Ideal cardiovascular health in adolescents and young adults is associated with alexithymia over two decades later: Findings from the cardiovascular risk in Young Finns Study

We evaluated the association of cardiovascular health in adolescence and young adulthood with alexithymia 25 years later. The study sample (n = 1122) participated in evaluations conducted in 1986 (baseline) and in 2011-2012 (T2). Baseline health factors and behaviors were assessed utilizing seven ideal cardiovascular health metrics (ICH index) including blood pressure, cholesterol and glucose levels, smoking, physical activity, body-mass-index, and diet. The stability of the ICH index was evaluated with corresponding assessments in 2007 (T1). At T2, alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). The main analyses were conducted using ANCOVA and adjusted for depression, age, and present social and lifestyle factors. TAS-20 subscales, Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking, were analyzed separately. The ICH index was significantly associated with the TAS-20 total score, as well as both with DIF and DDF. A less ideal cardiovascular health was associated with higher alexithymia scores. However, regarding the separate factors, only the association between non-ideal dietary habits and DIF was significant in the multivariate analyses. The baseline ICH index score was stable from baseline to T1. We conclude that non-ideal cardiovascular lifestyle habits in adolescence and young adulthood are significantly associated with later alexithymia

Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus

Objective: Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus. Design: Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES). Study sample: 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32. Results: The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4. Conclusions: Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus.Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).</p

In Vivo Availability of Cannabinoid 1 Receptor Levels in Patients with First-Episode Psychosis

Importance: Experimental and epidemiological studies implicate the cannabinoid 1 receptor (CB1R) in the pathophysiology of psychosis. However, whether CB1R levels are altered in the early stages of psychosis and whether they are linked to cognitive function or symptom severity remain unknown.Objective: To investigate CB1R availability in first-episode psychosis (FEP) without the confounds of illness chronicity or the use of illicit substances or antipsychotics.Design, Setting, and Participants: This cross-sectional, case-control study of 2 independent samples included participants receiving psychiatric early intervention services at 2 independent centers in Turku, Finland (study 1) and London, United Kingdom (study 2). Study 1 consisted of 18 volunteers, including 7 patients with affective or nonaffective psychoses taking antipsychotic medication and 11 matched controls; study 2, 40 volunteers, including 20 antipsychotic-naive or antipsychotic-free patients with schizophrenia or schizoaffective disorder and 20 matched controls. Data were collected from January 5, 2015, through September 26, 2018, and analyzed from June 20, 2016, through February 12, 2019.Main Outcomes and Measures: The availability of CB1R was indexed using the distribution volume (VT, in milliliters per cubic centimeter) of 2 CB1R-selective positron emission tomography radiotracers: fluoride 18–labeled FMPEP-d2 (study 1) and carbon 11–labeled MePPEP (study 2). Cognitive function was measured using the Wechsler Digit Symbol Coding Test. Symptom severity was measured using the Brief Psychiatric Rating Scale for study 1 and the Positive and Negative Syndrome Scale for study 2.Results: A total of 58 male individuals were included in the analyses (mean [SD] age of controls, 27.16 [5.93] years; mean [SD] age of patients, 26.96 [4.55] years). In study 1, 7 male patients with FEP (mean [SD] age, 26.80 [5.40] years) were compared with 11 matched controls (mean [SD] age, 27.18 [5.86] years); in study 2, 20 male patients with FEP (mean [SD] age, 27.00 [5.06] years) were compared with 20 matched controls (mean [SD] age, 27.15 [6.12] years). In study 1, a significant main effect of group on [18F]FMPEP-d2 VT was found in the anterior cingulate cortex (ACC) (t16 = −4.48; P Conclusions and Relevance: The availability of CB1R was lower in antipsychotic-treated and untreated cohorts relative to matched controls. Exploratory analyses indicated that greater reductions in CB1R levels were associated with greater symptom severity and poorer cognitive functioning in male patients. These findings suggest that CB1R may be a potential target for the treatment of psychotic disorders.</p

Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology

Background: Autistic people are disproportionately vulnerable to anorexia nervosa and other eating disorders (ED), and within the general population, autistic traits correlate with ED psychopathology. A putative mechanism which may underpin this heightened risk is alexithymia, a difficulty identifying and describing emotional states which is observed in both autism and ED. In two experiments with independent non-clinical samples, we explored whether alexithymia might mediate the heightened risk of eating psychopathology in individuals high in autistic traits. Methods: Our first experiment used the PROCESS macro for SPSS to examine relationships between alexithymia (measured by the Toronto Alexithymia Scale (TAS-20)), autistic traits (autism quotient (AQ)), and eating psychopathology (Eating Attitudes Test (EAT-26)) in 121 participants. Our second experiment (n = 300) replicated and furthered this analysis by examining moderating effects of sex and controlling for anxiety and depression as covariates. We also included an additional performance-based measure of alexithymia, the Levels of Emotional Awareness Scale (LEAS). Results: Study 1 suggested that TAS-20 scores mediated the relationship between heightened autistic traits and eating psychopathology. Replication and further scrutiny of this finding, in study 2, revealed that this mediation effect was partial and specific to the female participants in this sample. The mediation effect appeared to be carried by the difficulty identifying feelings subscale of the TAS-20, even when depression and anxiety were controlled for. LEAS scores, however, were not significantly related to autistic traits or eating psychopathology. Limitations: Cross-sectional data prevents any conclusions around the direction and causality of relationships between alexithymia, autistic traits, and eating psychopathology (alongside depression and anxiety), necessitating longitudinal research. Our non-clinical sample was predominantly Caucasian undergraduate students, so it remains to be seen if these results would extrapolate to clinical and/or autistic samples. Divergence between the TAS-20 and LEAS raises crucial questions regarding the construct validity of these measures. Conclusions: Our findings with respect to autistic traits suggest that alexithymia could partially explain the prevalence of ED in autistic people and may as such be an important consideration in the pathogenesis and treatment of ED in autistic and non-autistic people alike. Further research with clinical samples is critical to explore these ideas. Differences between men and women, furthermore, emphasize the importance of looking for sexspecific as well as generic risk factors in autistic and non-autistic men and women

