To determine the impact of specialized treatments, relative to comparator treatments, upon the weight and psychological symptoms of anorexia nervosa (AN) at end-of-treatment (EOT) and follow-up.
...Randomized controlled trials (RCTs) between January 1980 and December 2017 that reported the effects of at least two treatments on AN were screened. Weight and psychological symptoms were analyzed separately for each study. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed, and studies were assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) criteria and Cochrane risk of bias tool.
We identified 35 eligible RCTs, comprising data from 2524 patients. Meta-analyses revealed a significant treatment effect on weight outcomes at EOT g = 0.16, 95% CI (0.05-0.28), p = 0.006, but not at follow-up g = 0.11, 95% CI (-0.04 to 0.27), p = 0.15. There was no significant treatment effect on psychological outcomes at either EOT g = -0.03, 95% CI (-0.14 to 0.08), p = 0.63, or follow-up g = -0.001, 95% CI (-0.11 to 0.11), p = 0.98. There was no strong evidence of publication bias or significant moderator effects for illness duration, mean age, year of publication, comparator group category, or risk of bias (all p values > 0.05).
Current specialized treatments are more adept than comparator interventions at imparting change in weight-based AN symptoms at EOT, but not at follow-up. Specialized treatments confer no advantage over comparator interventions in terms of psychological symptoms. Future precision treatment efforts require a specific focus on the psychological symptoms of AN.
Findings from previous psychotherapy research suggest that the majority of improvement takes place in the initial phase of treatment with the relative effectiveness dropping at a negatively ...accelerating rate. However, the evidence for this pattern of change comes from investigations of short-term treatments and it is unclear whether this also holds for more flexible and long-term psychotherapy. We provided open-ended treatments under routine-care conditions for a representative sample of 362 patients, including a large proportion characterized by severe psychopathology. Patients attended 52 sessions on average (SD = 59, range = 1-364, Mdn = 36). Our results indicated that the degree of improvement was linearly associated with time spent in psychotherapy and contingent upon the severity of psychological problems at intake. The least severely afflicted received the shortest treatments, experienced the most rapid change but demonstrated smaller overall magnitudes of improvement. More severely suffering patients received longer treatments, had slower rates of change but in general received greater overall benefits. We argue that previous suggestions of psychotherapy dosage have been less appropriate for patients suffering from moderate to severe psychopathology.
The COVID‐19 outbreak imposed to Italian families many changes in their daily life increasing the risk of developing psychological problems. The present study explored risk factors associated with ...parenting stress and implications for children’s emotion regulation in families with different socioeconomic risks. Parents of 2–14 years old children completed a survey reporting difficulties experienced due to the lockdown, level of household chaos, parenting stress, parent involvement in the child’s daily life, and children emotion regulation competences. The general mean levels of parenting stress and children emotion regulation abilities were not at clinical level compared with Italian norms. Household chaos predicted higher levels of parenting stress, which, in turn, was associated with less effective emotion regulation in children through the mediating role of parental involvement. More stressed parents were less involved in their children’s activities, decreasing children’s effective emotion regulation. Only for SES no‐risk families, the lockdown constraints increased parenting stress. For SES at‐risk families, the impact of parenting stress and involvement on children regulation strategies was stronger, with a protective role played by parental involvement on children’s negativity not evident for SES no‐risk families. Dealing with the lockdown is a stressful experience for parents who have to balance personal life, work, and children upbringing, without other help. This situation potentially impairs their ability to be supportive caregivers and is consequently detrimental for children well‐being. Policies should take into consideration the implications of the lockdown for families’ mental health and tailor supportive interventions according to family’s risk factors.
Resumen
El brote de la COVID‐19 impuso a las familias italianas muchos cambios en su vida cotidiana, los cuales aumentaron el riesgo de desarrollar problemas psicológicos. El presente estudio analizó los factores de riesgo asociados con el estrés de la crianza y las consecuencias para la regulación emocional de los hijos en familias con diferentes riesgos socioeconómicos. Un grupo de padres de niños de entre dos y 14 años contestó una encuesta donde informó las dificultades vividas debido al confinamiento, el nivel de caos en el hogar, el estrés en la crianza, la participación de los padres en la vida diaria de los hijos y las competencias de los hijos para regular sus emociones. Los niveles promedio generales de estrés en la crianza y las habilidades de regulación emocional en los niños no estuvieron a nivel clínico en comparación con las normas italianas. El caos en el hogar predijo niveles más altos de estrés en la crianza, el cual, a su vez, estuvo asociado con una menor regulación emocional eficaz en los niños mediante el rol mediador de la participación de los padres. Los padres más estresados participaron menos en las actividades de sus hijos, lo cual disminuyó la regulación emocional eficaz en los niños. Solo en los casos de las familias sin riesgo socioeconómico las limitaciones del confinamiento aumentaron el estrés en la crianza. Para las familias de riesgo socioeconómico, el efecto del estrés en la crianza y la participación en las estrategias de regulación emocional de los niños fue más profundo, y en el caso de las familias sin riesgo socioeconómico, no se evidenció el papel protector desempeñado por la participación de los padres en la negatividad de los niños.
