IntroductionThis umbrella review is the frst to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions.ObjectivesThis review aimed to be the frst ...to evaluate whether psychological trauma fulflilled criteria as a transdiagnostic risk factor cutting across various diagnostic categories and spectra. Transdiagnosticity will be assessed against the framework of the TRANSD criteria (Fusar-Poli, World Psychiatry 2019; 18 361-362). The paper additionally aimed to analyse the association of psychopathology with specifc trauma type.MethodsWe searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classifed the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-efects p value, the 95% conf- dence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study efect, and excess significance bias. Additional outcomes were the association between specifc trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines.ResultsFourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across diferent diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR=2.92) and between childhood trauma and any mental disorder(OR=2.90). Regarding specifc trauma types, convincing evidence linked physical abuse (OR=2.36) and highly suggestive evidence linked sexual abuse (OR=3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR=3.05); there were no data for emotional abuse with other disorders.Image:Image 2:ConclusionsThese fndings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.Disclosure of InterestNone Declared
Rationale
Clozapine has proven to be superior to other antipsychotic drugs in the treatment of schizophrenia but is under-prescribed due to its potentially severe side effects. Clozapine-induced ...sialorrhea (CIS) is a frequent and extremely uncomfortable side effect, which remains understudied.
Objectives
To examine the prevalence of diurnal and nocturnal CIS in a sample of patients treated with clozapine, and to evaluate its impact on quality of life.
Methods
We conducted a cross-sectional, observational study of 130 patients with schizophrenia spectrum disorders treated with clozapine. The prevalence of CIS was evaluated via specific sialorrhea scales. None of the patients included in the study was receiving a specific treatment for hypersalivation during the study period. Possible associations between sialorrhea and clinical and quality of life variables were analyzed.
Results
Of 130 subjects, 120 (92.3%) suffered from CIS. Eighty-one (62.31%) suffered from diurnal CIS, 115 (88.56%) from nocturnal CIS, and 85 (65.38%) suffered from both. Significant positive associations between quality of life and diurnal CIS (
B
= 0.417;
p
= 2.1e − 6,
R
2
= 0.156) and nocturnal CIS (
B
= 0.411;
p
= 7.7e − 6,
R
2
= 0.139) were detected. Thirty per cent of the subjects reported a moderate to severe negative impact of sialorrhea on their quality of life.
Conclusions
The present study suggests that CIS is highly prevalent in patients with schizophrenia and has an important impact on quality of life in one-third of our sample. Therefore, the inclusion of a systematic evaluation and treatment of CIS in standard clinical practice is highly recommended.
Trial registration
Clinical Trials (
https://clinicaltrials.gov
) under reference NCT04197037.
Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and ...psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), combined with a non-invasive brain stimulation technique, such as multifocal transcranial current stimulation (MtCS), could be an innovative adjunctive treatment option. This double-blind randomized controlled trial (RCT) analyzes if EMDR therapy is effective in the reduction of pain symptoms in FM patients and if its potential is boosted with the addition of MtCS.
Forty-five patients with FM and a history of traumatic events will be randomly allocated to Waiting List, EMDR + active-MtCS, or EMDR + sham-MtCS. Therapists and patients will be kept blind to MtCS conditions, and raters will be kept blind to both EMDR and MtCS. All patients will be evaluated at baseline, post-treatment, and follow-up at 6 months after post-treatment. Evaluations will assess the following variables: sociodemographic data, pain, psychological trauma, sleep disturbance, anxiety and affective symptoms, and wellbeing.
This study will provide evidence of whether EMDR therapy is effective in reducing pain symptoms in FM patients, and whether the effect of EMDR can be enhanced by MtCS.
ClinicalTrials.gov NCT04084795 . Registered on 2 August 2019.
This umbrella review is the first to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions. We searched Pubmed, Scopus, and PsycNET databases from ...inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classified the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-effects
p
value, the 95% confidence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study effect, and excess significance bias. Additional outcomes were the association between specific trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines. Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across different diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR = 2.92) and between childhood trauma and any mental disorder (OR = 2.90). Regarding specific trauma types, convincing evidence linked physical abuse (OR = 2.36) and highly suggestive evidence linked sexual abuse (OR = 3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR = 3.05); there were no data for emotional abuse with other disorders. These findings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.
