The ultra-orthodox (Haredi) Jewish community in Israel adheres to strict observance of religious commandments with regard to separation between the sexes, and demands maximum personal modesty and discretion in all areas related to sexuality. Consequently, many young people find themselves facing a difficult conflict between their natural urges or drives and the restrictions imposed by the religious law (Halacha). In this article, I open a window onto this subject in the hope that the wider therapeutic community will attain a deeper understanding of the suffering and the complex emotional struggles experienced by these young people.
Quetiapine, an atypical antipsychotic with established efficacy in the treatment of schizophrenia, shows efficacy in the treatment of acute mania and depression associated with bipolar disorder. Quetiapine, either as monotherapy or in combination with lithium or divalproex sodium, is generally well tolerated and effective in reducing manic symptoms in adult and adolescent patients with acute bipolar mania, and is approved for use in adults for this indication. As monotherapy, the drug is also effective in reducing depressive symptoms in patients with bipolar depression. It is associated with a low incidence of Extrapyramidal Symptom (EPS)-related adverse events and low EPS ratings in bipolar disorder. Quetiapine thus shows potential in the treatment of bipolar depression, and represents a useful agent for the treatment of acute bipolar mania. But for children and adolescent, quetiapine show no difference to placebo. The both RCT and evidence-based medicine study indicate that quetiapine have no efficacy for children and adolescent bipolar depression.
Introduction: Atopic Dermatitis (AD) is one of the most common inflammatory skin diseases affecting individuals of all ages. It is proposed that intense pruritus, sleep cycle disturbances, stigmatization, and social isolation due to the visual nature of the disease, along with the poor quality of life and the presence of neuroinflammation, contribute to the development of anxiety and depression. According to recent systematic reviews and meta-analyses evaluating the relationship between AD, anxiety, and depression, there is a higher likelihood of developing depression during the disease, predominantly in children and both disorders in adults. However, no Mexican studies have determined the prevalence of anxiety and depression symptoms in children, adolescents, and adults diagnosed with AD. Objective: To determine the prevalence of anxiety and depression symptoms in patients diagnosed with AD. Material and Methods: This is an observational, cross-sectional, and comparative study. We included forty-eight patients who met the inclusion criteria and applied two self-administered screening questionnaires for anxiety and depression symptoms. Results: A prevalence rate of depression symptoms of 4.5% and 16.7% were found in children and adolescents, respectively, and 27.3% and 16.6% for anxiety symptoms, respectively. On the other hand, in the group of adults, the presence of clinically significant symptoms of anxiety and depression was present at 40% and 45%, respectively. Conclusion: It is crucial that allergists evaluate the psycho-emotional sphere in patients with AD with the available screening tools with the aim to identify and refer in a timely manner.
Depression and anxiety are two of the most prevalent mental health disorders worldwide, affecting millions of individuals across various age groups, and social categories. While the origins of these disorders are complex and multifaceted, recent advancements in Neuroscience provide valuable insights into the underlying mechanisms that contribute to the development and maintenance of mood and anxiety disorders. This review delves into the intricate interplay of neurobiological factors involved in these mental disorders, shedding light on the neural pathways, neurotransmitters, and structural/functional circuit changes that contribute to their manifestations. A special focus is given on new and upcoming insights in Neuroscience that emerge from a deeper understanding of the complex interplay of biological and environmental factors that takes place at a multi-scale level, from genes to behaviors.
Background:Opioid Use Disorder (OUD) is an escalating public health problem with over 100,000 drug overdose-related deaths last year most of them related to opioid overdose, yet treatment options remain limited. Non-invasive Vagal Nerve Stimulation (nVNS) can be delivered via the ear or the neck and is a non-medication alternative to treatment of opioid withdrawal and OUD with potentially widespread applications.Methods:This paper reviews the neurobiology of opioid withdrawal and OUD and the emerging literature of nVNS for the application of OUD. Literature databases for Pubmed, Psychinfo, and Medline were queried for these topics for 1982-present.Results:Opioid withdrawal in the context of OUD is associated with activation of peripheral sympathetic and inflammatory systems as well as alterations in central brain regions including anterior cingulate, basal ganglia, and amygdala. NVNS has the potential to reduce sympathetic and inflammatory activation and counter the effects of opioid withdrawal in initial pilot studies. Preliminary studies show that it is potentially effective at acting through sympathetic pathways to reduce the effects of opioid withdrawal, in addition to reducing pain and distress.Conclusions:NVNS shows promise as a non-medication approach to OUD, both in terms of its known effect on neurobiology as well as pilot data showing a reduction in withdrawal symptoms as well as physiological manifestations of opioid withdrawal.
