The experience sampling methodology in psychosis risk states: A systematic review.

The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has been recognized as a useful tool for understanding the characteristics, dynamics, and underlying mechanisms of prodromal symptoms of psychosis. The present systematic review aimed to provide a qualitative synthesis of findings provided by the ESM studies conducted in people with psychosis risk states. A systematic review of the MEDLINE, ERIC, Academic Search Ultimate, and Health Source: Nursing/Academic Edition databases, utilizing search terms related to the ESM and the risk of psychosis was conducted. Out of 1069 publication records identified, 77 studies met the inclusion criteria for the review. Data were synthesized around the following topics: 1) assessment of symptoms dynamics and social functioning; 2) assessment of the mechanisms contributing to the emergence of psychotic experiences and 3) assessment of stress sensitivity. The studies have shown that negative emotions are associated with subsequent development of paranoia. The tendency to draw hasty conclusions, aberrant salience, self-esteem, and emotion regulation were the most frequently reported mechanisms associated with the emergence of psychotic experiences. Studies using the ESM also provided evidence for the role of stress sensitivity, in the development of psychotic symptoms. The ESM has widely been applied to studies investigating psychosis risk states, using a variety of protocols. Findings from this systematic review might inform future studies and indicate potential targets for interventions.

The association between depression and the cortisol awakening response is moderated by loneliness in men from a non-clinical sample.

Previous studies investigating cortisol levels in people with depression or depressive symptoms have provided mixed findings. It has been suggested that the difficulty to generalize findings across studies in this field might be related to interindividual variability in experiencing depressive symptoms in terms of clinical and social contexts. Therefore, in the present study we aimed to test the association of morning cortisol levels and depressive symptoms in a non-clinical sample of young men taking into consideration the level of perceived loneliness. We hypothesized that the level of loneliness might moderate the association between morning cortisol levels and depressive symptoms. A total of 102 participants (aged 29.9 ± 5.0 years) completed questionnaires measuring the levels of depressive and anxiety symptoms, perceived stress, and loneliness. Cortisol levels were determined in four morning samples of saliva. There were significant positive correlations of the cortisol awakening response (CAR) and the mean increase in cortisol levels during the measurement period (MnInc) with the levels of depressive symptoms and loneliness. Moreover, a significant association of the depressive symptoms by loneliness interaction with the CAR and the MnInc was found. Specifically, the correlation of depressive symptoms with the CAR and the MnInc appeared to be significant and negative at high levels of loneliness. No significant association between depressive symptoms and the CAR was observed in men with low levels of loneliness. There were no significant associations of depressive symptoms, loneliness and the depressive symptoms by loneliness interaction with cortisol levels at awakening. In conclusion, findings from the present study indicate the importance of social contexts in understanding the association between altered activity of the hypothalamic-pituitary-adrenal axis and depressive symptoms in men.

Improvement of working memory in older adults with mild cognitive impairment after repetitive transcranial magnetic stimulation - a randomized controlled pilot study.

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique that could improve cognitive function. It is being developed as a non-pharmacological intervention to alleviate symptoms of cognitive deterioration. We assessed the efficacy of rTMS in improving cognitive functioning among people with Mild Cognitive Impairment (MCI) in a partially-blinded, sham-controlled randomized trial. Out of 91 subjects screened, 31 participants with MCI (mean age 70.73; SD = 4.47), were randomly assigned to one of three groups: (A) Active rTMS; (B) Active rTMS with Computerized Cognitive Training RehaCom; and (C) Sham control. The study evaluated cognitive function using the DemTect, FAS, and CANTAB tests before and after the stimulation. The following treatment protocol was applied: 2000 pulses at 10 Hz, 5-s train duration, and 25-s intervals at 110% of resting MT delivered over the left Dorsolateral Prefrontal Cortex (DLPFC) five times a week for 2 weeks. After 10 sessions of high-frequency rTMS, there was an improvement in overall cognitive function and memory, assessed by the DemTect evaluation, with no serious adverse effects. Analysis of differences in time (after 10 sessions) between studied groups showed statistically significant improvement in DemTect total score (time by group interaction p = 0.026) in favor of rTMS+RehaCom. The linear regression of CANTAB Paired Associates Learning revealed significant differences in favor of rTMS+RehaCom in three subtests. Our study shows that 10 sessions of rTMS over the left DLPFC (alone as well as combined with Computerized Cognitive Training) can have a positive impact on cognitive function in people with MCI. Further research should investigate the underlying mechanism and determine the optimal parameters for rTMS, which will be important for its efficacy in clinical settings.

