Neurocognitive markers of suicidal ideation in patients with anxiety and mood disorders

© 2020 Informa UK Limited, trading as Taylor & Francis Group. This is an accepted manuscript of an article published by Taylor & Francis in International Journal of Psychiatry in Clinical Practice on 12/03/2020, available online: https://doi.org/10.1080/13651501.2019.1666148.Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD). Methods: In sum, 186 (age = 39 ± 12.3 years; 142 [76.3%] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]). Results: Almost half (45.0%, n = 86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β = 0.726, p = .010 and β = 0.634, p = .019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms. Conclusions: Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.Peer reviewe

Mental Fatigue, But Not other Fatigue Characteristics, as a Candidate Feature of Obsessive Compulsive Personality Disorder in Patients with Anxiety and Mood Disorders—An Exploratory Study

Background: Obsessive compulsive personality disorder (OCPD) is commonly associated with anxiety and mood disorders (AMDs), in which fatigue and executive dysfunction represent key symptoms. Executive dysfunction has also been demonstrated in subjects with OCPD, and is additionally found to be a cardinal feature of fatigue. This study aimed to investigate the associations between fatigue, executive dysfunction, and OCPD in patients with AMDs. Methods: In this cross-sectional study, 85 AMD patients (78% females, mean age 39 ± 11 years) were evaluated for OCPD traits by using the observer-rated Compulsive Personality Assessment Scale. The Multidimensional Fatigue Inventory-20 was used to measure different aspects of fatigue, and the Trail Making Test was employed to assess executive functioning. The Hamilton rating scales were used to evaluate anxiety and depression symptoms. Results: Controlling for potential confounders, there was a significant link between OCPD and mental fatigue (OR, 1.27; 95% CI, 1.02 to 1.58; p = 0.033). No associations were found between the presence of OCPD and other relevant fatigue characteristics, including general fatigue, physical fatigue, reduced activity, and reduced motivation, as well as executive functions. Conclusions: To the best of our knowledge, this study is the first to report associations between OCPD and mental fatigue in patients with AMDs, suggesting mental fatigue as a clinically important symptom when considering particular personality pathologiesPeer reviewedFinal Published versio

Problems in Cognitive-Behavioral Supervision : Theoretical Background and Clinical Application

Cognitive-behavioural therapists and trainees are encouraged to undergo supervision when offering therapy to troubled clients and to process personal attitudes and events likely to affect their therapeutic work. We discuss common problems in cognitive behavioural therapy (CBT) supervision, which may arise at the client, supervisee, or supervisor level. These issues include difficulties with case formulation, therapeutic strategies, and the therapeutic relationship. A supervisor can help their supervisee deal with clients with multifaceted or particularly challenging problems, such as difficulties with compliance, complex psychosocial problems, or chronic mental disorders. We also discuss matters related to the supervision process, the supervisor's role, different supervisory styles, and issues affecting a supervisee's feelings of vulnerability and shame. Furthermore, we analyze distinct supervision styles and potential problems arising from the supervision of experienced CBT therapists.Peer reviewe

Chairwork in cognitive behavioral therapy and schema therapy : Options in practice

Chairwork is a creative and emotionally charged technique that enhances therapeutic progress. It is based on the assumption that if individuals become aware and express their inner beliefs or conflicts, it would help them understand and choose solutions more freely than if they act unaware and automatically. When used within the conceptualization of the client's problems, it can liberate clients' intense emotional pain and change their maladaptive cognitions. This article shares the clinical experience using the chair techniques by describing and illustrating typical examples of chairwork in cognitive behavioural and schema therapy. Additional recommendations on how to do chairwork and consider the pace, tone of voice, or location of the chairs are also provided.publishersversionPeer reviewe

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

Homework in Cognitive Behavioral Supervision : Theoretical Background and Clinical Application

Funding Information: This paper was supported by the research grant VEGA no. APVV-15-0502 Psychological, psychophysiological and anthropometric correlates of cardiovascular diseases. Publisher Copyright: © 2022 Prasko et al.The homework aims to generalize the patient’s knowledge and encourage practicing skills learned during therapy sessions. Encouraging and facilitating homework is an important part of supervisees in their supervision, and problems with using homework in therapy are a common supervision agenda. Supervisees are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself. Homework assigned in supervision usually deals with mapping problems, monitoring certain behaviors (mostly communication with the patient), or implementing new behaviors in therapy.publishersversionPeer reviewe

Effects of Different Amounts of Blue Lupine (L. Angustifolius L.) in The Diets of Heavy-Type Turkeys on Their Growth Rate, Carcass and Meat Qualities

