Depression and anxiety among high-risk obstetric inpatients

ObjectiveTo assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment.MethodsSixty-two participants hospitalized for high-risk obstetrical complications completed the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-item scale (GAD-7) and Short-Form 12 weekly until delivery or discharge, and once postpartum.ResultsAverage length of total hospital stay was 8.3±7.6days for women who completed an initial admission survey (n= 62) and 16.3±8.9 (n= 34), 25.4±10.2 (n= 17) and 35±10.9 days (n= 9) for those who completed 2, 3 and 4 surveys, respectively. EPDS was ≥ 10 in 27% (n= 17) and GAD-7 was ≥ 10 in 13% (n= 8) of participants at initial survey. Mean anxiety (4.2±6.5 vs. 5.2±5.1, p= .011) and depression (4.4±5.6 vs. 6.9±4.8, p= .011) scores were lower postpartum compared to initial survey. Past mental health diagnosis predicted depression symptoms [odds ratio (OR)=4.54; 95% confidence interval (CI) 1.91–7.17] and anxiety symptoms (OR=5.95; 95% CI 3.04–8.86) at initial survey; however, 21% (n= 10) with no diagnostic history had EPDS ≥ 10. Five percent (n= 3) received mental health treatment during pregnancy.ConclusionHospitalized high-risk obstetrical patients may commonly experience depression symptoms and/or anxiety symptoms and not receive treatment. A history of mental health treatment or diagnosis was associated with depression symptoms or anxiety symptoms in pregnancy. Of women with an EPDS ≥ 10, > 50% did not report a past mental health diagnosis.     

A cross-sectional study to investigate the correlation between depression comorbid with anxiety and serum lipid levels

BackgroundDepression is a common psychological disorder that severely threatens human health. Its pathology remains unclear, but it has been suggested to be associated with abnormal blood lipid metabolism.ObjectivesThis study aimed to explore the changes in blood lipid levels in patients with depression accompanied or not by anxiety, and assess whether adjusting the clinical therapeutic strategy could be based on blood lipid test results, providing a novel insight into depression treatment.MethodsThis was a cross-sectional study. We assessed 60 outpatients and inpatients diagnosed with depression from January 2013 to January 2014 who met the Chinese Classification of Mental Disorders version 3 (CCMD-3) criteria, with Hamilton Rating Scale for Depression (HAMD-24) ≥ 20. They were grouped into depression with anxiety (n = 29) and depression without anxiety (n = 31) groups by the Hamilton Anxiety Scale (HAMA).ResultsTG levels were higher in the depression with anxiety group compared with patients without anxiety (P = 0.045), which was confirmed by multifactorial analysis [P = 0.017, OR = 4.394, 95% CI (1.303–14.824)]. A negative correlation between anxiety score and HDL levels was observed in patients with depression (r = − 0.340, P = 0.046). Meanwhile, positive associations were obtained between retardation and LDL levels (r = 0.307, P = 0.017) as well as age at disease onset and total cholesterol levels (r = 0.410, P = 0.002).ConclusionTG levels differ in patients with depression accompanied by anxiety compared with those without anxiety.     

Utilization of care among drug resistant epilepsy patients with symptoms of anxiety and depression

PurposeEpilepsy patients have a significantly higher rate of anxiety and depression than the general population, and psychiatric disease is particularly prevalent among drug resistant epilepsy patients. Symptoms of anxiety and depression might serve as a barrier to appropriate epilepsy care.The aim of this study was to determine if drug resistant epilepsy patients with symptoms of anxiety and/or depression receive different epilepsy management than controls.MethodWe identified 83 patients with drug resistant focal epilepsy seen at the Penn Epilepsy Center. Upon enrollment, all patients completed 3 self-report scales and a neuropsychiatric inventory and were grouped into those with symptoms of anxiety and/or depression and controls. Each patient's medical records were retrospectively reviewed for 1–2 years, and objective measures of outpatient and inpatient epilepsy management were assessed.ResultsAt baseline, 53% (n = 43) of patients screened positive for symptoms of anxiety and/or depression. The remaining 47% (n = 38) served as controls. Patients with anxiety and/or depression symptoms had more missed outpatient visits per year compared to controls (median 0.84 vs. 0.48, p = 0.02). Patients with symptoms of both anxiety and depression were more likely to undergo an inpatient admission or procedure (56% vs. 24%, p = 0.02).ConclusionFor most measures of epilepsy management, symptoms of anxiety and/or depression do not alter epilepsy care; however, drug resistant epilepsy patients with anxiety and/or depression symptoms may be more likely to miss outpatient appointments, and those with the highest burden of psychiatric symptoms may be admitted more frequently for inpatient services compared to controls.     

