The development of mental illness often leads to pervasive losses in different areas of people's lives. However, previous research has tended to focus on the loss experienced by families while the ...examination of the loss experienced by individuals who are themselves coping with mental illness has been neglected. The present study tested the factor structure of the Hungarian version of the Personal Loss from Mental Illness (PLMI) scale, and analyzed its associations with age, gender, previous hospitalizations, marital status, loneliness, grief, and quality of life.
Mentally ill patients (N = 200) with different diagnoses were recruited from a mental health center in Hungary, and completed self-report questionnaires. Confirmatory factor analysis (CFA) with covariates was conducted.
CFA analyses rejected the previous four-factor structure and suggested a single factor structure to be superior. Higher loss perception was predicted by higher loneliness, grief, and lower quality of life. Patients with mood disorders reported higher loss as compared to patients with other psychiatric diagnoses.
The present study stresses the magnitude of loss and raises the need to examine further the role of loss in coping and recovery. Asking patients about their feelings in clinical practice is of high importance.
•Perceived loss due to mental illnesses has been little studied.•The Personal Loss from Mental Illness (PLMI) scale was utilized in the study.•The Hungarian PLMI in the present study demonstrated a one-factor structure.•Perceived loss was related with loneliness, grief, and lower quality of life.•Higher perceived loss was associated with mood disorders.
The therapeutic communication between psychotherapist and client is highly dependent on their socio-cultural background. The purpose of this study was to examine the effects of culture on ...decision-making style of psychotherapists in three dimensions of decision-making: expedience vs. realism, individualism vs. collectivism, and long-term orientation vs. short-term orientation. The sample of this study consisted of 144 psychotherapists (40 Iranians educated in Iran, 33 Iranians educated in the west, 36 Americans, and 35 Canadians). Each of the participants were presented with three scenario that involved clinical challenging situations. For each area of decision-making a statement was considered and the psychotherapist was requested to rate them based on importance in his/her clinical decision-making. Findings indicated that the groups differed significantly on all dimensions with few exceptions when American and Canadian psychotherapists were compared. The decision-making style of Iranian psychotherapists was more with expediency, collectivism and long-term orientation, while the decision-making style of American and Canadian psychotherapists was more with realism, individualism, and short-term orientation. According to the results of current study, socio-cultural background of psychotherapists, as a frame of reference, significantly influenced their clinical decision-making style.
•Culture, as an implicit frame of reference, influences the clinical judgment of psychotherapists.•Iranian psychotherapists are expedient and family-oriented in clinical decisions.•American and Canadian psychotherapists are realistic and client-oriented clinical decisions.•The socio-cultural background of therapeutic relationship influence on goals of therapy.
Methylphenidate (MPH) is the most frequently prescribed drug in Attention Deficit Hyperactivity Disorder (ADHD). Hitherto mostly the dopamine transporter gene has been studied in MPH-response and ...only a few studies analyzed the norepinephrine transporter (NET, SLC6A2) gene, although MPH is a potent inhibitor of both dopamine and norepinephrine transporters. We aimed to analyze this monoamine transporter gene in relation to ADHD per se and MPH-response in particular to gain further knowledge in ADHD pharmacogenetics using a Caucasian sample.
Six single nucleotide polymorphisms (rs28386840, rs2242446, rs3785143, rs3785157, rs5569, rs7194256 SNP) were studied across the NET gene in 163 ADHD children (age: 9.3±2.6; 86.5% male) using ADHD-RS hyperactivity-impulsivity and inattention scales. For case-control analysis 486 control subjects were also genotyped. At the MPH-response analysis responders had minimum 25% decrease of ADHD-RS total score after 2months of treatment, and chi-square test compared 90 responders and 32 non-responders, whereas ANOVA was used to assess symptom improvement after the first month among the 122 ADHD patients.
The classical case-control analysis did not yield any association with ADHD diagnosis, which was supported by meta-analysis conducted on the available genetic data (combining previously published and the present studies). On the other hand, the intronic rs3785143 showed nominal association with inattention symptoms (p=0.01). The haplotype analysis supported this association, and indicated the importance of the first haploblock encompassing the intronic and 2 promoter SNPs. With MPH-response only the promoter rs28386840 showed nominal association: Those with at least one T-allele were overrepresented in the responder group (42% vs 19%, p=0.08), and they had better improvement on the hyperactivity-impulsivity scale compared to the AA genotype (p=0.04).
Although none of our single SNP findings remained significant after correcting for multiple testing, our results from the MPH-response analysis indicate the potential importance of promoter variants in the NET gene.
•Case-control analysis of NET polymorphisms in childhood ADHD yielded negative results.•Meta analyses confirmed lack of association between the NET gene and ADHD.•NET rs3785143 SNP showed association with inattention symptoms among ADHD patients.•Haplotype analyses of NET gene intron-1 and promoter SNPs supported this association.•ADHD children with NET rs28386840 T-allele showed better methylphenidate response.
•CIWA-Ar is suitable for following the course of alcohol withdrawal syndrome.•CIWA-Ar scores indicated no significant differences in BZD and nBZD groups.•The CIWA-Ar is crucial in the ...symptom-triggered treatment for alcohol withdrawal.
Although the Clinical Institute Withdrawal Assessment for Alcohol – Revised (CIWA-Ar) is a gold standard tool for the clinical evaluation of alcohol withdrawal syndrome (AWS), a systematic analysis using the total scores of the CIWA-Ar as a means of an objective follow-up of the course and treatment of AWS is missing. The aims of the present study were to systematically evaluate scientific data using the CIWA-Ar, to reveal whether the aggregated CIWA-Ar total scores follow the course of AWS and to compare benzodiazepine (BZD) and non-benzodiazepine (nBZD) therapies in AWS.
