident adults aged ≥ 18 years in Singapore. Significant changes were tested using pooled multinomial logistic regression analyses.
RESULTS:
The prevalence of comorbid mental and physical disorders increased significantly from 5.8% in 2010 to 6.7% in 2016. Among those with physical disorders, there were significant increases over time in the prevalence of comorbid generalised anxiety disorder (GAD) (0.1% vs. 0.4%) and obsessive-compulsive disorder (OCD) (1.4% vs. 3.9%) in diabetes mellitus, and alcohol dependence in cardiovascular disorders (0.1% vs. 1.3%). Among those with mental disorders, there were significant increases over time in the prevalence of comorbid diabetes mellitus in OCD (4.1% vs. 10.9%), cancer in major depressive disorder (0.4% vs. 2.4%), and cardiovascular disorders in GAD (0.4% vs. 6.7%) and alcohol dependence (0.9% vs. 11.8%). Significant changes in the overall prevalence of comorbid mental and physical disorders were also observed across age group, education and employment status.
CONCLUSION
The prevalence of comorbid mental and physical disorders increased significantly over time. This finding supports the need for more appropriate clinical management with better integration between mental health and general medical care professionals across all aspects of the healthcare system to treat this comorbidity in Singapore.
Adult
;
Alcoholism/epidemiology*
;
Comorbidity
;
Cross-Sectional Studies
;
Depressive Disorder, Major/epidemiology*
;
Humans
;
Mental Disorders/epidemiology*
;
Prevalence
;
Singapore/epidemiology*
5.The impact of the COVID-19 pandemic on the mental health of young people: A comparison between China and the United Kingdom.
Ming-Bo LIU ; Géraldine DUFOUR ; Zhuo-Er SUN ; Julieta GALANTE ; Chen-Qi XING ; Jing-Ye ZHAN ; Li-Li WU
Chinese Journal of Traumatology 2021;24(4):231-236
PURPOSE:
As COVID-19 spreads globally and affects people's health, there are concerns that the pandemic and control policies may have psychological effects on young people (age from 17 to 35 years). This psychological impact might vary in different countries, and thus we compared the prevalence of self-reported psychological distress, loneliness and posttraumatic stress symptoms (PTSS) among young people in the United Kingdom (UK) and China at the beginning of the COVID-19 pandemic.
METHODS:
Data of this study came from two sources. One source was the first wave of COVID-19 study in Understanding Society, a special wave of the UK household longitudinal study, which provided the high-quality, national-wide representative panel data. The sample comprised 1054 young people. The other source was an online survey on the mental health of 1003 young people from Shanghai, a highly developed area in China. The questionnaire included questions on the prevalence of common mental disorders (cut-off score ≥ 4), loneliness and potential PTSS (cut-off ≥ 33). Univariable analyses were conducted to test the differences in the self-reported prevalence of psychological distress and loneliness between the two groups. Multivariable logistic regression analyses were run to explore the predictors of psychological distress and loneliness among all the young people from England and Shanghai.
RESULTS:
Among the samples with self-reported psychological distress, the UK sample accounted for 34.4% (n=1054) and the Chinese sample accounted for 14.1% (n=1003). The difference between the two groups was statistically significant (p < 0.001). Additionally, 57.1% of people in the UK and 46.7% in China reported that they sometimes or often felt lonely, of which the difference is statistically significant (p < 0.001). Regression analysis of the entire samples showed that nationality, gender, psychotherapy and loneliness were significant predictors of 12-item General Health Questionnaire scores, while the variables of age and living alone were not. Significant predictors of self-reported loneliness were the nationality, gender, age, living alone and psychotherapy. In China, 123 (12.3%) young people, 49 men (11.3%) and 74 women (13.0%), met the criteria of PTSS symptoms (cut-off scores ≥ 33). These scores were only collected in China.
CONCLUSION
This evidence suggests that mental health and loneliness reported by young people were lower in China than that in the UK during the studied period. More research is needed to understand these differences. If the differential negative psychological impacts are confirmed, country-specific measures of prevention and intervention should be adopted to improve the mental health of young people under the ongoing impact of the pandemic.
Adult
;
COVID-19/epidemiology*
;
China/epidemiology*
;
Female
;
Humans
;
Loneliness/psychology*
;
Male
;
Mental Health
;
Prevalence
;
Psychological Distress
;
SARS-CoV-2
;
Stress Disorders, Post-Traumatic/epidemiology*
;
United Kingdom/epidemiology*
;
Young Adult
6.Correlation between preoperative sleep disorders and postoperative delayed neurocognitive recovery in elderly patients.
