Psychiatry Int., Volume 3, Issue 4 (December 2022) – 11 articles

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition impacting children and adults. Current treatments are limited and there is increasing interest in the use of mindfulness, which is growing in popularity. Previous systematic reviews have typically focused on specific ages, outcome measures or interventions. The current review aimed to take a more comprehensive approach. Title and abstract searches were performed in five databases for randomized and non-randomized controlled trials or pre-post studies with participants with an ADHD diagnosis or a score above a clinically relevant cut-off on a validated ADHD measure. Studies had to measure symptoms of ADHD, global or social functioning. Extraction of key information including participant status (i.e., diagnosis, scale scores, comorbidities, medication use), study design, and outcome measures was conducted. Effect sizes (Hedge’s g) were calculated and where a measure had been used in at least three studies with the same population, meta-analyses were considered. Twenty-nine studies were initially identified, with seven deemed poor quality and removed from further analysis leaving, 22 studies containing data from 1237 children and adults with ADHD along with data from 525 family members. The data indicate possible benefits of mindfulness on self-compassion, quality of life, wellbeing, depression, and anxiety. The findings also suggest that mindfulness may also improve ADHD symptoms, executive function, problematic behaviours, and emotional dysregulation, although results vary by age of patient and measures used. Parent stress and parenting style have received limited attention, highlighting the need for more studies in these areas. Whilst the data presented suggest that mindfulness may be beneficial, the evidence base is not as strong as the popularity of the approach. Many of the studies lacked blind assessment, adequate randomization, or suitable control conditions. As such high-quality controlled studies considering medication, other psychosocial interventions, use of active and in active controls and comorbidity as well as longer follow-up periods, are needed to confirm this. Full article

Is war evitable? Besides being a question to which humanity is struggling to answer, it is the title of the letter exchange between Freud and Einstein that inspired this editorial. The aim is to address this question and analyse whether there is a pattern behind some historical events and mass behaviour, starting with Freud and ending with the possibility of applying chaos theory. What has been hypothesized for centuries is that the masses behave in a manner that can overcome the individual’s interest but are subject to the same risks and patterns as the individual is, i.e., hypernarcissism that fuels the vicious circle of victims and executioners. Is there a reason why historical memory does not stop humankind from pursuing war? Is there an intrinsic death drive that fuels man against one another, or are there other, more complex reasons why war could be (or could not be) inevitable? Full article

Workplaces can be associated with occupational stress, detrimental consequences in terms of loss of health and reduced psychosocial well-being. Importantly, employees may be particularly at risk of poorer well-being during times of adversity at work, when not able to apply adaptive coping strategies and adopt a more empathetic approach. This study aimed to develop a scale to estimate occupational stress both in terms of situational and individual components, by performing item selection, internal reliability assessment, and investigation of the ceiling/floor effect. The target population consisted of veterinarians (n = 116), based on evidence of high risk of occupational stress and related mental distress. Out of twenty initial candidate entries, exploratory factor analysis retained fifteen items consisting of three domains related to occupational stress, copying strategies, and empathy (SCOPE). The SCOPE scale demonstrated good internal consistency as a whole (Cronbach’s alpha = 0.79) and when considering the three subscales (stress, 0.85; coping, 0.77; and empathy, 0.71). On a possible range from 15 (worst adjustment) to 75 (best adjustment), the sample mean performance was 51.68 (SD, 8.50). Preliminary evidence indicated that the SCOPE questionnaire may reveal differential effects of type of work on levels of occupational stress and related coping and empathy skills. Full article

