Dating Violence and Mental Health in Emerging Adulthood.

Dating violence constitutes a serious social and health problem. This study aims to increase knowledge on dating violence in emerging adulthood by analysing the relevance of gender and of having or not having a current partner in the victimization and perpetration of such violence. It also analyses the association between dating violence and mental health, as well as the relevance of traditional gender role attitudes and the internalization of feminine/expressive and masculine/instrumental traits in the victimization and perpetration of such types of violence. The participants were 930 Spanish emerging adults who were assessed by six self-report questionnaires and scales. Men reported more psychological and physical violence victimization and physical violence perpetration than women, and women and men without a current partner reported more psychological and sexual violence than women and men with a current partner. Dating violence victimization was associated with more mental symptomatology, less life satisfaction, and lower self-esteem in men with a current partner and in women without a current partner. The main predictor of dating violence victimization was dating violence perpetration, and the main predictor of dating violence perpetration was victimization by such violence. More traditional gender role attitudes also predicted greater victimization and perpetration of dating violence, except among women without a current partner.

Sex differences in the relationship between hepatic steatosis, mood and anxiety disorders.

OBJECTIVE: To investigate the association between non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), mental symptoms (mood, anxiety disorders and distress) by sex. METHODS: This a cross-sectional study performed in working-age adults from a Health Promotion Center (primary care) in São Paulo, Brazil. Self-reported mental symptoms from rating scales (21-item Beck Anxiety Inventory, Patient Health Questionnaire-9, and K6 distress scale) were evaluated by hepatic steatosis (NAFLD and ALD). Logistic regression models estimated the association between hepatic steatosis subtypes and mental symptoms by Odds ratios (OR) adjusted by confounders in the total sample and sex stratified. RESULTS: Among 7241 participants (70.5% men, median age: 45 years), the frequency of steatosis was of 30.7% (25.1% NAFLD), being higher in men than women (70.5% vs. 29.5%, p < 0.0001), regardless of the steatosis subtype. Metabolic risk factors were similar in both subtypes of steatosis, but not mental symptoms. Overall, NAFLD was inversely associated with anxiety (OR = 0.75, 95%CI 0.63-0.90) and positively associated with depression (OR = 1.17, 95%CI 1.00-1.38). On the other hand, ALD was positively associated with anxiety (OR = 1.51; 95%CI 1.15-2.00). In sex-stratified analyses, only men presented an association of anxiety symptoms with NAFLD (OR = 0.73; 95%CI 0.60-0.89) and ALD (OR = 1.60; 95%CI 1.18-2.16). CONCLUSIONS: The complex association between different types of steatosis (NAFLD and ALD), mood and anxiety disorders indicates the need for a deeper understanding of their common causal pathways.

Fluoxetine plus lithium for treatment of mental health impairment in Long Covid.

Purposes: (1) To summarize the mental conditions that may accompany persistent symptoms following acute infection by SARS-CoV-2, often termed Long Covid; (2) to formulate treatment based upon the brain cells that are dominantly affected. Methods: (1) Review the reports relating to the mental symptoms occurring in Long Covid. (2) Review the drugs that address the brain cells affected in Long Covid, and suggest pharmacotherapy for those patients whose response to psychotherapy is suboptimal. Results: Long Covid affects ~ 10% of patients infected by SARS-CoV-2, and mental symptoms affect ~ 20% of persons with Long Covid. The brain cell-types that have been demonstrated as dominantly affected in Long Covid are astrocytes, oligodendrocytes, neurons, endothelial cells/pericytes, and microglia. Lithium and fluoxetine each address all of those four cell-types. Low dosage of each is likely to be well-tolerated and to cause neither clinically important adverse events (AE) nor serious adverse events (SAE). Conclusion: For those patients whose response to psychotherapy is suboptimal, lithium and fluoxetine should be administered in combination for both depth of benefit and reduction of dosages.

Burnout, mental health symptoms, and empathy in healthcare workers who care for children treated in a liver transplant center.

