mental

心理
  • 文章类型: Journal Article
    强迫症和症状在不同年龄段和民族中的全球患病率增加被认为是一个巨大的临床挑战。然而,在中东和海湾理事会国家,关于这一主题的数据有限。这项研究旨在通过确定在初级保健中心就诊的患者中的患病率和危险因素,提高巴林成年人对强迫症状的认识。
    在巴林初级保健中心就诊的成年患者中进行了一项横断面研究。使用谷歌表格的自我管理的在线问卷,一个免费的在线调查网站,通过WhatsApp消息分发。使用了雪球采样技术。问卷包括三个部分:参与者的社会人口统计数据,莫兹利强迫性清单,和耶鲁-布朗强迫症量表。进行了描述性和推断性分析。
    共有614名参与者被纳入,平均年龄为30.04±13.04岁。大多数参与者是女性(82.5%)和单身(n=347,56.5%)。参与者中强迫症状的估计患病率为15%;他们中的大多数报告了轻度症状(85%)。非巴林人的强迫性和强迫性症状明显增高(P<0.001和P<0.002),单(P<0.001和P<0.033),和学生参与者(P<0.001和P=0.002)与他们的同行相比,分别。此外,与其他参与者相比,大学生报告的痴迷程度更高(P=0.005)。
    大约,巴林每8人中就有1人出现强迫症,尤其是单身,学生,和非巴林参与者。这些发现强调了提高对强迫症及其症状的认识的必要性,以及早期发现和管理强迫症的重要性。
    UNASSIGNED: The global increasing prevalence of obsessive-compulsive disorders and symptoms among various age groups and nationalities is considered a great clinical challenge. However, limited data are available on this topic in the Middle East and Gulf Council Countries. This study aimed to raise awareness of obsessive-compulsive symptoms among adults in Bahrain by determining its prevalence and risk factors among patients attending primary healthcare centers.
    UNASSIGNED: A cross-sectional study was conducted among adult patients attending primary healthcare centers in Bahrain. A self-administered online questionnaire using Google form, a free online survey-creating website, was distributed through WhatsApp messages. A snowball sampling technique was used. The questionnaire consisted of three parts: the socio-demographic data of participants, the Maudsley Obsessional-Compulsive Inventory, and the Yale-Brown Obsessive-Compulsive Scale. Descriptive and inferential analyses were conducted.
    UNASSIGNED: A total of 614 participants were included with a mean age of 30.04 ± 13.04 years. Most participants were females (82.5%) and single (n = 347, 56.5%). The estimated prevalence of obsessive-compulsive symptoms among the participants was 15%; most of them reported mild symptoms (85%). Significantly higher obsession and compulsion symptoms were found among non-Bahraini (P < 0.001 and P < 0.002), single (P < 0.001 and P < 0.033), and student participants (P < 0.001 and P = 0.002) compared to their counterparts, respectively. In addition, undergraduates reported higher obsessions compared to other participants (P = 0.005).
    UNASSIGNED: Approximately, one in every eight people in Bahrain were found to suffer from obsessive-compulsive symptoms, especially single, students, and non-Bahraini participants. These findings highlight the need for raising awareness of obsessive-compulsive disorder and its symptoms as well as the importance of early detection and management of obsessive-compulsive disorder.
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  • 文章类型: Journal Article
    BACKGROUND: Assessing the risk of children developing mental, behavioral, and developmental disorders (MBDDs), including autism spectrum disorders (ASDs), as well as achieving early detection of such disorders, has become one of the most important undertakings for public mental health professionals worldwide.
    OBJECTIVE: This study aims to evaluate the risk of developing MBDDs and the prevalence of MBDDs among young children (18-48 months old) in Russia.
    METHODS: A two-level epidemiological screening approach was developed and adopted for the purposes of this study. At the first level, the parents of all children between 18 and 48 months old were questioned using Russian national validated Screening Checklist for Parents for Identification of the Risk of Mental, Behavioral, and Developmental Disorders in Early Childhood in nine regions of Russia (Volgograd, Kirov, Moscow, Novosibirsk, Orenburg, Tver, Chelyabinsk, Yaroslavl, and Stavropol). At the second level, children identified at the first level of screening as being at risk of developing MBDDs were assessed by a child psychiatrist on a voluntary basis and diagnosed according to the International Classification of Diseases, Tenth Revision criteria.
    RESULTS: The present study revealed that the risk of developing MBDDs stands at 13.07% or 1,307 cases per 10,000 child population aged 18-48 months, whereas the prevalence of confirmed MBDDs is 1.51% or 151 cases per 10,000 among a Russian child population aged 18-48 months.
    CONCLUSIONS: Screening for the risk of developing MBDDs, including ASDs, in Russia among very young children is a promising area of preventive medicine. This initiative allows us to develop optimal algorithms for specialized care measures that could help prevent the development and aggravation of children mental health issues.