Among matters that occupy the mind of people since early history are fears of the unknown and death that have most likely triggered the need for a patronizing superpower, namely, God. Limited understanding of surrounding wonders, hard survival, and refusal to comply with our relatively short life span have probably prompted this need, which intensified with growing hostility among tribes and rising civilizations fighting over territory, resources and leadership. Although physical power has always been a dominating factor in these human struggles (as is among animals), the developed brain and verbal communication provided an additional powerful tool used by smart individuals and minorities to gain control over ignorant, frightened masses. In convincing the audience about their ability to convey prayers and requests to the ‘heavenly patron’, God, these people (e.g., Shamans, Prophets, Priests, Monks, Rabies, Islamic preachers) have actually constituted a new status, ‘sanctified mediators’, from which the road to establishment of a new religious movement, based on an unusual individual, was paved. To ratify their sacred status, these people cleverly attributed the creation of the world (still an unsolved issue) to God, and formed a virtual reality accompanied by rituals that attracted the masses. They exploited the need of people for a patronizing superpower to constitute a religion that provided ‘answers’ to the rising curiosity, limited scientific knowledge, and spiritual requirements of the masses, but also to gain superiority as well as advance their own abundance and wealth. Not only that people now had a God to lean on, the sanctified mediators further strengthened their status by composing social and religious rules with an entire set of orders (do and don’t do) and worships that included prayers and ceremonies, aiming to please God and obtain his mercy and support. In administrating the worships these mediators utilized the amazing obedience consent of people to satisfy their spiritual needs, and so they took control over the masses.
The daily strive to get to work and back home through traffic congestions; passing the day without conflicts; improving the life style when money is short; overcoming medical problems; raising and securing the family, and tolerating unfulfilled dreams are only a portion of constantly bothering issues. No wonder then that in this chaotic reality and despite various joyful and satisfying moments, the majority of grown-ups claim that they are unhappy. Amazingly, however, there are always those who believe and declare that they are happy, which raises the question what is happiness and what is it constituted from. Google suggests that “Happiness is that feeling that comes over you when you know life is good and you can’t help but smile. It’s the opposite of sadness. Happiness is a sense of well-being, joy, or contentment. When people are successful, or safe, or lucky, they feel happy”. This description combines a number of positive experiences and feelings, that most likely affect our brain to release chemicals recognized as the ‘good guys’, in contrast to the ‘bad guys’, chemicals secreted in situations of sadness, agony, pain, failures, disappointments and frustrations that affect brain circuits associated with unpleasant emotions and thoughts. Although moments of satisfaction, joy and pleasure raise good feelings, these are usually temporary, whereas happiness in its broader essence reflects a positive state of mind based on numerous parameters that collectively raise a long-lasting contentment. When a person claims he is happy, he probably disregards his difficulties and concentrates on a particular issue that makes him feel good (e.g., love, professional success, good health, overcoming a major difficulty, listening to beloved music, winning in sport).
Girls with chronic headache often suffer also from marked anxiety and depression. The present study used psychological and biological characteristics related to stress load and stress coping to predict anxiety and depression. This was done by regression analysis. Anxiety could be better explained than depression. Psychological and physiological stress load played a significant role, but not activity of HPA axis, although cortisol awakening response was heightened specifically for headache sufferers.