Alterations in mental health and quality of life among healthcare workers in times of COVID-19: Four-stage cross-sectional study during first four pandemic waves in Poland.

Background: The COVID-19 pandemic has had many unexpected effects that have affected the mental health of healthcare workers. In response to the crisis, healthcare workers appear to be the most vulnerable to the psychological effects of the pandemic. The purpose of the study was to assess the prevalence of depressive and anxiety symptoms and healthcare workers' quality of life during the different stages of the COVID-19 pandemic. Materials and methods: The questionnaire was distributed in four stages corresponding to the different waves of the pandemic in Poland. The last stage of the study covered the period from November 1, 2021 to November 31, 2021 which coincided with the fourth wave of COVID-19 in Poland. The Beck Depression Inventory II (BDI-II), Generalized Anxiety Disorderd-7 (GAD-7), and Manchester Brief Assessment of Quality of Life (MANSA) scales were used. Results: A total of 1,243 respondents participated. A gradual increase in moderate and severe anxiety was observed as the pandemic continued, comparing waves I and IV of the pandemic. No statistically significant differences were observed in comparing the mean values of the BDI-II, GAD-7, and MANSA scales across waves. A decrease in fear due to the disease and neighbor's quarantine was found. Women, single people and those with a psychiatric history are more likely to be affected by the destructive impact of the pandemic. Conclusion: The COVID-19 pandemic is significantly affecting the mental health and quality of life of healthcare workers, but trend is not uniform. It is necessary to continue monitoring the mental health of medical workers, who are the most important link in the fight against the pandemic.

Depression, Anxiety and Quality of Life among Online Responders in Poland: A Cross-Sectional Study Covering Four Waves of the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic has affected the mental health of the population. This study aims to assess the prevalence of subjective depressive and anxiety symptoms as well as assess the quality of life in different waves of the COVID-19 pandemic based on an online survey. Methods: The study was conducted based on an original and anonymous questionnaire, consisting of a section assessing sociodemographic status and psychometric tools: Beck Depression Inventory (BDI), Generalised Anxiety Disorder Assessment (GAD-7) and Manchester Short Assessment of Quality of Life (MANSA). A total of 6739 people participated in the survey, with the largest number from the first wave of the pandemic (2467-36.6%), followed by 1627 (24.1%) for the second wave, 1696 (25.2%) for wave three and 949 (14.1%) for wave four. The mean age of the study group was 28.19 ± 9.94. Results: There was an initial, gradual increase in depressive and anxiety symptoms over the three waves. There were no significant differences in the quality-of-life scores, except for the second and third waves (-0.0846; p = 0.013. It was found that women, residents of big cities and people with psychiatric history showed higher BDI and GAD-7 scores. Conclusions: The impact of the pandemic on mental health was not homogeneous, with the first three waves of the COVID-19 pandemic having more of an impact compared to the fourth wave. Female respondents' sex, history of mental disease and reduced earning capacity exacerbated psychiatric symptoms.

The Deficit Schizophrenia Subtype Is Associated with Low Adherence to the Mediterranean Diet: Findings from a Case-Control Study.

