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  • 文章类型: Systematic Review
    背景:难民,寻求庇护者,和国内流离失所者由于经历创伤和压力事件而经历精神健康问题的沉重负担。目的:总结现有证据,分析简短的心理干预(<3个月)对改善心理健康结果的疗效。包括抑郁症,焦虑,和难民的创伤后应激障碍(PTSD)相关症状。方法:我们搜索了Medline,EMBASE,PsycINFO,CINAHL,和全球指数从成立到2023年12月19日。我们纳入了在短时间内(<3个月)使用任何认知行为疗法(CBT)或基于CBT的疗法的对照研究。报告了干预前后的心理健康结果。我们使用随机效应进行了荟萃分析,以得出汇总统计量。使用Cochrane偏差风险(RoB2)和ROBINS-I工具评估证据的质量。这项研究在开放科学框架上注册,DOI10.17605/OSF.IO/9CXU4。结果:检索了37篇出版物中的34项合格研究进行分析,荟萃分析中纳入了33项研究,包括4479名参与者.所有三个领域的即时心理健康结果都有了总体改善,分析了13项关于焦虑结局的研究(SMD-1.12,95%CI-1.72至-0.52),20项抑郁症研究(SMD-1.04,95%CI-1.97至-0.11),和24项关于创伤后应激障碍的研究(SMD-0.82,95%CI-1.20至-0.45)。在3至6个月的随访中,然而,对心理健康结果的分析显示,与基线相比没有显著变化,在4项研究中,SMD为0.24(95%CI-0.94至1.42),在9项研究中-0.73(95%CI-2.14至0.68),在12项焦虑研究中,0.29项(95%CI-0.94至1.53),抑郁症,和PTSD分别。结论:低质量证据表明,简短的心理干预对难民和国内流离失所者的心理健康具有积极的立竿见影的作用。然而,这些影响在短期随访中不会持续。异质性很高,即使在亚组中,影响我们的发现的普遍性。
    我们分析了使用简短的基于CBT的心理干预措施来改善被迫流离失所者的心理健康结果的证据。这些干预措施对焦虑有积极的影响,抑郁症和创伤后应激障碍,尽管研究之间存在高度异质性。对心理健康的积极影响在长期随访中消失了。
    Background: Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events.Objective: To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees.Method: We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4.Results: 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD -1.12, 95% CI -1.72 to -0.52), 20 studies on depression (SMD -1.04, 95% CI -1.97 to -0.11), and 24 studies on PTSD (SMD -0.82, 95% CI -1.20 to -0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI -0.94 to 1.42) across 4 studies, -0.73 (95% CI -2.14 to 0.68) across 9 studies, and 0.29 (95% CI -0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively.Conclusion: Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people\'s mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings\' generalisability.
    We analysed the evidence on the use of brief CBT-based psychological interventions to improve mental health outcomes in forcibly displaced persons.These interventions had a positive effect on anxiety, depression and PTSD, though there was high heterogeneity between studies.Positive effects on mental health disappeared at long-term follow-up.
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  • 文章类型: Journal Article
    背景:在第二次世界大战后占领奥地利期间,大约20,000-30,000“战争出生的孩子”(CBOW),也被称为职业儿童是通过奥地利妇女和占领军之间的亲密接触而出生的。对其他CBOW种群的研究表明,CBOW大多在困难的条件下长大,有时会有强烈的长期心理健康后果。目的:研究是否可以在奥地利职业儿童(AOC)中发现可比的社会心理后果,进行了第一次定量研究。方法:虐待儿童,创伤后应激障碍,抑郁症和躯体化,使用自我报告工具在98个AOC样本中评估了一般生活满意度。将结果与德国职业儿童样本进行比较(GOC;N=146)。结果:高于阈值的PTSD患病率高(10.2%)和部分(14.3%),在AOC中发现了躯体症状(16.3%)和抑郁症状(11.1%)。他们受到儿童虐待的风险很高(例如情感虐待:53.6%),这与当前的症状有关。值得注意的是,AOC倾向于报告较高的总体生活满意度。在GOC和AOC之间没有发现差异。结论:研究结果强调了发育状况和儿童虐待对CBOW心理健康的复杂和长期影响,甚至几十年后。高生活满意度的发现提供了整个生命周期的弹性和成熟过程的证据。
    奥地利职业儿童表现出儿童虐待及其长期后果的显著脆弱性,包括高于阈值的PTSD的高患病率,躯体,和抑郁症状。关于第二次世界大战后在奥地利成长为职业儿童的心理社会后果的发现与先前在类似人群中的研究一致,可以概括为战争出生的儿童或多或少典型的共同经历。尽管有心理困扰,职业儿童表现出惊人的生活满意度,暗示潜在的韧性。