At the beginning of 2020, Covid-19 pandemic has deeply and quickly changed healthcare transforming our hospitals and challenging health professionals both as clinicians and humans. We found ourselves fighting an invisible, unknown enemy, facing an unpredictable disease and had no choice but adapting and reacting to an overgrowing emergency situation. Whole hospitals were dedicated to Covid-19 patients and many specialized physicians had to quickly learn about treating Sars-Cov-2 infection. Over the last year better knowledge of pathophysiology and treatment as well as the establishment of redesigned organizational models have contributed to reduce the role of chance, fear and unexpected, but as the pandemic keeps unfolding, healthcare workers are still under pressure. As a result, they are exposed to a high risk of post-traumatic stress disorder as well as burn-out syndrome. As a neurosurgeon working in a Covid-converted hospital and an hypnologist I realized it was my duty to use my skills to help colleagues in need. I started offering hypnosis sessions to help colleagues to stay in-balance and react to this situation in a resilient way. In this letter I underline some features which I find to be peculiar to the Covid-19 pandemic (some of them more relevant to the first waves), describe their consequences on health professionals’ life and suggest the potential role of hypnosis as a tool to promote mental health. • Loss of anchors: entire hospitals or wards have been turned into Covid-dedicated areas, thus requiring professionals to change their daily habits, to quickly learn new skills and to be exposed to a constantly changing situation. The sudden and continuous loss of such anchors is deeply destabilizing. • Change in social engagement: self-quarantine, limiting of social activities, avoidance of close contacts and having to wear disposable equipment partially covering the face impact on the usual way of being socially involved. Paradoxically, family and community can’t offer a safe shelter in a moment of major need. • Identification: before vaccines became available, the high number of health professionals affected by the disease, the unfortunately common unavailability of proper personal protective equipment and the need for a constant monitoring of self health status, often lead to identification with patients or victims. • Lack of control: such a level of uncertainty and lack of knowledge is new to many young doctors who have been raised studying diagnosis and treatment of mostly well-defined and known conditions. • Social media impact: being connected inevitably exposes users to a constant flow of bad or fake news. Besides being a reason to recall a healthier digital lifestyle, this leads to rumination and prevents people from using spare time to fully recover from the fatigue. Carers who asked for hypnosis sessions mainly complained about sleep-related problems, panic attacks, rumination, anxiety and fear (of dying alone, of not being able to make plans for the future, of not being able to reconnect with loved ones, of transmitting the disease to family members or colleagues, of not being able to breathe). The reiteration of such symptoms puts health professionals on the dangerous road to burn-out and eventually PTSD. Hypnosis, as well as all disciplines aimed at improving mental health (mind-body techniques, mindfulness, meditation, yoga, deep relaxation..) may offer help in preventing them. Healthcarers who required hypnosis sessions were invited to join after or before their shift. I treated clinicians and nurses, aged 25-55 yo, mainly female. A short introductory talk was aimed at identifying their perception of the situation and potential topics to work on during the session. Being all the patients highly motivated in feeling better, almost none had difficulties in trance-induction. Sessions had a mean duration of 45-60’ and were held in the hospital facilities. I found the following techniques being particularly useful: • Focus on breathing: being Covid-19 disease mainly a respiratory illness and due to the need to work wearing uncomfortable masks, focus on breathing is crucial. Reconnecting people to their natural breath may help in keeping a healthy connection to the body and preventing panic attacks. • Safe place: visualizing and then anchoring a “safe place” help subjects to realize that they can actively choose to feel better going back to their safe place every time they need it. • Metaphors: the use of subject-tailored metaphors is particularly effective, giving immediate relief as well as working on a longer-lasting deeper level. • Temporal dissociation and retrieving happy memories: in difficult and uncertain times, reestablishing a connection with happy memories and with past achievements helps subjects to discover their own value, be self-confident and get rid of harmful helplessness feeling. • Future reorienting: for all the aforementioned reasons future reorienting techniques may be useful for those people feeling afraid of not being able to look beyond this challenging times All subjects were satisfied with the session, found it helpful and most of them asked to repeat the treatment. I hope this letter may contribute to increase institutions’ awareness on the need for measures aimed at maintaining and supporting mental health of all professionals involved in fighting the ongoing pandemic. Besides, it’s also addressed to professionals as a reminder to promptly identify stress-related red flags and ask for help. Hypnosis is a powerful, effective and safe tool.
Introduction: The incidence of cancer in Sudan, like other world, shows an increasing pattern; consequently, a greater number of people are expected to take the role of principal caregivers in the near future. Hence, it is high time to achieve inclusive knowledge about the outcome of caregiver burden related to the caregiver’s well-being. Materials and Methods: This study is a cross-sectional, observational study aiming to assess psychological distress among the principal family caregivers of cancer patients at oncology public specialized outpatients’ clinics in Khartoum State. Multiple validated and structured questionnaires and a checklist were implemented to collect relevant data related to both cancer patient and family caregiver. Systematic random sample was applied to recruit 143 of cancer patients’ caregivers. Results: Majority of cancer patients were females 56.6% and 32.2% were in the age group (51-65) years. Breast cancer and leukemia were the most frequent types of cancer among participants, with 11.9% each. Regarding family caregiver most of them were females 54.5% with average age was (37.7) years. About half of them were the cancer patient’s child descendants. Concerning psychological distress among family caregivers, depression and anxiety were reported by (53.8%) and (72.7%), respectively. Psychological distress is more prevalent among caregivers with subsequent characteristics: females, younger and middle age, and lower economic status. Conclusion: Findings point to high proportions of elevated psychological distress, among family caregivers of cancer patients. Further, longitudinal studies with qualitative dimensions are recommended. Multidisciplinary arrangements are necessary to meet caregivers’ needs.