Accumulating evidence indicates that individuals with schizophrenia show poor dietary habits that might account for increased susceptibility to cardiovascular diseases in this population. However, it remains unknown whether this observation can be generalized over the whole population of individuals with schizophrenia. Therefore, in this study we aimed to investigate dietary habits, in terms of adherence to the Mediterranean diet (MD) in subjects with the deficit subtype of schizophrenia (SCZ-D), those with non-deficit subtype (SCZ-ND), and healthy controls (HCs). We recruited 45 individuals with SCZ-ND, 40 individuals with SCZ-D, and 60 HCs. Dietary habits were assessed using the Food Frequency Questionnaire-6 with a 12-month recall. Adherence to MD was decreased only in subjects with SCZ-D compared with HCs. Lower adherence to MD was associated with significantly higher levels of clinician-rated and self-reported negative symptoms (including alogia, avolition, and anhedonia). No significant correlations of adherence to MD with depressive symptoms were found. Lower adherence to MD was related to significantly higher body mass index in subjects with schizophrenia, but not in HCs. Our results indicate that poor adherence to MD is associated with a diagnosis of SCZ-D, higher severity of negative symptoms, and greater risk of developing overweight or obesity.

Ketamine as a Novel Drug for Depression Treatment.

BACKGROUND: Depression is one of the most common mental disorders. Currently used antidepressants, acting on the monoaminergic system, are insufficient for depression treatment. In recent years, potential application of NMDA receptor modulators in the treatment of drug-resistant depression has gained attention. Administration of ketamine, being a non-competitive NMDA receptor antagonist, contributes to a faster remission of symptoms. SUBJECTS AND METHODS: The aim of this paper is to review current studies on the use of ketamine in the treatment of drug-resistant depression, compare results of various administration methods - intravenous, intranasal or oral, as well as compare its effectiveness with that of other antidepressants. RESULTS: Numerous studies show the drug is effective and well tolerated, particularly in patients with increased suicidal thoughts. However, there are concerns on increasing tolerance to the drug and the possibility of implementing a long-term treatment. CONCLUSION: Oral and intranasal forms of the drug are particularly promising due to their non-invasiveness and ability to self-administer. In March 2019, S-ketamine nasal spray was registered by the FDA for the treatment of drug-resistant depression.

Stigma Levels Toward Psychiatric Patients Among Medical Students-A Worldwide Online Survey Across 65 Countries.

Background: According to epidemiological data, over 450 million people worldwide suffer from mental disorders, presenting one of the major challenges of modern medicine. In their everyday lives, patients, in addition to fighting the disease itself, often struggle with stigmatization. This phenomenon negatively affects both the diagnostic and therapeutic processes, as well as the patients' everyday functioning. This study aimed to assess stigma attitudes toward psychiatry and psychiatric patients among undergraduate medical students. Methods: This study used a Computer-Assisted Web Interview (CAWI), which included the standardized items from the Mental Illness: Clinicians' Attitudes (MICA-2) scale to evaluate stigma. The study was disseminated via the internet to students from medical universities from 65 countries worldwide. Participation was voluntary and anonymous. The study involved 1,216 students from these 65 countries. Most of the sample were women, and most were medical faculty students and students living in cities with more than 500,000 residents. Taking into consideration Gross Domestic Product (GDP) per capita and Human Development Index (HDI) variables, it can be seen that there was a prevalence of medical students from highly developed countries. Results: For the whole sample, the mean MICA-2 score was 40.5 points. Women and medical and nursing students showed more positive attitudes toward psychiatric patients. Students from countries with the highest economic development levels also achieved statistically lower MICA-2 scores. Lower score means a more positive attitude. Conclusion: Stigma toward both psychiatry and psychiatric patients is common among undergraduate medical students. Female students and respondents with a history of mental disorders in countries with high HDI and GDP per capita indices show more favorable attitudes than other medical students. There is a need to further our understanding of the problem of stigmatization, both among the general population and among medical personnel, and to implement and maintain appropriate measures to reduce stigma toward psychiatry.

Anxiety and Depressive Disorders and Quality of Life Assessment of Poles-A Study Covering Two Waves of the COVID-19 Pandemic.