OBJECTIVE: The healthcare workers in pediatric liver transplantation units are exposed to various stresses; however, their burnout has not been clarified yet. This study aimed to determine burnout, psychological symptoms and empathy levels in healthcare workers, to examine the relationship between these variables and to investigate the predictors of burnout. METHOD: This cross-sectional study was conducted on healthcare workers in Turgut Özal Medical Center Pediatric Liver Transplant Institute. The participants filled out a questionnaire that investigating demographic and occupational characteristics, and including questions from Toronto Empathy Questionnaire, Maslach Burnout Inventory, and Brief Symptom Inventory. RESULTS: Fifty healthcare workers participated in the study. Based on moderate and higher severity scores, 48% of the participants were emotionally exhausted, 22% of them were depersonalized. All of them had a high perception of personal accomplishment. There was a correlation between psychological symptoms level and emotional exhaustion and personal accomplishment as well as empathy and personal accomplishment. Not choosing the profession and the department willingly, age, education level, marital status, duration of profession, unit, not receiving in-service training, empathy, depressive symptoms and hostility scores predicted different aspects of burnout. CONCLUSION: Considering that burnout and psychological stress lead to reduced professional abilities and the development of serious complications, the results obtained can guide managers on the measures to be taken.

Psychiatric Issues Among Health Professionals.

COVID-19 has increased the interest in the wellbeing of health professionals (HPs) as they have experienced stress, loss, and fatigue-related symptoms. Research evidence from previous epidemics points to an increase in the prevalence of affective, anxiety, and addictive disorders among them. HPs are trained to care for others and to recover from severe stressors. However, they tend to neglect self-care and have difficulties in seeking appropriate help when need it. This new scenario becomes an opportunity to promote a new culture of professionalism whereby caring for the caregivers becomes a priority both at a personal and institutional level.

How to Improve Training in Descriptive Psychopathology for Psychiatry Residents: A Delphi Study.

PURPOSE: Descriptive psychopathology (DP) is the language of psychiatry and is dedicated to the description of mental symptoms. Despite its core importance, a systematic review identified a series of shortcomings in its training. This Delphi study seeks to provide guidance for better didactic and clinical training in DP. METHOD: The authors used the Delphi method in order to gather, pool, and optimize the knowledgeable opinion of a highly qualified panel of international experts on how to improve DP training. A preliminary phase with open-ended questions was the basis to elaborate a Delphi questionnaire consisting of 14 questions on didactic and clinical training, which was then used in two successive Delphi rounds. Twenty-nine international experts in DP participated throughout the study. RESULTS: A series of hierarchical lists on how to improve DP training were elaborated. Regarding didactic training, the experts valued the contents and educational methods, as well as recommended authors and texts. Regarding clinical training, the experts valued educational methods, desirable characteristics in clinical supervisors, how to improve the supervisors' expertise, useful aspects and facilitating questions for direct supervision, and the suitability of including other evaluators besides the supervisor. In the final survey, 94% of the experts considered that the Delphi method had been effective to obtain and improve their opinions. CONCLUSIONS: Insufficient direct supervision in live interviews was considered the most important problem. A series of general measures were proposed to improve DP training: (i) adapting DP training throughout residency, with introductory and advanced levels; (ii) making DP training compulsory in psychiatry curricula; (iii) assessing residents' DP knowledge and clinical use; and (iv) training the trainers/supervisors in both content (DP) and form (how to train/supervise residents). Within didactic training, epistemology of DP and contemporary and classic authors/texts were the highest rated contents, while supervised discussions based on cases, videos, or readings were the highest rated methods. Within clinical training, 8 aspects of DP that could guide the supervisor were highly rated: mental state examination, dialogue, empathy and understanding, attitude/willingness, knowledge-practice bridge, mental symptom formation, implications for decision-making, and the written report of the encounter.

The effect of an anti-inflammatory in comparison with a low caloric diet on physical and mental health in overweight and obese women with knee osteoarthritis: a randomized clinical trial.