    UNASSIGNED: Оценка риска возникновения нарушений психического развития (НПР), психических и поведенческих расстройств, включая расстройства аутистического спектра (РАС), а также раннее выявление у детей НПР — это важнейшие направления деятельности специалистов по охране психического здоровья во всем мире.
    UNASSIGNED: Настоящее исследование направлено на оценку риска развития НПР и распространенности НПР у детей раннего возраста (18–48 месяцев) в России.
    UNASSIGNED: Для достижения целей настоящего исследования разработан и применен двухуровневый подход к эпидемиологическому скринингу. На первом уровне сплошным методом были опрошены родители детей в возрасте от 18 до 48 месяцев с использованием отечественной валидизированной «Скрининговой анкеты для родителей по выявлению риска возникновения нарушений психического развития у детей раннего возраста» в девяти регионах России (Волгоград, Киров, Москва, Новосибирск, Оренбург, Тверь, Челябинск, Ярославль, Ставрополь). На втором уровне дети, идентифицированные на первом уровне скрининга как находящиеся в группе риска по развитию НПР, осматривались врачом-психиатром на добровольной основе и в ряде случаев устанавливался диагноз в соответствии с критериями МКБ-10.
    UNASSIGNED: Установлено, что риск НПР составляет 13.07%, или 1307 случаев на 10,000 детей в возрасте 18–48 месяцев, тогда как распространенность подтвержденных НПР составляет 1.51%, или 151 случай на 10,000 детей, среди детского населения России в возрасте 18–48 месяцев.
    UNASSIGNED: Скрининг риска развития НПР, в том числе РАС, в России среди детей раннего возраста является перспективным направлением профилактической медицины. Эта инициатива позволит разработать оптимальные алгоритмы проведения специализированных мероприятий по профилактике возникновения и усугубления проблем психического здоровья детей.
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  • 文章类型: Journal Article
    每年仍有越来越多的老年人被拘留,导致越来越多的常见身心健康问题。先前没有基于证据的针对性心理干预措施支持这一群人,对他们的需求知之甚少,当前活动,和健康相关的问题。我们通过一个涉及老年囚犯的项目解决了这些差距,英格兰北部一名男女监狱工作人员和一个项目咨询小组。系统审查证据支持开发一个实施工具包,处理制定和实施可持续干预措施的战略,可接受,在监狱环境中也是可行的。监狱战略需要专门解决被拘留的老年人的需求。相对便宜的活动,有些人认为分娩和灵活性有可能有益于普通的身心健康,提高生活质量,降低高昂的经济和社会成本,死亡率,在这个年龄段再次犯罪。
    A growing number of older people remain in custody each year resulting in an increasing number of common mental and physical health concerns. No prior evidenced-based targeted psychological interventions support this group of people, and little is known about their needs, current activities, and health-related problems. We addressed these gaps through a project involving older prisoners, prison staff and a project advisory group in one male and one female prison site in the North of England. Systematic review evidence supports the development of an implementation tool kit addressing strategies to develop and deliver interventions that are sustainable, acceptable, and feasible in the prison environment. Prison strategies need to specifically address the needs of older people in custody. Relatively inexpensive activities, with some thought to delivery and flexibility have the potential to benefit common mental and physical health, increasing quality of life, reducing high economic and social cost, mortality, and reoffending in this age group.