Background: More than a year after the first case of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) viral pneumonia, the world is still engulfed by the pandemic, and we know that this condition has an enormous impact not only on individuals but also on the social order in virtually every aspect of daily life, deteriorating our mental health. This study aims to assess the prevalence of depressive and anxiety symptoms and the subjective assessment of the quality of life in the different stages of the COVID-19 (Coronavirus Disease 2019) pandemic based on a nationwide online survey. Materials and Methods: The study was conducted using an original questionnaire assessing the sociodemographic status and standardized psychometric tools: Beck Depression Inventory (BDI), Generalized Anxiety Disorder (GAD-7) and Manchester Short Assessment of Quality of Life (MANSA). The study was conducted in two stages corresponding to the first and second wave of the COVID-19 pandemic. Results: In total, 4,083 respondents participated in the survey. The first observation stage took place between 17 and 26 April 2020 and comprised 2,457 respondents; the repeated survey that took place between 1 and 30 December 2020 comprised 1,626 respondents. In both cases, women constituted the majority of respondents (82.5% in the first stage and 79.6% in the second stage). Statistically significantly higher levels of depression and anxiety were found in second stage, with mean scores of BDI and GAD-7. In the case of MANSA, participants in the different stages of the pandemic showed no significant differences in terms of mean scores. However, women were more susceptible to developing the depression and anxiety symptoms and it was obtained in both waves of the pandemic Conclusions: As the Covid-19 pandemic progressed, there was higher level of depressive and anxiety symptoms among Poles.

The Assessment of Attitudes of Students at Medical Schools towards Psychiatry and Psychiatric Patients-A Cross-Sectional Online Survey.

The aim of the study was the assessment of the level of stigmatisation of psychiatric patients and psychiatry as a field of study by students at medical schools in Poland and the comparison of students' attitudes over the years. The study was conducted based on a proprietary questionnaire assessing the stage of tertiary education, sociodemographic status, and MICA-2 psychometric tool that is used for assessing both the attitudes of students at medical schools towards psychiatry as a field of study and patients with mental health disorders. According to the MICA score, those who have higher scores have more negative attitudes towards psychiatry. The survey consisted of two rounds at an interval of 3 years. Results. The first-round survey, conducted in 2017, involved 480 students. The second-round survey, conducted in 2020, involved 573 students. In both cases, women constituted the vast majority of respondents. Women, as well as medical major students, achieved significantly lower scores than men p < 0.001. The said relationship was also observed for individual experience with mental illness. There was no correlation between the MICA-2 total score and the psychiatry course completion-p = 0.105. However, the levels of stigmatisation are still high. The implementation of educational methods to improve the perception of psychiatric patients by students at medical schools should be taken into consideration. An increase in direct student-patient contact, for example, by means of intensive elective classes, could be beneficial.

Impact of the COVID-19 Pandemic on Mental Well-Being. A Nationwide Online Survey Covering Three Pandemic Waves in Poland.

The COVID-19 pandemic has a significant impact on human life. This study aims to assess the prevalence of depressive and anxiety symptoms, and the assessment of the quality of life in different stages of the COVID-19 pandemic based on an online nationwide survey. The study was based on a voluntary, anonymous, and authors' own questionnaire. The first section assesses sociodemographic status. Then, standardized psychometric tools were used such as the Beck Depression Inventory (BDI), the Generalized Anxiety Disorder Assessment (GAD-7), and the Manchester Short Assessment of Quality of Life (MANSA). The study was conducted in three stages corresponding to the waves of the COVID-19 pandemic in Poland. The survey involved 5,790 respondents; 2,457, 1,626, and 1,707 for the first, second, and third pandemic wave, respectively. It was found that anxiety and depressive symptoms increased as the pandemic progressed. There was no significant effect on the subjective quality-of-life assessment. Moreover, there was a gradual decrease in anxiety about being infected with COVID-19 as well as reduced adherence to the Minister of Health's recommendations. As the COVID-19 pandemic progressed, depressive and anxiety symptoms increased among Poles. Women, singles, and people with prior psychiatric treatment are more likely to develop the aforementioned symptoms.