Anxiety sensitivity social concerns (ASSC), or the fear of observable anxiety symptoms, is a risk factor for social anxiety. ASSC predicts anxiety following the niacin biological challenge, a paradigm in which niacin is used to manipulate facial flushing during a speech task. However, it remains unclear if ASSC predicts physiological arousal during this task. The current study was designed to examine the effects of ASSC on self-reported distress and electrodermal activity (EDA) during the niacin biological challenge in a sample of undergraduates (N = 36; M age = 18.9, SD = 0.84; 69.4% female). Participants were randomly assigned to one of four conditions in a 2 (100 mg niacin vs. 100 mg sugar) × 2 (instructional set) design. Participants completed a speech task in a virtual reality environment. Participants rated their distress halfway through the speech and EDA was averaged over four intervals. There was a main effect for ASSC on subjective distress. There was a significant ASSC by condition interaction predicting EDA, in that ASSC was related to EDA only in the niacin condition. ASSC also was more strongly related to EDA anticipating the speech. These findings highlight the role of ASSC in predicting anxiety and physiological arousal. Full article

Catatonia is a clinical syndrome characterized by a distinct constellation of psychomotor disturbances. It is known as a clinical manifestation of many medical and psychiatric conditions. Neuroglycopenia is a term that refers to a shortage of glucose in the brain resulting in the alteration of neuronal function. Catatonia has been observed in hypoglycemic states. We present a single case report of a 36-year-old male, with no known medical or psychiatric history, presenting with catatonia and hypoglycemia due to malnutrition. Catatonia and hypoglycemia may present similarly, and can present a challenge in differentiating the underlying etiology. It is unclear whether the hypoglycemia-catatonia overlap phenomenon is rare or rather underdiagnosed. Full article

Electroconvulsive therapy (ECT) is important in the management of severe, treatment-resistant, and life-threatening psychiatric illness. Anesthesia supports the clinical efficacy and tolerability of ECT. The COVID-19 pandemic has significantly disrupted ECT services, including anesthesia. This study documents strategies for managing ECT anesthesia during the pandemic. Data were collected between March and November 2021, using a mixed-methods, cross-sectional, electronic survey. Clinical directors in ECT services, their delegates, and anesthetists worldwide participated. One hundred and twelve participants provided quantitative responses to the survey. Of these, 23.4% were anesthetists, and the remainder were ECT clinical directors. Most participants were from Australia, New Zealand, North America, and Europe. Most were located in a public hospital, in a metropolitan region, and in a ‘medium/high-risk’ COVID-19 hotspot. Half of the participants reported their services made changes to ECT anesthetic technique during the pandemic. Services introduced strategies associated with anesthetic induction, ventilation, use of laryngeal mask airways, staffing, medications, plastic barriers to separate staff from patients, and the location of extubation and recovery. This is the first multi-national, mixed-methods study to investigate ECT anesthesia practices during the COVID-19 pandemic. The results are vital to inform practice during the next waves of COVID-19 infection, ensuring patients continue to receive ECT. Full article

Individuals with an excessive use of social media may be frequently exposed to stimuli, such as (fake) news or images of violence, which might lead to a higher fear of war. Therefore, the objective of this study is to examine the association between a social media addiction and fear of war (conventional war and nuclear war) in Germany. Data were taken from a nationally representative survey with n = 3091 participants (18 to 74 years; data collection in mid-March 2022). Social media addiction was quantified using the validated Bergen Social Media Addiction Scale. Moreover, established items were used to quantify a fear of war. Medium differences (in terms of Cohen’s d) were identified regarding the fear of war between individuals without a social media addiction and individuals with a social media addiction. Adjusting for several covariates, the regressions revealed that individuals with a social media addiction had a higher fear of war compared to individuals without a social media addiction (fear of a conventional war: β = 0.44, p < 0.01; fear of a nuclear war: β = 0.61, p < 0.001). In conclusion, our study demonstrated an association between a social media addiction and fear of war. Full article