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  • 文章类型: Journal Article
    随着人口老龄化,认知能力下降变得更加普遍。使用益生菌针对肠脑轴的策略正在出现,以改善神经精神和神经系统疾病。然而,益生菌对健康老年人脑功能的有益作用尚不清楚.我们的目的是评估多物种益生菌制剂作为一种治疗方法,以减少健康成年人与衰老相关的情绪和认知能力下降。进行随机双盲安慰剂对照交叉试验。该研究涉及为期10周的干预,参与者每天食用指定的益生菌产品,在第二种情况开始之前进行为期4周的冲洗期。使用迷你精神状态检查(MMSE)和心理实验构建语言测试电池评估认知功能。在情感层面,使用贝克抑郁量表(BDI)和状态特质焦虑量表(STAI)。33名与会者,在2020年7月至2022年4月之间招募,摄入了多物种益生菌(鼠李糖乳杆菌和乳双歧杆菌)。干预之后,认知功能显著增强(平均差异1.90,95%CI1.09至2.70,p<0.005),按MMSE和数字任务划分的记忆(平均差4.60,95%CI2.91至6.29,p<0.005),和抑郁症状(平均差异4.09,95%CI1.70至6.48,p<0.005)。此外,在计划和解决问题的能力方面有了显著的提高,选择性注意,认知灵活性,冲动,和抑制能力。益生菌管理改善老年人的认知和情绪功能。有限的研究支持这一点,需要更多的科学证据,益生菌作为一种有效的治疗认知能力下降。这项研究已在ClinicalTrials.gov(NCT04828421;2020/7月/17)进行了前瞻性注册。
    As the population ages, cognitive decline becomes more common. Strategies targeting the gut-brain axis using probiotics are emerging to achieve improvements in neuropsychiatric and neurological disorders. However, the beneficial role of probiotics on brain function in healthy older adults remains unclear. Our aim was to evaluate a multi-species probiotic formulation as a therapeutic approach to reduce emotional and cognitive decline associated with aging in healthy adults. A randomized double-blind placebo-controlled crossover trial was conducted. The study involved a 10-week intervention where participants consumed the assigned probiotic product daily, followed by a 4-week washout period before the second condition started. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Psychological Experiments Construction Language Test Battery. At the emotional level, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used. Thirty-three participants, recruited between July 2020 and April 2022, ingested a multispecies probiotic (Lactobacillus rhamnosus and Bifidobacterium lactis). After the intervention, noticeable enhancements were observed in cognitive function (mean difference 1.90, 95% CI 1.09 to 2.70, p < 0.005), memory (mean difference 4.60, 95% CI 2.91 to 6.29, p < 0.005) by MMSE and digit task, and depressive symptoms (mean difference 4.09, 95% CI 1.70 to 6.48, p < 0.005) by BDI. Furthermore, there were significant improvements observed in planning and problem-solving skills, selective attention, cognitive flexibility, impulsivity, and inhibitory ability. Probiotics administration improved cognitive and emotional function in older adults. Limited research supports this, requiring more scientific evidence for probiotics as an effective therapy for cognitive decline. This study has been prospectively registered at ClinicalTrials.gov (NCT04828421; 2020/July/17).
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  • 文章类型: Journal Article
    计算12个月内女性职业足球运动员心理健康症状的患病率,并探讨严重伤害和相关手术与女性职业足球运动员心理健康症状的关系。
    一项观察性前瞻性队列研究是在12个月的随访期内通过分发电子问卷3次进行的。问卷基于经过验证的评估心理健康症状的筛查工具。
    共有74名女子职业足球运动员参加了这项研究。心理健康症状的范围从药物滥用的1%到基线运动心理困扰的65%,基线后6个月的运动心理困扰从6%到53%,基线后12个月的运动心理困扰从3%到55%。在过去的12个月中,饮食失调的患病率保持在15%至20%之间。只有一个关联具有统计学意义。每次手术后,女职业足球运动员报告与运动相关的心理困扰的可能性几乎是后者的两倍。
    女性职业足球运动员中心理健康症状的大量流行强调需要增加关注,意识和干预。此外,女性职业足球运动员在每次手术后报告与运动相关的心理困扰的可能性几乎是前者的两倍。从事女子足球的运动医学医师和心理健康专业人员应提供标准护理,这涉及到识别,监测和实施针对心理健康症状的定制干预措施。
    UNASSIGNED: To calculate the prevalence rates of mental health symptoms among female professional football players over a 12-month period and to explore the associations of severe injury and related surgery with mental health symptoms among female professional footballers.
    UNASSIGNED: An observational prospective cohort study was conducted over a 12-month follow-up period by distributing an electronic questionnaire three times. The questionnaire was based on validated screening tools for assessing mental health symptoms.
    UNASSIGNED: A total of 74 female professional football players participated in this study. Mental health symptoms ranged from 1% for substance misuse to 65% for sport-psychological distress at baseline, from 6% for anxiety to 53% for sport-psychological distress 6 months postbaseline and from 3% for substance misuse to 55% for sport-psychological distress 12 months postbaseline. The prevalence of disordered eating remained between 15% and 20% over the 12-month period. Only one of the associations was statistically significant. Female professional football players were nearly twice as likely to report sport-related psychological distress following every surgery.
    UNASSIGNED: The substantial prevalence of mental health symptoms among female professional football players emphasises the need for increased attention, awareness and interventions. Additionally, female professional football players are nearly twice as likely to report sport-related psychological distress after each surgery. Sports medicine physicians and mental health professionals working in female football should provide standard care, which involves identifying, monitoring and implementing tailored interventions for mental health symptoms.