Background: Strong evidence suggests that suicide attempters who repeat suicide (re-attempters) may differ from those with a single attempt (single attempters) in various clinical and sociodemographic factors. Furthermore, there is some evidence that re-attempters may be characterized by higher levels of neuroticism, a well-known risk factor for completed suicide compared to single attempters. Purpose: The aim of the present study was to investigate the possible association between neuroticism and re-attempted suicide. Methods and Materials: 230 recent drug-free suicide attempters were involved into the study. Clinical diagnoses were assessed by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R). Personality traits were measured by the Karolinska Scale of Personality (KSP). Results and Conclusions: There was a significant association between re-attempted suicide, female gender, personality disorder and higher levels of impulsivity. We found that re-attempters had significantly higher levels of neuroticism compared to single attempters adjusted of gender, personality disorder diagnosis, age and impulsivity. Our result gives further evidence for the association between re-attempted suicide and neuroticism.
Web-based conversational agents powered by Artificial Intelligence (AI) and rooted in cognitive-behavioral therapy have been proven efficacious in alleviating the symptoms of anxiety and depression, when compared to passive controls. However, the benefits of a fully automated agent vs. active controls have not yet been examined. Furthermore, the potential impact of such interventions on the transdiagnostic factors underlying anxiety and depression is not known. To elucidate this, 95 adults were randomized to receive (1) a 2-week intervention with an AI-powered chatbot (Woebot) (n=39) or (2) regular psychoeducational materials (n=54). In completers’ analyses, significant main effects of time were obtained for one of the primary outcomes, anxiety, and for the secondary outcomes, transdiagnostic factors, with both groups showing decreased anxiety and intolerance of uncertainty and increased rumination, selfcompassion, guilt and shame. No group by time interaction effects were found for either of the primary outcomes, depression and anxiety, or for the secondary outcomes. Intent-to-Treat analyses also revealed no significant effects of group on the primary or secondary outcomes. Our findings point to the necessity of further research to better understand the areas where chatbots might bring benefits superior to those obtained through simple and inexpensive strategies.
According to the World Health Organization (WHO), mental health is defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (World Health Organization 2018). A human being is not a human being without considering both their physical and mental health. Society has bred a stigma encompassing mental illness, prompting numerous individuals to feel as though a conversation about psychological well-being is unusual or unorthodox. The COVID-19 pandemic has witnessed an escalation in mental illness especially in the young adult population (ages 11-24), as a result of social isolation and decreased faceto- face connection with others. The adolescent and young adult population is vulnerable to mental health issues and is being cultivated in a society where conversations are not held. This study will evaluate the implementation of mental health literacy curriculums into several school systems, as mental health promotion should be mainstreamed to mitigate the potential growth of stigma in the future.
Systemic Lupus Erythematosus (SLE) is a chronic, relapsing, and remitting systemic disease. Autoimmunity and protean clinical manifestations affecting almost all the systems are the hallmarks of SLE. Systemic lupus can affect the central nervous system. The severity of CNS manifestations varies from less severe subclinical neurocognitive dysfunction affecting memory, intellect, and learning to more severe manifestations such as seizure, stroke, or transverse myelitis [1]. The psychotic features of primary psychiatric disorders overlap with Neuropsychiatric SLE (NPSLE) and often mask and delay the diagnosis of NPSLE.
Background: Limited knowledge exists on the role of Perceived Discrimination (PD) as a social determinant and risk factor that influences children’s brain development and whether this association is different for male and female children. Aim: To examine the association between PD, the superior frontal cortex, and sex differences in a national sample of 9/10-year-old children in the US. Methods: This cross-sectional study included 8,719 children from the Adolescent Brain Cognitive Development (ABCD) study. The exposure variable was PD, and the outcome variables were the right and left superior frontal cortex surface areas, measured using structural MRIs. Covariates included: age, family structure, parental education, household income, stressful life events, financial stress, neighborhood poverty, and neighborhood toxins/pollutants (lead, PM2.5, and NO2). We used a mixed-effect regression model for data analysis to adjust to the nested nature of the ABCD data. Results: There was an inverse association between PD and superior frontal cortex surface area in children. We found a statistically significant interaction between PD and the superior frontal cortex, indicating a more prominent inverse association between PD and superior frontal cortex surface area in males than females. Similar findings were observed for the right and left hemispheres. Conclusion: High levels of PD may be a more salient determinant of superior frontal cortex surface area for male than female children. Sex may alter the relevance of high PD for the brain development of US children. More research is needed on the mechanism by which sex differences emerge in the association between PD and brain development.
