Abstract The aim of the present study was to explore possible differences between serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and cortisol concentration ...in patients with major depressive disorder (MDD) with melancholic features, and MDD with atypical features. As secondary aim, we investigated possible associations with clinical features such as suicidal ideation, number of episodes, duration of depression and symptomatology severity. We included 55 MDD patients (32 with melancholic features and 23 with atypical features) and 18 healthy controls. When compared to healthy controls, MDD with melancholic or atypical features showed higher CRP and IL-6, but not TNF-α. Cortisol concentration was higher in MDD with melancholic type, in comparison to the atypical type of MDD or controls. A positive correlation was found between the severity of depressive symptoms, concentrations of IL-6 and cortisol in the MDD group with melancholic features, while a negative correlation was observed between IL-6 and CRP in the MDD group with atypical feature. Also, in the MDD group with atypical features, there was a correlation between the severity of anxiety symptoms based on the Hamilton Rating Scale for Anxiety (HARS), concentration of CRP, and the duration of symptoms. In conclusion, we observed several differences in serum CRP, IL-6, and cortisol concentrations in MDD patients considering clinical features as well.
The coronavirus (COVID-19) outbreak was labeled a global pandemic by the WHO in March of 2020. Understanding how crisis influence an individual's reactions to stressful events (and vice versa) is ...important in order to create meaningful and effective interventions. Our literature search have revealed lack of the papers related to psychodynamic approach to recent crisis. Psychodynamic places a large emphasis on defense mechanisms and unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings and thoughts are outside of our awareness, they still influence our behavior in many ways. Optimal application of psychodynamic approach offers the frame for acceptance of psychological stress in a more positive way and benefits psychological growth. We believe that including psychodynamic approach in the national public and mental health emergency system will empower Croatia and the world during (and after) COVID-19 pandemic crisis.
Previous research has demonstrated relations between lower level of personality organization (PO) and multiple indices of mental health disturbances. The goal of this research was to examine whether ...experience of shame would mediate the relationship between PO and depressive symptoms in a sample of 321 Croatian psychiatric outpatients (64% female; mean age, 38.67 years). The total PO level exhibited positive associations with depressive symptoms and with all three subscales of shame (p < 0.01). Characterological, behavioral, and bodily shame showed significant mediating effects in the PO-depression relationship, while controlling for the influence of age and sex. PO level seems to be strongly related to depressive disturbances, with the experience of shame representing one of the underlying mechanisms of this relationship. Given that patients with personality disorders (i.e., low PO level) suffer from poorer treatment outcomes for major mental disorders, more emphasis should be placed on psychotherapeutic management of shame-proneness.
The complex inter-relationship between external and internal reality, a source of interest and controversy in psychiatry, has come to the foreground more prominently in the context of more ...integrative understanding of psychopharmacotherapy. This paper discusses the meaning and clinical applications of the psychodynamic related to psychopharmacotherapy for difficult personality and eating disorders patients. The one of the psychodynamic explanations for patients' being difficult is related to their perceived lack of mentalizing (reflective) capacities. Lack of mentalizing capacity implies disturbed view of psychopharmacotherapy. Therapeutic relationship and optimal alliance offers the frame for acceptance of psychiatric drugs as positive and useful for personality and eating disorder patients. Mentalization and intersubjectivity theories have direct implications for clinical practice, and that the notion of the third is particularly useful in understanding what happens in the patient-doctor relationship.