Lidiar con el confinamiento es una experiencia estresante para los padres que tienen que compatibilizar la vida personal, el trabajo y la educación de los niños sin ninguna otra ayuda. Esta situación puede deteriorar su capacidad de ser cuidadores comprensivos y, como consecuencia, ser perjudicial para el bienestar de los niños. Las políticas deberían tener en cuenta las consecuencias del confinamiento en la salud mental de las familias y adaptar intervenciones de apoyo de acuerdo con los factores de riesgo de las familias.
摘要
新冠肺炎疫情给意大利家庭的日常生活带来许多变化，增加了出现心理问题的风险。本研究探讨不同社会经济风险家庭中，与父母压力相关的风险因素及它们对儿童情绪调节的影响。2至14岁儿童的父母完成了一项调查，报告了由于禁闭、家庭混乱程度、父母压力、父母参与儿童日常生活和儿童情绪调节能力所经历的困境。与意大利标准相比，养育压力和儿童情绪调节能力的一般平均水平没有达到临床水平。家庭混乱预示着更高程度的父母压力，反过来，通过父母参与的中介作用，孩子的情绪调节能力更低。父母压力越大，参与孩子活动就越少，孩子有效情绪调节能力就越弱。只有对没有社会经济地位风险的家庭来说，禁闭才会增加养育子女的压力。在有社会经济地位风险的家庭中，父母的压力和参与对儿童调节策略的影响更大，而父母参与对儿童消极情绪的保护作用在没有社会经济地位风险的家庭中并不明显。
对于那些不得不在没有其他帮助的情况下平衡个人生活、工作和抚养孩子的父母来说，应对禁闭是一件很有压力的事情。这种情况可能损害他们成为支持性照顾者的能力，因此对儿童的福祉有害。政策应考虑到封锁对家庭心理健康的影响，并根据家庭的风险因素制定支持性干预措施。
This study tested whether the strength of the mediational pathway involving interparental conflict, adolescent emotional insecurity, and their psychological problems depended on the quality of their ...sibling relationships. Using a multimethod approach, 236 adolescents (Mage = 12.6 years) and their parents participated in three annual measurement occasions. Tests of moderated mediation revealed that indirect paths among interparental conflict, insecurity, and psychological problems were significant for teens with low, but not high, quality bonds with siblings. High‐quality (i.e., strong) sibling relationships conferred protection by neutralizing interparental conflict as a precursor of increases in adolescent insecurity. Results did not vary as a function of the valence of sibling relationship properties, adolescent sex, or gender and age compositions of the dyad.
Background:
Psychosocial responses to infectious disease outbreaks have the potential to inflict acute and longstanding mental health consequences. Early research across the globe has found wide ...ranging psychological responses to the current COVID-19 pandemic. Understanding how different coping styles can be effective in mitigating mental ill health would enable better tailored psychological support.
Aims:
The aim of this study was to gain an understanding of psychosocial responses to the COVID-19 pandemic, including depression, anxiety and distress, as well as effective coping styles in an Australian sample.
Method:
A sample of 1,495 adults, residing in Australia between April 3rd and May 3rd 2020, completed an online survey which measured psychological distress (Impact of Events Scale-Revised), depression, anxiety, stress (DASS-21), as well as coping strategies (Brief COPE).
Results:
47% of the respondents were experiencing some degree of psychological distress. Females experienced higher levels of depression, anxiety and stress than males. Coping strategies associated with better mental health were positive reframing, acceptance and humour. Conversely, self-blame, venting, behavioural disengagement and self-distraction were associated with poorer mental health.
Conclusion:
Rates of psychological symptoms amongst the Australian population are similar to those reported in other countries. Findings add to the growing literature demonstrating a gender disparity in the mental health impacts of COVID-19. Positive emotion focused coping strategies may be effective for reducing psychological symptoms. Understanding psychosocial responses including beneficial coping strategies are crucial to manage the current COVID-19 situation optimally, as well as to develop mental health response plans for future pandemics.
•There existed high proportions of COVID-19 patients with psychological problems such as anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, fear.•The psychological ...problems of the patients varied in different investigation periods and different course stages, which was closely related to the patients themselves, their surroundings and social support.•The prevalence of anxiety, depression and insomnia in severe patients was higher than other patients.•The prevalence of PTSD in COVID-19 patients surveyed from mid-February to mid-March 2021 was higher than other periods.