    Background: During the post-World War II occupation of Austria, approximately 20,000-30,000 \'children born of war\' (CBOW), also called occupation children were born through intimate contacts between Austrian women and occupation soldiers. Research on other CBOW populations indicates that CBOW mostly grow up under difficult conditions, sometimes with strong long-term mental health consequences.Objective: To examine whether comparable psychosocial consequences can be found in Austrian occupation children (AOC), a first quantitative study was carried out.Method: Child maltreatment, post-traumatic stress disorder, depression and somatization, and general life satisfaction were assessed in a sample of 98 AOC using self-report instruments. Results were compared to a sample of German occupation children (GOC; N = 146).Results: High prevalence of above threshold full (10.2%) and partial (14.3%) PTSD, somatic (16.3%) and depressive (11.1%) symptomatology were found in AOC. They were at high risk of child maltreatment (e.g. emotional abuse: 53.6%), which was associated with current symptomatology. Notably, AOC tended to report high levels of general life satisfaction. No differences were found between GOC and AOC.Conclusions: Findings highlight the complex and long-term effects of developmental conditions and childhood maltreatment on mental health of CBOW, even decades later. Findings of high life satisfaction provide evidence of resilience and maturation processes across the lifespan.
    Austrian occupation children show a notable vulnerability to childhood maltreatment and its long-term consequences, including a high prevalence of above threshold PTSD, somatic, and depressive symptomatology.Findings on the psychosocial consequences of growing up as occupation children in Austria after World War II are consistent with previous studies in similar populations and can be generalized as more or less typical common experiences of children born of war.Despite psychological distress, occupation children showed surprising levels of life satisfaction, suggesting potential resilience.
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  • 文章类型: Journal Article
    背景:妊娠丢失(PL)是常见的,然而,很少检查与心理健康受损风险增加相关的公共卫生问题,尤其是抑郁症。目标:先前的研究表明,无子女与PL后的抑郁症有关。第一批研究还表明损失类型的关联,多重损失,关系质量,以及怀孕后抑郁的应对策略。然而,结果不一致,少数现有研究显示方法学缺陷。因此,我们期望没有活孩子的女性抑郁得分更高,我们探索性地研究了损失类型之间的关联,损失的数量,关系质量,以及患有PL的女性抑郁评分的应对策略。方法:在联机设置中,在过去的12个月中,n=172例流产(n=137)或死产(n=35)的妇女完成了患者健康问卷(PHQ-D),简短-COPE,和Partnerschaftsfragebogen(PFB),衡量关系质量的德国问卷。结果:在多元层次回归分析中,死产,β=0.15,p=.035,存在活着的孩子,β=-0.17,p=0.022,自责/情绪回避,β=0.34,p<.001,是抑郁评分的预测因子。然而,抑郁症状和其他应对策略之间没有关联,关系质量,多重损失。结论:特别是对于没有活孩子的妇女,患有死胎,或者受到自责/情感回避的影响,卫生保健提供者应监测抑郁症状的存在。我们的结果表明,PL后需要特定的工具来衡量应对方式和关系质量,因为PFB和Brief-COPE的标准项目似乎不适合此设置。
    与流产相比,死产与更高的产妇抑郁评分相关。有活着孩子的女性在怀孕后比没有孩子的女性表现出更低的抑郁评分。自责和情绪回避与怀孕失败后更高的母亲抑郁评分相关。
    Background: Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.Objective: Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.Method: In an online setting, N = 172 women with miscarriage (n = 137) or stillbirth (n = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.Results: In a multiple hierarchical regression analysis, stillbirth, β = 0.15, p = .035, presence of living children, β = -0.17, p = .022, and self-blame/emotional avoidance, β = 0.34, p < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.Conclusions: Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.
    Stillbirth is associated with higher maternal depression scores than miscarriage.Women with living children show lower depression scores after pregnancy loss than childless women.Self-blame and emotional avoidance are associated with higher maternal depression scores after pregnancy loss.