Background: Depression stigma is a clinically relevant factor negatively affecting the help-seeking process and depression care. Relatives of individuals suffering from depression play an important role in service utilization and in depression treatment, but little is known about their depression stigma compared to the stigma of individuals affected. Aims: We investigated whether individuals with depression, relatives and individuals being both - affected and relative - differ in depression stigma. Methods: Paper-pencil questionnaire data of 216 study participants from a German depression congress in 2017 were analyzed using Kruskal-Wallis tests to investigate subgroup differences and Mann-Whitney-U tests for post-hoc comparisons. Ordinal logistic generalized regression models with the dependent variables being the stigma sum scores and the independent variables “group”, “gender” and “age” were computed. Results: Participants being a relative of an individual with depression, being affected by depression or being both - relative and affected - reported comparable personal and perceived depression stigma. There was a statistical trend for group differences in personal stigma in the total sample, due to significantly lower personal stigma in male participants being affected by depression compared to male participants having a family member affected. Conclusions: Relatives of individuals with depression appear to have similar stigmatizing attitudes as affected individuals themselves. Potential differences in personal stigma in male relatives compared to male patients require further research, since they have implications for anti-stigma activities as well as for depression care.
Objectives: Older primiparas are more likely to be at risk for physical and mental health problems. The purpose of this study is to develop and evaluate a program to understand the physical and mental health of older primiparas and strengthen their marital relationship. Design: A semi-experimental study of one group without control groups. Method: Participants included 15 older primiparas Japanese couples who attended regular childbirth and childcare preparation classes held at two maternity hospitals in Japan. Participants responded to sociodemographic questions, Edinburgh Postnatal Depression Scale (EPDS), questions regarding understanding, satisfaction, and utilization of the program (process evaluation), and the Quality Marriage Index (QMI; outcome evaluation). Data was collected before the pregnancy program and one and three months after childbirth. Results: Participants understood and were satisfied with the information provided in the program. There was no significant decrease in postpartum marital satisfaction after participating in the program. However, the usefulness assessment of the pregnancy program dropped to about 80% at one and three months after childbirth. Conclusions: Findings indicate that this program improves mutual understanding and sharing of thoughts and feelings between couples. It was suggested that a postnatal program be held so that the couple could continue learning after childbirth.
Anxiety is an unpleasant state of inner turmoil which causes nervous behavior like fear, apprehension and worries.Vernonia amygdalina commonly called bitter leaf, belongs to the family Astaraceae, and has been reported to be used locally in the management of psychiatric disorders.However, no work has been reported on pharmacological potentials of Vernonia amygdalina on anxiety in male rats.This study was therefore designed to investigate the effect of Vernonia amygdalina (VA) on anxiety status in male rats.The air-dried leaves of Vernonia amygdalina (VA) pulverized and macerated in methanol for 72 hours.The methanol was filtered with cotton wool and filter paper and concentrated using rotary evaporator at 40ºC and further concentrated in a vacuum oven at temperature of 40ºC and pressure of 600mmHg.The anxiolytic-like effect of VA was investigated using the Open Field Test (OPF), Hole-board apparatus and Y-maze apparatus.The results obtained were expressed as mean ± S.E.M. Data were analyzed using Oneway Analysis of Variance (ANOVA), followed by Newman-Keuls' multiple comparisons test P<0.05.Vernonia amygdalina showed anxiolytic-like effect in rat, 50 mg/kg were significantly different from control in open field test, hole board test.In conclusion, this study has shown that methanol extract Vernonia amygdalina possess anxiolytic-like effects in male rats.
Suicide and attempts to end your life are not rare occurrences.Depression and anxiety are often a precursor of suicidal intentions.Public concern initiated the establishment of a special centre for suicide prevention in 1996 in Norway.Mortality statistics were collected for self-harm in the period 1970 to 2016.Reduction in the suicide rate was not observed.The established compulsory risk assessment tools used in psychiatric facilities did neither contribute to a reduction in suicidal acts in the population.
The application of tVNS plus Brain Entrainment is expected to rapidly reduce the sympathetic activity and increase the parasympathetic activity.In this study, analysis of the system by a complete poligraphy consisting of HR, GSR and EEG demonstrated that a combined stimulus of supplement Cream + tVNS + Brain Entrainment and light blocking was able to produce a dominant parasympathetic state mixed to a drastic reduction of sympathetic activity in cases of depression, anxiety and stress.
