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Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder. Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment. Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression. Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure. Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the e

The aim of study is to examine patient emotional cues to oncologists’ responses and explore the association between the concerns and emotional cues during the consultation and the physicians’ response to them throughout treatment, satisfaction, and the assessment of the patients’ perception of the established communication. Cross-sectional design, involved 12 adults patients undergoing cancer treatment and eight physicians in the study. The twelve video-recorded medical consultations werecoded (349 cues/concern) using the Verona coding definitions of emotional sequences (VR-CoDES). A strong association between explicit with reducing space responses and the physiological symptoms cues (x²=6.029; p=0.014), and related to the repetition cue of the content by the patient (x²=5.599; p=0.018) was observed. Patients expressed fewer non-verbal behaviors (for example, crying, silence, silent pauses), as they had been undergoing treatment for a longer time, therefore, provided with more empathic responses from physicians. The identification of emotions can help physicians to further explore patients’ underlying cues that reveal emotional distress concerning illness and treatment in a less explicit way. There is a need for improvement in the physician’s ability to recognize patients’ concerns and to provide space for patients to have comprehensive health care, considering the severity of cancer disease and its negative emotional impacts for patients., El objetivo de este estudio es examinar cómo los oncólogos responden a las preocupaciones emocionales de las personas con cáncer durante el tratamiento, relacionarlas con la satisfacción y evaluar las percepciones de comunicación de los pacientes. Diseño transversal, en el que participaron 12 pacientes adultos en tratamiento oncológico y ocho médicos en el estudio. Las doce consultas médicas grabadas en vídeo se codificaron (349 pistas/inquietudes) utilizando las definiciones de codificación de secuencias emocionales de Verona (VR-CoDES). Hubo fuerte asociación entre respuestas explícitas con reducción de espacio y claves de síntomas fisiológicos (x²=6,029; p=0,014), y relacionada con la repetición de claves de contenido por parte del paciente (x²=5,599; p=0,018). Los pacientes expresaron menos comportamientos no verbales (por ejemplo, llanto, silencio, pausas silenciosas) ya que habían estado en tratamiento por más tiempo y, por lo tanto, tenían respuestas más empáticas por parte de los médicos. La identificación de las emociones puede ayudar a los médicos a explorar más a fondo las pistas subyacentes de los pacientes que revelan angustia emocional por la enfermedad y el tratamiento de una manera menos abierta. Existe la necesidad de mejorar la capacidad del médico para reconocer las preocupaciones de los pacientes y hacer espacio para que los pacientes tengan una atención integral en salud, considerando la gravedad de la enfermedad oncológica y sus impactos emocionales negativos para los pacientes.

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3-7 times a week (vs. no contact), and digital social contact less than once a week or 1-7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help id

Background The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder.Objective This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions We identified stressors, risk, and protective factors that may help identify individuals a

Juvenile systemic lupus erythematosus (JSLE) is diagnosed in children younger than 18 years of age. Depression and anxiety are common, but not well understood in JSLE. We investigated the clinical and psychological factors associated with the psychological manifestations of JSLE. Twenty-nine JSLE patients were recruited for the study. Patients completed surveys evaluating their psychological status and perceptions about their health. Medical records were used to obtain laboratory results. The JSLE patient population was compared with adult-onset SLE (ASLE) patients and unaffected controls. Kidney involvement was associated with depression in the JSLE patients. The BUN levels, BUN/creatinine ratio, and leukocyturia were all significantly associated with depressive symptoms. Multivariate analysis found that the BUN/creatinine ratio was the most predictive value for both depression and anxiety. Depressive symptoms in JSLE were less pronounced than in ASLE, although anxiety was not different. Age and education are likely to be protective against depression in the JSLE patients. These findings may indicate that symptomatology is an important indicator of whether the patient needs psychiatric care.