搜索结果：Journal of anxiety disorders

Exposure to parental depression is a risk factor for offspring mental illness. To examine the association between the timing of exposure to parental depression, from pregnancy to young adulthood, and adult offspring mental health. This prospective longitudinal cohort study of adult offspring aged 22 to 27 years in the Avon Longitudinal Study of Parents and Children, a British birth cohort, was conducted from September 1990 to July 2020. Data were analyzed from March 2024 to January 2026. Parental depressive symptoms were assessed repeatedly using the Edinburgh Postnatal Depression Scale (score range, 0 to 30, with higher scores indicating more severe depressive symptoms) beginning in pregnancy through offspring age of 21 years. The main outcomes were offspring symptoms of depression at age 27 years, anxiety at age 25 years, psychotic disorders at age 24 years, and alcohol use disorder (AUD) at age 22 years. Covariates included socioeconomic status and maternal-offspring polygenic risk for multiple psychiatric disorders. A total of 5329 adult offspring (3276 females [61.5%]) provided at least 1 outcome measure, which included 3795 participants providing symptoms of depression (mean [SD] age, 27.8 [0.5] years), 3505 participants providing symptoms of anxiety (mean [SD] age, 25.3 [0.6] years), 3342 participants with assessments for psychotic disorders (mean [SD] age, 24.5 [0.8] years), and 3392 participants reporting on symptoms of AUD (mean [SD] age, 22.9 [0.5] years). Cumulative exposure to parental depression across all time points was associated with increased odds of offspring depression (maternal: AOR, 2.36 [95% CI, 1.91-2.92]; paternal: AOR, 2.13 [95% CI, 1.60-2.83]) and anxiety (maternal: AOR, 2.58 [95% CI, 2.06-3.23]; paternal: AOR, 1.98 [95% CI, 1.49-2.63]). Only maternal depression was associated with increased odds of psychosis symptoms (maternal: AOR, 1.90 [95% CI, 1.27-2.82]; paternal: AOR, 1.63 [95% CI, 0.95-2.80]). There were no statistically significant associations with AUD. Significant associations between maternal depression and adult offspring depression were observed from 32 weeks' gestation (AOR, 1.08 [95% CI, 1.01-1.15]) to age 18 years (AOR, 1.08 [95% CI, 1.01-1.16]). Maternal depression from the 8-month postnatal period (AOR, 1.06 [95% CI, 1.01-1.11]) onward (aged 21 years: AOR, 1.13 [95% CI, 1.02-1.24]) was associated with offspring anxiety symptoms. Paternal depression was significantly associated with offspring depression from mid-childhood (AOR, 1.08 [95% CI, 1.01-1.15]) onward (aged 21 years: AOR, 1.22 [95% CI, 1.04-1.43]), with similar associations between paternal depression and offspring anxiety from mid-childhood (aged 5 years: AOR, 1.11 [95% CI, 1.03-1.18]) onward (aged 21 years: AOR, 1.22 [95% CI, 1.04-1.43]). Only maternal prenatal depression at 32 weeks' gestation was associated with offspring psychotic symptoms (AOR, 1.20 [95% CI, 1.03-1.41]). In this cohort study, analyses of 2 decades of data found distinct temporal associations between maternal and paternal depression and offspring psychiatric symptoms, and pregnancy was found to be a sensitive period in the association between maternal depression and offspring psychotic experiences. The findings suggest a substantial role of timing for specifying the association between parental depression and psychiatric outcomes in young adults and emphasize the need to support parental mental health from pregnancy onward.

Patients with nasopharyngeal carcinoma often face sleep and anxiety problems during chemoradiotherapy. These two issues interact with each other, forming a vicious cycle that seriously affects the patients' quality of life and treatment outcomes. In order to address the neglect of group heterogeneity in traditional studies, this study employs latent profile analysis and network analysis methods to explore patient subgroups and reveal the association patterns between symptoms, thereby providing a basis for precise nursing interventions. From September 2023 to March 2025, a convenience sampling method was used to select 513 patients with nasopharyngeal carcinoma who were receiving initial treatment in the Radiotherapy Department of a Grade A tertiary hospital in Nanning, Guangxi. General information questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and the Anxiety Subscale of the Hospital Anxiety and Depression Scale (HADS-A) were used to assess the patients' sleep quality and anxiety. Latent Profile All assessments were conducted at the mid-stage of concurrent chemoradiotherapy (2-4 weeks after the initiation of treatment), and the specific treatment phase of each participant was recorded and summarized. Latent Profile Analysis (LPA) was applied to identify potential patient subgroups with different "sleep-anxiety" characteristics. For different subgroups, symptom networks of sleep and anxiety were constructed respectively, and the core symptoms were identified and compared. The sleep quality and anxiety symptoms of nasopharyngeal carcinoma patients undergoing chemoradiotherapy can be divided into 4 latent profiles: low distress group (43.86%), emotional distress dominant group (21.25%), sleep problem dominant group (23.59%), and high anxiety-sleep disorder group (11.31%). Network analysis shows that in the low distress group network, the association between HADS1 and PSQI2 was the strongest, and PSQI2, PSQI3, and PSQI4 had the highest centrality. In the network of the emotional distress dominant group, the association between PSQI3 and PSQI4 was the strongest, and HADS4 also had relatively high centrality. In the sleep problem dominated group network, the association between HADS1 and PSQI2 was the strongest among all subtypes, and PSQI2, HADS1, and PSQI3 were the core symptoms in this network. In the network of the high anxiety-sleep disorder group, the association between HADS3 and PSQI3 was the strongest, and PSQI3, HADS3, and HADS2 were the core symptoms with high centrality. There is group heterogeneity in sleep-anxiety symptoms among patients with nasopharyngeal carcinoma undergoing chemoradiotherapy, which can be divided into four subgroups with different core symptom characteristics. The identified symptom associations provide hypothesis-generating insights for clinical intervention, and targeted strategies for core symptoms in each subgroup may help optimize symptom management in this population.