Like the other medical professions, mental health workers need appropriate motivation for effective treatment work. This study aims to determine the motivators and assess working conditions of mental ...health workers and how they differ from the motivators and working conditions of other health workers on the example of one of the largest hospital institutions in Croatia – University Hospital Centre Zagreb. The study chose a survey method and distributed a questionnaire among 124 Zagreb University Hospital Centre health workers. The sample covers about 16% of the entire medical staff of the observed departments (psychiatry, emergency, microbiology, gynecology, anesthesiology, COVID-19 unit, and orthopedic surgery). The ANOVA method was used to detect differences in data groups. The results show that Croatian mental health workers are mainly motivated extrinsically. However, compared to other medical professions, e.g., gynecologists, orthopedists, or anesthesiologists, they are upper-middle motivated and leaders in several motivators. Observed Croatian mental health workers are more satisfied with their patient interactions than their colleagues. Female mental health workers are more motivated but less satisfied with the working conditions than males. The study showed that even in one medical institution, there are significant differences in the needs of representatives of different professions. The paper concludes that mental health workers have different motivations, which can be satisfied by creating appropriate working conditions.
AcknowledgmentsThe authors acknowledge the COST Action CA19113 «The European Researchers’ Network Working on Second Victims» (ERNST) for short-term scientific mission grant and supporting this study; staff of University Hospital Centre Zagreb for participating in the survey; and the Hauge School of Management of the NLA University College (Kristiansand, Norway) for supporting this publication.
Cloninger's psychobiosocial model of personality proposes that consistent patterns of health behavior are determined by the complex interaction of different neurobiological processes of the patient's ...temperament and character dimensions. Poor medication adherence is a pervasive problem among glaucoma patients and can lead to increased morbidity and disability. The objective of the present study was to investigate the association between Cloninger's personality dimensions and medication adherence among glaucoma patients.
The cross-sectional study was conducted among 113 primary open-angle glaucoma (POAG) patients. The treatment adherence was assessed through a valid and reliable self-administered questionnaire, the Culig Adherence Scale (CAS). Personality dimensions were evaluated using the abbreviated version of the Temperament and Character Inventory-Revised (TCI-140). Statistical analyses were performed using TIBCO Statistica 14.0.1. The study protocol was registered in the DRKS - German Clinical Trials Register; (DRKS-ID: DRKS00022081).
According to CAS, only 39.8% of patients were adherent to glaucoma treatment. Adherence was significantly negatively related only to the character dimension of Self-Transcendence (
< 0.05). No other TCI-140 dimension was significantly associated with medication adherence (
> 0.05).
The results suggest that POAG patients with higher scores on the Self-Transcendent personality dimension are more likely to experience difficulties adhering to medication regimen. The study highlights the importance of a holistic approach to glaucoma treatment, which takes into account not only the biological aspects of disease but also the psychosocial factors that influence patient behavior. Healthcare providers may need to consider glaucoma patients' personality dimensions, beliefs and values when developing treatment plans and strategies to improve medication adherence.
BackgroundIt is vital to assess whether research on psychological or psychiatric states using validated questionnaires is still lagging in low- and middle-income countries and to what degree, and to ...continue to assess the psychometric properties of the most informative questionnaires.MethodsWe performed a bibliometric analysis of Web of Science Core Collection for all years to determine the number of studies performed in each country that used an inventory or a questionnaire on aggression, anxiety, depression, borderline personality, narcissism, self-harm, shame, or childhood trauma. We conducted a simple observational analysis of distributions by countries to derive the main overall conclusions, assisted by ChatGPT to test its ability to summarise and interpret this type of information. We also carried out a study in Croatia to examine some psychometric properties of five commonly used questionnaires, using Cronbach’s α coefficient and zero-order correlations.ResultsWe observed a concentration of research activity in a few high-income countries, primarily the United States and several European nations, suggesting a robust research infrastructure and a strong emphasis on studying psychological and psychiatric states within their population. In contrast, low- and middle-income countries were notably under-represented in research on psychological and psychiatric states, although the gap seems to be closing in some countries. Turkey, Iran, Brazil, South Africa, Mexico, India, Malaysia and Pakistan have been consistently contributing an increasing number of studies and catching up with the most research-intensive high-income countries. The national case study in Croatia confirmed adequate psychometric properties of the most frequently used questionnaires.ConclusionsAddressing research gaps in low- and middle-income countries is crucial, because relying solely on research from high-income countries may not fully capture the nuances of psychological and psychiatric states within diverse populations. To bridge this gap, it is essential to prioritise mental health research in low-resource settings, provide training and resources to local researchers, and establish international collaborations. Such efforts can lead to the development of culturally valid questionnaires, an improved understanding of psychological and psychiatric states in diverse contexts, and the creation of effective interventions to promote mental well-being on a global scale.