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  • 文章类型: Journal Article
    在西非,治疗师的数量大大超过训练有素的心理健康专业人员。患有严重精神疾病(SMI)的人经常在“祈祷营”中被治疗师看到,在那里他们也可能遭受侵犯人权的行为。我们开发了M&M,一项为期8周的双管齐下的干预措施,包括(1)智能手机提供的工具包,旨在让治疗师接受简短的心理社会干预,并鼓励他们维护人权(M-Healer应用程序),和(2)为患者提供药物的来访护士(移动护士)。
    我们检查了可行性,可接受性,安全,以及M&M干预在现实世界祈祷营环境中的初步有效性。
    我们在加纳的一个祈祷营与SMI和治疗师的人进行了M&M的单臂现场试验。为治疗师提供了安装了M-Healer的智能手机,并由实践促进者培训以使用数字工具包。并行,一名研究护士参观了他们的祈祷营,为他们的病人服用药物。临床评估人员在治疗前(基线)对SMI参与者实施研究措施,治疗中期(4周)和治疗后(8周)。
    17名参与者被登记,大多数(n=15,88.3%)被保留。参与者的平均年龄为44.3(SD13.9)岁,其中59%(n=10)为男性。14名(82%)参与者被诊断为精神分裂症,2名(18%)被诊断为双相情感障碍。对四名治疗师进行了使用M-Healer的培训。平均而言,他们自我发起的应用程序每周使用31.9(SD28.9)次。治疗者平均观看了19.1(SD21.2)个视频,响应1.5(SD2.4)提示,并每周使用该应用程序5.3(SD2.7)天。Pre-postanalysisdiscoveredasignificantandpassiallymeaningreductioninpsychiatricsympticlesseverity(BriefPsychiatricRatingScalegards52.3to30.9;BriefSymptomInvestoryscoreradsrange76.4to27.9),心理困扰(Talbieh短暂困扰清单得分范围为37.7至16.9),羞耻(Shamer量表其他评分范围为41.9至28.5),和污名(简短的内化污名精神疾病量表评分范围为11.8至10.3)。我们记录了链接天数的显着减少(1.6至0.5)和强制禁食天数的减少趋势(2.6至0.0,P=.06)。我们没有发现患者报告的与治疗师的工作联盟(工作联盟清单)的显着事后变化,抑郁症状严重程度(患者健康问卷-9),生活质量(雷曼精神病患者生活质量访谈),关于药物的信念(关于药物的信念问卷-一般危害分量表),或其他侵犯人权的行为。没有大的副作用,违反健康和安全规定,或在试验过程中发生严重不良事件.
    并购干预被证明是可行的,可接受,安全,临床上很有前途。初步调查结果表明,M-Healer工具包可能改变了祈祷营中治疗师的行为,从而减少了侵犯人权的行为。
    UNASSIGNED: In West Africa, healers greatly outnumber trained mental health professionals. People with serious mental illness (SMI) are often seen by healers in \"prayer camps\" where they may also experience human rights abuses. We developed \"M&M,\" an 8-week-long dual-pronged intervention involving (1) a smartphone-delivered toolkit designed to expose healers to brief psychosocial interventions and encourage them to preserve human rights (M-Healer app), and (2) a visiting nurse who provides medications to their patients (Mobile Nurse).
    UNASSIGNED: We examined the feasibility, acceptability, safety, and preliminary effectiveness of the M&M intervention in real-world prayer camp settings.
    UNASSIGNED: We conducted a single-arm field trial of M&M with people with SMI and healers at a prayer camp in Ghana. Healers were provided smartphones with M-Healer installed and were trained by practice facilitators to use the digital toolkit. In parallel, a study nurse visited their prayer camp to administer medications to their patients. Clinical assessors administered study measures to participants with SMI at pretreatment (baseline), midtreatment (4 weeks) and post treatment (8 weeks).
    UNASSIGNED: Seventeen participants were enrolled and most (n=15, 88.3%) were retained. Participants had an average age of 44.3 (SD 13.9) years and 59% (n=10) of them were male. Fourteen (82%) participants had a diagnosis of schizophrenia and 2 (18%) were diagnosed with bipolar disorder. Four healers were trained to use M-Healer. On average, they self-initiated app use 31.9 (SD 28.9) times per week. Healers watched an average of 19.1 (SD 21.2) videos, responded to 1.5 (SD 2.4) prompts, and used the app for 5.3 (SD 2.7) days weekly. Pre-post analyses revealed a significant and clinically meaningful reduction in psychiatric symptom severity (Brief Psychiatric Rating Scale score range 52.3 to 30.9; Brief Symptom Inventory score range 76.4 to 27.9), psychological distress (Talbieh Brief Distress Inventory score range 37.7 to 16.9), shame (Other as Shamer Scale score range 41.9 to 28.5), and stigma (Brief Internalized Stigma of Mental Illness Scale score range 11.8 to 10.3). We recorded a significant reduction in days chained (1.6 to 0.5) and a promising trend for reduction in the days of forced fasting (2.6 to 0.0, P=.06). We did not identify significant pre-post changes in patient-reported working alliance with healers (Working Alliance Inventory), depressive symptom severity (Patient Health Questionnaire-9), quality of life (Lehman Quality of Life Interview for the Mentally Ill), beliefs about medication (Beliefs about Medications Questionnaire-General Harm subscale), or other human rights abuses. No major side effects, health and safety violations, or serious adverse events occurred over the course of the trial.
