On a front line.

Like the patients, doctors in Sarajevo depend largely on humanitarian aid; everyone in the public sector has worked without pay for almost three years. The hospital is on a front line; yet the psychiatric department continues to function, even conducting large scale studies of psychosocial aspects of war in Bosnia-Hercegovina. The type of inpatient morbidity and treatment patterns have changed. A plethora of psychosocial rehabilitation programmes has emerged, including counselling, drop in centres, and attending to special needs of elderly people, schoolchildren, and women. The most prominent psychological symptoms were exhaustion at the prospect of a third winter of war and bewilderment at the Western stereotype of Bosnians as Muslim fundamentalists.     

Reporting distress and quality of life of patients with diabetes mellitus in primary and secondary care in Greece

Background and aim This study constitutes an initial attempt at elucidating the relationship between quality of life (QoL), health status and psychological distress in patients with diabetes mellitus (DM) in Greece, by comparing patients with DM registered at a rural primary healthcare centre (PHCC) and those attending a diabetes outpatient clinic (DOC) at an urban hospital.Methods Cross-sectional study. Participants were consecutive, consenting patients with a known history of type 2DM(T2 DM), currently registered at either of the two centres. All patients were administered the Short Form-36 version 2 (SF-36 v2) and the Problem Areas In Diabetes (PAID) questionnaire, and information in relation to socio-demographic data and clinical characteristics were also obtained.Results Patients with DM had a lower QoL over all domains when compared with general population normative data. In addition, mean scores for the SF-36 v2 Physical Component Summary (PCS) and Mental Component Summary (MCS) and six subscales of the SF-36 v2 demonstrated significant differences between the two participating centres (P < 0.0001). The mean PAID score was 19.18 (±15.58) for patients from the PHCC, versus 40.19 (±17.36) for the DOC (P < 0.0001). Lower scores on the MCS of the SF-36 v2, and higher scores on PAID in patients with T2 DM were related to major co-morbidities, insulin use and duration of DM.Conclusions Patients with T2 DM from the urban DOC had significantly higher levels of distress and consequently lower levels of QoL compared with patients from the rural PHCC. The findings from this study may have important implications with regard to the individualisation of patient care in Greece, and encouragement of patient participation in the treatment process.     

Neurophysiological and Psychophysiological Effects of Sulpiride in the Norm and in Patients with Opiate Addiction

We studied characteristics of the EEG activity and psychophysiological indices in healthy persons and patients with opiate addiction (in the states of abstinence and remission) before and after peroral introduction of 200 mg sulpiride. In the initial state, spectral characteristics of EEG in patients with opiate addiction differed from those in the control (in healthy tested subjects) by higher relative powers of low- and high-frequency components (delta and beta waves) and a considerable depression of the alpha rhythm. Treatment with sulpiride evoked changes in the spectral characteristics of EEG, which showed a significant intergroup specificity; intensification of alpha oscillations was a general effect in all groups. We conclude that the effects of sulpiride on the EEG activity comprised components typical of both neuroleptics and antidepressants; in the group of patients in the abstinence state, the pattern of effects of sulpiride was close in its profile to the effect of anxiolytics. Dynamics of the indices of psychophysiological testing after sulpiride treatment demonstrated that the drug exerts mostly positive regulating effects on the state of higher nervous functions in patients with opiate addiction.     

药物成瘾相关的神经结构可塑性改变

不计后果的药物渴求和滥用是药物成瘾的一个显著特征。药物滥用可以诱导行为学和心理学持续性改变的发生,这些持续性改变由相关神经通路(尤其是奖赏系统)神经结构的可塑性变化所引起。本文综述了安非他明、可卡因、尼古丁和吗啡等药物诱发的相关脑区的神经可塑性改变以及引起这些改变的可能原因。药物成瘾诱发的神经结构可塑性改变反映了相关神经系统突触连接的重塑,这些重塑改变该系统的功能,由此便产生了药物滥用的一系列后遗症状———包括成瘾。     

Partner Violence and Psychosocial Distress among Female Sex Workers in China

Background

Despite recognized vulnerability of female sex workers (FSW), most data on this population are focused on their HIV and STI prevalence; studies on their experience of partner violence and psychosocial distress are limited, especially FSW in China.