Background. Preliminary evidence suggests that psychological trauma, especially childhood trauma, is a risk factor for the onset of fibromyalgia (FM). Objective. The main objective of this study ...consisted of evaluating the prevalence and detailed characteristics of psychological trauma in a sample of patients with FM, the chronology of trauma across the lifespan, and its clinical symptoms. We also calculated whether childhood trauma could predict the relationship with different clinical variables. Method. Eighty-eight females underwent an interview to assess sociodemographic data, psychiatric comorbidities, level of pain, FM impact, clinical symptoms of anxiety, depression, insomnia, quality of life, and psychological trauma. Results. The majority of participants (71.5%) met the diagnostic criteria for current post-traumatic stress disorder (PTSD). Participants reported having suffered traumatic events throughout their lifespan, especially in childhood and early adolescence, in the form of emotional abuse, emotional neglect, sexual abuse, and physical abuse. Traumatic events predict both poor quality of life and a level of pain in adulthood. All patients showed clinically relevant levels of anxiety, depression, insomnia, suicidal thoughts, and pain, as well as somatic comorbidities and poor quality of life. Pain levels predicted anxiety, depression, dissociation, and insomnia symptoms. 84% of the sample suffered one or more traumatic events prior to the onset of pain. Conclusions. Our data highlight the clinical complexity of patients with FM and the role of childhood trauma in the onset and maintenance of FM, as well as the high comorbidity between anxiety, depression, somatic symptoms, and FM. Our data also supports FM patients experiencing further retraumatization as they age, with an extremely high prevalence of current PTSD in our sample. These findings underscore the need for multidisciplinary programs for FM patients to address their physical pain and their psychiatric and somatic conditions, pay special attention to the assessment of psychological trauma, and provide trauma-focused interventions. Trial registration: ClinicalTrials.gov NCT04476316. Registered on July 20th, 2020.
Psychological trauma has been identified in substance use disorders (SUD) as a major etiological risk factor. However, detailed and systematic data about the prevalence and types of psychological ...trauma in dual disorders have been scarce to date. In this study, 150 inpatients were recruited and cross-sectionally screened on their substance use severity, psychological trauma symptoms, comorbidities, and clinical severity. One hundred patients fulfilled criteria for a dual disorder, while 50 patients were diagnosed with only SUD. Ninety-four percent of the whole sample suffered from at least one lifetime traumatic event. The prevalence rates of Posttraumatic Stress Disorder diagnosis for dual disorder and only SUD was around 20% in both groups; however, patients with dual disorder presented more adverse events, more childhood trauma, more dissociative symptoms, and a more severe clinical profile than patients with only SUD. Childhood maltreatment can also serve as a predictor for developing a dual disorder diagnosis and as a risk factor for developing a more complex and severe clinical profile. These data challenge our current clinical practice in the treatment of patients suffering from dual disorder or only SUD diagnosis and favor the incorporation of an additional trauma-focused therapy in this population. This may improve the prognosis and the course of the illness in these patients.
Autocuidado del profesional de la salud Márquez Rodríguez, M; Gardoki Souto, I; Novo Corral, A ...
Psicooncologia,
01/2016, Letnik:
13, Številka:
S1
Journal Article
Recenzirano
El objetivo principal es hacer una exposición teórica que justifique la importancia del autocuidado de los profesionales que trabajan en el ámbito de la salud, aportando técnicas específicas ...centradas en la autoconciencia, gestión de emociones y control del estrés.