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  • 文章类型: Journal Article
    背景:这项研究旨在确定潜在医疗状况数量之间的差异,抑郁症,和焦虑,当控制年龄的协变量时,性别,完成教育。
    方法:参与者(n=484)指出了调查期间出现的医疗状况的数量,还包括PHQ-9和GAD-7,以评估抑郁和焦虑,分别。
    结果:在控制上述协变量后,在医疗条件组和PHQ-9和GAD-7的组合值之间发现了差异(F4,954=5.78;WilksΛ=0.95;P<0.0005)。单变量检验显示3组间PHQ-9(F2,478=8.70;P<0.0005)和GAD-7(F2,478=11.16;P<0.0005)的差异。最后,事后分析显示,有一种医疗状况和无医疗状况的参与者之间存在差异(PHQ-9:MD=1.82;95CI,0.25-3.40;GAD-7:MD=1.73;95CI,0.55-2.91),以及有一种以上疾病的参与者和无疾病的参与者之间(PHQ-9:MD=3.10;95CI,1.11-5.10;GAD-7:MD=2.46;95CI,0.97-3.95)。
    结论:我们的结果表明,在COVID-19大流行期间患有疾病的人更容易出现严重的焦虑和抑郁症状。
    BACKGROUND: This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education.
    METHODS: Participants (n = 484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively.
    RESULTS: Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4,954 = 5.78; Wilks\' Λ = 0.95; P < 0.0005). The univariate tests showed differences for PHQ-9 (F2,478 = 8.70; P < 0.0005) and GAD-7 (F2,478 = 11.16; P < 0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD = 1.82; 95%CI, 0.25-3.40; GAD-7: MD = 1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: MD = 3.10; 95%CI, 1.11-5.10; GAD-7: MD = 2.46; 95%CI, 0.97-3.95).
    CONCLUSIONS: Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.
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  • 文章类型: Systematic Review
    背景:众所周知,不坚持服用精神药物对患者和社会都有有害后果。
    目的:收集有关不依从发生率的信息,以及影响重度和持续性精神障碍患者坚持精神药物治疗的因素和原因。
    方法:对过去五年(2015-2020年)在PubMed等专业数据库上发表的有关成年患者(>17岁)的科学文章进行了系统回顾,Scopus,Scielo和BioMed.来自索引期刊的影响因子>0.5的原始文章,英文或西班牙文,通过分析,prospective,回顾性,纳入横断面和随机设计.一旦确定了物品,对它们进行了分析,提取回答研究问题所需的信息。
    结果:共15篇。其中,40%(n=6)在2020年发表,20%(n=3)在中国生产,53.3%(n=8)具有观察性设计。共纳入5,837名患者,其中50.6%是男性(n=2955),在10项调查中报告了中等依从性(n=10;66.7%)。不依从性从7.7%到60.6%不等。影响依从性的因素是患者特有的(年龄和性别),他们的家庭支持网络,与疾病或治疗有关。不坚持的主要原因是缺乏洞察力。
    结论:精神药物治疗的依从性是多因素的。应改善获得精神卫生服务的机会,重点放在病人教育和提供更多的精神疾病知识。促进教育和与精神科医生互动的干预措施可能是有益的。
    BACKGROUND: It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society.
    OBJECTIVE: To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders.
    METHODS: A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015-2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions.
    RESULTS: Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight.
    CONCLUSIONS: Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial.
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  • 文章类型: Journal Article
    背景:抑郁症是全球因疾病致残的主要原因之一。以前的研究已经证明了抑郁症诊断的显著异质性,有必要开发新的诊断方法。网络分析是将症状视为精神疾病本身的组成部分的观点。目的是使用CES-D和ZDS抑郁量表确定抑郁症状的结构。
    方法:使用CES-D和ZDS量表对194例患者进行二次分析的横断面研究。从数据库中构建相关矩阵和正则化偏相关网络。估计了中心性度量,并进行了网络稳定性分析。
    结果:在CES-D量表上,最核心的项目是“悲伤”;而在ZDS量表上,最核心的项目是“悲伤”和“生活”。在CES-D尺度上,“享受”和“快乐”之间的联系是最强烈的。在ZDS尺度上,最强的连接是项目之间的“活”与“有用”。项目“早晨”是ZDS上连接最少的项目。
    结论:CES-D量表最主要的症状是悲伤,而从ZDS量表来看,是悲伤和快感。
    BACKGROUND: Depression represents one of the leading causes of disability due to illness worldwide. Previous studies have demonstrated the significant heterogeneity of the diagnosis of depression, making it necessary to develop new diagnostic approaches. Network analysis is a perspective that considers symptoms as constituents of the psychiatric disorder itself. The objective was to determine the structure of depressive symptoms using the CES-D and ZDS depression scales.