Background: Despite ongoing debate on the necessity of using the Continuous Traumatic Stress Response (CTSR) concept in contexts of repetitive threat - where the traditional post-traumatic stress disorder (PTSD) paradigm is insufficient [Goral, A., Feder-Bubis, P., Lahad, M., & Aharonson-Daniel, L. (2022). 'In the middle, between anxiety victims and PTSD, there are people that have some kind of a disorder that has no name yet' Insights about the traumatic stress consequences of exposure to ongoing threat. Trauma Care, 2(2), 185-196. https://doi.org/10.3390/traumacare2020015], validated measurement tools remain scarce. Moreover, because previous operationalizations focused primarily on civilian populations, adapting CTSR measures to military contexts is essential given their sensitivity to contextual factors.Objective: The present study aimed to adapt the CTSR scale [Goral, A., Feder-Bubis, P., Lahad, M., Galea, S., O'Rourke, N., & Aharonson-Daniel, L. (2021). Development and validation of the Continuous Traumatic Stress Response scale (CTSR) among adults exposed to ongoing security threats. PLoS One, 16(5), e0251724. https://doi.org/10.1371/journal.pone.0251724] for Ukrainian military personnel by examining their specific psychoemotional responses to continuous traumatic stress (CTS).Methods: A total of 1,902 military personnel completed 25 CTSR items, the Patient Health Questionnaire-9, the International Trauma Questionnaire, and a sociodemographic survey. Exploratory and confirmatory factor analyses were used to identify context-specific psychological responses to CTS, followed by assessments of homogeneity and discriminant validity.Results: Cross-validation procedure resulted in a three-factor structure encompassing psychoemotional responses of exhaustion, helplessness - depression, and psychosocial disruption. This structure was confirmed by CFA and supported by Cronbach's α values ranging from 0.74 to 0.87. Correlation between PTSD and CTSR remained below the 0.7 threshold, indicating good construct discrimination. Notably, higher CTSR scores were observed among younger personnel with shorter service length and among administrative staff compared to combat and combat-support personnel.Conclusions: The adapted CTSR scale revealed a focused clinical profile of CTSR in a military context. While PTSD-related events increased CTSR levels, discriminant validity analysis confirmed the two constructs as clearly distinct. Further analyses indicated that CTSR may be more applicable to military personnel operating in settings of mild-to-moderate ongoing stress rather than in high-exposure combat situations. Content analysis further revealed overlap between CTSR and depressive or burnout-like manifestations. The findings suggest that the CTSR framework may offer a more comprehensive conceptualization of psychological responses to recurrent, yet not high-exposure, threat. The Continuous Traumatic Stress Response (CTSR) scale was adapted for Ukrainian military personnel. A three-factor clinical profile comprising exhaustion, helplessness-depression, and psychosocial disruption was identified, showing strong psychometric properties, including satisfactory construct validity (CFA) and internal consistency (Cronbach’s α). Covariances with depression and posttraumatic stress disorder (PTSD) symptoms, none of which exceeded 50%, provided evidence of good construct discrimination.Although the severity of CTSR symptoms increased with the number of PTSD-related experiences, findings supported the conceptual independence of the two constructs. Further analyses suggest that CTSR may be particularly suited to populations exposed to continuous moderate stress rather than acute high-exposure combat conditions. Content analysis additionally revealed symptom overlap with depressive and burnout-related manifestations, such as exhaustion, powerlessness, motivation loss, despondency, changes in self-perception and behaviour.The findings reinforce the conceptualization of CTSR as a multidimensional construct that shares common features with other mental health conditions arising from the dysregulation of psychological and physiological systems under conditions of sustained allostatic load, but is clearly distinctive from PTSD. Antecedentes: A pesar del debate en curso sobre la necesidad de utilizar el concepto de Respuesta de Estrés Traumático Continuo (RETC) en contextos de amenaza repetitiva – en los que el paradigma tradicional del trastorno de estrés postraumático (TEPT) resulta insuficiente [Goral, A., Feder-Bubis, P., Lahad, M., & Aharonson-Daniel, L. (2022). ‘In the middle, between anxiety victims and PTSD, there are people that have some kind of a disorder that has no name yet' Insights about the traumatic stress consequences of exposure to ongoing threat. Trauma Care, 2(2), 185–196. https://doi.org/10.3390/traumacare2020015] – , las herramientas de medición validadas siguen siendo escasas. Además, dado que las operacionalizaciones previas se han centrado principalmente en poblaciones civiles, resulta esencial adaptar las medidas de RETC a contextos militares, considerando su sensibilidad a los factores contextuales. Objetivo: El presente estudio tuvo como objetivo adaptar la escala de RETC [Goral, A., Feder-Bubis, P., Lahad, M., Galea, S., O'Rourke, N., & Aharonson-Daniel, L. (2021). Development and validation of the Continuous Traumatic Stress Response scale (CTSR) among adults exposed to ongoing security threats. PLoS One, 16(5), e0251724. https://doi.org/10.1371/journal.pone.0251724] para personal militar ucraniano, mediante el examen de sus respuestas psicoemocionales específicas ante el estrés traumático continuo (ETC). Métodos: Un total de 1.902 miembros del personal militar completaron los 25 ítems de la escala RETC, el Patient Health Questionnaire-9, el Cuestionario Internacional de Trauma, y una encuesta sociodemográfica. Se realizaron análisis factoriales exploratorios y confirmatorios para identificar respuestas psicológicas específicas del contexto ante el ETC, seguidos de evaluaciones de homogeneidad y de validez discriminante. Resultados: El procedimiento de validación cruzada dio lugar a una estructura de tres factores que abarca respuestas psicoemocionales de agotamiento, indefensión–depresión y disrupción psicosocial. Esta estructura fue confirmada mediante CFA y respaldada por valores de α de Cronbach que oscilaron entre 0,74 y 0,87. La correlación entre el TEPT y la RETC se mantuvo por debajo del umbral de 0,7, lo que indica una adecuada discriminación de constructo. Cabe destacar que se observaron puntuaciones más altas en la RETC entre el personal más joven con menor tiempo de servicio, así como entre el personal administrativo en comparación con el personal de combate y de apoyo de combate. Conclusiones: La escala RETC adaptada reveló un perfil clínico específico de RETC en un contexto militar. Si bien los eventos relacionados con TEPT se asociaron con un aumento en los niveles de RETC, el análisis de validez discriminante confirmó que ambos constructos son claramente distintos. Análisis adicionales indicaron que la RETC podría ser más aplicable al personal militar que opera en entornos de estrés en curso leve a moderado, más que en situaciones de combate con alta exposición. Asimismo, el análisis de contenido reveló solapamientos entre RETC y manifestaciones de tipo depresivo o similares al burnout. En conjunto, los hallazgos sugieren que el marco conceptual de la RETC podría ofrecer una conceptualización más amplia de las respuestas psicológicas ante amenazas recurrentes, aunque no necesariamente de alta exposición.