PURPOSE: To evaluate the effect of an anti-inflammatory compared to a low-calorie diet on the physical and mental health of patients with knee OA. METHODS: In this randomized parallel clinical trial, participants were selected among overweight and obese women aged 40 years or older with mild to moderate OA. Sixty women with a ratio of 1:1 were randomly assigned to receive either low-calorie or anti-inflammatory accompanied by a low-calorie diet for two months. The dietary intake and weight of participants were measured. Study variables were assessed using the Western Ontario and McMaster Index (WOMAC), visual analog pain scale (VAS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI-I), and the Short Form 36 Health Survey Questionnaire (SF-36) to indicate the quality of life (QoL). RESULTS: There was no statistically significant difference between the two groups in demographic and baseline variables except for the emotional well-being subscale of QoL. There was significant difference in anti-inflammatory compared to low-calorie diet in terms of weight (MD (95% CI): - 4.02 kg (- 6.77 to - 1.28); p = 0.005), VAS (MD (95% CI): - 0.97 (- 1.53 to - 0.41); p = 0.001), WOMAC-total score (MD (95% CI): - 9.91 (- 15.05 to - 4.78); p < 0.001), WOMAC-pain subscale (MD (95% CI): - 3.30 (- 5.30 to - 1.29); p = 0.002), WOMAC-physical function (MD(95% CI): - 5.48 (- 9.41 to - 1.53); p = 0.007), depression (p = 0.003), anxiety (p = 0.011), QoL-physical functioning (0.041), and QoL-pain (0.010) after the intervention. CONCLUSION: An anti-inflammatory accompanied by a low-calorie diet resulted in greater weight loss and greater improvement in pain intensity, functional status, depression, anxiety, and some dimension of QoL in overweight and obese women with knee OA compared to the low-calorie diet. Trial registration number and date of registration: IRCT201610220030424N2; 2018-04-23.

Efficacy of a Relaxation Scenario in Virtual Reality for the Comorbid Symptoms of Anxiety and Asthenia in a General Hospital Setting: A Pilot Comparative Randomized Open-Label Study.

BACKGROUND: Patients in general hospitals often display concomitant signs of mental maladjustment: low mood, anxiety, apathy, asthenia, all of which can have a negative impact on the course of the underlying disease and the recovery process. One of the non-pharmacological approaches that has gained wider acceptance in medical practice in recent years is the use of procedures based on virtual reality. AIM: Assess the efficacy of the new domestic, virtual reality application Flow as relates to symptoms of anxiety and asthenia in patients undergoing inpatient treatment. METHODS: The study was open-label and had a comparison group; the patients were assigned to the experimental or control group using a randomization table. The patients were assessed using the Spielberger State Anxiety Inventory; the Fatigue Symptom Rating Scale; the Well-being, Activity, Mood questionnaire; the Depression Anxiety Stress Scale; and the Clinical Global Impression Scale. Physical parameters were measured before and after each virtual reality session. The obtained data were statistically processed. RESULTS: The study involved 60 patients. In 40 patients, the treatment program included a course of five daily relaxation sessions in virtual reality; the control group consisted of 20 patients, who were treated in accordance with the usual practice of the institution. The addition of virtual reality sessions to the standard treatment course yielded significant advantage in terms of affective symptoms reduction in patients both after a single session and as a result of undergoing the full course, and several days after its completion. The patients in the experimental group also showed a significant decrease in blood pressure after the sessions, and this was most pronounced in individuals who initially had elevated and high blood pressure. CONCLUSION: The use of relaxation program courses in the virtual reality application Flow is an effective and promising means of non-pharmacological care for non-psychiatric inpatients showing symptoms of anxiety, apathy, depressive mood, as well as hypertension.

Which symptoms are the psychopathological core affecting the manifestation of pseudo-cardiac symptoms and poor sleep quality in young adults? Symptoms of personality disorders versus clinical disorders.