Biodiversity loss caused by housing is not a well-defined sector of environmental impact. This research quantifies effects on biodiversity of an average Spanish Single-Family House (SFH) with 180 m2 ...of built surface. The current Spanish SFH stock GWP amounts to 1.16 Gt CO2eq in a 50-year life cycle, 40 % of which is embodied in the building materials and the 60 % are emissions due to the use of the building. This stock also impacts with 10.2 Gt 1,4-DCB the land, water and human health. SFHs also drive 6052 species extinct in a 50 year life cycle, and account for 3.03 M years of life lost due to premature death or lived with a disability. Divided by the 16 M people living in Spanish SFHs, each one lost 0.19 years of their lives (68.1 days) due to their home's impacts on human health.
The article compares a reference conventional building against three low-impact cases, to understand how different building techniques and materials influence environmental outcomes that keep biodiversity loss the lowest possible. Scenarios include a standard brick and concrete house as Scenario 0 (SC0, Base), a timber Passivhaus as Scenario 1 (SC1), a straw-bale house with renewable energies as Scenario 2 (SC2), and an earth bioclimatic house as Scenario 3 (SC3). An initial Global Warming Potential (GWP) analysis was performed to relate previous building Life Cycle Assessment (LCA) studies with biodiversity metrics. Three main biodiversity metrics; ecotoxicity (as midpoint indicator), biodiversity loss and damage to human health (both as endpoint indicators) have been considered.
Compared to SC0 with 1292 kgCO2-eq·m−2 (516 embodied) of GWP, we found that SC1 emitted −47.0 % of that, SC2–41.4 % and SC3–80.9 %. Concerning ecotoxicity, where SC0 has 11,399 kg 1,4 DCB, the results are −27.9 % in SC1, −19.2 % in SC2, and −45.6 % in SC3. Regarding biodiversity loss, where SC0 has 7.54 E−06 species.yr·m−2, the impacts are −30.9 % in SC1, −32.6 % in SC2, and −58.6 % in SC3.
Human health damage in SC0 being 3.37 E−03 DALY, has been reduced in the timber home (SC1) is −44.2 %, of the Straw SFH (SC2) −39.2 %, and of the earth house (SC3) −67.1 %.
This article shows that with current existing technological solutions GWP could be reduced in −80.9 %, ecotoxicity in −45.6 %, biodiversity loss in −58.6 % and human health in −67.1 %. Spanish Single-Family Houses built in timber, earth or straw-bale are real alternatives to current cement traditional building.
Display omitted
•Damage of single-family houses on biodiversity and human health is assessed in a 50 year lifecycle.•Terrestrial ecotoxicity midpoint impacts weight more than CO2eq emissions to the atmosphere.•Timber, straw, or rammed earth constructions cut impacts of conventional brick houses by half.•The Spanish stock of single-family houses drives yearly 6.052 species extinct in a 50 year lifecycle.
Over the years, our oceans have witnessed an enormous accumulation of marine plastic waste resulting from ocean‐related economic activities. As plastic pollution adversely affects marine wildlife and ...habitat, our society requires urgent solutions to address this increasingly alarming dilemma. Here, we turn our attention to circular economy principles to reduce the amount of nonbiodegradable petroleum‐based marine litter. We consider a production process based on 3D printing to fabricate products for the marine industry, which uses marine plastic waste as a source material. Additionally, the suitability of virgin bio‐based polyamide (bio‐PA), polylactic acid (PLA), and polyhydroxybutyrate (PHB) is explored. PHB is selected due to its extraordinary rapid biodegradation in aquatic environments. To quantify the environmental impacts of the proposed processes, a cradle‐to‐grave life cycle assessment (LCA) is applied according to ISO 14040:2006 and ISO 14044:2006 standards. Different end‐of‐life alternatives are proposed, including landfill deposition, thermal degradation, and composting. LCA results reveal that the use of marine plastic waste is environmentally preferred in comparison with bio‐PA, PLA, and PHB. Specifically, the global warming indicator, considered a prime driver toward sustainability, shows a 3.7‐fold decrease in comparison with bio‐PA. Importantly, the environmental impacts of PHB production through crude glycerol fermentation are quantified for the first time. Regarding the end‐of‐life options with a composting scenario, PLA and PHB are preferred as they yield biogenic carbon dioxide (CO2), which can be used as a renewable energy source.
PDF