    UNASSIGNED: The M&M intervention proved to be feasible, acceptable, safe, and clinically promising. Preliminary findings suggest that the M-Healer toolkit may have shifted healers\' behaviors at the prayer camp so that they commit fewer human rights abuses.
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  • 文章类型: Randomized Controlled Trial
    背景:恐慌症是临床实践中常见且重要的疾病,会降低个体生产力并增加医疗保健使用。治疗包括药物治疗和认知行为治疗。然而,不良的药物作用和不良的治疗依从性意味着需要新的治疗模式.
    目的:我们假设恐慌症的数字化治疗可以改善恐慌症的症状,并且治疗反应与功能近红外光谱(fNIRS)评估的大脑活动变化有关。
    方法:招募有惊恐发作史的个体(n=50)。在使用惊恐障碍的应用程序之前和之后评估症状,在这项研究中,这是一个基于智能手机的应用程序,用于治疗恐慌症的临床症状,恐慌症状,抑郁症状,和焦虑。通过fNIRS测量静息状态下额叶皮质的血液动力学。该应用程序有四个部分:日记,教育,quest,严肃的游戏。研究试验获得中安大学医院机构审查委员会的批准(1041078-202112-HR-349-01),并获得所有参与者的书面知情同意书。
    结果:应用组恐慌症状改善的参与者人数(20/25,80%)大于对照组(6/21,29%;χ21=12.3;P=0.005)。治疗期间,应用组的惊恐障碍严重程度量表(PDSS)评分改善大于对照组(F1,44=7.03;P=0.01).在应用程序使用组中,总PDSS评分下降了42.5%(基线时平均评分14.3,SD6.5,干预后平均评分7.2,SD3.6),而对照组的PDSS评分下降了14.6%(基线时平均评分12.4,SD5.2,干预后平均评分9.8,SD7.9).在应用和对照组之间,基线时累积的氧合血红蛋白(accHbO2)没有显着差异。治疗期间,在应用中,右腹外侧前额叶皮质(VLPFC;F1,44=8.22;P=.006)和右眶前额叶皮质(OFC;F1,44=8.88;P=.005)的accHbO2降低幅度大于对照组.
    结论:应用惊恐障碍可以有效减轻惊恐障碍患者的症状和VLPFC和OFC脑活动。惊恐障碍症状的改善与静息状态下VLPFC和OFC脑活动的降低呈正相关。
    背景:临床研究信息服务KCT0007280;https://cris。nih.走吧。kr/cris/search/detailSearch.做?seq=21448。
    BACKGROUND: Panic disorder is a common and important disease in clinical practice that decreases individual productivity and increases health care use. Treatments comprise medication and cognitive behavioral therapy. However, adverse medication effects and poor treatment compliance mean new therapeutic models are needed.
    OBJECTIVE: We hypothesized that digital therapy for panic disorder may improve panic disorder symptoms and that treatment response would be associated with brain activity changes assessed with functional near-infrared spectroscopy (fNIRS).
    METHODS: Individuals (n=50) with a history of panic attacks were recruited. Symptoms were assessed before and after the use of an app for panic disorder, which in this study was a smartphone-based app for treating the clinical symptoms of panic disorder, panic symptoms, depressive symptoms, and anxiety. The hemodynamics in the frontal cortex during the resting state were measured via fNIRS. The app had 4 parts: diary, education, quest, and serious games. The study trial was approved by the institutional review board of Chung-Ang University Hospital (1041078-202112-HR-349-01) and written informed consent was obtained from all participants.
    RESULTS: The number of participants with improved panic symptoms in the app use group (20/25, 80%) was greater than that in the control group (6/21, 29%; χ21=12.3; P=.005). During treatment, the improvement in the Panic Disorder Severity Scale (PDSS) score in the app use group was greater than that in the control group (F1,44=7.03; P=.01). In the app use group, the total PDSS score declined by 42.5% (mean score 14.3, SD 6.5 at baseline and mean score 7.2, SD 3.6 after the intervention), whereas the PDSS score declined by 14.6% in the control group (mean score 12.4, SD 5.2 at baseline and mean score 9.8, SD 7.9 after the intervention). There were no significant differences in accumulated oxygenated hemoglobin (accHbO2) at baseline between the app use and control groups. During treatment, the reduction in accHbO2 in the right ventrolateral prefrontal cortex (VLPFC; F1,44=8.22; P=.006) and the right orbitofrontal cortex (OFC; F1,44=8.88; P=.005) was greater in the app use than the control group.
    CONCLUSIONS: Apps for panic disorder should effectively reduce symptoms and VLPFC and OFC brain activity in patients with panic disorder. The improvement of panic disorder symptoms was positively correlated with decreased VLPFC and OFC brain activity in the resting state.