Methods and Findings

A cross-sectional survey was administered among 1,022 FSW recruited from 9 different types of commercial sex venues in Southwest China. Partner violence scales were adapted from WHO''s Women''s Health and Domestic Violence scale and psychosocial distress was measured by five indicators, including alcohol intoxication, drug use, suicidal behavior, depression, and loneliness. Random effects modeling was used to control for cluster effects. Findings: About 58% of FSW ever experienced violence from their stable partners, and 45% suffered it from their clients. Partner violence was strongly associated with each of the five measures of psychosocial distress, even after controlling for potential confounders.

Conclusion

This study is one of the first to examine the association between partner violence and psychosocial distress among FSW in China. The high prevalence of violence experience and distress in this population suggests urgency for intervention. The public health programs targeting FSW should go beyond the focus on HIV/STI prevention and care for the fundamental health and human rights of millions of FSW in China.     

Loneliness,Depression, and Physical Activity in Older Adults: The Therapeutic Role of Human–Animal Interactions

ABSTRACT

The global population of older persons is projected in 2050 to reach approximately 2.1 billion. As people age, feelings of loneliness, depression, and physical inactivity often occur due to a multitude of reasons. These feelings may manifest and cause adverse health outcomes. With the predicted increase of older adults worldwide, the prevalence of loneliness, depression, and physical inactivity may also worsen over time if unattended. Since older adults are subject to psychological and physical changes as they age, it is important to find creative ways to address the health needs of this growing population. Therefore, interventions are needed to prevent or decrease the psychological and physical challenges that older adults face. This paper examines existing literature on human–animal interactions (HAIs) in the lives of older adults in relation to concepts such as loneliness, depression, and physical activity. The psychological and physical health benefits of animals for older adults include decreased loneliness and depression, improved cardiovascular health, and increased physical activity. There is mounting evidence supporting the therapeutic psychological and physical health benefits of animals in the lives of older adults. However, there are practical and financial implications that must be considered. Methodological considerations and future directions for human–animal interaction research with older adults are also discussed.     

The Functional State of Athletes Addicted to Exercises during Exercise Deprivation

The objective of this study is to identify markers of the addictive condition developing in athletes during exercise deprivation by analyzing electroencephalograms (EEGs), electromyograms (EMGs), skin temperature measurements, sympathetic nervous system activity, levels of anxiety and depression (by psychological tests). A cohort of professional football players (N = 50) voluntarily participated in the study. The athletes were tested under two test conditions: during active training sessions and during exercise deprivation (for seven days). The analyzed results have shown that the functional state of athletes with exercise addiction (due to exercise deprivation), compared with athletes showing no addictive behavior, was characterized by lower brain bioelectric activity (a decrease in the α-rhythm amplitude and power), growth in the muscular tension, increased sympathetic activity, and elevated levels of anxiety and depression. We have concluded that an athlete’s functional state during exercise deprivation is an important predictor for exercise dependence. A prolonged exercise deprivation causes intense psychophysiological changes in the body of athletes inclined to exercise addiction. The obtained results may be useful for experts in the field of sports medicine, as well as for further studies in different types of addictions.     

Predicting loneliness with polygenic scores of social,psychological and psychiatric traits

Loneliness is a heritable trait that accompanies multiple disorders. The association between loneliness and mental health indices may partly be due to inherited biological factors. We constructed polygenic scores for 27 traits related to behavior, cognition and mental health and tested their prediction for self‐reported loneliness in a population‐based sample of 8798 Dutch individuals. Polygenic scores for major depressive disorder (MDD), schizophrenia and bipolar disorder were significantly associated with loneliness. Of the Big Five personality dimensions, polygenic scores for neuroticism and conscientiousness also significantly predicted loneliness, as did the polygenic scores for subjective well‐being, tiredness and self‐rated health. When including all polygenic scores simultaneously into one model, only 2 major depression polygenic scores remained as significant predictors of loneliness. When controlling only for these 2 MDD polygenic scores, only neuroticism and schizophrenia remain significant. The total variation explained by all polygenic scores collectively was 1.7%. The association between the propensity to feel lonely and the susceptibility to psychiatric disorders thus pointed to a shared genetic etiology. The predictive power of polygenic scores will increase as the power of the genome‐wide association studies on which they are based increases and may lead to clinically useful polygenic scores that can inform on the genetic predisposition to loneliness and mental health.     

Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis

Background

Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA).

Methods

Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (Trier Social Stress Test; TSST) 1 week after the stress management training and at a 9-week follow-up. Psychological and physical functioning, and the acute psychophysiological response to the stress test were assessed.

Results

Patients in the intervention group showed significantly lower psychological distress levels of anxiety after the training than did the controls. While there were no between-group differences in stress-induced tension levels, and autonomic (α-amylase) or endocrine (cortisol) responses to the stress test 1 week after the intervention, levels of stress-induced tension and cortisol were significantly lower in the intervention group at the 9-week follow-up. Overall, the response to the intervention was particularly evident in a subgroup of patients with a psychological risk profile.

Conclusion

A relatively short stress management intervention can improve psychological functioning and influences the psychophysiological response to stress in patients with RA, particularly those psychologically at risk. These findings might help understand how stress can affect health and the role of individual differences in stress responsiveness.

Trial Registration

TrialRegister.nl NTR1193     

Psychophysiological Performance Characteristics of Gas Production Operators Exposed to Natural Climatic Conditions of an Arid Zone

Systemic examination of gas production operators in the southeastern Kara Kum was carried out to reveal the physiological and psychological indices characteristic of different components of the human performance system and labor quality. It was found, in operators of two psychophysiological types, i.e., sensoricognitive and sensorimotor types, these indices varied seasonally (spring and summer) and depending on the working period during a shift. Adaptive changes were found not only in both physiological functions and psychophysiological performance pattern, but also in personality traits, including introversion and extroversion and the level of neuroticism. The empirical data are interpreted in the context of the ergonomic concept of the human performance system.     

Typology of the nervous system and personality

The paper deals with structural organization of psycho-physiological and psychological characteristics of personality. The following characteristics were estimated: psychomotor, intellectual, creative abilities, features of imagination as well as basic properties of personality: extraversion--introversion, and neuroticism. Using the Q-technique of factor analysis of the 1-st, 2-nd and 3rd orders, the authors singled out three types of psychophysiological and psychological human organization. Each type was given a generalized interpretation. Conclusion is made that these types reflect more generalized processes than factors derived with R-technique of factor analysis.     

Do weather changes influence pain levels in women with fibromyalgia,and can psychosocial variables moderate these influences?

The aim of this study was to examine the association between fibromyalgia pain and weather, and to investigate whether psychosocial factors influence this relationship. Women with chronic widespread pain/fibromyalgia (N?=?50) enrolled in a larger study, were recruited from a 4-week inpatient rehabilitation program in Norway ( 2009–2010), and reported their pain and psychological factors up to three times per day (morning, afternoon, evening) for 5 weeks. These ratings were then related to the official local weather parameters. Barometric pressure recorded simultaneously impacted pain significantly while temperature, relative humidity, and solar flux did not. No psychological variables influenced the weather–pain interaction. No weather parameter predicted change in the subsequent pain measures. The magnitude of the inverse association between pain and barometric pressure was very small, and none of the psychological variables studied influenced the association between pain and barometric pressure. All in all, the evidence for a strong weather–pain association in fibromyalgia seems limited at best.     

Plasma heat shock protein 60 and cardiovascular disease risk: the role of psychosocial, genetic, and biological factors