Background: Diagnosing and identifying the psychological origin of pseudo-cardiac symptoms and comorbid conditions such as poor sleep quality is very difficult due to its extensive and complex nature. The present study was conducted to determine the contribution of symptoms of personality disorders (PDs) and clinical disorders (CDs; i.e., psychological symptoms measured using the Symptom Checklist-90) to the manifestation of pseudo-cardiac symptoms and poor sleep quality. Methods: Subjects in this cross-sectional study were 953 (64.3% female; 28.8 ± 6.2 years) community samples in the west of Iran who were selected by convenience sampling. After applying the inclusion criteria, data were collected using the Symptom Checklist-90 (SCL-90-R), the Personality Diagnostic Questionnaire (PDQ-4), and the Scale for Pseudo-Cardiac Symptoms and Poor Sleep Quality (SPSQ). Pearson correlations, factor analytical techniques, and hierarchical regression models were used to examine associations between symptoms of PDs/CDs and outcome factors. Results: Factor analytical techniques confirmed both the integrated structure of symptoms of PDs and CDs. Both pseudo-cardiac symptoms and poor sleep quality were more strongly associated with symptoms of CDs than PDs. The results of the hierarchical analysis show that the CDs factor alone could explain the total variance of both pseudo-cardiac symptoms (change in R2 = 0.215 vs. 0.009; p < 0.001) and poor sleep quality (change in R2 = 0.221 vs. 0.001; p < 0.001). Conclusion: The different capabilities of two unique factors for the symptoms of PDs and CDs were confirmed by factor analytical methods and regression analysis techniques. Although each of the symptoms of PDs and CDs independently contributes to the manifestation of pseudo-cardiac symptoms and poor sleep quality, the CDs factor is the psychopathological core.

Mental distress and incident functional disability among a rural ageing population in South Africa.

OBJECTIVES: The aim of the study was to investigate the association between mental symptoms and incident functional disability among middle-age and older adults in South Africa. METHODS: Longitudinal data from two consecutive population surveys (2014/2015-2018/2019) in Agincourt, South Africa, were analysed. RESULTS: In total, 298 of 3813 participants without functional disability in wave 1 (8.8%) had functional disability in wave 2. The prevalence of baseline functional disability was 9.1%. In the fully adjusted models for people without functional disability at baseline, depressive symptoms (AOR: 1.74, 95% CI: 1.08-2.80) among men and lower life satisfaction among men (AOR: 0.86, 95% CI: 0.80-0.93) and among women (AOR: 0.90, 95% CI: 0.83-0.98) increased the odds of incident functional disability. Posttraumatic stress disorder symptoms, poor sleep quality, restless sleep, and loneliness were not significantly associated with incident functional disability. CONCLUSIONS: Depressive symptoms among men and lower life satisfaction among both sexes were independently associated with incident functional disability in ageing rural South Africans.

Self-initiated dietary changes reduce general somatic and mental symptoms in a relatively healthy Dutch population.

The risk for development of non-communicable diseases (NCDs) can be predicted by somatic or mental symptoms and dietary alterations aimed at improvement of those symptoms could potentially delay development of NCDs. The goal of this study was to identify whether self-initiated dietary changes could reduce mental and somatic symptoms in relatively healthy individuals. Participants (n = 494) recruited from the Dutch population filled out weekly questionnaires on dietary intake, somatic and mental symptoms and physical activity at baseline and during dieting for four weeks. There was a significant reduction in mental and somatic symptoms, body weight, and waist circumference at four weeks, whereas physical activity remained unchanged. Five dietary patterns were identified by principal component analysis labelled "Processed foods", "Animal source foods", "Wheel of Five", "Traditional Dutch", and "Party". Reduction in mental symptoms was correlated to increased physical activity and increased intake of Wheel of Five foods. Reduction in somatic symptoms was correlated to body weight loss and less Processed foods, more Wheel of Five foods, and lower intake of fat and protein. Higher intake of protein and fat and lower intake of carbohydrates, however, were correlated to body weight loss. In conclusion this research showed that a self-initiated dietary change can lead to a significant reduction of mental and somatic symptoms.

Children and Adolescents' Mental Health Following COVID-19: The Possible Role of Difficulty in Emotional Regulation.