Renhua LI ; Na CHEN ; E WANG ; Zhaohui TANG
Journal of Central South University(Medical Sciences) 2021;46(11):1251-1259
OBJECTIVES:
Perioperative neurocognitive disorders (PND) is one of the important factors affecting the recovery of the elderly after surgery, and sleep disorders are also one of the common diseases of the elderly. Previous studies have shown that the quality of postoperative sleep may be factor affecting postoperative cognitive function, but there are few studies on the relationship between preoperative sleep disorders and postoperative cognitive dysfunction. This study aims to explore the relationship between preoperative sleep disorders and postoperative delayed neurocognitive recovery in elderly patients, and provide references for improving the prognosis and quality of life of patients.
METHODS:
This study was porformed as a prospective cohort study. Elderly patients (age≥65 years old) underwent elective non-cardiac surgery at Xiangya Hospital of Central South University from October 2019 to January 2020 were selected and interviewed 1 day before the operation. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) were used to assess the patient's baseline cognitive status. Patients with preoperative MMSE scores of less than 24 points were excluded. For patients meeting the criteria of inclusion, Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the patients, and the patients were divided into a sleep disorder group and a non-sleep disorder group according to the score. General data of patients were collected and intraoperative data were recorded, such as duration of surgery, anesthetic time, surgical site, intraoperative fluid input, intraoperative blood product input, intraoperative blood loss and drug use. On consecutive 5 days after surgery, Numerical Rating Scale (NRS) was used to evaluate the sleep of the previous night and the pain of the day, which were recorded as sleep NRS score and pain NRS score; Confusion Assessment Method for ICU (CAM-ICU) scale and Confusion Assessment Method (CAM) scale were used to assess the occurrence of delirium. On the 7th day after the operation, the MMSE and MoCA scales were used to evaluate cognitive function of patients. We compared the incidence of postoperative complications, the number of deaths, the number of unplanned ICU patients, the number of unplanned secondary operations, etc between the 2 groups. The baseline and prognosis of the 2 groups of patients were analyzed by univariate and multivariate logistics to analyze their correlation.
RESULTS:
A total of 105 patients were collected in this study, including 32 patients in the sleep disorder group and 73 patients in the non-sleep disorder group. The general information of the 2 groups, such as age, gender, body mass index, and surgery site, were not statistically significant (all
CONCLUSIONS
Preoperative sleep disorders can increase the risk of delayed neurocognitive function recovery in elderly patients. Active treatment of preoperative sleep disorders may improve perioperative neurocognitive function in elderly patients.
Aged
;
Humans
;
Mental Status and Dementia Tests
;
Postoperative Complications/epidemiology*
;
Prospective Studies
;
Quality of Life
;
Sleep Quality
;
Sleep Wake Disorders/etiology*
7.Analysis of 123 Cases of Forensic Psychiatry Testimony of Individuals Suspected of Road Traffic Offences.
Shu Jian WANG ; Yu Zi ZHENG ; Yong HE ; Mei Ling YU ; Gang Qin LI ; Ze Qing HU
Journal of Forensic Medicine 2020;36(6):784-790
Objective To explore the characteristics of individuals with mental disorders suspected of road traffic offences and to find their differences from normal offenders, in order to regulate mental disorder patients' driving activities and prevent road traffic offences. Methods One hundred and twenty-three cases of forensic psychiatry testimony of individuals suspected of road traffic offences between 2014 and 2019 from the West China Forensic Center of Sichuan Province were collected. Fisher exact probability test was used to compare the differences between offenders with mental disorders and without mental disorders in terms of demographic characteristics, criminological characteristics, psychiatric characteristics and criminal responsibilities. Results There was no statistical significance in the differences of demographic characteristics, vehicles and kinds of alcohol between the two groups (P>0.05). The main type of road traffic related crimes committed by offenders with mental disorders was risky driving and were mainly evaluated as partial criminal responsibility, whereas most offenders without mental disorders committed crime of causing traffic casualties and all were evaluated as full criminal responsibility. There was statistical significance in the differences of the types of crime and the criminal responsibility rating between the two groups (P<0.05). Meanwhile, patients with mental disorders were characterized by long course of disease and irregular treatment, and individuals diagnosed as having mental disorders caused by psychoactive substances accounted for a large proportion. Conclusion There are differences in the characteristics of road traffic-related crimes between mental disorder patients and normal people. It is of great practical significance for reducing road traffic offences to evaluate whether the individuals with mental disorders are fit for driving.
Automobile Driving
;
China/epidemiology*
;
Crime
;
Criminals
;
Forensic Psychiatry
;
Humans
;
Mental Disorders/epidemiology*
8.Risk profiling in patients undergoing penile prosthesis implantation.