Is Antidepressant Use Associated With Difficulty Identifying Feelings? A Brief Report

Studies on the subjective effects of antidepressants suggest that they may not only improve depressed mood, but as an adverse effect also cause "emotional blunting." This phenomenon is poorly understood and little studied. The aim of this study was to examine the association of serotonergic antidepressant use and subjective emotional awareness. Emotional awareness was assessed using the Difficulty Identifying Feelings subscale from the 20-Item Toronto Alexithymia Scale. Fifty-seven individuals on antidepressant medication and 441 controls were compared. The effects of sex, age, education, as well as current depressive symptoms were controlled for. After controlling for selected variables, the antidepressant group scored higher in subjective difficulty identifying feelings, compared to controls. (p = .043, Adjusted means by Group 14.2 vs. 15.5, 95% confidence interval for mean difference between Groups 0.04-2.5). Serotonergic antidepressant use may be associated with difficulty identifying feelings. Future studies with a longitudinal setting are warranted to clarify causality.</p

Alexithymia, body mass index and gestational diabetes in pregnant women — FinnBrain birth cohort study

ObjectiveOverweight, obesity, and associated problems in metabolic health are an increasing public health concern. Personality traits and emotional processing styles may play a role in the regulation of food intake and reward. Alexithymia is a personality construct involving difficulties in identifying and expressing emotions and has been previously associated with eating disorders and metabolic problems. We examined associations between alexithymia dimensions, Body Mass Index (BMI) and gestational diabetes in pregnant women.MethodsThe participants were 1660 pregnant women living in Finland from the FinnBrain Birth Cohort Study. We investigated the associations between alexithymia and its dimensions as measured by the Toronto Alexithymia Scale (TAS-20), overweight, and gestational diabetes. The effects of age, education, and depressive symptoms were controlled for using hierarchical regression analysis.ResultsAlexithymic individuals had a higher prevalence of overweight compared to those with low or moderate levels of alexithymia (66.0% vs. 34.8%, OR 3.6, adjusted OR 3.6, CI95% 1.9–6.8, p p p = .005].ConclusionsAlexithymia, and especially its dimension of EOT is associated with overweight and gestational diabetes in pregnant women. Future studies should clarify causality and examine potential mechanisms and associations with pregnancy outcomes and fetal health.</div

Sairaanhoitajien näkemykset moniammatillisen yhteistyön toteutumisesta syöpää sairastavien potilaiden hoitotyössä

Sairaanhoitajien näkemykset moniammatillisen yhteistyön toteutumisesta syöpää sairastavien potilaiden hoitotyössä. Tutkimuksen tarkoitus: Kuvata syöpäpotilaita hoitavien sairaanhoitajien näkemyksiä moniammatillisen yhteistyön toteutumisesta yhdessä Syöpäkeskuksessa ja tunnistaa siihen mahdollisesti yhteydessä olevia tekijöitä. Aineisto ja menetelmät: Tutkimusaineisto kerättiin sairaanhoitajilta (n=278) yhdestä alueellisesta Syöpäkeskuksesta Suomessa vuosina 2018 ja 2019 Moniammatillinen yhteistyö ja johtaminen (MONAMI) -kyselylomakkeella. Aineisto analysoitiin kuvailevilla tilastotieteen menetelmillä. Tulokset: Sairaanhoitajat arvioivat moniammatillisen yhteistyön toteutuvan kohtalaisesti Syöpäpotilaiden hoidossa. He tunnistivat moniammatillisen yhteistyön hyödyt, mutta moniammatillisen toiminnan tavoitteita ei vastaajien mukaan kuitenkaan ollut määritelty yhdessä. Sairaanhoitajan työkokemuksen pituus, kuuluminen moniammatilliseen tiimiin ja osallistuminen moniammatillista toimintaa edistävään koulutukseen olivat yhteydessä positiivisempaan näkemykseen moniammatillisesta toiminnasta. Päätelmät: Tutkimus vahvistaa näkemystä moniammatillisen yhteistyön tärkeydestä syöpäpotilaan hoidossa sairaanhoitajien näkökulmasta. Moniammatillista yhteistyötä ja sen johtamista tulee kehittää edelleen ja korostaa toisten ammattiryhmien tuntemista ja arvostusta. Säännöllinen moniammatillista toimintaa tukeva koulutus voisi osaltaan edistää moniammatillisen yhteistyön toteuttamista. Tutkimusta tulee kohdentaa moniammatillista toimintaa edistävien interventioiden ja niiden vaikutusten arviointiin sekä eri ammattiryhmien toisiaan täydentäviin rooleihin. Asiasanat: johtaminen, kysely, moniammatillinen yhteistyö, sairaanhoitaja, syöpäpotilaan hoitotyö