Trouble stress post traumatique,dépression et anxiété chez les parents d’enfant(s) atteint(s) d’épilepsie

IntroductionPost-traumatic Stress Disorder (PTSD), depression and anxiety are the most common psychiatric consequences among parents of children with epilepsy.ObjectivesWe aimed to investigate the prevalence and predictors of PTSD, depression and anxiety in a sample of parents of children with epilepsy.MethodsA survey of 135 parents of children with epilepsy, treated in the pediatric neurology department at the Sfax Teaching Hospital in Tunisia, was conducted in the last quarter of 2019. The PTSD Checklist for DSM-5 and the Hospital Anxiety and Depression Scale (HADS) were used to assess, respectively, PTSD, depression and anxiety in parents. Associations with clinical and demographic variables with PTSD, depression and anxiety were evaluated in a logistic regression model.ResultsResults revealed PTSD rates of 20.7%, depression rates of 28.9% and anxiety rates of 55.6%. The main factors associated with PTSD on multivariable analysis were female gender (P = 0.026, ORa = 13.1), insufficient involvement of partner in disease management (P < 10^?3, ORa = 12.1) and duration of epilepsy less than 12 months (P = 0.001; ORa = 0.1). Female gender (P = 0.006, ORa = 18.1) and restriction of social life (P = 0.006, ORa = 4.1) were associated with depression. Factors associated with anxiety were insufficient involvement of partner in disease management (P = 0.03, ORa = 4.6) and PTSD (P = 0.005, ORa = 9.1).ConclusionThese findings suggest that clinicians should pay more attention to psychological health of parents of children with epilepsy and help healthcare providers to develop preventive and intervention strategies for parents of such children.     

L’efficacité thérapeutique du Montage Composite Réceptif à visée Projective (MCR-P) contre la dépression en psychiatrie

ObjectivesThe Receptive Projective Composite Montage (RPCM) is a short-term therapy associating musicotherapy and clinical psychology in order to improve the psychiatric treatment of depression. This study aims at showing the therapeutic efficiency of the RPCM on depression and anxiety symptoms and on the in-patient's alexithymia level. Furthermore, this study explores the explanatory processes of the therapeutic effects in order to bring an additional dimension to this approach.MethodThe sample consists of 23 patients diagnosed with depression, aged between 27 and 73 (average age = 49.91 ± 10.47) who receive psychiatric treatment. Participants have been categorized into two experimental groups: the therapeutic group who received 3 sessions of RPCM (n = 13) and the control group who received psychiatric treatment only (n = 10). These two groups allowed us to achieve a test re-test method over three weeks with a comparative group. The evaluation tools are the Beck's Depression Inventory (BDI) for the evaluation of depression, the Hospital Anxiety and Depression Scale (HADS) for the anxiety level and the Toronto Alexithymia Scales-20 (TAS) for the alexithymia level.ResultsOver a three-week therapy with the RPCM, in-patients from the therapeutic group have a significantly lower level of depression, anxiety and alexithymia after therapeutic process (P = .002; P = .001 and P = .009 respectively). Moreover, depression scores of experimentals groups are significantly different during second evaluation (P = .006). Finally, therapeutic group depression and anxiety scores have a medium effect size (d = .5).Discussion and conclusionWith these results, the RPCM seem to be a tool with beneficial effects on the in-patient's symptomatology of depression. The RPCM can be used as a support technique in order to maximize the treatment of depression. We recommend using a minima three RPCM section at the start of internment by a trained therapist. More experimental and complementary studies are necessary to confirm these results.     

