Search

BackgroundThere is currently no undisputed, validated, clinically meaningful measure for deficits in the broad spectrum of PSP phenotypes.ObjectiveTo develop a scale to monitor clinical deficits in patients with PSP across its broad phenotypes.MethodsThe Progressive Supranuclear Palsy Clinical Deficits Scale was conceptualized to cover seven clinical domains (Akinesia-rigidity, Bradyphrenia, Communication, Dysphagia, Eye movements, Finger dexterity, and Gait & balance), each scored from 0 to 3 (no, mild, moderate, or severe deficits). User guidelines were developed to standardize its application. Progressive Supranuclear Palsy Clinical Deficits Scale scores were collected in patients fulfilling the MDS-PSP diagnostic criteria in two independent, multicenter, observational studies, both cross-sectionally (exploratory DescribePSP cohort; confirmatory ProPSP cohort) and longitudinally (12-months' follow-up, both cohorts).ResultsCognitive pretesting demonstrated easy scale utility. In total, 164 patients were scored (70.4 ± 7.6 years; 62% males, 35% variant phenotypes). Mean Progressive Supranuclear Palsy Clinical Deficits Scale completion time was 4 minutes. The Progressive Supranuclear Palsy Clinical Deficits Scale total score correlated with existing scales (e.g., Progressive Supranuclear Palsy Rating Scale: R = 0.88; P

Vaccines against COVID-19 and influenza are highly recommended for the chronically ill. They often suffer from co-morbid mental health issues. This cross-sectional observational study analyzes the associations between depression (PHQ-9) and anxiety (OASIS) with vaccination readiness (5C) against COVID-19 and influenza in chronically ill adults in primary care in Germany. Sociodemographic data, social activity (LSNS), patient activation measure (PAM), and the doctor/patient relationship (PRA) are examined as well. Descriptive statistics and linear mixed-effects regression models are calculated. We compare data from n = 795 study participants. The symptoms of depression are negatively associated with confidence in COVID-19 vaccines (p = 0.010) and positively associated with constraints to get vaccinated against COVID-19 (p = 0.041). There are no significant associations between symptoms of depression and vaccination readiness against influenza. Self-reported symptoms of a generalized anxiety disorder seem not to be associated with vaccination readiness. To address confidence in COVID-19 vaccines among the chronically ill, targeted educational interventions should be elaborated to consider mental health issues like depression. As general practitioners play a key role in the development of a good doctor/patient relationship, they should be trained in patient-centered communication. Furthermore, a standardized implementation of digital vaccination management systems might improve immunization rates in primary care. [ABSTRACT FROM AUTHOR]

Summary: Symptoms of insomnia are an important risk factor for the development of mental disorders, especially during stressful life periods such as the coronavirus disease 2019 (COVID‐19) pandemic. However, up to now, most studies have used cross‐sectional data, and the prolonged impact of insomnia symptoms during the pandemic on later mental health remains unclear. Therefore, we investigated insomnia symptoms as a predictor of other aspects of mental health across 6 months, with altogether seven assessments (every 30 days, t0–t6), in a community sample (N = 166–267). Results showed no mean‐level increase of insomnia symptoms and/or deterioration of mental health between baseline assessment (t0) and the 6‐ month follow‐up (t6). As preregistered, higher insomnia symptoms (between persons) across all time points predicted reduced mental health at the 6‐month follow‐up. Interestingly, contrary to our hypothesis, higher insomnia symptoms at 1 month, within each person (i.e., compared to that person's symptoms at other time points), predicted improved rather than reduced aspects of mental health 1 month later. Hence, we replicated the predictive effect of averagely increased insomnia symptoms on impaired later mental health during the COVID‐19 pandemic. However, we were surprised that increased insomnia symptoms at 1 month predicted aspects of improved mental health 1 month later. This unexpected effect might be specific for our study population and a consequence of our study design. Overall, increased insomnia symptoms may have served as a signal to engage in, and successfully implement, targeted countermeasures, which led to better short‐term mental health in this healthy sample. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate a newly developed brief, cost-effective, flexible, and broadly accessible online programme designed to enhance employee well-being. Considering the demands of the working world, the development of the positive intervention (PI) programme was based on empirical findings and latest theoretical advances from the field of positive psychology, namely the PERMA model of well-being. The new PERMA-based programme’s effectiveness to increase employee well-being was evaluated with a longitudinal field experiment, including a wait list control group and an already established PI programme (i.e., gratitude programme) for comparison (three-armed randomized controlled trial;n = 303,Nmale = 99,Nfemale = 203,Mage = 41.16, SD = 12.26). Repeated measures analyses of variance (ANOVAs) supported that on average, participants of the gratitude programme and the PERMA-based programme reported significant increases in employee well-being after the intervention, as compared to no increases in the wait list control group. The significant increases yielded small effect sizes for general subjective well-being and medium effect sizes for work-related subjective well-being.Post-hocanalyses controlling for baseline well-being also supported the efficacy of the PIs. Contrary to the prediction of the PERMA-based programme’s superiority, participants of both online PI programmes reported similar gains in employee well-being components. Practical implications, limitations, and future research are discussed. [ABSTRACT FROM PUBLISHER]