Prevention of child maltreatment - incorporating physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence - is a clearly defined global policy priority. Global Burden of Disease studies have focused on estimating burden attributable to childhood sexual abuse omitting other forms of child maltreatment. This study aims to estimate burden attributable to child maltreatment using data from the first comprehensive national study, the Australian Child Maltreatment Study (ACMS), accounting for the co-occurrence of multiple forms, the complex impact of multi-type maltreatment and the contribution of interrelated factors. We estimated burden attributable to child maltreatment by age and gender for Australia in 2021. Risk-outcome pairs that met criteria for sufficient evidence for a causal relationship were included. Relative risks were estimated as a function of exposure based on data from the ACMS incorporating increased risk with multi-type maltreatment and adjustment for confounding. Levels of exposure in each of the 32 mutually exclusive combinations or patterns of child maltreatment were estimated based on ACMS data by age and gender. The theoretical minimum risk exposure level was determined as no exposure to child maltreatment in the population and population attributable fractions (PAFs) were calculated. Attributable mortality, years of life lost, years lived with disability and disability-adjusted life years (DALYs) were estimated by multiplying PAFs by the relevant burden of disease estimates by age and gender for Australia in 2021. Sensitivity analyses were conducted to assess the robustness of the results. Uncertainty was propagated into attributable burden estimates using Monte Carlo simulation methods. Overall, child maltreatment accounted for 6.6% (95% uncertainty interval (UI), 6.2-6.9%) of all DALYs for women and 6.4% (95% UI, 6.0-6.7%) of all DALYs for men in Australia in 2021. An estimated 71.2% of self-harm, 57.1% of anxiety disorders and 49.3% of major depressive disorder (MDD) DALYs in women, and 63.8% of self-harm, 55.9% of anxiety disorders and 42.9% of MDD DALYs in men were attributable to child maltreatment. Child maltreatment contributes to a substantial proportion of burden of disease in Australia, equivalent to leading lifestyle-related risk factors such as high body mass index, high blood pressure and smoking. This research significantly advances knowledge of the disease burden attributable to child maltreatment and provides novel methodology for measuring the impact of all five forms of child maltreatment combined on mental health and health risk behaviours nationally and globally.

After pancreaticoduodenectomy, perioperative neurocognitive disorders (PND) are a common complication. Parecoxib, a selective cyclooxygenase-2 inhibitor, is used for its analgesic and antiinflammatory effects, but its impact on postoperative anxiety and cognitive function is not clear. The patients undergoing laparoscopic pancreaticoduodenectomy at the Second Hospital of Hebei Medical University were enrolled in the study from November 1, 2020 to September 30, 2022 in this randomized controlled trial. Patients were randomly divided into Group P who received 20&#x2009;mg of parecoxib intravenously 10 minutes before anesthesia and at the end of surgery and Group C who received an equal volume of normal saline at the same times. Primary outcomes included the effect of parecoxib on anxiety, cognitive impairment, and postoperative intestinal function recovery, with the incidence of PND calculated using the Z-value method. Secondary outcomes included pain control, length of hospital stay, postoperative recovery, complication rates, and analgesic use. 80 patients were enrolled and randomly divided into 2 groups of 40 equally: there were no significant differences in postoperative flatus passage, defecation time, hospital stay, or complication rates (P&#x2005;>&#x2005;.05). In terms of postoperative anxiety, the experimental group had significantly lower State Anxiety Inventory scores at 24 hours postoperatively (T2) (P&#x2005;<&#x2005;.05). Cognitive function, measured by Montreal Cognitive Assessment scores, did not show significant differences; however, cognitive decline was less pronounced in the experimental group. PND rates were 5% (2/40) in the experimental group versus 12.5% (5/40) in the control group, suggesting a possible clinical tendency toward reduced incidence, although the difference did not reach statistical significance. The rates of PND at 24 hours (T2) and 7 days (T3) postoperatively were 10% (4/40) and 5% (2/40) for the experimental group, compared to 15% (6/40) and 12.5% (5/40) for the control group using the Z-value method, Although the between-group differences did not reach statistical significance, a lower incidence was observed in the parecoxib group, suggesting a possible clinical tendency. Parecoxib, when used with pancreaticoduodenectomy, alleviates postoperative anxiety and neurocognitive disorders without affecting postoperative intestinal function recovery or increasing the incidence of postoperative complications.