Effect of COVID-19 on mental health among the young population in Lebanon

BackgroundCOVID-19 is a global pandemic that has raised worldwide public health concerns. The wide spread of the virus has led to unprecedented disturbance to regular life for people around the globe and impacted their mental health.AimsThe aims of the current study were to investigate the prevalence of psychiatric symptoms related to insomnia, depression, and anxiety, and identify risk factors contributing to psychological stress in Lebanese young population during COVID-19 pandemic.MethodA cross-sectional study was done on the Lebanese young population. Participants were 4397 males and females aged 18 to 35 years who filled a self-administered online questionnaire. Three validated scales were used to measure the mental health status of the participants during the COVID-19 pandemic: 7-item Insomnia Severity Index for insomnia, the Patient Health Questionnaire 9-item depression module for depression, and the 7-item Generalized Anxiety Disorder scale for anxiety.ResultsThe median interquartile range scores for anxiety, insomnia, and depression, were 8 (4–13), 10 (5–14), and 9 (5–12) respectively. Higher anxiety scores were reported with female gender (P < 0.001) and alcohol usage (P = 0.04). Moderate to severe insomnia was associated with single (P = 0.02) and divorced marital status (P = 0.003), university education (P < 0.001), consumption of caffeinated beverages (P = 0.02) and energy drinks (P = 0.03). Higher depression scores were associated with status of being the only person working at home (P = 0.01), family income more than 500 USD (P = 0.008), multiple insurance plans (P = 0.01), and contact with a confirmed COVID-19 case (P = 0.01).ConclusionsThe findings of this study demonstrate the considerable impact of COVID-19 pandemic and lockdown on Lebanese young population's mental status such as anxiety, depression and insomnia. Further follow-up studies are warranted to assess the long-term mental effects that can be imposed by the pandemic.     

Medical comorbidity and distress in patients with irritable bowel syndrome: The moderating role of age

ObjectivesIrritable bowel syndrome (IBS) affects people across the age spectrum and is highly comorbid with other medical conditions. The aim of this study was to determine the moderating effect of age on the relationship between medical comorbidity and health outcomes in IBS patients.MethodsPatients (n = 384) across the age spectrum (18 to 70) completed questionnaires regarding medical comorbidities, anxiety, depression, IBS symptom severity, and IBS quality of life (QOL).ResultsThe mean age was 41 (SD = 15). Age interacted with medical comorbidities to predict anxiety, F(7,354) = 5.82, p = 0.009, R² = 0.10. Results revealed significant main effects for education, β = − 0.16, p < 0.05, age, β = − 0.15, p < 0.05, medical comorbidities, β = 0.25, p < 0.05, and a significant interaction, β = − 0.15, p < 0.01. Anxiety was greater among patients with many comorbidities, with this effect being more pronounced for younger adults. Depression, also predicted by the interaction between age and comorbidities, showed the same pattern as anxiety. There was no significant interaction between age and medical comorbidities in predicting IBS symptom severity or IBS QOL.ConclusionDistress among IBS patients with medical comorbidities varies with age, with higher levels of anxiety and depression among younger adults than their older counterparts. Medical comorbidity may have a more selective impact on psychological distress as compared to IBS symptom severity and quality of life for younger adults with IBS. Distress may increase IBS burden for these patients and complicate its medical management.     

Intervention centrée sur les ressources pour réduire les troubles anxieux et dépressifs chez les patients atteints de cancer : une étude pilote