Background: Cognitive models of obsessive-compulsive disorder suggest that changes in obsessive beliefs are a key mechanism of treatments for obsessive-compulsive disorder. Thus, in the present process-outcome study, we tested whether changes in obsessive beliefs during a primarily cognitive behavioral inpatient treatment predicted treatment outcome and whether these changes mediated symptom changes over the course of treatment. Methods: Seventy-one consecutively admitted inpatients with obsessive-compulsive disorder were assessed with the Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire at treatment intake, after six weeks of treatment and at discharge, and with the Beck-Depression-Inventory-II at intake and discharge. Results: Changes in obsessive beliefs during the first six weeks of treatment predicted obsessive-compulsive symptoms at discharge when controlling for obsessive-compulsive and depressive symptoms at intake in a hierarchical regression analysis. Multilevel mediation analyses showed that reductions in obsessive beliefs partially mediated improvements in obsessive-compulsive symptoms over time. Conclusions: Our findings indicate that decreasing obsessive beliefs in inpatient cognitive behavioral therapy for obsessive-compulsive disorder might be a promising treatment approach. [ABSTRACT FROM AUTHOR]

Background: Cancer-related cognitive dysfunction has mostly been attributed to chemotherapy; this explanation, however, fails to account for cognitive dysfunction observed in chemotherapy-naïve patients. In a controlled, longitudinal, multisite study, we tested the hypothesis that cognitive function in breast cancer patients is affected by cancer-related post-traumatic stress., Methods: Newly diagnosed breast cancer patients and healthy control subjects, age 65 or younger, underwent three assessments within one year, including paper-and-pencil and computerized neuropsychological tests, clinical diagnostics of post-traumatic stress disorder (PTSD), and self-reported cognitive function. Analysis of variance was used to compare three groups of participants-patients who did or did not receive chemotherapy and healthy control subjects-on age- and education-corrected cognitive performance and cognitive change. Differences that were statistically significant after correction for false discovery rate were investigated with linear mixed-effects models and mediation models. All statistical tests were two-sided., Results: Of 226 participants (166 patients and 60 control subjects), 206 completed all assessment sessions (attrition: 8.8%). Patients demonstrated overall cognitive decline (group*time effect on composite z -score: -0.13, P = .04) and scored consistently worse on Go/Nogo errors. The latter effect was mediated by PTSD symptoms (mediation effect: B = 0.15, 95% confidence interval = 0.02 to 0.38). Only chemotherapy patients showed declined reaction time on a computerized alertness test. Overall cognitive performance correlated with self-reported cognitive problems at one year ( T = -0.11, P = .02)., Conclusions: Largely irrespective of chemotherapy, breast cancer patients may encounter very subtle cognitive dysfunction, part of which is mediated by cancer-related post-traumatic stress. Further factors other than treatment side effects remain to be investigated., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)