The Whitehall Study is a prospective epidemiological study of cardiovascular risk factors in healthy members of the British Civil Service, which has identified psychological distress as a major risk factor for coronary heart disease. The levels of circulating Hsp60 in 860 participants from the Whitehall cohort and 761 individuals diagnosed with diabetes have been measured and related to psychological, biological, and genetic factors. In the Whitehall participants, concentrations of Hsp60 ranged from undetectable to mg/mL levels. Circulating Hsp60 correlated with total and low-density lipoprotein (LDL) cholesterol and was positively associated with a flattened slope of cortisol decline over the day. Levels of this stress protein also correlated with measures of psychological stress including psychological distress, job demand, and low emotional support. Mass spectrometric analysis of circulating immunoreactive Hsp60 reveal that it is predominantly the intact protein with no mitochondrial import peptide, suggesting that this circulating protein emanates from mitochondria. The Hsp60 is stable when added to plasma and the levels in the circulation of individuals are remarkably constant over a 4-year period, suggesting plasma levels are partly genetically controlled. Sequence analysis of the HSP60-HSP10 intergenic promoter region identified a common variant 3175 C>G where the G allele had a frequency of 0.30 and was associated with higher Hsp60 levels in 761 type 2 diabetic patients. The extended range of plasma Hsp60 concentrations in the general population is genuine and is likely to be related to genetic, biological, and psychosocial risk factors for coronary artery disease.     

Psychological evaluation of young women after medical treatment for central precocious puberty

OBJECTIVE: This study aimed at the evaluation of the subjective experience and long-term behavioral and psychological effects of precocious puberty (PP). METHODS: 19 female patients who had been treated with GnRH agonists participated in a semistructured interview and completed two standardized checklists. Their parents completed the Child Behavior Checklist (CBCL). RESULTS: The CBCL yielded significantly elevated Internalizing and Total Behavior Problem scores. An elevated risk was found for patients with short adult stature and a relatively late onset of PP. The latter tended to neuroticism, to accentuation of their physical appearance, and felt significantly more insecure than age-related non-PP girls. CONCLUSION: Our findings suggest that PP can lead to specific behavioral problems, and that patients with a risk factor may need psychosocial support.     

Association between somatosensory,motor and psychological variables by levels of disability in patients with cervicogenic dizziness

Abstract

Cervicogenic dizziness is a musculoskeletal disorder mainly characterized by dizziness associated with neck pain. The aim of this study was to assess the association between somatosensory, motor and psychological variables by levels of disability due to dizziness in patients with cervicogenic dizziness. A total of 64 patients were classified into two groups according to the presence of higher and lower levels of disability due to dizziness. The degree of disability due to dizziness, the magnitude of chronic pain, catastrophizing and kinesiophobia were evaluated by self-reports. The cervical active range of motion and the pressure pain thresholds were also assessed. The psychosocial variables showed significant differences. Higher values were found in the group with the highest level of disability due to dizziness (d?=?0.80). Regarding motor variables, some differences were found in extension (d?=?0.52) and in right rotation cervical movement (d?=?0.90), with lower values in the group with greater disability due to dizziness. No differences were observed in the somatosensory variables (p?>?.05). In the group with lower levels of disability due to dizziness, negative associations were found with the range of cervical motion and positive associations were found with kinesiophobia. Our results suggest that levels of disability due to dizziness could be an important factor to consider in patients with cervicogenic dizziness. The influence of psychological factors and some ranges of cervical movement should be considered clinically.     

A Potential Role for Creatine in Drug Abuse?

Supplemental creatine has been promoted for its positive health effects and is best known for its use by athletes to increase muscle mass. In addition to its role in physical performance, creatine supplementation has protective effects on the brain in models of neuronal damage and also alters mood state and cognitive performance. Creatine is found in high protein foods, such as fish or meat, and is also produced endogenously from the biosynthesis of arginine, glycine, and methionine. Changes in brain creatine levels, as measured using magnetic resonance spectroscopy, are seen in individuals exposed to drugs of abuse and depressed individuals. These changes in brain creatine indicate that energy metabolism differs in these populations relative to healthy individuals. Recent work shows that creatine supplementation has the ability to function in a manner similar to antidepressant drugs and can offset negative consequences of stress. These observations are important in relation to addictive behaviors as addiction is influenced by psychological factors such as psychosocial stress and depression. The significance of altered brain levels of creatine in drug-exposed individuals and the role of creatine supplementation in models of drug abuse have yet to be explored and represent gaps in the current understanding of brain energetics and addiction.     