The COVID-19 pandemic has shattered routines throughout the world, creating closures and social isolation. Preliminary studies conducted during the pandemic have shown that children and adolescents are mainly affected by social distancing and the lack of a supportive framework. The purpose of the present study was to compare mental health symptoms of 430 children and adolescents who sought mental health services in the community before vs. during the pandemic. The study examined children's perceived burden of the pandemic, reports of emotional and behavioral problems (SDQ) anxiety (SCARED), depressed moods (SMFQ-C), and difficulty in emotional regulation (DERS), as well as intervening variables such as age and gender. Furthermore, the effect of difficulty in emotional regulation on children's mental health symptoms was explored. Findings indicate an increase in all mental health symptoms excluding anxiety, during the pandemic. Boys reported more difficulty in emotional regulation during the pandemic than before, and girls reported more emotional and behavioral problems. Children reported an increase in emotional and behavioral problems and adolescents in peer relationship problems. Difficulty in emotional regulation predicted all mental health symptoms in both samples, more so in girls and adolescents. These initial findings support the need for further studies to examine the long-term mental health effects of COVID-19 pandemic on children and adolescents.

The More Internet Access, the More Mental Symptoms Students Got, the More Problematic Internet Use They Suffered: a Meta-analysis of Mainland Chinese Adolescents and Young Adults.

The traditional view is that mental symptoms and problematic Internet use are positively related. Still, other researchers have questioned this view, and they believe that mental symptoms are negatively associated with problematic Internet use. Since then, this controversy has continued yet. The current study attempts to use meta-analysis to explore the relationship between mental symptoms and problematic Internet use in mainland Chinese students to provide a reliable basis for resolving this dispute. Sixty-three articles were included in this study, including 66 sample sizes and 47,968 subjects. It found that mental symptoms are positively correlated with problematic Internet use (r = .288, 95% confidence interval [.255, .320]). The correlation is affected by regions. Compared with coastal areas, problematic Internet users in the non-coastal areas are more likely to be affected by mental symptoms. In addition, gender differences also significantly affect the relationship between mental symptoms and problematic Internet use. The correlation coefficient between mental symptoms and problematic Internet use of girls is significantly higher than that of boys. Moreover, year also significantly affects the relationship between mental symptoms and problematic Internet use-the correlation increases by growing years.

Comparison of the relative sensitivity of two dimensional personality models to the psychopathological symptoms: the section III DSM-5 maladaptive traits versus affective temperaments.

BACKGROUND: The Personality Inventory for DSM-5 (PID-5) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) are tools designed for personality dispositions for mental health symptoms. The present study was conducted to compare these models in terms of their relative sensitivity to the symptoms of personality disorders (PDs) and non-personality disorders (NPDs). METHODS: Subjects in this cross-sectional study were 1232 (805 female; 63.5%) community samples in western Iran. Data were collected using the PID-5, the TEMPS-A, the Symptom Checklist-90 (SCL-90-R), and the Personality Diagnostic Questionnaire (PDQ-4). Correlations and Regression models were used to examine associations between traits and symptoms. RESULTS: Maladaptive traits assessed by the PID-5 were more strongly associated with PD symptoms, whereas affective temperaments measured by the TEMPS-A were more strongly associated with NPD symptoms. CONCLUSION: The present findings highlighted the practical utility of both the PID-5 and TEMPS-A indicating risk for psychopathology, but also suggest a distinction between PDs and NPDs in terms of underlying personality dispositions.

Roles of childhood maltreatment, personality traits, and life stress in the prediction of severe premenstrual symptoms.

