Terapia sistémica breve en personas expuestas a un evento altamente estresante reciente: Un ensayo controlado aleatorizado / Brief systemic therapy in people exposed to a recent highly stressful event: A randomised controlled trial

Resumen: Antecedentes: Los eventos altamente estresantes pueden tener efectos nocivos en el bienestar y salud mental en las personas. Objetivo: Evaluar la eficacia de un protocolo de intervención preventiva basado en la Terapia Sistémica Breve orientado a personas que vivenciaron de manera reciente un evento altamente estresante. Método: Participaron 75 personas, 39 conformaron el grupo experimental y 36 el grupo control. Para el análisis de los datos se siguió un diseño cuantitativo con dos grupos (experimental y control) y con dos puntos temporales (pre y post-intervención). Al grupo experimental se añadió un seguimiento a los seis meses. El protocolo estuvo estructurado en cuatro sesiones y apuntaba a incidir sobre los síntomas postraumáticos, el crecimiento postraumático, la respuesta rumiativa y las estrategias de afrontamiento. Resultados: Se observó un aumento del crecimiento postraumático, de la rumiación deliberada, del afrontamiento centrado en el problema y de la reinterpretación positiva en el grupo experimental. En cambio, solo hubo una tendencia no significativa en la reducción de la sintomatología postraumática y en la búsqueda de apoyo social. Conclusiones: Estos resultados contribuyen al desarrollo de la Terapia Sistémica Breve y apoyan su utilidad en la intervención preventiva con personas expuestas a un evento altamente estresante.

Abstract: Background: Highly stressful events can have harmful effects on people's well-being and mental health. Objective: To evaluate the efficacy of a preventive intervention protocol based on Brief Systemic Therapy oriented to people who recently experienced a highly stressful event. Method: Seventy-five people participated, 39 were in the experimental group and 36 in the control group. A quantitative design with two groups (experimental and control) and two time points (pre- and post-intervention) was used for data analysis. A six-month follow-up was added to the experimental group. The protocol was structured in four sessions and aimed to impact on posttraumatic symptoms, posttraumatic growth, ruminative response and coping strategies. Results: An increase in posttraumatic growth, deliberate rumination, problem-focused coping, and positive reinterpretation was observed in the experimental group. In contrast, there was only a nonsignificant trend in reduced posttraumatic symptomatology and in seeking social support. Conclusions: These results contribute to the development of Brief Systemic Therapy and support its usefulness in preventive intervention with people exposed to a highly stressful event.

Estrategias de afrontamiento, estrés percibido y bienestar psicológico en individuos con cefalea primaria / Coping strategies, perceived stress and psychological well-being in individuals with primary headache

Resumen El propósito de este estudio fue evaluar la asociación entre las estrategias de afrontamiento, el bienestar subjetivo y el estrés en personas con cefalea primaria -es decir, con dolor de cabeza sin origen orgánico-. En total, participaron 150 personas adultas -135 mujeres y 15 hombres- diagnosticadas con cefalea primaria y episodios de cefalea en los últimos seis meses. Los instrumentos de medida utilizados fueron la Escala de satisfacción con la vida de Diener, la escala de estrategias de afrontamiento Brief Cope, la Escala de estrés percibido de Cohen, dos preguntas sobre la intensidad y frecuencia del dolor, y un cuestionario sociodemográfico. En general, se encontró que el bienestar subjetivo se relaciona positivamente con la planificación y negativamente con el uso de sustancias y la frecuencia del dolor; a la vez que el estrés percibido se asocia positivamente con negar la realidad del acontecimiento estresante, culpabilizarse por la situación ocurrida y la frecuencia del dolor, y negativamente con la aceptación de la situación estresante. Además, se observó un mayor estrés percibido en usuarios de atención pública de salud que en aquellos que son atendidos en el sistema privado. Este estudio permite identifi car las estrategias que deben ser potenciadas o modificadas con ayuda del personal de salud para mejorar la calidad de vida de las personas con cefalea primaria.

Abstract The purpose of this study was to assess the association between coping strategies, subjective well-being and stress in people with primary headache, i.e., headache with no organically -based origin. In total, 150 adult persons participated -135 women and 15 men -diagnosed with primary headache and headache episodes in the last six months. The measurement instruments used were the Diener Life Satisfaction Scale, the Brief Cope Coping Strategies Scale, the Cohen Perceived Stress Scale, two questions on pain intensity and frequency, and a sociodemographic questionnaire. In general, it was found that subjective well-being is positively related to planning and negatively to substance use and frequency of pain; while perceived stress is positively associated with denying the reality of the stressful event, blaming oneself for the situation that occurred and the frequency of pain, and negatively with accepting the stressful situation. Also, greater perceived stress was observed in users of public health care than in those who are seen in the private system. This study allows the identification of strategies that should be enhanced or modified with the help of health personnel to improve the quality of life of people with primary headache.