This work aimed to translate the Perinatal Anxiety Screening Scale into Chinese and test its validity and reliability. Anxiety symptoms are common in the perinatal period and negatively affect maternal and fetal outcomes. However, a sensitive anxiety screening tool specific to perinatal women, including a broad range of problematic anxiety symptoms, is not available in the Chinese language. Based on the translation, adaptation and validation of instruments or scale guideline, the Chinese version of the Perinatal Anxiety Screening Scale was developed by translation, synthesis, back-translation, pilot testing and psychometric testing. By convenience sampling, 350 perinatal women participated in this study from a tertiary hospital in Guangzhou, China. The Chinese version of the Perinatal Anxiety Screening Scale comprised four dimensions with 31 items and demonstrated good internal consistency (Cronbach's &#x3b1;: 0.94) and acceptable test-retest reliability within a two-week interval (intraclass correlation coefficient: 0.81). An expert panel evaluated that the average Scale-Content Validity Index (S-CVI/Ave) was 0.96, and the Item Content Validity Index (I-CVI) ranged from 0.89 to 1.00. As expected, the PASS significantly correlated with the Pregnancy-specific Anxiety Questionnaire and Self-Rating Anxiety Scale (r&#x2009;=&#x2009;0.74, p&#x2009;<&#x2009;0.001; r&#x2009;=&#x2009;0.67, p&#x2009;<&#x2009;0.001). In exploratory factor analysis, the cumulative contribution rate of the four common factors was 66.19%. The PASS-C was rigorously developed following the translation, adaptation and validation guidelines. The PASS-C was evaluated to have good reliability and validity. Additionally, it was verified to be easy and fast to assess the severity of anxiety symptoms in perinatal women for clinicians in China. We therefore advise that the PASS-C be introduced into clinical practice as a rapid screening instrument of anxiety disorders in antenatal and postnatal women. This enables nurses or clinicians to initiate timely, evidence-based interventions, such as psychological support or referrals to mental health specialists, thereby improving maternal and infant outcomes.

Mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD) are highly prevalent among forcibly displaced populations. Prevalence rates of common mental health conditions have been studied in refugee groups. However, research is sparse regarding the heterogeneity of psychiatric symptoms and quality of life (QoL) profiles among individuals with recent displacement experiences. The current study employed Latent Profile Analysis (LPA) to identify profiles of psychopathology and QoL in a sample of 510 recently arrived refugees in Sweden. The associations of profile membership with socio-demographic factors were thereafter investigated. Three distinct profiles were identified: a severe psychopathology/low QoL profile (36.27%), a PTSD-dominant/preserved QoL profile (33.14%) and a mild psychopathology/high QoL profile (30.59%). Nationality and residence status were moderately associated with profile membership. Individuals with Afghan nationality were over-represented, and those with Syrian nationality under-represented, in the severe psychopathology/low QoL profile. This association is likely explained by residence status: 82% of individuals in the severe psychopathology/low QoL profile lacked a residence permit, with only 3.6% of Afghans having received a residence permit, compared to 59.1% of Syrians. The results underscore the heterogeneity of psychopathological symptoms and QoL in individuals with recent displacement experiences, as well as a significant influence of contextual factors like residence status on their mental health and QoL. These findings may have implications for informing psychological treatments and migration policies.

Dental anxiety (DA) and generalized anxiety (GA) significantly impact patients' quality of life, influencing their social interactions, job performance, self-esteem, self-confidence, and overall oral health. Previous literature showed that females have a higher probability of experiencing psychological burdens compared with males. This study aimed to examine the correlation between GA and DA among females. This is a cross-sectional study that utilized the online survey study design using Qualtrics software in Jordan and Saudi Arabia in 2024. The convenience sampling technique was employed in this research. The correlation between GA and DA scores was examined using the Pearson correlation coefficient test. Multiple logistic regression analysis was conducted to identify predictors of severe DA. A total of 1858 females were involved in this study. The prevalence of severe anxiety (a total score of 15 and above) among the study sample was 24.2%. The mean DA score among the study participants was 12.6 (standard deviation&#x2005;=&#x2005;5.1) out of 25. Around 38.2% of the study sample showed moderate level of DA. A total of 16.0% of the study sample showed high level of DA. A moderately positive correlation was identified between Generalized Anxiety Disorder-7 score and Modified Dental Anxiety Scale score (r&#x2005;=&#x2005;0.270; 95% confidence interval&#x2005;=&#x2005;0.226-0.316; P value&#x2005;<&#x2005;.001). Females with a monthly income of 1500 to 2000 dollars were at a lower likelihood of experiencing severe DA level (P&#x2005;<&#x2005;.05). DA and GA were significant burdens among female study samples in Saudi Arabia and Jordan. Anxiety-minimizing and coping techniques can be considered by dentists while dealing with female patients. Educational campaigns should promote the importance of oral health and decrease public fear of dental visits.