BACKGROUND: About 3% to 8% of women of fertile age are thought to have premenstrual dysphoric disorder (PMDD), which is regarded as a serious form of premenstrual syndrome (PMS), although the details of this common condition remain unclear. The aim of this study was to analyze the interrelations of childhood maltreatment, personality traits, and life stress in the etiology of PMS/PMDD. METHODS: A total of 240 adult female volunteers from a community in Japan were investigated, using the following 5 questionnaires: Patient Health Quesstionaire-9, Child Abuse and Trauma Scale, Temperament and Character Inventory (TCI), Life Experiences Survey, and premenstrual dysphoric disorder (PMDD) scale. The questionnaire data were subjected to path analyses to clarify the association between childhood maltreatment and the severity of premenstrual symptoms, mediated by personality traits and life stress. RESULTS: The 2 path analysis models showed that high harm avoidance (HA) on the TCI and low self-directedness (SD) on the TCI had significant direct effects on the severity of premenstrual symptoms. Moreover, childhood maltreatment was associated with the severity of premenstrual symptoms, both directly and indirectly through personality traits. CONCLUSION: Our findings suggest that HA on the TCI might be a risk factor for severe premenstrual symptoms among general women and furthermore that SD on the TCI may be a protective factor. In addition, childhood maltreatment is associated with severe premenstrual symptoms both directly and indirectly through personality traits.

A new mutation in the GNAL gene in familial dystonia presenting with mental symptoms.

GNAL mutations (DYT25) have lately been identified as the firstly proven cause of focal adult-onset dystonia. We report here a new mutation in the GNAL gene in two siblings with dystonia. The new mutation is called NM 001,142,339:c.97C > T. Our research emphasizes the possible effects of new mutation on disease risk and the significance of genetic tests for GNAL mutations in confirming the molecular diagnosis.

Work exposures and mental and musculoskeletal symptoms in organic farming.

This study focussed on harmful exposures and mental and musculoskeletal symptoms in organic and conventional farming using interview data of Finnish farmers over the winter of 2014-2015. The data consisted of 2,169 full-time farmers, out of whom 231 (11%) practiced organic farming and 1,938 (89%) conventional farming. Exposure to poisonous and irritating substances was less frequent while exposures to vibration and mould ('smell of root cellar') were more frequent on organic farms. Mental and musculoskeletal symptoms were slightly more common among organic farmers, but the associations were not statistically significant in regression modelling. Risk factors for mental symptoms included animal production, hired labour, female gender, constant hurry, working alone, economic uncertainty, and inadequate recovery from workdays. Risk factors for musculoskeletal symptoms included older age, female gender, constant hurry, economic uncertainty, difficult working postures, heavy lifting and carrying, and inadequate recovery. Workload and recovery, managing the transition period and better follow-up of the occupational well-being were identified as concerns among organic farmers. Practitioner summary: Converting from conventional to organic farming has become increasingly common. Farmer interviews indicated that exposure to poisonous and irritating substances was less frequent while exposures to vibration and mould were more frequent on organic farms. Mental and musculoskeletal symptoms and risk factors were similar in both types of farming.

Correlation of serum homocysteine level with psychiatric symptoms and social ability in patients with schizophrenia / 中国基层医药

Objective:To correlate serum homocysteine (Hcy) level with psychiatric symptoms and social ability in patients with schizophrenia.Methods:A total of 143 patients with schizophrenia who received treatment in the Third Hospital of Quzhou from January 2018 to January 2020 were included in this study. They were randomly divided into abnormal Hcy group (Hcy ≥ 10) μmol/L, n = 46) and normal Hcy group (Hcy < 10 μmol/L, n = 97) according to different serum Hcy levels. Baseline data, the scores of the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), and the Substance Dependence Severity Scale (SDSS) were compared between the two groups. The correlation between serum Hcy level and psychiatric symptoms and social ability was analyzed using the Pearson correlation analysis. Results:PANSS total score and BPRS total score were (77.86 ± 8.37) points and (94.47 ± 9.36) points, respectively in the abnormal Hcy group, and (74.37 ± 7.94) points and (90.35 ± 9.26) points, respectively in the normal Hcy group. There were significant differences in PANSS total score and BPRS total score between the two groups ( t = 2.41, 2.47, both P < 0.05). SDSS total score was significantly higher in the abnormal Hcy group than in the normal Hcy group [(11.75 ± 2.38) points vs. (10.53 ± 2.28) points, t = 2.88, P < 0.05]. Pearson correlation analysis showed that serum Hcy level was positively correlated with PANSS positive subscale score ( r = 0.73, P < 0.001), general mental symptom score ( r = 0.43, P = 0.032) and PANSS total score ( r = 0.53, P = 0.027), but it was not correlated with PANSS negative symptom score ( P > 0.05). Serum Hcy level was positively correlated with BPRS excitement subscale score ( r = 0.42, P = 0.037) and hostility subscale score ( r = 0.37, P = 0.047), but it was not correlated with anxiety, blunted affect, unusual thought content subscale scores and BPRS total score (all P > 0.05). Conclusion:Serum Hcy level is correlated with psychiatric symptoms and social ability in patients with schizophrenia. The higher the level of Hcy, the more severe the psychiatric symptoms, and the higher the degree of social disability.