Good Psychometric Properties of the Addiction Version of the Revised Illness Perception Questionnaire for Health Care Professionals

BackgroundAddiction, or substance dependence, is nowadays considered a chronic relapsing condition. However, perceptions of addiction vary widely, also among healthcare professionals. Perceptions of addiction are thought to contribute to attitude and stigma towards patients with addiction. However, studies into perceptions of addiction among healthcare professionals are limited and instruments for reliable assessment of their perceptions are lacking. The Illness Perception Questionnaire (IPQ) is widely used to evaluate perceptions of illness. The aim of this study was to evaluate the psychometric properties of the IPQ: factor structure, internal consistency, and discriminant validity, when applied to evaluate healthcare professionals’ perceptions of addiction.MethodsParticipants were 1072 healthcare professionals in training and master students from the Netherlands and Indonesia, recruited from various addiction-training programs. The revised version of the IPQ was adapted to measure perceptions of addiction (IPQ-A). Maximum likelihood method was used to explore the best-fit IPQ factor structure. Internal consistency was evaluated for the final factors. The final factor structure was used to assess discriminant validity of the IPQ, by comparing illness perceptions of addiction between 1) medical students from the Netherlands and Indonesia, 2) medical students psychology students and educational science students from the Netherlands, and 3) participants with different training levels: medical students versus medical doctors.ResultsFactor analysis revealed an eight-factor structure for the perception subscale (demoralization, timeline chronic, consequences, personal control, treatment control, illness coherence, timeline cyclical emotional representations) and a four-factor structure for the attribution subscale (psychological attributions, risk factors, smoking/alcohol, overwork). Internal reliability was acceptable to good. The IPQ-A was able to detect differences in perceptions between healthcare professionals from different cultural and educational background and level of training.ConclusionsThe IPQ-A is a valid and reliable instrument to assess healthcare professionals’ perceptions of addiction.     

Effect of sociobiological factors on the formation of adaptive responses in school students during puberty

Analysis of psychological, social, and psychophysiological mechanisms underlying the formation of adaptive responses during puberty demonstrated a significant dependence of adolescent behavioral, autonomic, and endocrine parameters on sociobiological factors that determine the identification and individualization of genetically determined behavioral programs. Comparison of the adaptive capabilities of students from an innovative educational institution and from a vocational school showed that the levels of completeness of their adaptation were different and depended on social support, typological features, and autonomic regulation.     

Population based study of fatigue and psychological distress.

OBJECTIVES--To determine the prevalence of fatigue in the general population and the factors associated with fatigue. DESIGN--Postal survey. SETTING--Six general practices in southern England. SUBJECTS--31,651 men and women aged 18-45 years registered with the practices. MAIN OUTCOME MEASURES--Responses to the 12 item general health questionnaire and a fatigue questionnaire which included self reported measures of duration, severity, and causes of fatigue. RESULTS--15,283 valid questionnaires were returned, giving a response rate of 48.3%, (64% after adjustment for inaccuracies in the practice registers). 2798 (18.3%) of respondents reported substantial fatigue lasting six months or longer. Fatigue and psychological morbidity were moderately correlated (r = 0.62). Women were more likely to complain of fatigue than men, even after adjustment for psychological distress. The commonest cited reasons for fatigue were psychosocial (40% of patients). Of 2798 patients with excessive tiredness, only 38 (1.4%) attributed this to the chronic fatigue syndrome. CONCLUSION--Fatigue is distributed as a continuous variable in the community and is closely associated with psychological morbidity.     

Genetic addiction: selfish gene's strategy for symbiosis in the genome

The evolution and maintenance of the phenomenon of postsegregational host killing or genetic addiction are paradoxical. In this phenomenon, a gene complex, once established in a genome, programs death of a host cell that has eliminated it. The intact form of the gene complex would survive in other members of the host population. It is controversial as to why these genetic elements are maintained, due to the lethal effects of host killing, or perhaps some other properties are beneficial to the host. We analyzed their population dynamics by analytical methods and computer simulations. Genetic addiction turned out to be advantageous to the gene complex in the presence of a competitor genetic element. The advantage is, however, limited in a population without spatial structure, such as that in a well-mixed liquid culture. In contrast, in a structured habitat, such as the surface of a solid medium, the addiction gene complex can increase in frequency, irrespective of its initial density. Our demonstration that genomes can evolve through acquisition of addiction genes has implications for the general question of how a genome can evolve as a community of potentially selfish genes.