Background: ICD-11 distinguishes post-traumatic stress disorder (PTSD) from complex PTSD (CPTSD) by introducing disturbances in self-organization (DSO) as a defining feature of CPTSD. Accurate identification of these conditions requires instruments aligned with the ICD-11 framework. The International Trauma Questionnaire (ITQ) was specifically developed to assess PTSD and CPTSD from ICD-11, but the Serbian version has not yet been validated in a clinical population.Objective: This study aimed to evaluate the psychometric properties of the Serbian version of the ITQ in a clinical sample, including its factor structure, reliability, and concurrent and discriminant validity in relation to trauma exposure, childhood adversity, emotional distress, emotional dysregulation, dissociation, suicidality, and quality of life.Method: A total of 199 adult psychiatric patients at the Institute of Mental Health in Belgrade completed the ITQ, Life Events Checklist (LEC-5), Impact of Event Scale-Revised (IES-R), Adverse Childhood Experiences Questionnaire (ACE-Q), Depression Anxiety Stress Scales (DASS-21), Difficulties in Emotion Regulation Scale (DERS), Brief Dissociative Experiences Scale (DES-B), Suicidal Ideation Attributes Scale (SIDAS), and the Manchester Short Assessment of Quality of Life (MANSA). Confirmatory factor analysis was used to compare competing ICD-11 models of PTSD and CPTSD.Results: Both the six-factor correlated model and the second-order PTSD-DSO model showed good fit, whereas the single-factor model of CPTSD was not supported. CPTSD was more common than PTSD (25.7% vs. 18.7%) and was associated with higher levels of emotional dysregulation, dissociation, suicidality, and poorer quality of life. PTSD symptoms were more strongly associated with trauma-related distress, while DSO showed stronger associations with depression, anxiety, and negative self-concept.Conclusions: The Serbian version of the ITQ demonstrates good reliability, validity, and clinical utility for the assessment of PTSD and CPTSD according to ICD-11. Its use may improve diagnostic differentiation and support more targeted trauma-informed treatment in Serbian clinical settings. In this study, the International Trauma Questionnaire (ITQ) was adapted and psychometrically evaluated in a clinical population of trauma-exposed adults in Serbia.As a result of this study, the first reliable and valid instrument for assessing Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (CPTSD) according to ICD-11 is now available for use in clinical and research settings in Serbia, allowing for accurate differentiation between PTSD and Disturbances in self-organization (DSO).The results of confirmatory factor analyses indicate that the two-factor model provides the most appropriate representation of trauma-related symptoms in this population, supporting the clinical relevance of differentiating CPTSD from PTSD in mental health services in Serbia. Antecedentes: La CIE-11 distingue el trastorno de estr&#xe9;s postraum&#xe1;tico (TEPT) del TEPT complejo (TEPTC) al introducir las alteraciones en la autoorganizaci&#xf3;n (AAO) como una caracter&#xed;stica definitoria del TEPTC. La identificaci&#xf3;n precisa de estas condiciones requiere [instrumentos alineados con la CIE-11]. El Cuestionario Internacional de Trauma (ITQ) se desarroll&#xf3; espec&#xed;ficamente para evaluar el TEPT y TEPTC basados en la CIE-11, pero la versi&#xf3;n serbia [a&#xfa;n no ha sido validada en poblaci&#xf3;n cl&#xed;nica]. Objetivo: Este estudio tuvo como objetivo evaluar las propiedades psicom&#xe9;tricas de la versi&#xf3;n serbia del ITQ en una muestra cl&#xed;nica, incluida su estructura factorial, confiabilidad y validez concurrente y discriminante en relaci&#xf3;n con la exposici&#xf3;n a trauma, adversidades en la infancia, malestar emocional, desregulaci&#xf3;n emocional, disociaci&#xf3;n, suicidalidad y calidad de vida. M&#xe9;todo: Un total de 199 pacientes psiqui&#xe1;tricos adultos del Instituto de Salud Mental en Belgrado completaron la ITQ, LEC-5, IES-R, ACE-Q, DASS-21, DERS, DES-B, SIDAS y MANSA. Se utiliz&#xf3; an&#xe1;lisis factorial confirmatorio para comparar los modelos en competencia de TEPT y TEPTC de la CIE-11. Resultados: Tanto el modelo de seis factores correlacionados [como] el modelo TEPT-AAO de segundo orden mostraron un buen ajuste, mientras que el modelo de un solo factor para el TEPTC no se confirm&#xf3;. El TEPTC fue m&#xe1;s frecuente que el TEPT (25,7% vs. 18.7%) y se asoci&#xf3; con mayores niveles de desregulaci&#xf3;n emocional, disociaci&#xf3;n, suicidalidad y peor calidad de vida. Los s&#xed;ntomas de TEPT se asociaron m&#xe1;s fuertemente con angustia relacionada con el trauma, mientras que las AAO mostraron una asociaci&#xf3;n m&#xe1;s fuerte con depresi&#xf3;n, ansiedad y un autoconcepto negativo. Conclusiones: La versi&#xf3;n serbia del ITQ demuestra buena confiabilidad, validez y utilidad cl&#xed;nica para la evaluaci&#xf3;n del TEPT y TEPTC seg&#xfa;n la CIE-11. Su uso podr&#xed;a mejorar la diferenciaci&#xf3;n diagn&#xf3;stica y respaldar un tratamiento m&#xe1;s espec&#xed;fico basado en trauma en contextos cl&#xed;nicos serbios.

