| 1. |
- Breeze, Catherine, et al.
(författare)
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Unique contributions of anxiety, stress and depression to immunity: A cross-cultural investigation
- 2024
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Ingår i: Journal of Affective Disorders Reports. - 2666-9153. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- While immunity and psychological distress are strongly associated, studies seldom consider how different types of distress relate to immune functioning. The literature tends to emphasis the impact of stress on immunity. The present cross-sectional study estimated the unique contributions of depression, anxiety, and stress on immune function in culturally diverse samples of adults from Italy, New Zealand and India. Participants were Italian (n = 1061), New Zealand (n = 1037), and Indian (n = 384) volunteers. Stepwise multiple linear regression and dominance analysis were used to analyse differences in immunity uniquely explained by anxiety, depression, and stress. While samples from the three countries differed significantly, anxiety consistently explained the greatest proportion of differences in immunity. After accounting for the effect of anxiety, stress and depression explained only negligible variation in immune functioning. This association of anxiety with immune functioning was consistent across three different countries and this unique impact was further confirmed by the results of dominance analysis. These findings suggest a clear link between anxiety and immunity, which advances the prevailing stress-disease model and foster further experimental and longitudinal research into the impact of anxiety on immunity.
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| 2. |
- Cunningham, Janet L., et al.
(författare)
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Experiences in implementing immunopsychiatry in real life
- 2023
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier. - 2666-9153. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Immunological mechanisms, both alone and in combination, are associated with a broad range of psychiatric disorders encompassing autoimmune, autoinflammatory disorders but also genetic, metabolic, or other immunological disorders. Early treatment improves the outcome for autoimmune disorders, but early diagnosis is more difficult when isolated psychiatric symptoms are manifestations of autoimmunity. Treatment of these cases must encompass integrated models of disease, as both systemic autoimmunity and psychological processes influence mental health. Several challenges need to be overcome to efficiently merge psychiatric and somatic disease paradigms and medical care ranging from language and conceptual barriers to organizational barriers. Since 2015, the Immunopsychiatry team at Uppsala University has developed a collaborative multidisciplinary approach to improve and integrate care for patients with moderate to severe psychiatric disorders. Based on this experience, we have outlined the obstacles to be overcome in taking steps forward to achieve the long-term goal of understanding and early detection and identification of treatable immunological conditions within the psychiatric patient population; the described framework of evaluations and work-flow may serve as a model for other centers.
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| 3. |
- Guerriero, Giuseppe, et al.
(författare)
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Efficacy of transcutaneous vagus nerve stimulation as treatment for depression: A systematic review
- 2021
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier BV. - 2666-9153. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Transcutaneous vagus nerve stimulation (tVNS) has been suggested as a treatment method for depression. Methods: A systematic review to systematically evaluate the efficacy of tVNS for the treatment of depression was conducted according to PRISMA guidelines. Primary outcomes were mortality, self-harm, depressive symptoms, and health-related quality of life (HRQoL). Secondary outcomes were anxiety symptoms, medication use, everyday functioning, complications, and patients’ experiences of treatment. Five databases were searched systematically. The included articles were critically appraised and certainty of evidence was assessed using GRADE. Results: Two studies evaluating efficacy and a case series collecting data on complications were included. One randomized trial (n = 37) and one cohort study (n = 160) comparing tVNS with sham-tVNS reported significant reduction in the tVNS group of self-rated (SMD = -0.82, 95%-CI = -1.50, -0.15) but not clinician-rated depressive symptoms, after two weeks, and of both self-rated (SMD = -0.99, 95%-CI = -1.32, -0.66) and clinician-rated (SMD = -0.89, 95%-CI = -1.22, -0.57) depressive symptoms, after four weeks, respectively. Furthermore, the cohort study found reduction of both self-rated (SMD = -0.66, 95%-CI = -0.98, -0.34) and clinician-rated (SMD = -0.14, 95%-CI = -0.46, 0.17) anxiety symptoms. One case series (n = 12), collecting data on complications, reported mild to moderate transient side effects. Limitations: Available studies are few and heterogeneous, have major study limitations, problems with directness and imprecision. Conclusions: It is uncertain whether tVNS reduces depressive symptoms and anxiety. Although existing studies show promising results, further studies are needed to increase the certainty of evidence. © 2021 The Authors
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| 4. |
- Henriksson, Elin, et al.
