Frontiers in psychiatry
-
Frontiers in psychiatry · Jan 2019
ReviewDeep Brain Stimulation for Refractory Obsessive-Compulsive Disorder: Towards an Individualized Approach.
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder featuring repetitive intrusive thoughts and behaviors associated with a significant handicap. Of patients, 20% are refractory to medication and cognitive behavioral therapy. Refractory OCD is associated with suicidal behavior and significant degradation of social and professional functioning, with high health costs. ⋯ VC/VS-DBS, amSTN-DBS, and ALIC-DBS were also found to improve mood, behavioral adaptability and potentially both, respectively. Because OCD is such a heterogeneous disease with many different symptom dimensions, the ultimate aim should be to find the most appropriate DBS target for a given refractory patient. This quest will benefit from further investigation and understanding of the individual functional connectivity of OCD patients.
-
Frontiers in psychiatry · Jan 2019
Psychometric Properties and Factor Structure of the Chinese Version of the Hospital Anxiety and Depression Scale in People Living With HIV.
The population of people living with HIV (PLWH) is growing in number and usually results in mental health problems that impact their quality of life. Therefore, valid instruments and screening methods for psychological disorders are of great significance. The Hospital Anxiety and Depression Scale (HADS) reveals good psychometric properties, but shows ambiguous results in factor structure. ⋯ The C-HADS has good psychometric properties in terms of internal reliability and structure validity of a bifactor model. The C-HADS is recommended to be used as a total scale that measures general psychological distress, instead of anxiety and depression separately, when applied to PLWH. Further studies are needed to evaluate criterion validity, the cutoff score, and the effect of wording and scoring of the HADS.
-
Frontiers in psychiatry · Jan 2019
Childhood Maltreatment Influences Mental Symptoms: The Mediating Roles of Emotional Intelligence and Social Support.
Childhood maltreatment and its influence on mental health are key concerns around the world. Previous studies have found that childhood maltreatment is a positive predictor of mental symptoms, but few studies have been done to explore the specific mediating mechanisms between these two variables. Previous studies have found that there is a negative correlation between childhood maltreatment and emotional intelligence and between childhood maltreatment and social support, both of which are strong indicators of mental symptoms. ⋯ The results showed a significant and positive correlation between childhood maltreatment and mental symptoms (β = 0.26, P < 0.001); meanwhile, social support played a significant mediating role in the influence of childhood maltreatment on emotional intelligence [95% confidence intervals, (-0.594 to -0.327)]; and emotional intelligence likewise played a significant mediating role in the effect of social support on mental symptoms [95% confidence intervals, (-0.224 to -0.105)]. These results indicated that childhood maltreatment not only directly increases the likelihood of developing mental symptoms, but also affects emotional intelligence through influencing social support and then indirectly increasing the likelihood of developing mental symptoms. This study provided a theoretical basis for ameliorating adverse effects of childhood maltreatment on mental symptoms by enhancing emotional intelligence and social support.
-
Frontiers in psychiatry · Jan 2019
ReviewPlacebo and Nocebo Effects Across Symptoms: From Pain to Fatigue, Dyspnea, Nausea, and Itch.
Placebo and nocebo effects are, respectively, the helpful and harmful treatment effects that do not arise from active treatment components. These effects have thus far been researched most often in pain. It is not yet clear to what extent these findings from pain can be generalized to other somatic symptoms. ⋯ Individual characteristics do not consistently predict placebo or nocebo effects across symptoms or studies. In sum, many conclusions deriving from placebo and nocebo pain studies do appear to apply to other somatic symptoms, but a number of important differences exist. Understanding what type of learning mechanisms for which symptom are most likely to trigger placebo and nocebo effects is crucial for generalizing knowledge for research and therapies across symptoms and can help clinicians to optimize placebo effects in practice.
-
Frontiers in psychiatry · Jan 2019
ReviewImpacts of Psychological Stress on Osteoporosis: Clinical Implications and Treatment Interactions.
The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for osteoporosis, the mechanisms that may link these conditions, and potential implications for treatment. Traditional, alternative, and adjunctive therapies are discussed. ⋯ Review of the current literature identifies several potentially overlapping mechanistic pathways that may be of interest (e.g., glucocorticoid signaling, insulin-like growth factor signaling, serotonin signaling) for further basic and clinical research. Current literature also supports the potential for cross-effects of therapeutics for osteoporosis and mental health disorders. While studies examining a direct link between osteoporosis and chronic psychological stress are limited, the studies reviewed herein suggest that a multi-factorial, personalized approach should be considered for improved patient outcomes in populations experiencing psychological stress, particularly those at high-risk for development of osteoporosis.