    BACKGROUND: Clinical Research Information Service KCT0007280; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=21448.
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  • 文章类型: Clinical Study
    背景:重度抑郁症在一生中影响约五分之一的成年人,是全球残疾的主要原因。然而,少数群体由于人的水平而接受适当的治疗(例如,与提供商的地理距离)和系统级(例如,训练有素的提供者短缺)障碍。数字工具可以通过提供灵活的,减少有效治疗所需的治疗时间和频率来改善这种治疗差距,自动化支持。
    目的:本研究旨在研究可行性,可接受性,以及Mindset对抑郁症的初步临床效果,基于智能手机的8周认知行为疗法(CBT)的部署就绪,并与治疗师进行简短的远程治疗预约。
    方法:这8周,单臂开放式试验测试了MindsetforDepression应用程序,并结合了8次简短(16-25分钟)的视频会议访问,获得许可的博士级CBT治疗师(n=28名参与者).该应用程序提供了灵活的,无障碍的心理教育,CBT技能练习,和支持患者以及临床医生的指导,以促进持续参与,监视器安全,并根据个体患者的需求定制治疗。为了增加可访问性,从而提高泛化性,所有研究程序均远程进行.通过减员评估可行性和可接受性,患者的期望和反馈,和处理利用率。主要的临床结果测量是临床医生评定的汉密尔顿抑郁量表,在预处理时施用,中点,和后处理。还收集了功能损害和生活质量以及维持收益的次要指标(3个月的随访)。
    结果:治疗可信度(第4周),预期(第4周),满意度(第8周)中等至高,损耗低(n=2,7%)。参与者自我报告使用该应用程序或练习(在应用程序上或下)在应用程序中教授的CBT技能,平均每周50分钟(IQR30-60;第4周)或60分钟(IQR30-90;第8周);参与者平均在36.8天(SD10.0)内访问该应用程序,并在第8周评估前完成了8个步骤中的7个(IQR6-8)步骤。该应用程序在参与领域中获得了积极评价,功能,美学,和信息。参与者的抑郁严重程度评分从基线时表示中度抑郁的平均汉密尔顿抑郁量表评分(平均19.1,SD5.0)下降到表示轻度抑郁的第8周平均评分(平均10.8,SD6.1;d=1.47;P<.001)。还观察到功能损害和生活质量的改善。在3个月的随访中保持了进展。
    结论:结果表明,抑郁症的心态对于重度抑郁症患者来说是一种可行且可接受的治疗选择。这种以智能手机为主导的治疗方法有望成为一种有效的,可扩展,和具有成本效益的治疗选择。接下来的步骤包括在完全有效的随机对照试验和现实世界的临床环境中测试抑郁症的心态。
    背景:ClinicalTrials.govNCT05386329;https://clinicaltrials.gov/study/NCT05386329?term=NCT05386329。
    BACKGROUND: Major depressive disorder affects approximately 1 in 5 adults during their lifetime and is the leading cause of disability worldwide. Yet, a minority receive adequate treatment due to person-level (eg, geographical distance to providers) and systems-level (eg, shortage of trained providers) barriers. Digital tools could improve this treatment gap by reducing the time and frequency of therapy sessions needed for effective treatment through the provision of flexible, automated support.
    OBJECTIVE: This study aimed to examine the feasibility, acceptability, and preliminary clinical effect of Mindset for Depression, a deployment-ready 8-week smartphone-based cognitive behavioral therapy (CBT) supported by brief teletherapy appointments with a therapist.
    METHODS: This 8-week, single-arm open trial tested the Mindset for Depression app when combined with 8 brief (16-25 minutes) video conferencing visits with a licensed doctoral-level CBT therapist (n=28 participants). The app offers flexible, accessible psychoeducation, CBT skills practice, and support to patients as well as clinician guidance to promote sustained engagement, monitor safety, and tailor treatment to individual patient needs. To increase accessibility and thus generalizability, all study procedures were conducted remotely. Feasibility and acceptability were assessed via attrition, patient expectations and feedback, and treatment utilization. The primary clinical outcome measure was the clinician-rated Hamilton Depression Rating Scale, administered at pretreatment, midpoint, and posttreatment. Secondary measures of functional impairment and quality of life as well as maintenance of gains (3-month follow-up) were also collected.
