The effectiveness of a virtual reality attention task to predict depression and anxiety in comparison with current clinical measures

Previous studies have revealed that attention and inhibition are impaired in individuals with elevated symptoms of depression and anxiety. Virtual reality (VR)-based neuropsychological assessment may be a valid instrument for assessing attention and inhibition given its higher ecological validity when compared to classical tests. However, it is still unclear as to whether a VR assessment can predict depression and anxiety with the same or higher level of effectiveness and adherence as classical neuropsychological measures. The current study examined the effectiveness of a new VR test, Nesplora Aquarium, by testing participants with low (N = 41) and elevated (N = 41) symptoms of depression and anxiety. Participants completed a continuous performance test where they had to respond to stimuli (species of fish) in a virtual aquarium, as well as paper-and-pencil and computerised tests. Participants’ performance in Nesplora Aquarium was positively associated with classic measures of attention and inhibition, and effectively predicted symptoms of depression and anxiety above and beyond traditional cognitive measures such as psychomotor speed and executive functioning, spatial working memory span. Hence, VR is a safe, enjoyable, effective and more ecological alternative for the assessment of attention and inhibition among individuals with elevated anxiety and depression symptoms.</p

Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them

Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method.Methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed.Results: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients.Discussion: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.<br /

ATTRIBUTIONAL STYLE AND REACTION TO FRUSTRATION IN DELUSIONAL DISORDERS

REZUMAT Scopul: Stilul atribuţional şi reacţiile la frustrare joacă un rol important atât în depresie cât şi în paranoia. Aceste aspecte reprezintă elemente caracteristice cogniţiei sociale. Ultimele studii în acest sens (există studii doar pe stilul de atribuire) au demonstrat deficite semnificative ale stilului atribuţional, deficite ce se reflectă apoi în mecanismul de producere şi menţinere a simptomatologiei delirante precum şi în funcţionarea socială a deliranţilor. Obiectivul acestei lucrâri a fost de a studia stilul de atribuire şi reacţiile la frustrare în cadrul deliranţilor persistenţi cu şi fără depresie asociată, în scopul unei mai bune înţelegeri a cogniţei sociale a acestora. Instrumente şi metodă: Un grup de 40 de subiecţi, diagnosticaţi după ICD 10 cu tulburare delirantă şi având o perioadă de evoluţie de 8 ani au fost împărţiţi în doua loturi : a) cu depresie şi b) fără depresie. Toate cazurile fac parte din Proiectul Timişoara de Studiu al Tipologiei Psihozelor Endogene ce monitorizează psihozele funcţionale cu debut de după 1985. Pentru fiecare subiect au fost aplicate în perioada de remisie BPRS (Brief Psychiatric Rating Scale), ASQ (Attributional Style Questionnaire) şi Rosenzweig frustration test. Rezultate: Deliranţii depresivi fac atribuiri stabile pentru ambele tipuri de evenimente, însă pentru cele negative atribuirea este predominant externă, iar pentru evenimentele pozitive, atribuirea este internă. În cazul reacţiilor de frustrare aceştia reacţionează mai frecvent extrapunitiv şi de tipul persistenţei necesităţii. Deliranţii simpli pentru evenimentele de viaţă negative fac atribuiri externe şi particulare, iar pentru cele pozitive interne şi stabile. În cazul situaţiilor frustrante, aceştia dau frecvent răspunsuri fără pedeapsă şi de tipul persistenţei necesităţii. Concluzii: În ciuda coloraturii depresive, deliranţii depresivi fac atribuiri externe pentru evenimentele negative, iar, spre deosebire de cei fără coloratură depresivă, aceştia reacţionează extrapunitiv în situaţiile frustrante. Cuvinte cheie: atribuire, reacţie la frustrare, delir, depresie ABSTRACT Background: The attribution style and the reactions to frustration play an important role both in depression and paranoia. These aspects are characteristic elements of social cognition. The latest studies done in this area (there are studies only related to attribution) proved significant deficiencies to the attribution style, that later reflect in the mechanism of production and manifestation of delusional symptomatology and also in the social functionality of the delusional. The objective of this paper is to study the attribution style and the reactions to frustration in the persistent delusional patients with and without an associated depression, in order to better understand their social cognition. Material and methods: Forty patients diagnosed with ICD 10 delusional disorder with a period of evolution of 8 years, were grouped into 2 subgroups: a) patients with depression and b) patients without depression. They are all part of the Case Register of Timisoara Psychiatric Clinic (CRPTC), which monitors the functional psychoses since 1985. ASQ (Attribution Style Questionnaire) and Rosenzweig frustration test was applied for each patient in the period of remission BPRS (Brief Psychiatric Rating Scale). Results: Depressive delusional patients make stable attributions for both type of events, but for the negative ones, the attribution is prevalently external and for the positive events the attribution is internal. Common delusional patients make external and particular attributions for negative life events, while for the positive events the attributions are internal and stable. Concerning the response to frustrating situations, persistent delusional psychosis patients with depression give answers which are prevailing extra punitive, whereas those without depression give prevailing need-persistence answers. There are significant similarities between the two groups concerning the type of persisting necessity. Conclusions: Among the persistent delusional psychosis patients, those with depressive features demonstrate an aggression directed mostly towards the exterior in frustrating situations, while associating less the negative events to their own personality, compared to the pure persistent delusional patients