We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic.
In this living systematic review and meta-analyses, we searched seven electronic databases for cross-sectional studies and longitudinal studies on psychological problems on COVID-19 patients from Jan 1, 2020 to Oct 7, 2020. The primary outcome was prevalence of various psychological problems such as anxiety, depression, stress, insomnia, somatization, and fear. We pooled data for prevalence with their 95% confidence interval (CI) using random effect models and assessed the study quality based on the 11-item checklist recommended by the Agency for Healthcare Research and Quality.
Fourty-four studies, including studies from China(35), Italy(2), Iran(2), India(1), Korea(1), Ecuador(1), Switzerland(1), Germany(1), were identified by comprising a total of 8587 completed questionnaires and 38 studies for meta-analyses. The prevalence of anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, and fear in patients with COVID-19 was 16.6% (10.1%-23.1%), 37.7% (29.3%-46.2%), 41.5% (9.3%-73.7%), 68.3% (48.6%-88.0%), 36.5% (20.2%-52.8%), 47.6% (9.4%-85.7%), respectively. The prevalence of anxiety, depression, and insomnia in severe COVID-19 patients (intensive care unit inpatients) was higher than mild or clinically stable COVID-19 patients.
A significant degree of heterogeneity in terms of populations, sampling methods, scales was noted across studies.
There existed high proportions of COVID-19 patients with psychological problem. The prevalence of psychological problems was closely related to the patients themselves, their surroundings and social support. It is imperative to provide ontime psychological care service for COVID-19 patients and to follow-up them for a longer period.
Aim and Background: Epidemiology of psychological problems of children with type 1 diabetes is particularly important due to the ever-increasing prevalence of its sufferers in the world and difficult ...and stressful conditions of living with this disease and also the long-term negative effects it can have on the physical, psychological, social, and spiritual development of people. Because knowing the current condition of these children is essential for any psychological planning and intervention; the present study was conducted with the aim of epidemiology of psychological problems of children with type 1 diabetes. Methods and Materials: In this descriptive-cross-sectional study, 100 children aged 8 to 12 years with type 1 diabetes in Isfahan province who were cared for in medical centers of the University of Medical Sciences in 2022 were investigated. Psychological problems including emotional-behavioral problems were measured by Children's Behavior Inventory (CBCL). The data was analyzed through SPSS software version 26 and with descriptive (mean, standard deviation and percentage) and inferential (chi-square, one-sample t-test and one-way analysis of variance) indicators. Findings: 68.7% of children examined in this research had psychological problems at the clinical level (55.2%) or borderline (13.5%).Some psychological problems were significantly related to gender and economic and educational level of the family (p ≤ 0.05). Conclusions: Children with type 1 diabetes have internalized psychological problems such as anxiety, depression, somatization, as well as externalized problems such as rule-breaking and aggressive behaviors at the clinical and borderline levels. It is necessary to design and implement a context by strengthening the relationship between the medical team and the consultants to facilitate the acceptance of life with diabetes and help the children and their families express emotions properly.
We studied the short-term psychological effects of the COVID-19 crisis and the quarantine on 3550 adults from the Spanish population in a cross-sectional survey. Symptoms of anxiety, depression, and ...stress were analyzed using the 21-item version of the Depression Anxiety Stress Scale. Symptoms of posttraumatic stress disorder were analyzed using the Impact of Event Scale. Symptomatic scores of anxiety, depression, and stress were observed in 20% to 30% of respondents. Symptomatic scores indicating psychological stress were found in 47.5% of respondents. Similar to the findings of other multiple studies, confinement has been found to have significant emotional impact in the Spanish population.
More information about the pattern of behavioural and psychological symptoms of dementia (BPSD) in the course of dementia is needed to inform patients and clinicians and to design future ...interventions.
To determine the persistence and incidence of BPSD and their relation to cognitive function, in individuals with dementia or in cohorts investigated for dementia onset.
A systematic literature review analysed the baseline prevalence, persistence and incidence of 11 symptoms. The review was conducted according to established guidelines with the exception that we could not exclude the possibilities of bias in the studies examined.
The 59 included studies showed considerable heterogeneity in their objectives and methods. The symptoms hyperactivity and apathy showed high persistence and incidence; depression and anxiety low or moderate persistence and moderate incidence; and psychotic symptoms low persistence with moderate or low incidence.
Despite heterogeneity across studies in terms of setting, focus and length of follow-up, there were clinically relevant differences in the longitudinal courses of different BPSD. Apathy was the only symptom with high baseline prevalence, persistence and incidence during the course of dementia.
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