(författare)
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Assessing emotional blunting in a psychiatric population: Psychometric properties of the Swedish version of the Oxford Depression QuestionnaireODQ-Swedish in a psychiatric population
- 2023
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Ingår i: Journal of Affective Disorders Reports. - 2666-9153. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Emotional blunting is frequently reported among depressed patients treated with antidepressants. A validated measure of this phenomenon would be of great value to clinicians and researchers in order to augment treatment for depression. To date, there has been no such measure in Swedish. This study aimed to explore the psychometric properties of the Swedish version of the Oxford Depression Questionnaire (ODQ-Swedish) in a psychiatric setting. Methods: Ninety psychiatric outpatients treated with antidepressants for depressive disorders were administered the ODQ-Swedish, the Hospital Anxiety and Depression Scale and a ‘gold standard question’. Thirty-nine participants completed a follow-up administration of the ODQ-Swedish. Results: Correlations between the depressive symptom anhedonia and the domains of the ODQ-Swedish followed the patterns found in previous studies when the previously validated ODQ-English confirming the validity of the ODQ-Swedish. The internal consistency and the test-retest reliability were also satisfactory. Sensitivity-to-change analysis indicated that the ODQ-Swedish could detect changes in emotional blunting, as quantified by the ‘gold standard question’. Furthermore, the completion rate (98%) suggested high acceptability. Conclusions: The fact that the ODQ is the only validated measure of emotional blunting for patients medicating with antidepressants is both a strength and a limitation. There is a need for measures that can monitor emotional changes. However, the lack of another measure also limits the assessment of contruct validity. Despite certain limitations, this study indicates that the Swedish translation has good psychometric properties and that the ODQ can be used as a self-report measure in a psychiatric population.
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| 5. |
- Jernelöv, Susanna, et al.
(författare)
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Treatment feasibility and preliminary evaluation of group-delivered cognitive behavioral therapy for insomnia adapted for patients with bipolar and related disorders : A pragmatic within-group study
- 2022
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier BV. - 2666-9153. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep disturbances, including insomnia, are common in bipolar disorder. Treatment of choice for insomnia is cognitive behavioral therapy (CBT-i), but evidence for CBT-i in patients with bipolar disorder is scarce. We investigated a group delivered treatment based on CBT-I; treatment feasibility in patients with bipolar and related disorders, and improvement in insomnia severity following treatment.Methods: This pragmatic within-group evaluation with a pre to post and three-month follow-up design was set at two psychiatric out-patient clinics specialized in bipolar and related disorders. As an adjunct to care-as-usual, the treatment was offered as six two-hour group sessions over eight weeks. Data were analyzed with intent-to-treat using hierarchical linear mixed models.Results: Thirty-four patients (48 [range 19–72] years; 68% female) with bipolar and related disorders and sleep problems provided informed consent. Patients had suffered from sleep problems for 12.7 [range 0.3–65] years, 97% used sleep medications, 91% medicated for their primary disorder. Patient interest, attendance, dropout, satisfaction, credibility, and adverse events met feasibility criteria, and therapists endorsed the manual. Post-treatment, insomnia severity (Insomnia Severity Index; score range 0–28) had improved with 6.1 points (95% CI, 3.27–8.93, g = 1.11, p = 0.0001) and at three months with 7.0 points (95% CI, 4.03–9.97, g = 1.26, p < 0.0001) from pre-treatment.Limitations: Lack of control group and no control for care-as-usual content.Conclusions: CBT-i adjusted for bipolar disorder delivered as a group treatment is promising for improving insomnia severity in patients with bipolar and related disorders and disturbed sleep.
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| 6. |
- Martin, Sylvia, et al.