Linda M HUYNH ; Mohamad M OSMAN ; Faysal A YAFI
Asian Journal of Andrology 2020;22(1):8-14
Penile prosthesis implantation is the gold standard of surgical therapy for patients with medication-refractory erectile dysfunction. However, this umbrella definition includes significant heterogeneity and associated risk profiles that should be candidly discussed and addressed perioperatively. Factors associated with operative success and patient satisfaction are often surgery specific; however, risk profiling via patient selection, preoperative optimization, proper device selection, and intraoperative consideration are highly correlated. Some examples of common risk profiles include comorbidity(ies) such as cardiovascular disease, diabetes mellitus, prior abdominal surgery, Peyronie's disease, and psychological risk factors. Similarly, integration of surgeon- and patient-amenable characteristics is key to decreasing risk of infection, complication, and need for revision. Finally, patient risk profiling provides a unique context for proper device selection and evidence-based intraoperative considerations.
Cardiovascular Diseases/epidemiology*
;
Comorbidity
;
Diabetes Mellitus/epidemiology*
;
Erectile Dysfunction/surgery*
;
Humans
;
Male
;
Mental Disorders/epidemiology*
;
Patient Satisfaction
;
Patient Selection
;
Penile Implantation/methods*
;
Penile Induration/epidemiology*
;
Penile Prosthesis
;
Postoperative Complications/prevention & control*
;
Prosthesis-Related Infections/prevention & control*
;
Reoperation
;
Risk Assessment
;
Surgical Wound Infection/prevention & control*
9.Psychological Profile of Patients with Psoriasis.
Derek Sy LIM ; Anthony BEWLEY ; Hazel H OON
Annals of the Academy of Medicine, Singapore 2018;47(12):516-522
INTRODUCTION:
Psoriasis is a chronic inflammatory disease with a global prevalence of approximately 2% and significant psychiatric comorbidity. There is a great deal of existing literature assessing different aspects of psychology in psoriasis. We aimed to conduct an in-depth review of current evidence linking psoriasis to personality traits and psychiatric comorbidities, as well as factors that put these patients at risk of psychopathology.
MATERIALS AND METHODS:
A search of the PubMed database identified 1632 articles. We included articles studying psychological comorbidity in patients with psoriasis, looking especially at personality characteristics, and data linking psoriasis with increased risks of psychological distress, depression, anxiety and suicidality. In particular, we also evaluated subgroups in psoriasis found to be at risk.
RESULTS:
Patients with psoriasis are more likely to be alexithymic, lack body awareness and possess a Type D personality. Alcohol, but not illicit drug use, disorders are also more common in patients with psoriasis. Patient groups who are especially at risk of psychological distress include women, younger patients, patients with a younger age of disease onset, those who self-assess their psoriasis to be severe, and those with lesions on visible or sensitive areas. Adopting motivational interviewing skills and incorporating the use of learning materials during consultations have been found to be useful.
CONCLUSION
The knowledge of personality characteristics, "at-risk" groups, and early recognition of psychological distress among patients with psoriasis can help clinicians provide better holistic care and encourage a change in patients' behaviour.
Affective Symptoms
;
epidemiology
;
psychology
;
Age Factors
;
Age of Onset
;
Alcoholism
;
epidemiology
;
psychology
;
Anxiety
;
epidemiology
;
psychology
;
Comorbidity
;
Depression
;
epidemiology
;
psychology
;
Humans
;
Mental Disorders
;
epidemiology
;
psychology
;
Motivational Interviewing
;
Personality
;
Psoriasis
;
epidemiology
;
psychology
;
Sex Factors
;
Stress, Psychological
;
epidemiology
;
psychology
;
Substance-Related Disorders
;
epidemiology
;
psychology
;
Suicidal Ideation
;
Type D Personality
10.Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis.
Hirotsuna OHASHI ; Ichiro WADA ; Yui YAMAOKA ; Ryoko NAKAJIMA-YAMAGUCHI ; Yasukazu OGAI ; Nobuaki MORITA
Environmental Health and Preventive Medicine 2018;23(1):14-14
BACKGROUND:
Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare.
METHODS:
The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model.
RESULTS:
About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference).
CONCLUSIONS
Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be proactive in prevention or intervention for adults with perpetration risk.
Adolescent
;
Caregivers
;
psychology
;
Child
;
Child Abuse
;
psychology
;
statistics & numerical data
;
Child Protective Services
;
statistics & numerical data
;
Child, Preschool
;
Domestic Violence
;
psychology
;
statistics & numerical data
;
Family Characteristics
;
Female
;
Humans
;
Incidence
;
Infant
;
Japan
;
epidemiology
;
Longitudinal Studies
;
Male
;
Mental Disorders
;
epidemiology
;
psychology
;
Risk Factors
;
Substance-Related Disorders
;
epidemiology
;
etiology

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