IntroductionCancer, a widespread chronic disease, represented 400,000 diagnoses in France in 2017. The diagnoses as well as the treatments are a major source of stress for most patients concerned. Secondary effects may be painful and disturbing (pain, nausea, fatigue, loss of social and/or professional status, anxiety of death), and may lead to maladaptive coping strategies (avoidant coping), psychological inflexibility, anxiety, depression, and suicide risks which are twice as important as in the general population. Research in the field of psychotherapy for cancer patients represents an important international target, in particular in what concerns enhanced patient quality of life during and after treatment. Cognitive Behavioral Therapy, Mindfulness-Based Stress Reduction, as well as adapted physical activity have shown promising results to enhance patients’ quality of life at different stages of the process. However, results mainly show significant short-term effects and usually only for patients with high levels of anxiety and depression symptoms. With the development of third wave Cognitive Behavioral Therapy, more global interventions (not just aimed at anxiety and depression symptoms) have emerged. Research has underlined their efficacy on both symptom reduction (anxiety and depression) and quality of life enhancement through the development of more varied and adaptive responses to stressful situations. Positive psychology interventions, mindfulness, and Acceptance and Commitment Therapy have inspired third wave Cognitive Behavioral Therapy. Emotional acceptance, mindful awareness of thoughts and emotions, and engaging in actions that are coherent with one's values all form part of the means by which these interventions may help patients to find ways to better adjust to their stressful situation. The results of the efficacy trials carried out using these approaches were mixed, and effects were mainly modest. Furthermore, most of the studies only tested one approach at a time, while each approach activated mechanisms, which can be useful for these patients. Hence, the aim of the current study was to test an integrative program based on classical second wave Cognitive Behavioral Therapy as well as on practices from the third wave of Cognitive Behavioral Therapy. We aimed at carrying out a preliminary study assessing the potential effects of the program on cancer patients’ anxiety, depression symptoms, well-being and psychological flexibility.MethodSixteen cancer patients were enrolled in a second and third wave Cognitive Behavioral Therapy workshop composed of six sessions. In-session practices were based on validated practices. Participants completed the following questionnaires before the first workshop (T1) and at the end of the sessions (T2) in order to assess anxiety, depression symptoms, well-being and psychological flexibility: HAD, WEMWBS, MPFI, AAQ-2. Qualitative data regarding acceptability were also collected at the end of the last session.ResultsAmong the sixteen participants, nine women (mean age = 56.1 years old) completed the questionnaires seven of whom had breast cancer. The results of this preliminary study showed a significant pre-to-post reduction in anxiety and depression symptoms (P = 0.017) as well as on certain dimensions of psychological flexibility: reduced “self as content” (P = 0.011), and enhanced cognitive diffusion (P = 0.018). Only marginal differences were found on other dimensions: reduced inaction (P = 0.074) and experiential avoidance (P = 0.089), and enhanced “self as context” (P = 0.062). Content analysis showed (1) increased positive perceptions about experiences with more serenity, (2) positive attitudes towards self (self-compassion), (3) enhanced positive relationships, and (4) ability to accept negative affect.ConclusionPatients’ qualitative feedback highlighted the potential feasibility and adaptability of the program for this population. The results of this preliminary study show promising avenues for research in the field of cancer patients’ adaptive coping enhancement as well as reduce anxiety and depression symptoms. This type of workshop can be considered as complementary to individual psychotherapies as they may tap into different mechanisms that help foster psychological flexibility as the group format enhances decentering processes. Further research avenues are proposed in order to assess the efficacy of such interventions in cancer patients compared to other types of interventions. Further research should also look into individual differences in order to orient patients towards practices that fit them best.     

Anxiety and depression in primary and secondary dystonia: A burden on health related quality of life

Dystonia is a reason of visible chronic motor and/or psychological disability that may influence the quality of life. Our aim was to investigate depression and anxiety in patients with primary and secondary dystonia, and to evaluate their effects on the quality of life. Patients with primary and secondary dystonia, and age-matched healthy volunteers were enrolled in the study. Anxiety and depression was evaluated with Hospital Anxiety Depression (HAD) scale. Short Form-36 was used to assess the quality of life in both study groups. Both mean anxiety and depression subscales scores were found to be increased in the patients with dystonia, when compared with the control group (p < 0.05). There were no statistically significant differences in the HAD scores patients with primary and secondary dystonia (p > 0.05). When compared with controls, all domains of SF-36 were found to be decreased in patients with dystonia contributing to a deterioration in the HR-QoL (p < 0.05). Among dystonia patients, a statistically significant decrease was found in all domains of SF-36, except vitality and mental health in secondary dystonia (p < 0.05). Multiple regression analysis revealed that secondary dystonia, long term disease, depression and anxiety have a great impact on quality of life of patients with dystonia. Dystonia can be considered as an important risk factor for anxiety and depression which leads to a deterioration in the quality of life of patients.     