Breast cancer is the most common cancer found in women including in Indonesia. Breast cancer patients are prone to have anxiety and it affects their quality of life. Interleukin-6 (IL-6) is one of the pro-tumorigenic cytokines that increases in breast cancer and is associated with worse prognosis and cancer metastasis. Several studies demonstrated the correlation between inflammatory cytokines and anxiety disorders. Therefore, this study aimed to determine the correlation between IL-6 and quality of life with anxiety syndrome in patients with late-stage breast cancer. This cross-sectional study involved women with late-stage breast cancer (Stage III and IV) in Haji Adam Malik General Hospital. IL-6 levels were assessed using Sandwich enzyme-linked immunosorbent assay (Sandwich-ELISA). The quality of life and anxiety syndromes were assessed using the European Organization for Research and Treatment of Cancer 30-Item Quality of Life Questionnaire (EORTC QLQ-C30) and Hospital Anxiety and Depression Scale (HADS)-A questionnaire, respectively. Kruskal-Wallis test was used to determine the correlation between variables. A p-value < 0.05 was considered statistically significant. Fifty-nine women met the inclusion criteria. The analysis demonstrated that higher IL-6 levels (p < 0.001) and poor QoL (p < 0.001) were related to severe anxiety disorders in late-stage breast cancer patients. IL-6 level and quality of life were potentially used in the risk stratification and early detection of anxiety syndrome in late-stage breast cancer cases.

Psychosomatic symptoms are highly prevalent among individuals with type 2 diabetes mellitus (T2DM), yet they often cluster into heterogeneous patterns that are inadequately characterized by single-symptom assessments or composite scores. This study aimed to identify latent psychosomatic symptom profiles in T2DM and to examine their associations with clinical characteristics, psychosocial resources, and health-related quality of life. This single-center cross-sectional study enrolled 312 adults with T2DM. Six psychosomatic symptom domains (depressive symptoms, anxiety, fatigue, sleep quality, pain intensity, and diabetes-related distress) were assessed as continuous indicators and analyzed using latent profile analysis. Sociodemographic and clinical variables, psychosocial resources (self-efficacy and perceived social support), and quality-of-life measures were compared across identified profiles. Multinomial logistic regression was conducted with the low symptom burden profile as the reference, using a clinical model (age, diabetes duration, and glycated hemoglobin) and an extended model incorporating psychosocial resources. Among the 312 participants (mean age 58.5&#x2005;&#xb1;&#x2005;10.3 years; 59.6% male), a 3-profile solution provided optimal fit (entropy&#x2005;=&#x2005;0.93; Lo-Mendell-Rubin test P&#x2005;=&#x2005;.012). The profiles comprised a low symptom burden group (59.6%), a high fatigue-emotional distress group (21.8%), and a high overall symptom burden group (18.6%). Symptom severity differed significantly across profiles (all P&#x2005;<&#x2005;.001). Compared with the low symptom burden profile, individuals in the high symptom burden profile were older, had longer diabetes duration, and more frequently reported neuropathy and prior hypoglycemia (all P&#x2005;&#x2264;&#x2005;.05), whereas glycated hemoglobin and body mass index did not differ significantly. In multivariable analyses, greater self-efficacy (odds ratio 0.66, 95% confidence interval 0.56-0.78) and higher perceived social support (odds ratio 0.92, 95% confidence interval 0.89-0.95) were independently associated with reduced odds of belonging to the high symptom burden profile. Health-related quality of life demonstrated a clear gradient across profiles, with the poorest physical and mental health scores in the high symptom burden group (P&#x2005;<&#x2005;.001). Distinct psychosomatic symptom profiles were identified among patients with T2DM. A high symptom burden profile was characterized by greater clinical complexity, diminished psychosocial resources, and substantially impaired quality of life, independent of glycemic control.

Depression and anxiety are psychiatric disorders that significantly affect patients' well-being, morbidity, and mortality. Aerobic exercise (AE) and resistance exercise (RE) have been proposed as interventions to alleviate depressive and anxiety symptoms; however, their comparative effectiveness remains unclear. This study compared the associations of AE, RE, and their combination (total exercise; TE) with depression and anxiety in a large representative sample of the Korean population. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) were used to analyze 21,298 participants for depression (measured using the Patient Health Questionnaire-9) and 8,707 participants for anxiety (measured using the Generalized Anxiety Disorder-7). The participants were divided into four exercise groups: TE, AE, RE, and non-AE-RE. Propensity score based exact matching was applied using a 1:1:1:1 ratio across the four exercise groups to control for confounding factors such as age and sex. Multivariate linear and logistic regression analyses were conducted to evaluate the effects of each exercise type on depression and anxiety. After propensity score matching, the RE group had the lowest depression (&#x3b2; = -0.534; 95% confidence interval [CI], -0.765 to -0.303; P < 0.001) and anxiety (&#x3b2; = -0.459; 95% CI, -0.808 to -0.110; P = 0.010) scores compared with the non-AE-RE group. The TE group also showed favorable associations with depression (&#x3b2; = -0.473; 95% CI, -0.706 to -0.241; P < 0.001), although to a lesser extent than the RE group. AE was not significantly associated with either of the outcomes. Subgroup analyses indicated stronger associations of RE in women and older adults. RE was more strongly associated with lower depression and anxiety levels than AE, particularly in women and older adults. This study underscores the importance of incorporating resistance training into exercise prescriptions and public health interventions to enhance mental health outcomes.