    METHODS: Cross-sectional study of secondary analysis of 194 patients using the CES-D and ZDS scales. Correlation matrices and regularised partial correlation networks were constructed from the database. Centrality measures were estimated, and a network stability analysis was performed.
    RESULTS: On the CES-D scale, the most central item was \"Sad\"; while on the ZDS scale, the most central items were \"Sad\" and \"Live\". On the CES-D scale, the connection between \"Enjoy\" and \"Happy\" was the strongest. On the ZDS scale, the strongest connection was between the items \"Live\" with \"Useful\". The item \"Morning\" was the least connected on the ZDS.
    CONCLUSIONS: The most central symptom from the CES-D scale was sadness, while from the ZDS scale, was sadness and anhedonia.
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  • 文章类型: Journal Article
    背景:难民和寻求庇护者(ASR)除了受到各种其他压力外,还经常遭受损失,并且经常表现出高水平的各种心理症状。目的:本研究旨在初步确定长期悲伤障碍(PGD)的集群,创伤后应激障碍(PTSD),和失去亲人的ASR中的抑郁症状,其次确定聚类成员关系的预测因子。在探索性分析中调查了与社会人口统计学和飞行相关的变量。方法:德国的ASR(N=92)与人际流失接触,即至少一个失踪或去世的亲戚或朋友,通过基于访谈的PGD问卷进行评估,创伤后应激障碍,和抑郁症状。我们使用k均值聚类分析来区分症状概况,并使用逻辑回归分析来确定聚类成员的预测因子。结果:我们发现了一个三簇解决方案。PGD簇(30%)的特征主要是PGD症状,而PGD/PTSD集群(32%)具有较高的PGD和PTSD以及中度抑郁症状。弹性集群(38%)总体症状较低。相对于弹性集群,不安全居住状态预测PGD和PGD/PTSD集群中的成员资格,而相对于其他集群,较高的依恋焦虑预测了PGD/PTSD集群中的成员资格。探索性分析显示,住院时间是一个重要的预测因素。结论:研究结果可以扩展有关欧洲丧亲ASR中不同症状特征的最新知识。对依恋和迁移相关变量进行区分的见解为干预提供了起点。
    在德国失去亲人的寻求庇护者和难民可以分为三个症状群:(1)主要是长时间的悲伤,(2)长时间的悲伤,高创伤后压力,和中度抑郁症状,(3)症状负荷低。与附件和迁移相关的变量(即居住状态,逗留时间,和依恋焦虑)区分聚类成员。结果强调了在失去亲人的寻求庇护者和难民中关注概况的重要性,而不仅仅是单一类别的症状和依恋特征。
    Background: Refugees and asylum seekers (ASRs) are frequently exposed to loss in addition to a variety of other stressors and often display high levels of various psychological symptoms.Objective: The study aimed to primarily determine clusters of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in bereaved ASRs and secondly identify predictors of cluster membership. Sociodemographic  - and flight-related variables were investigated in exploratory analyses.Method: ASRs in Germany (N = 92) with interpersonal loss exposure, i.e. at least one missing or deceased relative or friend, were assessed with interview-based questionnaires for PGD, PTSD, and depressive symptoms. We used k-means cluster analysis to distinguish symptom profiles and logistic regression analyses to identify predictors of cluster membership.Results: We found a three-cluster-solution. The PGD-cluster (30%) was characterised predominantly by PGD symptoms, while the PGD/PTSD-cluster (32%) had high PGD and PTSD and moderate depressive symptoms. The resilient cluster (38%) showed low symptoms overall. insecure residence status predicted membership in the PGD and PGD/PTSD clusters relative to the resilient cluster, whilst higher attachment anxiety predicted membership in the PGD/PTSD cluster relative to the other clusters. Explorative analysis revealed duration of stay as a significant predictor.Conclusion: Findings can extend the current knowledge about different symptom profiles among bereaved ASRs in Europe. Insights to attachment  - and migration-related variables distinguishing between these profiles offer starting points for interventions.