Postgraduate Medical Education System in Romania

AbstractAfter the enlargement of European Community, the access to work in different European Union countries became easier. An increasing number of postgraduate trainees (residents) chose to leave their country for better financial conditions, working facilities, and research opportunities. The aim is to identify those factors that describe important characteristics of the Romanian postgraduate medical training from the residents’ perspective. The study was conducted in two samples of Romanian trainees: psychiatric and non-psychiatric residents from university hospitals. Residents were asked to fill in a questionnaire regarding their satisfaction about the postgraduate medical training. Also, they were asked to express preferences about their future medical perspectives there are no significant differences between psychiatric and non-psychiatric trainees. Most residents rate an average financial situation. Although their satisfaction regarding hospital practice is moderate, they rate a good relationship with the attending physicians. Because the training takes place in university hospitals, residents have access to conferences, lectures and case presentation. Very few have access to PhD opportunities, to sponsored pharmacologic studies, or to psychotherapy. The majority of the trainees would prefer to remain in their country, close to their families. Residents rate the medical training system as satisfying, but because of limited working opportunities after finishing residency, they consider living the country

Quality of Life in Patients with Chronic Psychotic Disorders: A Practical Model for Interventions in Romanian Mental Health Centers

Background and Objectives: Current psychiatric care is increasingly focusing on patients&rsquo; quality of life (QoL). Research is still trying to determine the main factors which influence QoL. The present study aims to assess the QoL of patients with chronic psychotic-spectrum disorders, as well as its relation to symptomatology, functionality, adaptive behavior, and perceived level of recovery. Materials and Methods: The study included a sample of 78 patients with chronic psychosis. Symptomatology and illness severity were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale-Severity (CGI-S) scales, respectively. The Global Assessment of Functioning Scale (GAFS) and the Adaptive Behavior Assessment System II (ABAS-II)-Adult Form were used for the assessment of patients&rsquo; functionality, and the Quality-of-Life Inventory (QOLI) scale was applied for the evaluation of QoL. Results: According to the CGI-Severity scale, 20.5% of the patients were borderline mentally ill, and 24.4% were mildly ill. The highest number of patients (34.6%) were moderately ill, while 14.1% and 2.6% were markedly ill and severely ill, respectively. Among the moderately ill patients, more than half (63%) were patients with schizophrenia, 18.5% were patients with delusional disorder, and 18.5% were patients with schizoaffective disorder. Most of the patients (43.6%) presented moderate functioning deficiency, while 38.5% of the patients presented severe deficiency, according to the GAFS score. When assessed with the ABAS, we observed that almost half of the patients (44.9%) showed an average functioning across skill areas in the conceptual, social, and practical domains. A percent of 67.9% of the patients presented an average QoL, while 15.4% and 12.8% showed a very low and low QoL. QoL was not influenced by the patients&rsquo; symptomatology, gender, and education level. Having children, family support, better social and conceptual skills, and a higher perceived level of recovery was correlated with an increased QoL, hierarchical multiple regression R2 = 0.379, F(9, 68) = 2.616, and p = 0.012. Conclusions: Psychiatric interventions in psychosis should focus not only on symptoms&rsquo; control, but also on improving social and family support, as well as adaptive skills to increase the patients&rsquo; QoL

Defensive and Coping Styles for Residents in Psychiatry

AbstractThe nature of this profession requires the development of adequate defensive and coping styles. Also to have chosen this for your career might mean to have some particularities in these areas. The evaluation of coping and defense style mechanisms for residents in psychiatry that conduct clinical work. A descriptive study was developed to determine and evaluate defensive and coping styles for residents in psychiatry. DSQ-60 and COPE scales were applied on a 31 willing resident in psychiatry from approximate 50 residents in total from the center in which the study was conducted. The most frequent mechanisms found on the evaluated group are: “Altruism”,”Self-observation” – superior defense styles and “Positive interpretation and growth” - an emotion focused coping style and „Planning” – a problem focused coping style. The chosen profession can be a factor that underlines some inborn abilities but also a modulating factor for one's structure. The developing of adequate coping and defense styles might be a requirement for becoming a psychiatrist or it might be a gain for someone working in this field day by day

Social and Neurocognitive Deficits in Remitted Patients with Schizophrenia, Schizoaffective and Bipolar Disorder

This study assesses the empathy level, cognitive performance and emotion recognition skills of remitted patients with schizophrenia, schizoaffective disorder and bipolar disorder, and also explores the relationship between impairments in the mentioned domains. The study was performed on 77 subjects divided into two groups: PAT sample (N = 37) included remitted patients with either schizophrenia, schizoaffective or bipolar disorder who were compared with healthy control subjects from the HC sample (N = 40). Along with sociodemographic and clinical data, empathy levels (using EQ (Empathy Quotient) scale), the ability to recognize another person’s emotional state (using RMET (Reading the Mind in the Eyes Test)), and cognitive performance (using MoCA (Montreal Cognitive Assessment) Scale) were investigated. The intensity of the psychiatric symptoms was measured with BPRS-E (Brief Psychiatric Rating Scale—Expanded). The remitted patients had lower EQ (p = 0.02) and RMET (p &lt; 0.0001) scores than the healthy subjects. In the PAT group, RMET scores were positively correlated with MoCA total scores. Both EQ and RMET scores were negatively correlated with BPRS-E total scores. Psychiatric disorder was a significant predictor for deficits in emotion recognition. There were no significant differences in RMET, EQ and MoCA scores between patients with respect to diagnosis, the type of antipsychotic or the associated medication. In both samples, females had higher empathy levels (p = 0.04) and better emotion recognition abilities (p = 0.04) than males. Patients with schizophrenia, schizoaffective or bipolar disorder, currently in remission, displayed lower empathy levels and poorer emotion recognition skills than healthy subjects. Poor emotion recognition skills were associated with symptom severity and impairments in global cognition