Does alexithymia expose to mental disorder symptoms in late adolescence? A 4-year follow-up study

ObjectiveTo investigate the possible causal link between alexithymia and the emergence of anxiety and depression symptoms, as well as alcohol consumption in a sample of late adolescents.MethodThe nonclinical sample comprised late adolescents (n= 315), including both females (n= 256) and males (n= 59). The follow-up period was 4 years, and at baseline, the mean age of the subjects was 19 years (range 17−21 years). Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), depression symptoms with the short form of the Beck Depression Inventory (RBDI), anxiety with the State-Trait Anxiety Inventory (STAI) and alcohol consumption with the Alcohol Use Disorders Identification Test (AUDIT). The three TAS-20 subscales were assessed separately. Linear and cumulative logistic regression analyses were used for the evaluation of associations, and the analyses were adjusted with the corresponding baseline scores.ResultsThe TAS-20 total and subscale scores did not predict the RBDI or AUDIT scores at follow-up. However, the TAS-20 subscale “difficulty identifying feelings” was significantly associated with both STAI-State (P= .007) and STAI-Trait (P= .004) scores at follow-up.ConclusionsAlexithymic features may be individual predictors of later anxiety symptoms. The significant differences between the various dimensions of alexithymia should be considered in future studies.     

Higher CSF interleukin-6 and CSF interleukin-8 in current depression in older women. Results from a population-based sample

ObjectiveThe literature regarding cerebrospinal fluid (CSF) cytokines in geriatric depression is sparse. The aim of this study was to examine associations between CSF interleukin-6 (IL-6), interleukin-8 (IL-8) and depression in a population-based sample of older women who were followed for 17 years.Methods86 dementia-free women aged 70–84 years who participated in the Prospective Population Study of Women in Gothenburg, Sweden took part in a lumbar puncture in 1992–3. CSF IL-6 and CSF IL-8 were measured. Psychiatric symptoms were rated with the Comprehensive Psychopathological Rating Scale at baseline and at three subsequent face-to-face examinations. Depression (major or minor) was diagnosed in accordance with DSM-IV/DSM-IV research criteria.ResultsAt baseline, women with ongoing major (n = 10) or minor depression (n = 9) had higher levels of CSF IL-6 (p = 0.008) and CSF IL-8 (p = 0.007) compared with those without depression (n = 67). Higher CSF IL-8 was related to higher MADRS score (p = 0.003). New cases of depression were observed in 9 women during follow-ups. No associations between CSF cytokine levels and future depression could be shown in women without depression at baseline.ConclusionHigher levels of CSF IL-6 and IL-8 were associated with current depression in this population-based sample. CSF IL-6 and CSF IL-8 may play a role in depression in late life.     

Psychosocial outcomes and counselee satisfaction following genetic counseling for hereditary breast and ovarian cancer: A patient-reported outcome study

ObjectiveWe investigated the psychosocial consequences of genetic counseling and testing (GCT) for hereditary breast and ovarian cancer (HBOC) at follow-up in a “real-life” sample of counselees at an Austrian tertiary care center.MethodsThe study cohort included counselees who had undergone genetic counseling for HBOC and completed a follow-up self-report questionnaire battery on psychosocial outcomes (quality of life, psychological distress, satisfaction with counseling and decisions). For comparison of distress, we recruited a reference sample of breast cancer survivors (BCS; n = 665) who had not requested GCT in the same setting.ResultsOverall, counselees did not exhibit increased levels of anxiety and depression when compared to BCS. No specific follow-up deleterious psychosocial consequences were detected among the former group. Of the 137 counselees, 22.6% and 9.8% experienced clinically relevant levels of anxiety and depression, respectively, at an average follow-up time of 1.8 years. However, both anxiety and depression significantly decreased with time and were alike between counselees with and without cancer diagnosis. Follow-up cancer worry seems to be significantly higher among counselees who had not undergone genetic testing or were undecided about it than among counselees who had been tested.ConclusionOur results strongly support GCT as part of routine care for patients with HBOC. The risk factors of increased distress in specific subgroups of counselees, such as recent cancer diagnosis or uncertainty about testing, warrant further exploration and specific attention in clinical routines. Particularly, the psychological needs of undecided counselees warrant ongoing attention and potential follow-ups.     