    Bereaved asylum seekers and refugees in Germany can be grouped into three symptom clusters: (1) predominantly prolonged grief, (2) high prolonged grief, high posttraumatic stress, and moderate depressive symptoms, and (3) low symptom load.Attachment  – and migration-related variables (i.e. residence status, duration of stay, and attachment anxiety) distinguish between cluster membership.Results highlight the importance of attending to profiles and not only single categories of symptoms and attachment features in bereaved asylum seekers and refugees.
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  • 文章类型: Journal Article
    OBJECTIVE: The goal of our study is to determine the level of Internet addiction (IA) in adolescents by utilizing the IA scale.
    METHODS: We employed two tools: the IA test (IAT) and the beck depression inventory (BDI), complemented by a sociodemographic information form, to assess IA and depression levels.
    RESULTS: A total of 201 participants were included. A positive correlation was found between daily Internet usage time and IAT scores (r = 0.388, p < 0.001) and between BDI scores and IAT scores (r = 0.161, p = 0.013). Females had a lower mean IAT score (63.56 ± 28.08) (p < 0.001). The BDI scores varied significantly across the groups (p = 0.004). The mean BDI scores were higher in the severe addiction group (13.53 ± 7.15) compared to the moderate (11.04 ± 6.62), mild (10.11 ± 5.38), and normal usage groups (9.28 ± 5.54). A significant difference was found in gender distribution across the groups (p = 0.001). The presence of suicidal ideation differed significantly across the groups (p = 0.002). The presence of depression showed a significant difference (p = 0.038).
    CONCLUSIONS: Our study reveals a significant correlation between increased Internet usage and heightened levels of IA and depression among adolescents, with notable gender differences in IA severity.
    OBJECTIVE: Determinar el nivel de adicción a internet en adolescentes utilizando una escala de adicción a internet.
    UNASSIGNED: Nuestro estudio involucró a 201 estudiantes con adicción a internet. Empleamos dos herramientas, la IAT (internet addiction test) y el BDI (beck depression inventory), que se complementaron con un formulario de información sociodemográfica, para evaluar los niveles de adicción a internet y de depresión.
    RESULTS: Se encontró una correlación positiva entre el tiempo diario de uso de internet y las puntuaciones del IAT (r = 0.388; p < 0.001), así como entre las puntuaciones del BDI y del IAT (r = 0.161; p = 0.013). Las mujeres tuvieron una puntuación media más baja en el IAT (p < 0.001). Las puntuaciones del BDI variaron significativamente entre los grupos (p = 0.004). Las puntuaciones medias del BDI fueron más altas en el grupo de adicción grave en comparación con los grupos de adicción moderada y de uso normal. Se encontró una diferencia significativa en la distribución por sexo entre los grupos (p = 0.001). La presencia de ideación suicida difirió significativamente entre los grupos (p = 0.002). La presencia de depresión mostró una diferencia significativa (p = 0.038).
    CONCLUSIONS: Nuestro estudio revela una correlación significativa entre mayor uso de internet y niveles elevados de adicción y depresión en adolescentes, con diferencias de sexo notables en la gravedad de la adicción.
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  • 文章类型: Journal Article
    OBJECTIVE: The objective of the study is to evaluate how electroconvulsive therapy (ECT) affects treatment-resistant depression, bipolar and schizophrenic patient groups, and suicide attempt histories and to evaluate the relationship between treatment variables and patient outcomes.
    METHODS: In a retrospective cohort study at the inpatient psychiatry clinic of Çam and Sakura City Hospital between January, 2021, and February, 2023, 103 patients receiving ECT were analyzed. They were categorized into two groups according to indications that suicide risk (n = 76) and resistance to pharmacotherapy (n = 27).
    RESULTS: The analysis revealed no significant age (p = 0.374) or gender (p = 0.304) differences between groups. However, significant differences emerged in diagnostic distribution (p = 0.027), with the suicide risk group receiving more ECT sessions (13.6 ± 11.2, p = 0.025) and experiencing longer total seizure times (427 ± 325 s, p = 0.023) compared to the treatment-resistant group (8.5 ± 4.7 sessions and 279 ± 115 s, respectively).