1054 findings were identified with the keyword “ciwa” from four databases (PubMed, ScienceDirect, Web of Science, Cochrane Registry). Articles using CIWA-Ar in patients treated with AWS were incorporated and two measurement intervals (cumulative mean data of day 1−3 and day 4−9) of the CIWA-Ar total scores were compared. Subgroup analysis based on pharmacotherapy regimen was conducted to compare the effectiveness of BZD and nBZD treatments.
The random effects analysis of 423 patients showed decreased CIWA-Ar scores between the two measurement intervals (BZD: d = –1.361; CI: –1.829 < δ < –0.893; nBZD: d = –0.858; CI: –1.073 < δ < –0.643). Sampling variances were calculated for the BZD (v1 = 0.215) and the nBZD (v2 = 0.106) groups, which indicated no significant group difference (z = −1.532).
Our findings support that the CIWA-Ar follows the course of AWS. Furthermore, nBZD therapy has a similar effectiveness compared to BZD treatment based on the CIWA-Ar total scores.
In recent years, drug prevention networks and drug education programs have started using Web-based or mobile phone apps as novel prevention tools, testing their efficacy compared with face-to-face ...prevention.
The aim of this study was to assess the potential of an interactive app called Once Upon a High (VoltEgySzer).
The app approaches drug prevention from 6 different aspects, and it addresses youngsters with 6 different modules: (1) interactive comics/cartoons, telling stories of recovery; (2) quiz game; (3) roleplay game; (4) introduction of psychoactive drugs; (5) information on the somatic and psychological effects of psychoactive substances; (6) list of available treatment units, rehabs, and self-support groups in Hungary. Students of 2 vocational schools and 2 high schools filled out a questionnaire at a baseline (T0) and a 2-month follow-up (T1) data collection session. Students of 1 vocational school and 1 high school downloaded the Once Upon a High app (app group), whereas students from the other vocational school and high school did not (nonapp group). The time points of T0 and T1 questionnaires contained demographic variables, items with regard to substance use characteristics for both legal and illegal substances, including novel psychoactive substance, exercise habits, knowledge about psychoactive substances, attitudes toward substance users and validated instruments measuring the severity of tobacco (Fagerström Test for Nicotine Dependence), alcohol (Alcohol Use Disorder Identification Test), cannabis (Cannabis Abuse Screening Test), and synthetic cannabinoid consumption. Beliefs about substance use (Beliefs About Substance Abuse) and perceived self-efficacy (General Perceived Self-Efficacy) were also measured. At T1, members of the app group provided additional evaluation of the app.
There were 386 students who participated in the T0 session. After dropout, 246 students took part in T1 data collection procedure. Alcohol was the most frequently consumed psychoactive substance (334/364, 91.8% lifetime use), followed by tobacco (252/386, 65.3%, lifetime use) and cannabis (43/323, 13.3% lifetime use). Decreased self-efficacy (beta=-.29, P=.04) and increased daily physical exercise frequencies (beta=.04, P<.001) predicted higher frequencies of past month energy drink consumption, whereas elevated past month alcohol consumption was mainly predicted by a decrease in negative attitudes toward substance users (beta=-.13, P=.04) in the regression models. Once Upon a High was found to be effective only in reducing energy drink consumption (beta=-1.13, P=.04) after controlling for design effect, whereas perceived utility of the app showed correlation with a decreasing alcohol use (r
=.32, P=.03). The roleplay module of the app was found to be the most preferred aspect of the app by the respondents.
The Once Upon a High app can be a useful tool to assist preventive intervention programs by increasing knowledge and self-efficacy; however, its efficacy in reducing or preventing substance use needs to be improved and further studied. Additional potential impacts of the app need further testing.
Background:
Mental disorders may show inherent cross-national variability in their prevalence. A considerable number of meta-analyses attribute this heterogeneity to the methodological diversity in ...published epidemiological studies. Cultural values are characteristically not assessed in meta-regression models as potential covariates.
Aim:
Our aim was to conduct a meta-regression analysis to explore to what extent certain cultural values and immigration rates (as indicator of cultural diversity) might be associated with the cross-national heterogeneity of prevalence rates.
Method:
To minimize methodological differences that may exert a confounding effect, prevalence rates were obtained from the World Health Organization’s (WHO) World Mental Health Survey Initiative. Cultural indices (overall emancipative values; overall secular values) were collected from the World Value Survey, while immigration rates were registered by utilizing the data of the United Nations’ World Population Policies 2005 report.
Results:
Meta-regression analysis indicated that overall emancipative values (i.e. promoting self-expression, non-violent protest) showed significant connection with lifetime and last year prevalence of any mood disorders (Z = 4.71, p = .001; Z = 2.35, p = .02) and any internalizing disorders (a merged category that combined mood and anxiety disorders; Z = 2.82, p = .004; Z = 2.34, p = .02). Overall secular values (i.e. rejecting authority and obedience) were negatively associated with last year prevalence of depression (Z = −2.75, p = .06). Multistep regression analysis indicated that immigration rate moderated the connection between cultural values and mental disorders. Countries with higher immigration rates showed higher emancipative and secular values.
Conclusion:
Our findings might function as potential foundation for formulating hypotheses regarding the cultural context’s influence on the population’s mental health.
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