(författare)
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Insight’s level in borderline personality disorder, questioning consciousness
- 2021
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier. - 2666-9153. ; 3, s. 100045-
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Tidskriftsartikel (refereegranskat)abstract
- Objective Borderline Personality disorder (BPD) stands as a hard to treat the disorder. We investigate the insight level differences between BPD patient and results from the literature regarding other hard to treat disorders -schizophrenia (SZD) and bipolar disorder (BD). As insight is related to symptomatology, we considered its two aspects: cognitive and clinical. Method We recruited one hundred and one patients suffering from BPD from DSM 5 Criteria (Mean age = 35.90 years), measured their clinical insight with the Scale to Assess unawareness of Mental disorder and the cognitive insight with the Beck Cognitive insight scale. Results compared to the literature references BPD patients demonstrated the same BCIS scores as BD and SZD patients but showed better scores than SZD however, equal to BD for SUMD. BCIS score was related to symptomatology level. Limitations BCIS and SUMD scales were constructed to assess insight in schizophrenia so we need to compare the results with another insight scale. Conclusions BPD has a good insight level, like BD’s. Clinical implications of results and their impact on treatment orientation are discussed.
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| 7. |
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| 8. |
- Psouni, Elia, et al.
(författare)
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Anxiety among Fathers in the Postnatal Period : Links to Depression, Attachment Insecurity and Emotion regulation
- 2021
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier. - 2666-9153. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent research has established postnatal anxiety as a common mental health problem among fathers, yet our knowledge regarding its underlying mechanisms is limited. The aim of the present study was to assess postnatal anxiety symptoms in fathers, to investigate comorbidity with postnatal depressive symptoms, and to examine the unique and shared contribution of attachment and emotion regulation as potential underlying mechanisms of postnatal anxiety, as compared to postnatal depression. Methods: A community sample of fathers (N=186) of infants 1-18 months were assessed with the Perinatal Anxiety Screening Scale (PASS), the Edinburgh Gotland Depression Scale (EGDS), the Attachment Style Questionnaire (ASQ-SF), and the Emotion Regulation Questionnaire (ERQ). Assessment was based on self-reports. Results: Over 30% of fathers reported high levels of postnatal anxiety, and a majority reported in addition burdening depressive symptoms. The strongest unique predictor for both outcomes was attachment anxiety, also after controlling for previous paternal mental health problems, and concurrent maternal depression. Emotion regulation strategy did not predict postnatal anxiety, but cognitive reappraisal predicted depressive symptoms negatively. For both anxiety and depression, the severity of symptoms in the one condition uniquely explained variance in the other condition. Limitations: The use of self-report measures does not allow clinical diagnosis. The unavoidable self-selected bias in recruitment posits limits to generalization. Conclusion: Despite high comorbidity between the two mental health outcomes, predictors of postnatal anxiety differ from those of postnatal depression in fathers, suggesting different underlying mechanisms and a need for distinct treatment approaches.
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| 9. |
- Vikhareva, O., et al.
(författare)
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Anxiety reduction through obstetric consultation combined with ultrasound examination in women after cesarean section
- 2022
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier. - 2666-9153. ; 8, s. 100342-100342
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Tidskriftsartikel (refereegranskat)abstract
- Background:Women are at increased risk of developing anxiety or depression disorders after Cesarean section (CS). This study aims to evaluate whether an appointment with a senior obstetrician combined with an ultrasound examination reduces levels of anxiety in women after CS.Methods:A prospective observational study was conducted in Sweden. Women underwent an appointment with an obstetrician 6–9 months after their first CS. Before the appointment, women were asked to fill in the state and trait subscales of the Spielberger State-Trait Anxiety Inventory and the Beck's Depression Inventory. The women's experience of the childbirth was discussed and an ultrasound examination of the hysterotomy scar was performed. After the appointment, the participants filled in the state scale again. The women were divided into low trait anxiety (< 40) and high trait anxiety (≥ 40) groups for comparisons.Results:147 women were included. Of those, 114 (78%) had lower trait score <40 (mean 29.2 ± 5.4) and 33 (22%) had higher trait score ≥ 40 (mean 47.4 ± 6.5). Mean difference of state score in the low trait anxiety group before and after the examination was 4.8 ± 5.6 (95% CI 7.20 to 11.97, p<0.0001) and in the high trait anxiety group, the mean difference was 9.2 ± 6.5 (95% CI 3.77 to 5.82, p<0.0001).Limitations:A clinical examination with a diagnosis of depression in these women was not made by a psychiatrist.Conclusions:A supportive obstetric consultation combined with an ultrasound examination of the uterine scar decreased anxiety levels in women after CS, particularly in patients with higher anxiety
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