Attachment style,relationship quality,and psychological distress in patients with psychogenic non-epileptic seizures versus epilepsy

ObjectivesPsychopathology levels are elevated in patients with psychogenic non-epileptic seizures (PNES) and those with epilepsy. However, patients with PNES report higher rates of trauma and neglect, poorer health-related quality of life (HRQoL), and an increased prevalence of insecure attachment. We examined to what extent attachment style and relationship quality with their main informal carer impact on levels of HRQoL, depression, and anxiety in patients with PNES versus those with epilepsy.MethodConsecutive patients with PNES (N = 23) and epilepsy (N = 72) completed questionnaires about attachment style, quality of their relationship with their main informal carer, seizure severity, HRQoL, depression, and anxiety.ResultsPatients with PNES reported higher levels of anxiety and depression and lower HRQoL than those with epilepsy. PNES: No significant correlations were found with HRQoL but depression correlated positively with attachment avoidance, attachment anxiety, and relationship conflict. Anxiety correlated positively with attachment avoidance, attachment anxiety, and relationship conflict, and negatively with relationship depth and support. Epilepsy: HRQoL correlated negatively with seizure severity, depression, anxiety, attachment avoidance, and attachment anxiety. Depression correlated positively with attachment avoidance, attachment anxiety, and relationship conflict. Anxiety correlated positively with seizure severity, attachment avoidance, and attachment anxiety. Correlations between measures of relationship quality and anxiety were stronger in patients with PNES versus those with epilepsy (zs = 2.66 to 2.97, ps < 0.004). Attachment style and relationship quality explained larger amounts of variance in depression (45%) and anxiety (60%) in the patients with PNES than those with epilepsy (16% and 13%).SignificanceLevels of anxiety and depression were higher in patients with PNES than those with epilepsy. Interpersonal problems were much more closely associated with anxiety and depression in patients with PNES than those with epilepsy. The findings support the use of therapeutic interventions for PNES focusing on attachment and relationship issues.     

Depression and anxiety in patients with diabetes in a Moroccan region

AimsTo estimate prevalence of anxiety and depression in patients with diabetes mellitus and identify their determinants.MethodsA cross-sectional study was conducted at Hassan II University-Hospital of Fes in 2019–2020. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariate analysis by logistic regression was used to determine factors associated with depression and anxiety, adjusting for confounding factors. All statistical analyses were conducted using EPIINFO7.ResultsA total of 243 diabetics were included in the study. The average age of the participants was 48.07 ± 14.25 years, 58% were females and 72% were diagnosed with diabetes type II. The prevalence of depressive symptoms and anxiety symptoms was (18, 1%, CI_95% = (13–23)) and (29.6%, CI_95% = (24–35)), respectively. The prevalence of depression and anxiety was higher among women than man and increases with increasing duration of the disease. In multivariate analysis, illiterates (OR = 3.19, CI_95% = (1.46–6.98)), those with depression (OR = 3.61, CI_95% = (1.78–7.32)), and type 1 diabetics (OR = 3.22, CI_95% = (1.44–7.21)) are a higher risk of developing anxiety. Depression was associated with older age (OR = 2, 65, CI_95% = (1, 14–6, 14)), use of insulin (OR = 3.77 CI_95% = (1.50–9.44)) and anxiety symptoms (OR = 4, 27, CI_95% = (2, 05–8, 91)).ConclusionHigh prevalence of depressive and anxiety symptoms in diabetics suggests consideration of psychological aspect in implementation of diabetes managing program.     