A study on the evaluation of Stressful Impact of the COVID-19, Depression and Anxiety among Healthcare Workers and Non-Health Care people who have recovered from COVID 19

Background: Due to the COVID-19, there is an increase in psychological complaints. Healthcare and non- healthcare persons have had differential complaints like anxiety, depression, stress. Such complaints have also seen in the general public but more so in recovered patients from COVID-19. With this background, we conducted this study find out the stressful impact of COVID-19, prevalence of stress, anxiety and depression between healthcare workers and non-healthcare people. Methodology: A cross-sectional study was done in the tertiary-care COVID hospital in Ahmedabad. 50 healthcare workers (HCWs) and 50 non-healthcare people (NHCPs) who had recovered from COVID-19 were included (age 18-65 years) in the study after they consented for the same. They are assessed with a clinical socio-demographic proforma, clinical variables, Impact Of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9) and Anxiety-Self Rating Scale (ASRS). The results were then statistically analysed. Results: Distress by stressful life events and anxiety were not significant (14% and 32%), (14% and 30%) in HCWs and NHCPs respectively. Depression was more prevalent (44% and 38%) in HCWs and NHCPs respectively. Medical illness was more in NHCPs (50%) compared to HCWs (4%) and associated with depression (52.63%) in NHCPs as compared to HCW (4.5%). Clinical variables, O2 requirement was also more in NHCPs (20%) as compared to HCWs (4%) and also significantly associated with anxiety (40% and 12.5%) and depression (36.84% and 4.5%) in NHCPs and HCWs respectively. Conclusions: The prevalence of depression was much higher amongst HCWs and suggests more attention would be required for improving the mental health among HCWs and NHCPs and overall mental health needs attention in patients that are recovering from COVID-19.

Vulnerability to Minor Stressful Events in Young Women with Premenstrual Syndrome / 신경정신의학

PURPOSE: Although numerous etiological models of premenstrual syndrome(PMS) such as the biochemical, hormonal, psychosocial models have been proposed, there is no consistent conclusion. Especially, in psychosocial model, state-dependent changes in the perception of stressors according to menstrual cycle phases was suggested for PMS. In this study, we investigated relationship between menstrual cycle and daily minor stressors in young women, and vulnerability to minor stressors in young women with PMS. METHODS: 46 female college students completed modified daily rating form(DRF) of premenstrual symptoms which based on DSM-IV criteria for PMDD, and daily stress inventory(DSI) during at least one menstrual cycle. If the mean score of at least one DRF item during premenstrual phase were more than 3 on 6 point scale and 30% increase in symptom severity during premenstrual phase compared with during postmenstrual phase, they were referred as PMS group(N=20), and the others as non-PMS group(N=26). The event, impact, and impact/event ratio scores of DSI were compared in two groups. Data were analyzed by analysis of variance with repeated measure ANOVA. And post hoc simple; repeated contrast test were performed when indicated by significant repeated measure ANOVA. RESULTS: In all subjects, the event and the impact scores in premenstrual and menstrual phases were significantly higher than in postmenstrual phase. Among the DSI categories, the impact scores of interpersonal problem and cognitive stressors in premenstrual and menstrual phases were significantly higher than in postmenstrual phase. In PMS group, there was a significant difference between premenstrual and postmenstrual phase in the impact score but not in the event score, and the event and the impact scores were significantly increased in menstrual phase than postmenstrual phase. In non-PMS group, the event and the impact scores in premenstrual and menstrual phases were significantly higher than in postmenstrual phase. There was no significant difference in the impact/event ratio scores in both groups. Between the PMS and non-PMS group, there was significant difference in the impact/event ratio scores in premenstrual phase, but not in the event score and the impact scores at any phase. CONCLUSION: Young women may experience more daily minor stressors and may be impacted more severely in premenstrual and menstrual phases than in postmenstrual phase. In premenstrual phase, the young women with PMS are likely to have more vulnerability to daily minor stressors than controls. Further studies using larger sample size with varied age are required.

Perceived Stressful Life Events, Coping Style, Social Support and Depressive Symptoms of the Functional Dyspepsia Patients / 신경정신의학

OBJECTIVES: To investigate various factors that can mediate stress and response, such as coping style, social support, level of perceived stress, and psychopathology(especially anxiety and depression) of the functional dyspepsia(FD). METHODS: Thirty adults with functional dyspepsia were compared to thirty healthy adults who had visited the hepatobiliary clinic due to non-organic complaints(tiredness and fatigue) without FD, but the results of medical examination were normal. All subjects were evaluated for anxiety and depressive symptoms, perceived stress, coping style and social support. Symptom Checklist-90-Revision, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Ways of Coping Checklist, Interpersonal Support Evaluation List, and a self-reporting questionnaire were included to measure the quantity of perceived stressful life events. RESULTS: The FD patients had significantly more symptoms of depression, more perceived stressful life events, demonstrated less problem-focused coping, and less social support than the control subjects. Depressive symptoms of the FD patients were negatively correlated with interpersonal support and were positively correlated with trait anxiety, whereas, problem-focused coping were positively correlated with interpersonal support. The two groups did not differ significantly in terms of anxiety and emotion-focused coping. CONCLUSION: Our results suggest that FD patients need to be evaluated for psychiatric problems, and might benefit from psychiatric treatment with psychotherapeutic and psychopharmacological modalities.