Prevalence of alexithymia among medical students in Nepal: A cross-sectional study based on a self-administered questionnaire.

Background and Aims: Alexithymia is a state in which one cannot comprehend and put their emotions or feelings into words. It is a disturbance that is common among general population as well as people with mental health disorders. Medical students are at higher risk of developing alexithymia due to the extensive nature of their course and clinical postings. The presence of alexithymia is negatively correlated with the self-efficacy of the students eventually affecting self-care and patient care in the future. The aim of this study is to find the prevalence of alexithymia among medical students in Nepal and know its associated factors. Methods: This cross-sectional study used convenient sampling for selecting responders and the TAS-20 tool for data collection. Data were analyzed by using SPSS 20. Frequency was calculated for all the variables. Prevalence with 95% confidence interval [CI] is reported and the χ 2 test is used to see the difference in alexithymia status among different categories of dichotomous independent variables. Results: Out of 386 students, 380 of them responded. The ratio of male and female was 1.8 with the mean age of 22.22 ± 1.77 years. The prevalence of alexithymia was found to be 22.89% (95% CI, 18.9-27.1). There was no statistically significant difference between the presence and absence of alexithymia among categories of sex, year of study, staying at hostel, involvement in extracurricular activities, involvement in daily exercise/yoga/outdoor sports, and smoking habit. Conclusion: The prevalence of alexithymia in our study was 22.89% with no association with known factors.

Effect sizes of associations between neuroimaging measures and affective symptoms: A meta-analysis.

BACKGROUND: The utility of brain-based biomarkers for psychiatric disorders hinges among other factors on their ability to explain a significant portion of the phenotypic variance. In particular, many small scale studies have been unable to arbitrate whether structural or functional magnetic resonance imaging has potential to be a biological marker for these disorders. METHODS: This study conducted a meta-analysis to examine the relationship between study power and published effect sizes for the relationship between affective symptoms and structural or functional magnetic resonance imaging measures. The current analyses are based on 821 brain-affective symptom association effect sizes derived from 120 publications, which employed a univariate region-of-interest approach. RESULTS: For self-assessed affective symptoms published brain imaging measures accounted for on average 8% (confidence interval: 1.6%-23%) of between-subject variation. This average effect size was based mostly on studies with small sample sizes, which have likely led to inflation of these effect size estimates. CONCLUSIONS: These findings support the conclusion that brain imaging measures currently account for a smaller proportion of the interindividual variance in affective symptoms than has been previously reported. The current findings support the need for both large-sample clinical studies and new statistical and theoretical models to more robustly capture systematic variance of brain-affective symptom relationships.

Relationship between social cognition, general cognition, and risk for suicide in individuals with a psychotic disorder.

OBJECTIVE: Cognitive alterations putatively contribute to the risk for suicide in individuals with psychosis. Yet, a comprehensive assessment of social- and general-cognitive abilities in a large sample is lacking. METHODS: Seven-hundred-fifteen individuals diagnosed with a psychotic disorder performed tasks of facial emotion recognition, Theory of Mind, and general cognitive functioning (sustained attention, set-shifting, IQ-tests and verbal learning) as part of the Genetic-Risk-and-Outcome-of-Psychosis (GROUP) study. Presence of past suicide attempt/s and/or current suicidal ideation was reported by 261 individuals and 454 individuals reported no suicide attempt or ideation. We used general linear models to investigate group differences in task performance. All analysis were controlled for age, sex, education, and psychotic symptom severity. RESULTS: Individuals with suicide attempt and/or ideation showed better performance on the facial emotion recognition task and lower performance on tasks of sustained attention and verbal learning, compared to individuals without suicide attempt and/or ideation, without a clear effect of attempt or ideation. Theory of Mind performance was also better for individuals with suicide attempt and/or ideation, with largest differences between individuals who reported both attempts and ideation compared to individuals without suicide attempt and/or ideation. No effect of suicide attempt and/or ideation was found on misperception of facial emotions, IQ and set-shifting. Overall, effect sizes were small. CONCLUSION: Higher sensitivity to social-emotional cues together with weakened attentional control and learning capacity was observed in individuals with psychosis and suicide attempt and/or ideation. This may suggest that insufficient capacity for regulating perceived social stress contributes to suicidal thoughts and behavior.

Estrés y emociones negativas en adultos medios con hipertensión arterial esencial / Stress and Negative Emotions in Middle-aged Adults with Essential Hypertension