Training Psychiatry Residents in Descriptive Psychopathology: A Systematic Review.

PURPOSE: Descriptive psychopathology (DP, sometimes called psychopathology or phenomenology) is the language of psychiatry and is dedicated to the description of mental symptoms. Due to its importance, there is an ongoing case to put it back at the heart of psychiatry and its training. This study seeks to examine the literature on how to train psychiatry residents in DP, including reported educational interventions and educational methods. METHOD: The authors conducted a systematic review following the PRISMA and BEME guidelines to identify literature on how to train psychiatry residents in DP. In May 2019, they searched in Embase, ERIC, PsycINFO, PubMed, Scopus, and Web of Science; of 7,199 initial results, 26 sources were finally included for analysis. The assessment tools were the CRAAP test, Kirkpatrick's 4 levels, and (when applicable) the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: The mean CRAAP score was 38.885 of a possible 50 (SD 0.983; range: 36.859-40.910). Fourteen sources (53.8%) had some kind of training evaluation: Kirkpatrick's level 1 was present in nearly all (13) and was the highest in half of them (7). Regarding the educational interventions, the mean MERSQI score was 10.592 of a possible 18 (SD 2.371; range 9.085-12.098). Lectures were the most widely reported educational method (5); among those in clinical settings, the live supervised interview with feedback was the most usual (4). CONCLUSIONS: Despite its core importance as the language of psychiatry, the literature about training psychiatry residents in DP is scarce and heterogeneous. General lack of training evaluation and ongoing overemphasis on Kirkpatrick's levels 1-2 at the expense of levels 3-4 are causes for concern. During the review process, the authors identified a selection of educational interventions that could serve as the basis for the design of new training efforts in both clinical and nonclinical settings. Topics for future research are also suggested, such as the role of DP in competency-based training frameworks now in vogue and a series of neglected contents. Finally, the combined use of the CRAAP test and the MERSQI may be useful for future systematic reviews in medical education.

Mental symptoms and its influencing factors of patients with malignant tumor undergoing chemotherapy in general hospital / 中华行为医学与脑科学杂志

Objective:To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods:A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital, Fudan University who met all standards were chosen. The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients. SPSS 25.0 software was used for χ 2 test, Pearson correlation analysis and multiple regression analysis. Results:The most common symptoms in the patients were depressive symptoms(85/314, 27.1%), somatic symptoms (79/314, 25.2%), manic symptoms (78/314, 24.5% ) and anxiety symptoms (76/314, 24.3%). The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64, 40.6%) was significantly higher than that in patients who were taken care of by immediate relatives(50/250, 20.0%)(χ 2=12.23, P<0.05). Patients with unstable working conditions were more likely to have depressive symptoms (χ 2=7.64, P<0.05). There was a significant negative correlation between the patients' understanding of the disease and their scores of depressive symptoms, somatic symptoms, manic symptoms, anxiety symptoms and the total score of mental symptoms( r= -0.26, -0.15, -0.12, -0.25, -0.22, all P<0.05). In addition, the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status( r=0.11, 0.11, both P<0.05), and negatively correlated with patients' education ( r=-0.13, P<0.05). Multiple regression analysis showed that the degree of understanding of the disease( β=-0.203) and family status( β=0.197) were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital ( F=13.653, P<0.001). Conclusion:Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms. The high incidence mainly includes depressive symptoms, somatic symptoms, manic symptoms and anxiety symptoms. The understanding of the patients to the disease and family situation are the main influencing factors.