Objectives: This study aimed to understand if the emotional resource group (ERG), a transdiagnostic group intervention, significantly improved emotion regulation (ER) in the short and long term. Methods: Participants completed pre- and post-measures of emotional regulation, psychological distress, wellbeing, self-efficacy and confidence in managing mental health problems. Measures were repeated at three and six months post intervention. 14 participants completed a qualitative interview. Results: ER ability and secondary measures improved following the intervention, but the improvement was not maintained over the three and six month follow-up period. From the themes identified through thematic analysis, the ERG was part of a wider process of learning and change for most participants. Participants described changes in awareness, and implementation of new skills to manage their emotional difficulties. Conclusion: Overall the ERG was a positive experience for most participants, providing improvements in ER and other aspects of mental health. However, it is unclear if these improvements are sustained in the longer term. There may be many reasons for this, including fidelity to the ERG model and the short-term nature of the group. The ERG should be considered an option for participants with ER difficulties and further intervention should be offered when the ERG ends. Full article

Psychosis is a clinical syndrome that can cause significant distress leading to hospitalisation/long term stays in psychiatric services. However, limited academic evidence is available examining the lived experience of psychosis. Additionally, no evidence is available looking to combine both learned and experiential knowledge as it pertains to psychosis. As such this article was created to combine both knowledge subsets in order to provide a more complete interpretation of the syndrome itself. This was achieved through academic input from a psychiatrist’s perspective as well as a reflective, autoethnographic input from a service user who has experienced psychosis. Following this collaboration, several recommendations were made to support health professionals to engage appropriately with service users with psychosis. However, the lived experiences of psychosis itself requires further investigation to identify commonalities in experiences that can support clinicians in the diagnosis and co-production of treatment regimens for these service users. Full article

Affective states play a role in dietary behaviors. Yet, little research has studied within-subjects associations between affect and diet during pregnancy. We examined the acute bidirectional relationships between affect and food intake and moderation by pre-pregnancy body mass index (BMI) in low-income, Hispanic pregnant women using ecological momentary assessment (EMA). Women (N = 57) completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Higher positive affect (PA) or lower negative affect (NA) predicted greater likelihood of fruit/vegetable consumption in the next two hours in women with lower pre-pregnancy BMI and lower likelihood in women with higher pre-pregnancy BMI. Higher PA predicted less likelihood of fast food consumption in the next two hours in women with lower pre-pregnancy BMI and slightly higher likelihood in women with higher pre-pregnancy BMI. Women with lower pre-pregnancy BMI had higher PA when they reported consuming chips/fries in the past two hours, and women with higher pre-pregnancy BMI had lower PA when they reported consumption of chips/fries in the past two hours. Results showed differential relationships between affect and food intake as a function of pre-pregnancy BMI. Full article

This study aimed to investigate the prevalence and characteristics of geriatric neurosurgical conditions in the Neurosurgical Department at Khoula Hospital (KH), Muscat, Sultanate of Oman. The majority of various neurosurgical conditions is increasing in elderly patients, which leads to an increase in neurosurgical demand. The aging population has a direct effect on hospital decision-making in neurosurgery. However, limited data are available to assess geriatric neurosurgery in developing countries. A retrospective chart review of geriatric cases admitted to the Neurosurgery Department in KH served as our example of a neurosurgical center in a high-income developing country from January 2016 to 31st December 2019. Patients’ demographics, risk factors, diagnosis, Glasgow Coma Scale on arrival, treatment types, and length of stay were recorded. A total of 669 patients who were above the age of 65 years were recruited into our retrospective review. The mean age was 73.34 years in the overall cohort and the male-to-female ratio was (1.6:1). The most common diagnostic category was trauma, which accounted for 35.4% followed by oncology and vascular (16.3% each). Hydrocephalus accounted for 3.7% of the admissions. Most of the patients underwent surgical interventions (73.1%). The associations were significant between the treatment types (surgical vs. conservative), Length of Stay, and the GCS on arrival (p < 0.05). In conclusion, the trend of geriatric neurosurgery is increasing in developing countries. The most common reason for admission to the neurosurgical ward was Traumatic Brain Injury. Special care must be taken when dealing with geriatric neurosurgical cases and a more holistic approach is needed. Full article