Introducción: la hipertensión arterial constituye una de las patologías crónicas de mayor impacto en la morbilidad y mortalidad cardiovascular, fenómeno que está relacionado con factores psicosociales como el estrés y las emociones negativas. Objetivo: determinar el nivel de estrés, emociones negativas y modos de afrontamiento en adultos medios con hipertensión arterial esencial del consultorio 1 del Área V del municipio Cienfuegos. Método: se realizó un estudio descriptivo efectuado en el consultorio 1 del Área V de salud del municipio Cienfuegos, en el período comprendido entre enero-marzo de 2014. La selección de la muestra se realizó de forma probabilística, se utilizó un muestreo bietápico y aleatorio simple, por lo que quedó conformada por 30 pacientes hipertensos esenciales comprendidos en las edades de 40 a 60 años. El sexo, color de la piel, nivel de escolaridad, estado civil, ocupación, nivel de estrés, vulnerabilidad y modos de afrontamiento al estrés, ansiedad y depresión constituyeron las variables del estudio. Resultados: predominó el sexo femenino, el color de la piel blanca, como nivel de escolaridad el medio superior, estado civil casados y ocupación profesional. Resultaron ser altos los niveles y la vulnerabilidad al estrés. Utilizaron como modos de afrontamiento la confrontación y el apoyo social. La ansiedad rasgo-estado que predominó fue media y aunque presentaron síntomas depresivos, la depresión no caracterizó a la mayoría de los pacientes. Fueron las mujeres, amas de casa, técnicos y profesionales quienes presentaron mayores niveles de estrés. No hubo distinción en cuanto a sexo y ocupación con el nivel de ansiedad. Conclusión: los pacientes hipertensos presentaron elevado estrés, moderada ansiedad y en menor medida depresión.

Introduction: arterial hypertension is one of the chronic pathologies with the greatest impact on cardiovascular morbidity and mortality, a phenomenon that is related to psychosocial factors such as stress and negative emotions. Objective: to determine the level of stress, negative emotions and ways of coping with it in middle-aged adults with essential arterial hypertension of the office 1 of Area V of the Cienfuegos municipality. Method: a descriptive study was carried out in medical office 1 of Health Area V of the Cienfuegos municipality, in the period between January-March 2014. The sample selection was carried out probabilistically, using a simple two-stage and random sampling, being composed of 30 essential hypertensive patients included in ages from 40 to 60 years. Sex, color of the skin, schooling level, marital status, occupation, stress level, vulnerability and ways of coping with stress, anxiety and depression were the variables under study. Results: female sex, white skin color, upper middle school level, married marital status and professional occupation were predominant. The levels and vulnerability to stress were high. Confrontation and social support were used as coping modes. The trait-state anxiety that predominated was average and although they presented depressive symptoms, depression did not characterize the majority of the patients. It was the women, housewives, technicians and professionals who presented higher stress levels. There was no distinction in terms of sex and occupation with the level of anxiety. Conclusion: hypertensive patients presented high stress, moderate anxiety and to a lesser extent depression.

Neuroanatomic pathways associated with monoaminergic dysregulation after stroke.

OBJECTIVE: We examined the complex relationship between lesion location, symptoms of depression (affective and apathetic), and monoamine dysfunction after stroke. METHODS: Magnetic resonance imaging was performed on 48 post-stroke patients that had been assessed for affective and apathetic symptoms using the Hospital Anxiety and Depression Scale and the Apathy Scale, respectively. Noradrenalin (NA), dopamine (DA), their metabolites, and a metabolite of serotonin (5-HT) were measured using 24-h urine samples, and 5-HT and 3-methoxy-4-hydroxyphenylglycol were measured using blood samples. We developed a statistical parametric map that displayed the associations between lesion location and both positive and negative alterations of monoamines and their metabolites. RESULTS: Multivariate analysis indicated that basal ganglia lesions and 5-HT showed relationships with affective symptoms, whereas homovanillic acid was related to apathetic symptoms. Univariate analysis showed no such relationships. However, decreases in NA and DA and increases in NA and DA turnover were related to lesions in the brainstem, whereas increases in NA and DA as well as decreases in NA and DA turnover were related to cortical and/or striatum lesions. 5-HT turnover data showed a pattern opposite to that seen for NA and DA turnover. CONCLUSIONS: Monoaminergic neuronal pathways are controlled by both receptor-mediated feedback mechanisms and turnover; thus, depletion of monoamines is not the only cause of depression and apathy. Moreover, the monoamine neuronal network might be divided into two branches, catecholamine (NA and DA) and 5-HT, both of which are anatomically and functionally interconnected and could respectively influence apathetic and affective symptoms of depression.

El fracaso escolar como un síntoma afectivo en niños y niñas bajo condiciones de orfandad / School failure as a affective symptom in children and girls under conditions of orphanhood

El presente artículo emerge a partir de una revisión crítica acerca de los conceptos de fracaso escolar y la experiencia de orfandad, estableciendo las limitaciones actuales con que se aborda el fenómeno educativo y la conceptualización sobre la infancia huérfana. De esta forma, se cuestionan las dimensiones afectivas y traumáticas que subyacen al fracaso escolar. Al final, se invita a la investigación empírica para abordar el fenómeno preguntando si es posible considerar que la experiencia de abandono en niños y niñas, con todas sus vivencias de maltrato y deprivación, pueda estar relacionada con las dificultades en el aprendizaje y en últimas con el fracaso escolar.

This paper emerges from a critical review of the concepts of school failure and experience orphans, establishing the current limitations with the educational phenomenon and the conceptualization of the orphaned children is addressed. Thus, the emotional and traumatic dimensions underlying question school failure. In the end, they are invited to empirical research to address the phenomenon wondering if you might consider the experience of abandonment in children, with all their experiences of abuse and deprivation, it can be related to learning difficulties and ultimately with school failure.