    RESULTS: Treatment credibility (week 4), expectancy (week 4), and satisfaction (week 8) were moderate to high, and attrition was low (n=2, 7%). Participants self-reported using the app or practicing (either on or off the app) the CBT skills taught in the app for a median of 50 (IQR 30-60; week 4) or 60 (IQR 30-90; week 8) minutes per week; participants accessed the app on an average 36.8 (SD 10.0) days and completed a median of 7 of 8 (IQR 6-8) steps by the week 8 assessment. The app was rated positively across domains of engagement, functionality, aesthetics, and information. Participants\' depression severity scores decreased from an average Hamilton Depression Rating Scale score indicating moderate depression (mean 19.1, SD 5.0) at baseline to a week 8 mean score indicating mild depression (mean 10.8, SD 6.1; d=1.47; P<.001). Improvement was also observed for functional impairment and quality of life. Gains were maintained at 3-month follow-up.
    CONCLUSIONS: The results show that Mindset for Depression is a feasible and acceptable treatment option for individuals with major depressive disorder. This smartphone-led treatment holds promise to be an efficacious, scalable, and cost-effective treatment option. The next steps include testing Mindset for Depression in a fully powered randomized controlled trial and real-world clinical settings.
    BACKGROUND: ClinicalTrials.gov NCT05386329; https://clinicaltrials.gov/study/NCT05386329?term=NCT05386329.
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  • 文章类型: Journal Article
    当前的精神卫生保健模式侧重于临床恢复和症状缓解。该模型的疗效受治疗师对患者恢复潜力和治疗关系深度的信任影响。精神分裂症是一种具有严重症状的慢性疾病,康复的可能性是一个有争议的问题。随着人工智能(AI)融入医疗保健领域,重要的是检查其评估精神分裂症等主要精神疾病恢复潜力的能力。
    本研究旨在评估大型语言模型(LLM)与心理健康专业人员相比的能力,以评估有或没有专业治疗的精神分裂症的预后以及长期的积极和消极结果。
    Vignettes被输入到LLM界面中,并由4个AI平台进行了10次评估:ChatGPT-3.5,ChatGPT-4,GoogleBard,还有克劳德.共收集了80项评估,并对照现有规范进行了基准评估,以分析哪些精神卫生专业人员(全科医生、精神病医生,临床心理学家,和心理健康护士)和公众思考有或没有专业治疗的精神分裂症预后以及精神分裂症干预措施的积极和消极长期结果。
    对于专业治疗精神分裂症的预后,ChatGPT-3.5非常悲观,而ChatGPT-4,克劳德,和巴德与专业观点一致,但与普通公众不同。所有LLM都认为,未经专业治疗的精神分裂症将保持静止或恶化。对于长期结果,ChatGPT-4和Claude预测的负面结果比Bard和ChatGPT-3.5更多。为了取得积极成果,ChatGPT-3.5和Claude比Bard和ChatGPT-4更悲观。
    在考虑“治疗”条件时,发现4个LLM中有3个与心理健康专业人员的预测密切相关,这证明了该技术在提供专业临床预后方面的潜力。ChatGPT-3.5的悲观评估是一个令人不安的发现,因为它可能会降低患者开始或坚持精神分裂症治疗的动机。总的来说,尽管法学硕士在加强医疗保健方面有希望,它们的应用需要严格的验证和与人类专业知识的和谐融合。
    UNASSIGNED: The current paradigm in mental health care focuses on clinical recovery and symptom remission. This model\'s efficacy is influenced by therapist trust in patient recovery potential and the depth of the therapeutic relationship. Schizophrenia is a chronic illness with severe symptoms where the possibility of recovery is a matter of debate. As artificial intelligence (AI) becomes integrated into the health care field, it is important to examine its ability to assess recovery potential in major psychiatric disorders such as schizophrenia.
    UNASSIGNED: This study aimed to evaluate the ability of large language models (LLMs) in comparison to mental health professionals to assess the prognosis of schizophrenia with and without professional treatment and the long-term positive and negative outcomes.
    UNASSIGNED: Vignettes were inputted into LLMs interfaces and assessed 10 times by 4 AI platforms: ChatGPT-3.5, ChatGPT-4, Google Bard, and Claude. A total of 80 evaluations were collected and benchmarked against existing norms to analyze what mental health professionals (general practitioners, psychiatrists, clinical psychologists, and mental health nurses) and the general public think about schizophrenia prognosis with and without professional treatment and the positive and negative long-term outcomes of schizophrenia interventions.
    UNASSIGNED: For the prognosis of schizophrenia with professional treatment, ChatGPT-3.5 was notably pessimistic, whereas ChatGPT-4, Claude, and Bard aligned with professional views but differed from the general public. All LLMs believed untreated schizophrenia would remain static or worsen without professional treatment. For long-term outcomes, ChatGPT-4 and Claude predicted more negative outcomes than Bard and ChatGPT-3.5. For positive outcomes, ChatGPT-3.5 and Claude were more pessimistic than Bard and ChatGPT-4.