While psychological and emotional changes have been reported in some cases of idiopathic central precocious puberty (CPP), definitive conclusions about these associations are still lacking. This study aimed to investigate the emotional and psychosocial dimensions of girls diagnosed with CPP compared to healthy controls. The study comprised 21 cases with CPP and their parents, as well as 22 healthy controls and their parents. All participants underwent the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL) during psychiatric evaluation. Additionally, patients completed the Revised Child Anxiety and Depression Scale -Child (RCADS-CV), and Pediatric Quality of Life Inventory (PedsQL) questionnaire. Parents completed the Attention Deficit Hyperactivity Disorder Scale (ADHD), Emotion Regulation Checklist (ERC), Children Empathy-Systemize Scale (EQ-SQ), Strengths and Difficulties Questionnaire (SDQ), Revised Child Anxiety and Depression Scales -Parent Version (RCADS-P), Pediatric Quality of Life Inventory (PedsQL) for their children, and the Beck Depression Inventory for themselves. The median ages in the CPP and control groups were 7.6&#xa0;years (range: 6-8) and 7.2&#xa0;years (range: 6.5-8), respectively. KSADS-PL revealed significantly higher rates of anxiety disorder in CPP cases compared to controls. Notable differences were found in the impulsivity subscale of the ADHD scale, physical and school functioning in PedsQL (child and parent forms), peer problems in the SDQ, emotion regulation (ERC), and social phobia and separation anxiety (RCADS-CV). Parental separation anxiety (RCADS-P) also showed significant differences between groups. &#xa0;Our findings suggest that patients diagnosed with precocious puberty are at an increased risk for psychiatric comorbidities compared to the control group. It is crucial to consider children's psychiatric comorbidities at the time of diagnosis. Additionally, this study provides data for future investigations aimed at assessing stress levels following GnRHa treatment. &#x2022; Early pubertal onset has been associated with increased vulnerability to anxiety, emotional distress, and&#xa0;&#xa0;psychosocial difficulties in children. &#x2022; Previous studies on idiopathic CPP have reported inconsistent findings regarding the extent of psychological and&#xa0;behavioral impairments. &#x2022; This study demonstrates that girls with idiopathic CPP show significantly higher rates of DSM-based anxiety disorders&#xa0;and broader psychosocial difficulties at the time of diagnosis. &#x2022; In addition to anxiety, impairments in emotional regulation, peer relationships, impulsivity, and quality of life were&#xa0;identified, highlighting a multidimensional psychosocial impact.

Children and adolescents with intellectual disability (ID) frequently experience various comorbid psychiatric symptoms. However, research on the comorbidity of psychiatric disorders in this population remains limited. In this study, we aimed to comprehensively examine the prevalence of psychiatric disorders among children and adolescents with ID in South Korea from 2012 to 2021. We obtained data from the National Health Insurance Service-National Health Information Database (NHIS-NHID) on individuals aged 2-18 years who were diagnosed with ID (F70-F79.9) between 2012 and 2021. Psychiatric disorders were identified using the following the International Classification of Diseases, 10th Edition codes: attention-deficit/hyperactivity disorder (ADHD) (F90), autism spectrum disorder (ASD) (F84), language disorder (F80), tic disorders (F95), anxiety disorders (F401-F402, F410-F411, F930-F932), depressive disorder (F32, F33), conduct disorder (F918, F928, F911), and oppositional defiant disorder (ODD) (F913). We analyzed the annual prevalence of comorbid psychiatric disorders. Throughout the study period, males consistently outnumbered females (62.6-65.5% vs. 34.5-37.4%). ADHD had the highest prevalence among psychiatric disorders, increasing from 30.23% in 2012 to 41.77% in 2021. Similar increasing trends were observed for ASD (10.95-15.46%) and depression (10.46-19.37%). Significant sex differences were observed in most disorders: ADHD, ASD, tic disorders, language disorder, conduct disorder, and ODD showed male predominance (P < 0.001), while depressive disorder showed female predominance (P < 0.01). Anxiety disorders showed no significant sex differences. This study enhances our understanding of the epidemiology of psychiatric comorbidities in South Korean children and adolescents with ID. The evaluation of comorbid psychiatric disorders in this population is crucial for prognosis, with particular attention needed for ADHD and depressive disorder due to their relatively high prevalence. Future research should focus on preventing and treating psychiatric comorbidities in children and adolescents with ID.

Multiple studies have assessed Health-Related Quality of Life (HRQoL) in children with urea cycle disorders (UCDs); investigations in adults with the same disorders are rarer. Understanding the variables that modify self-reported HRQoL has become increasingly important as novel treatments are developed, with clinically meaningful endpoints required to assess efficacy. This was an ambispective study of participants enrolled in the Longitudinal Study of Urea Cycle Disorders (NCT00237315) conducted by the Urea Cycle Disorders Consortium (UCDC). Inclusion criteria included age&#x2009;&#x2265;&#x2009;18&#x2009;years and at least one completion of one of five HRQoL patient-reported outcome measures (PROMs). A total of 144 participants met inclusion criteria. Covariates included age at last assessment, sex at birth, specific UCD subtype, symptomatic status, treatments, and disease severity. The enrollees' self-reported HRQoL T-scores were not significantly different from the normative population. Whereas participants categorized as asymptomatic differed from those categorized as symptomatic in terms of disease severity, age at last HRQoL, and full-scale IQ, overall HRQoL did not differ. A model including age, sex, specific UCD subtype, symptomatic status, and disease severity revealed that perceived cognitive function was related to specific UCD subtype, while Anxiety and Emotional and Behavioral Dyscontrol were associated with sex at birth. When post-liver transplant participants were excluded, the pattern of associations was unchanged. Among adults with UCDs, responses on HRQoL measures revealed no significant differences in HRQoL when compared to normative populations. Cognitive reserve did not moderate the impact of diagnosis or treatment. Additional work in understanding and measuring HRQoL in this population is required.