    CONCLUSIONS: ECT\'s therapeutic application does not differ from demographic variables but is influenced by clinical diagnosis, with suicide risk patients receiving more intensive treatment. These findings highlight the necessity of individualized ECT protocols and suggest that diagnostic considerations are critical in optimizing ECT treatment strategies. Despite its retrospective design, the study underscores the importance of personalized ECT regimens and calls for further prospective research to validate these findings.
    OBJECTIVE: Evaluar cómo la terapia electroconvulsiva afecta a grupos de pacientes con depresión resistente al tratamiento, trastorno bipolar, esquizofrenia y antecedentes de intentos suicidio, y evaluar la relación entre variables de tratamiento y resultados.
    UNASSIGNED: En una cohorte retrospectiva en la clínica de psiquiatría para pacientes internados del Çam and Sakura City Hospital, entre el 01/2021 y el 03/2023, se analizaron 103 pacientes que recibieron terapia electroconvulsiva. Estos se clasificaron en dos grupos según los indicios de riesgo de suicidio (n = 76) y de resistencia a la farmacoterapia (n = 27).
    RESULTS: El análisis no mostró diferencias significativas en cuanto a edad (p = 0.374) y sexo (p = 0.304) entre los grupos. Sin embargo, hubo diferencias significativas en la distribución diagnóstica (p = 0.027), con el grupo de riesgo de suicidio recibiendo más sesiones de terapia electroconvulsiva (13.6 ± 11.2; p = 0.025) y experimentando tiempos totales de convulsión más largos (427 ± 325 segundos; p = 0.023) en comparación con el grupo resistente al tratamiento (8.5 ± 4.7 sesiones y 279 ± 115 segundos, respectivamente).
    CONCLUSIONS: La aplicación terapéutica de la terapia electroconvulsiva no difiere según las variables demográficas, pero sí se ve influenciada por el diagnóstico clínico, recibiendo los pacientes de riesgo de suicidio un tratamiento más intensivo.
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  • 文章类型: Journal Article
    目的:分析COVID-19大流行对西班牙院外急救服务护士心理健康的影响,确定更严重的预测因素。
    方法:设计了一项多中心横断面描述性研究,包括2021年01月02日至2021年04月30日期间在任何西班牙医院外急诊服务工作的所有护士。主要结果是抑郁水平,通过DASS-21量表评估焦虑和压力。社会人口统计学,临床,还收集了职业信息。进行单变量和多变量分析以确定变量之间可能的关联。
    结果:样本包括474名护士。32.91%,32.70%和26.33%的参与者患有严重或极严重的抑郁症,焦虑和压力,分别。处理压力情况能力较低的专业人士,那些在大流行发作之前曾使用过精神药物和/或心理治疗的人,或者那些改变了工作条件的人更有可能患上更严重的抑郁症,焦虑和/或压力。
    结论:西班牙院外急救服务的护士出现了中等水平的抑郁症,大流行期间的焦虑和压力。临床和职业因素与较高程度的心理困扰有关。有必要采取策略,促进专业人员的自我效能和减轻负面情绪状态的触发。
    OBJECTIVE: To analyse the impact of the COVID-19 pandemic on the mental health of nurses in Spanish out-of-hospital Emergency Services, identifying predictor factors of greater severity.
    METHODS: A multicentre cross-sectional descriptive study was designed, including all nurses working in any Spanish out-of-hospital Emergency Services between 01/02/2021 and 30/04/2021. The main outcomes were the level of depression, anxiety and stress assessed through the DASS-21 scale. Sociodemographic, clinical, and occupational information was also collected. Univariate and multivariate analyses were conducted to determine possible associations between variables.
    RESULTS: The sample included 474 nurses. 32.91%, 32.70% and 26.33% of the participants had severe or extremely severe levels of depression, anxiety and stress, respectively. Professionals with fewer competencies to handle stressful situations, those who had used psychotropic drugs and/or psychotherapy on some occasion before the pandemic onset, or those who had changed their working conditions presented more likelihood of developing more severe levels of depression, anxiety and/or stress.
    CONCLUSIONS: Nurses in Spanish out-of-hospital Emergency Services have presented medium levels of depression, anxiety and stress during the pandemic. Clinical and occupational factors have been associated with a higher degree of psychological distress. It is necessary to adopt strategies that promote professionals\' self-efficacy and mitigate the triggers of negative emotional states.
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