ABSTRACT A study was carried out to determine the effects of soybean meal replacement with different amounts of blue lupine in the diets of turkeys on the growth rate, anatomic carcass dissection data, chemical indicators of breast and thigh muscles and the content of tryptophan and oxyprolin. In total three hundred and sixty cross BIG-6 turkeys were allotted to two control and ten experimental groups of 30 one-day-old turkeys. The control group of turkeys was fed the diet containing soybean meal, whereas the trial groups were offered different amounts (from 20 to 30%) of lupines. Group 4 and 5 were additionally given probiotic mixture Bio Plus 2B and allzyme SSF, respectively. Soybean oil replacement from 20 to 30% lupine in the diet had no influence on the growth rate, dressing percentage, edible parts and abdominal fat content of turkeys. The study indicated that lupines in the diet of turkeys had a different effect on the meat quality of different genders. Lupines did not have any negative effect on the meat quality of female turkeys and 30% lupines even improved the protein value index of breast muscles. However, 20-30 and 25-30% lupines in male turkey diets lowered dry matter and protein contents in breast muscles but had no negative influence on the main quality indicators in thigh muscles. The results of the study showed that the negative effect on the male breast muscle quality might be avoided using Bio Plus 2B or allzyme SSF additives in the male diets containing 30% lupines

Effect of linseed oil sediment in the diet of pigs on the growth performance and fatty acid profile of meat

ABSTRACT The objective of this investigation was to examine the influence of dietary linseed oil sediment on the growth performance and fatty acid composition in the muscle tissue of pigs. Sixty-eight crossbred Swedish Yorkshire × Norwegian Landrace pigs were allocated to two trials with two different levels of linseed oil sediment. Twenty-four pigs in Trial 1 were allotted into control 1 and experimental 1, of 12 animals each, and forty-four pigs in Trial 2 were allotted into control 2 and experimental 2, of 22 animals each. In both treatments, control and experimental groups were formed by animals analogous by origin, gender, weight, and condition score. Control pigs were fed identical diets ad libitum in both trials. The treated pigs were fed the same diet as control pigs, but vegetable oil was replaced by linseed oil sediment at a rate of 25 g kg−1 (experimental group 1) in Trial 1 and 50 g kg−1 (experimental group 2) in Trial 2. The results indicated that in both trials, vegetable oil replacement for linseed oil sediment had no significant influence on the growth rate of pigs, though a tendency was observed for a more rapid daily gain. Addition of linseed oil sediment to the diets increased the content of n-3 α-linolenic (C18:3n-3), eicosatrienoic (C20:3n-3), and eicosapentaenoic (C20:5n-3) acids and total n-3 polyunsaturated fatty acids (PUFA) and decreased the C18:2n-6/C18:3n-3 and n-6:n-3 ratios and the thrombogenic index of meat. Moreover, the addition of 50 g kg−1 linseed oil sediment resulted in higher content of docosapentaenoic (C22:5n-3) fatty acid, total PUFA, and PUFA:SFA ratio. Supplementation of pig diets with linseed oil sediment increases the content of α-linolenic, eicosatrienoic, eicosapentaenoic, and docosapentaenoic fatty acids and total content of n-3 polyunsaturated fatty acids and have a positive effect by improving the polyunsaturated fatty acids:saturated fatty acids and n-6:n-3 fatty acid ratios in meat

Multidimensional Structure of the Alcohol Use Disorders Identification Test: Factorial Validity and Reliability in Patients with Anxiety and Mood disorders in Lithuania

© 2020 Oxford University Press. This is the accepted manuscript version of an article which has been published in final form at https://dx.doi.org/10.1093/alcalc/agaa118.Aims. The current study aimed to evaluate the factorial structure of the Lithuanian version of the Alcohol Use Disorders Identification Test (AUDIT) in patients with anxiety and mood disorders (AMD). Methods. The AUDIT was completed by 199 consecutive outpatients with AMD (21% men, mean age 39±12 years), as defined by AMD criteria in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) (Association, 2013). The MINI International Neuropsychiatric Interview (Sheehan, 2016) was used for current diagnosis of alcohol use disorder. Sociodemographic and clinical data were also collected. Results. In patients with AMD, the AUDIT showed high internal consistency (Cronbach's alpha = 0.88) and good psychometric characteristics for identifying current alcohol use disorder at a cut-off value of ≥9 (positive predictive value=83.7%, sensitivity=94.7%, specificity=95.7%). The confirmatory factor analysis suggested a three-factor (‘consumption’, ‘dependence’, and ‘related consequences’) structure and indicated adequate fit to the model (comparative fit index=0.966, normed fit index=0.936, root mean square error of approximation=0.072). Conclusions. The findings are in line with increasing evidence suggesting that the AUDIT measures three separate factors related to alcohol misuse level of consumption, dependence and alcohol-related consequences and support the utility of AUDIT as a screening instrument for alcohol use disorder in AMD patients in Lithuania.Peer reviewe