Short-term impact of alcohol detoxification on facial emotions recognition

Background and aimsAlcohol use disorder (AUD) is associated with impaired social cognition, including the disturbance of facial emotion recognition (FER). Previous studies have focused on the assessment of basic emotions decoding among patients with AUD, but the evolution of these performances in the early phase of alcohol withdrawal remains unknown.MethodsThis study was based on evolution of social cognition over a period of 21 days in two groups of individuals: a group of 20 AUD patients and a control group of 25 healthy individuals. AUD patients were tested on admission in a detoxification ward and after a 3-week stay. We evaluated FER with the Reading the Mind in the Eyes Test (RMET). We assessed empathy with a multidimensional questionnaire, the Interpersonal Reactivity Index (IRI). We measured anxiety and depression through the self-rating scale Hospital Anxiety and Depression (HAD). We hypothesized that FER would be impaired in AUD patients on admission and improve after detoxification, while being stable in the control group.ResultsRMET scores on admission and at discharge were inferior in AUD patients to those observed in HC (P = 2 × 10⁻⁶ and P = 0.033, respectively). In the patient group, the RMET score improved over the stay (P = 0.034). A time-by-group interaction for RMET score was observed (P = 0.003). IRI scores on admission were superior in AUD patients (P = 0.023) whichwas no longer observed at discharge (P = 0.54). This suggests that RMET might be more accurate in measuring theory of mind evolution in AUD patients after withdrawal. HAD scores on admission and at discharge were inferior in AUD patients compared to controls (P = 3 × 10⁻⁵ and P = 0.007, respectively). After controlling for HAD initial score, a time-by-group interaction was still observed for RMET scores (P = 0.026).ConclusionFER is impaired in patients with Alcohol Use Disorder compared to controls. This alteration improves after alcohol detoxification. We suggest the RMET could be used to follow the improvement of FER during the first month of abstinence, especially as RMET performance has been associated with maintenance of alcohol withdrawal.     

Mindfulness-based stress reduction for healthy individuals: A meta-analysis

BackgroundAn increasing number of mindfulness-based stress reduction (MBSR) studies are being conducted with nonclinical populations, but very little is known about their effectiveness.ObjectiveTo evaluate the efficacy, mechanisms of actions, and moderators of MBSR for nonclinical populations.Data sourcesA systematic review of studies published in English journals in Medline, CINAHL or Alt HealthWatch from the first available date until September 19, 2014.Study selectionAny quantitative study that used MBSR as an intervention, that was conducted with healthy adults, and that investigated stress or anxiety.ResultsA total of 29 studies (n = 2668) were included. Effect-size estimates suggested that MBSR is moderately effective in pre–post analyses (n = 26; Hedge's g = .55; 95% CI [.44, .66], p < .00001) and in between group analyses (n = 18; Hedge's g = .53; 95% CI [.41, .64], p < .00001). The obtained results were maintained at an average of 19 weeks of follow-up. Results suggested large effects on stress, moderate effects on anxiety, depression, distress, and quality of life, and small effects on burnout. When combined, changes in mindfulness and compassion measures correlated with changes in clinical measures at post-treatment and at follow-up. However, heterogeneity was high, probably due to differences in the study design, the implemented protocol, and the assessed outcomes.ConclusionsMBSR is moderately effective in reducing stress, depression, anxiety and distress and in ameliorating the quality of life of healthy individuals; however, more research is warranted to identify the most effective elements of MBSR.     

L’addiction aux smartphones : validation française de l’échelle Internet Addiction Test-version smartphone (IAT-smartphone) et caractéristiques psychopathologiques associées