Love is a delicate experience that delves into the foundations of the psyche, and many sources of the emotional experience of love remain unconscious. The nature of love is twofold and contradictory, ...regressive and progressive, constructive and destructive, connecting and separating, directed toward the object and the self. The ability to idealize is a precondition for "falling in love". Abrupt disappointments can be traumatizing, but gradual ones include the work of mourning and may lead to a more authentic relationship that is less obscured by narcissistic needs. Some aspects of projective identification, which can be a defense, a primitive form of object relation, and a path for psychological change, may be present in all forms of love. These are the close interaction of self and object, blurred boundaries between them, the need that the other person feels what one feels, and a strong desire to continue the relationship. A therapeutic setting can enable the long-term transformation of love in transference and more mature expressions of love in life. The maturation of narcissism is the hallmark of mature love. One of the prerequisites for mature love is a mature superego, which does not require suffering as a prerequisite for satisfying one's needs. Clear differentiation of the boundaries of the self enables safe (temporary) blurring or disappearing of its boundaries and satisfaction of needs for repetition of lost fusion with the primary object of love. Mature love also means the capacity for tolerating ambivalence, i.e., the capacity to integrate both love and hatred experiences of the same person. One can see love as a "glue" that helps integrate different aspects of the psyche into a harmonious whole.
Recent research has revealed poor physical health among individuals with personality disorders (PDs). We aimed to compare chronic physical illnesses (CPI) and chronic physical multimorbidity (CPM) ...prevalence between the general population (GEP) and PD patients, and to explore the relationship between CPM and various aspects of PD, predominantly within the ICD-11 framework.
This cross-sectional study included 126 PD patients and 126 matched controls from the GEP. Patients were evaluated for the ICD-11 PD severity and maladaptive personality domains, subjective emptiness, and reflective functioning. CPI was assessed using a standardized self-report questionnaire.
PD patients had a higher mean number of CPIs (2.05 vs. 1.02) and a more frequent CPM occurrence (49.2% vs. 26.2%) compared to the matched controls (p < .001). The ICD-11 PD severity (OR = 1.143, p = .007) and maladaptive domain Negative affectivity (OR = 4.845, p = .002), and poor reflective functioning (OR = 1.694, p = .007) were significant predictors of CPM, independent of sociodemographic, clinical and lifestyle factors. Negative affectivity showed the most robust effect on CPM, while smoking did not significantly mediate these relationships.
Our study found increased CPM burden in PD patients and a link between CPM and various PD aspects under the ICD-11 framework, highlighting the need for more integrated healthcare.
Purpose
Numerous studies are conducted to investigate factors influencing eating and weight-related problems, given the alarming prevalence of such behaviours among adolescents. The relationship ...between shame, especially body shame, and eating disorders has received increased attention in recent years. The current study contributes to this field by exploring body shame as a potential mediator of the relationship between body dissatisfaction and eating behaviours among adolescent girls, while controlling for age and body mass index (BMI).
Methods
The participants, 187 adolescent girls from three secondary schools in Zagreb, completed self-report measures of demographic, eating behaviours, body satisfaction and body shame.
Results
Body shame and body dissatisfaction explained statistically significant amount of eating behaviours variance, while controlling for age and BMI. Further, body shame partially mediated the relationship between body dissatisfaction and eating behaviours.
Conclusions
This study provides further evidence of the experience of body shame among adolescent girls and suggests that this shame is associated with disordered eating behaviours. Future longitudinal research designed to specifically explore body shame and other potentially shared risk factors is needed, and would enhance our understanding of eating disorder aetiology.
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