    UNASSIGNED: The finding that 3 out of the 4 LLMs aligned closely with the predictions of mental health professionals when considering the \"with treatment\" condition is a demonstration of the potential of this technology in providing professional clinical prognosis. The pessimistic assessment of ChatGPT-3.5 is a disturbing finding since it may reduce the motivation of patients to start or persist with treatment for schizophrenia. Overall, although LLMs hold promise in augmenting health care, their application necessitates rigorous validation and a harmonious blend with human expertise.
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  • 文章类型: Journal Article
    背景:慢性化脓性中耳炎(CSOM)是一种普遍且持续的中耳疾病,不仅影响听觉健康,而且可能影响个人生活的各个方面。本研究探讨了CSOM,抑郁症,焦虑,和压力,使用21项抑郁症,焦虑,和应力标度(DASS21),还使用慢性耳朵调查(CES)问卷评估生活质量(QoL)。这项研究的主要目的是收集前瞻性听力学数据以及有关疾病特定生活质量和心理健康的信息。利用经过验证的测量仪器。
    方法:这项横断面研究是在印度中部的三级护理中心进行的,涉及182例CSOM患者。该研究包括至少一只耳朵被诊断为CSOM的18岁及以上的个体。有心理障碍史的患者,头部受伤,那些有糖尿病等合并症的人,高血压,排除了慢性心脏病。纯音测听法用于听力评估,而心理健康评估采用了DASS21问卷。此外,使用CES工具评估生活质量。
    结果:从最初的182例诊断为CSOM的患者队列中,根据预定义的标准排除了32个,最终得到150名患者的样本。队列,平均年龄34.3岁,以女性为主(63.3%)。使用DASS21进行的心理评估显示22名(14.7%)患者患有抑郁症,23名(15.3%)患者患有焦虑症。在抑郁症患者中,大多数参与者患有轻度抑郁症。同样,在那些焦虑的人中,发现大多数人正在经历轻度焦虑。双侧CSOM表现出更高的焦虑和抑郁患病率,建立一个重要的协会。QoL参数,由慢性耳朵调查评估,在所有类别的双侧病例中,除症状外,均显示出更多的不利影响。心理幸福感之间的相关分析,生活质量,和听力损失的严重程度产生了统计学上显著的结果。
    结论:具有听力损失症状的CSOM可导致患病个体的QoL和心理幸福感降低。这项研究强调了CSOM的心理影响,特别是在双侧病例和严重听力损失中。将心理支持纳入治疗计划对于全面的患者护理至关重要。定期评估对于指导及时干预至关重要,确保采取整体方法,以提高受CSOM影响的个人的生活质量和心理健康。
    BACKGROUND: Chronic suppurative otitis media (CSOM) is a prevalent and persistent middle ear condition that not only affects auditory health but also potentially influences various aspects of an individual\'s life. This study explores the correlation between CSOM, depression, anxiety, and stress, using the 21-item Depression, Anxiety, and Stress Scale (DASS 21), also assessing quality of life (QoL) using the Chronic Ear Survey (CES) questionnaire. The primary objective of this study was to gather prospective audiological data along with information on both disease-specific quality of life and psychological well-being, utilizing validated measurement instruments.
    METHODS: This cross-sectional study was conducted at a tertiary care center in Central India, involving 182 patients with CSOM. The study included individuals aged 18 years and above diagnosed with CSOM in at least one ear. Patients with a history of psychological disorders, head injury, and those with comorbidities such as diabetes, hypertension, and chronic heart diseases were excluded. Pure tone audiometry was employed for hearing evaluation, while the assessment of psychological well-being utilized the DASS 21 questionnaire. Furthermore, the quality of life was evaluated using the CES tool.
    RESULTS: From the initial cohort of 182 patients diagnosed with CSOM, 32 were excluded based on predefined criteria, resulting in a final sample of 150 patients. The cohort, with a mean age of 34.3 years, exhibited a predominantly female population (63.3%). Psychological assessments using DASS 21 revealed depression in 22 (14.7%) patients and anxiety in 23 (15.3%) patients. Among those with depression, majority of the participants had mild depression. Similarly, among those with anxiety, the majority were found to be experiencing mild anxiety. Bilateral CSOM demonstrated a higher prevalence of anxiety and depression, establishing a significant association. QoL parameters, assessed by the Chronic Ear Survey, indicated a more adverse impact in bilateral cases across all categories except symptoms. Correlation analysis between psychological well-being, quality of life, and hearing loss severity yielded statistically significant results.
    CONCLUSIONS: CSOM with the symptom of hearing loss can lead to reduced QoL and psychological well-being in the affected individuals. This study highlights the psychological impact of CSOM, particularly in bilateral cases and severe hearing loss. Integrating psychological support into treatment plans is crucial for comprehensive patient care. Regular assessments are essential for guiding timely interventions, ensuring a holistic approach to enhance both quality of life and psychological well-being in individuals affected by CSOM.
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