IntroductionSince their first appearance in 1992 smartphones have improved constantly, and their use, combined with the rapid spread of the Internet, has increased dramatically. The recent emergence of this technology raises new issues, at both individual and societal levels. Several studies have investigated the physical and psychological harm that may be caused by smartphones. The issue of excessive smartphone use as an addictive disorder is frequently raised and debated, although it is not acknowledged in international classifications. In France, there is no validated assessment tool for smartphone addiction. Therefore, the aims of this research were: to validate a French translation of the Internet Addiction Test-smartphone version (IAT-smartphone); to study the links between smartphone addiction, Internet addiction, depression, anxiety and impulsivity.MethodTwo hundred and sixteen participants from the general population were included in the study (January to February 2016), which was available online using Sphinx software. We assessed smartphone addiction (French version of the Internet Addiction Scale – smartphone version, IAT-smartphone), specificity of smartphone use (time spent, types of activity), Internet addiction (Internet Addiction Test, IAT), impulsivity (UPPS Impulsiveness Behavior Scale), and anxiety and depression (Hospital Anxiety and Depression scale, HAD). We tested the construct validity of the IAT-smartphone (exploratory factor analysis, internal consistency, non-parametric correlation tests for convergent validity). We also carried out multiple linear regressions to determine the factors associated with IAT-smartphone.ResultsMean age was 32.4 ± 12.2 years; 75.5% of the participants were women. The IAT-smartphone had a one-factor structure (explaining 42 % of the variance), excellent internal consistency (α = 0.93) and satisfactory convergent validity. Smartphone addiction was associated with Internet addiction (ρ = 0.85), depression (ρ = 0.31), anxiety (ρ = 0.14), and some impulsivity subscales, including “negative urgency” (ρ = 0.20; P < 0.01), “positive urgency” (ρ = 0.20; P < 0.01), and “lack of perseverance” (ρ = 0.16; P < 0.05). Age was negatively associated with the IAT-S total score (ρ = −0.25; P < 0.001), and there was a non-significant difference between the IAT-S total scores of men and women (29.3 ± 10.2 vs. 32.7 ± 12.4; P = 0.06). Multiple linear regression showed that age, anxiety, depression, average time spent on the smartphone, impulsivity and Internet addiction explained 71.4 % of the variance of IAT-smartphone scores. However, this score dropped to 13.2 % when Internet addiction was removed from the model. This variable alone explained 70.8 % of the IAT-smartphone scores.ConclusionThe French version of the IAT-smartphone is a reliable and valid questionnaire to assess smartphone addiction. This addiction appears to be strongly linked to anxiety, depression and impulsivity. The strong association between smartphone addiction and Internet addiction suggests that smartphone addiction is one of the many forms of Internet addiction. In fact, smartphones may not be the object of the addiction but rather a medium facilitating Internet access as it makes it possible to connect anywhere anytime. This raises the issue of the potential role of smartphones in speeding up and facilitating the development of Internet addiction.     

The effect of cigarette smoking on vitamin D level and depression in male patients with acute ischemic stroke

ObjectiveThe association between low vitamin D levels and depression has been well documented in nonstroke subjects. Accumulating evidence shows that low vitamin D levels may be also associated with depression post stroke. Cigarette smoking was associated with lower vitamin D levels. The purposes of this study were to compare vitamin D levels in smokers to nonsmokers and examine the association between vitamin D levels and depression symptoms in patients with acute ischemic stroke.Materials and methodsSerum levels of 25-hydroxyvitamin D [25(OH)D] were measured in 194 males within 24 h after admission: 116 smokers and 78 nonsmokers. Depression symptoms were assessed with the 17-item Hamilton Depression Scale (HAMD-17). Patients with the HAMD-17 score >7 were identified to have depression symptoms.ResultsThe chi-square test showed that the frequency of depression in the smoker group was 23.3% (27/116), which was significantly higher than that in the nonsmoker group (11.5% = 9/78), with an odds ratios (OR) of 2.33 (95% CI: 1.03–5.27; χ² = 4.25, df = 1, p = 0.039, φ = 0.15). Vitamin D levels were significantly lower in smokers than in nonsmokers (52.4 ± 20.8 vs 61.7 ± 19.2; F = 9.88, p = 0.002), with an effect size of 0.05 (η_p²). Patients with depression symptoms showed lower vitamin D levels than those with no depression symptoms (49.2 ± 19.6 vs 57.7 ± 20.6; F = 5.03, p = 0.03), with an effect size of 0.03 (η_p²).ConclusionHigher rates of depression in smokers with acute ischemic stroke may be associated with lower vitamin D levels induced by smoking.