The Generalized Anxiety Disorder 7-Item Scale (GAD-7) is a brief self-reported measure for screening for anxiety symptoms. However, the evidence about its cross-cultural validity is fragmentary and usually focused on specific settings. Therefore, we aimed to critically review and synthesize the existing evidence about the cross-cultural validity of the GAD-7. We conducted a systematic review of studies assessing the cross-cultural validity of the GAD-7 in following the PRISMA guidelines. Additionally, the quality of the studies was assessed following the COSMIN guidelines, and the quality of the evidence was assessed with the GRADE. Data were synthesized narratively. Out of 1,965 unique records, 9 unique studies were deemed eligible for the COSMIN appraisal and the narrative synthesis (total sample: 11,894, 53.7% females and 20 different cultural groups). Most studies (7) had adequate quality and showed evidenced of the unitary structure of the GAD-7 across cultural groups. In 4 studies also assessing possible cultural bias, the effect on the general score was deemed negligible. The evidence about the cross-cultural validity of the GAD-7 is very limited. Although more research is needed, the evidence available shows that the GAD-7 could be a cross-culturally valid tool for the assessment of anxiety symptoms in clinical contexts and epidemiological studies. Until new high-quality evidence will be available, these results would constitute a key first step for supporting the use of the GAD-7 in multi-cultural clinical settings and to inform clinical, public health and global health decision making in relation to anxiety.

The effects of anxiety on psychological pathways underpinning psychosis and suicidal thoughts are poorly understood. The overall goal of the present study was to rectify this by examining pathways linking emotional distress from psychotic symptoms, specifically, auditory hallucinations and delusions with suicide ideation severity, via anxiety, defeat, entrapment, and hopelessness. Participants had psychosis and recent suicidal experiences and were under the care of mental health services. The design was cross-sectional. Two key mediated models were examined. In the first, the extent to which anxiety mediated the association between distress from psychosis and suicidal ideation severity was tested. In the second, the extent to which distress mediated the association between anxiety and ideation was tested. In both models, defeat, entrapment and hopelessness were parallel, proximal, mediators of suicidal ideation severity. General psychiatric symptoms were statistically controlled, as were severity levels of hallucinations and delusional symptoms. There was an indirect, mediated, association linking emotional distress from auditory hallucinations and delusions with ideation severity via anxiety and entrapment. There was also a second mediated effect in which anxiety was associated with suicidal ideation severity via emotional distress from auditory hallucinations and delusions and entrapment. These mediation effects were not significant when symptom severity, rather than distress arising from symptoms, was tested. Our findings underscore the importance of incorporating into contemporary suicide theories the complex dynamics underpinning the emotional impact of auditory hallucinations and delusions on suicidal thoughts especially when linked with anxiety and entrapment, whilst simultaneously developing suicide-focused therapies.

Mother-infant bonding disorders have the potential to impact infant development and maternal mental health during the perinatal period. In Mexico, the limited information regarding their prevalence is associated with the absence of validated instruments for their detection. The Postpartum Bonding Questionnaire (PBQ) is one of the most widely used instruments internationally, although it reports high psychometric heterogeneity depending on the context. The objective of this study was to adapt and evaluate the psychometric properties of a Mexican version of the PBQ (PBQ-Mx) and to establish its sensitivity and specificity in Mexican mothers. The PBQ-Mx was administered to 455 women in the first postpartum year. A Confirmatory Factor Analysis (CFA) and an Item Response Theory (IRT) analysis were performed. A ROC curve analysis was also performed on a subsample of 134 mothers with a clinical diagnosis of the quality of mother-infant bonding using the Stafford Interview to determine sensitivity, specificity, and a cut-off point. The original 25-item structure of the PBQ was confirmed, exhibiting good overall reliability (&#x3b1;&#x2009;=&#x2009;0.82, &#x3a9;&#x2009;=&#x2009;0.86), though factor 3 (infant-focused anxiety) demonstrated low reliability. IRT analysis confirmed the validity of the theoretical model. The prevalence of mother-infant bonding disorders was 7%. The cut-off point of &#x2265;&#x2009;12 demonstrated a sensitivity of 100% and a specificity of 88% (AUC&#x2009;=&#x2009;0.980). The PBQ-Mx demonstrated psychometric properties that support its use as a valid and reliable tool for the early detection and research of mother-infant bonding difficulties in the Mexican postpartum population.

Obsessive-compulsive spectrum disorders are rarely included in hierarchical dimensional models of psychopathology due to limited available data. The current study examined the higher order structure of the obsessive-compulsive and related disorders (OCRDs) in the DSM/ICD. Measures of OCRD severity were administered in community (N&#xa0;=&#xa0;1110) and clinical (N&#xa0;=&#xa0;690) samples. Confirmatory factor analyses were used to determine the optimal structure of OCRD symptoms, and structural regression models to explore association with indicators from the internalizing, externalizing and thought disorder spectra. In both samples, the data fit best with a correlated two-factor model comprised of a grooming dimension (with loadings from hair pulling, skin picking and nail biting/picking disorders) and a compulsivity dimension (with loadings from obsessive-compulsive, hoarding, body dysmorphic, olfactory reference, and illness anxiety disorders). A three-factor model which included body preoccupation factor (body dysmorphic, olfactory reference, and illness anxiety disorders) was not viable due to out of bounds correlations with compulsivity (obsessive-compulsive and hoarding disorders). The broad compulsivity factor, but not the grooming factor, had robust associations with indicators of internalizing and thought disorder spectrum. Both factors had small and inconsistent associations with alcohol and substance use. The findings suggest that the higher order structure of OCRDs may be best represented by separable compulsivity and grooming dimensions. Future research is needed to examine the scope of these dimensions, and their placement within the meta structure of psychopathology.