Current Psychiatry Research and Reviews - Volume 19, Issue 1, 2023

Schizophrenia is one of the most common and devastating mental disorders. Due to the possibility of relatively robust control over clinical symptoms, the focus of care for schizophrenia patients has shifted from institutionalized to community-based outpatient treatment options. While this change in paradigm allows affected individuals to socialize and take part in everyday activities, it has also increased the burden on family caregivers. At the same time, the interpretation of self-reported quality of life scores can be challenging due to known influencing factors like changes in internal standards, values, and goals. We present the theory of response shift as an adaptive mechanism that summarizes these complex changes and explains the seemingly contradicting long-term findings regarding quality of life ratings in informal caregivers. This state-of-the-art narrative review was undertaken to give an overview of the most critical factors that negatively impact the quality of life of caregivers and to summarize the current evidence, if any, of the response shifts in nonprofessional family caregivers. To our knowledge it is the first time that response shift and its impact on the quality of life in family caregivers of patients is reviewed in this way.

Background: Oxidative Stress (OS) is a chief contributing factor to the pathological advancement of Schizophrenia (SCZ). In recent years, OS has emerged as an important aspect in SCZ research and provides abundant opportunities and expectations for a better understanding of its pathophysiology, which may lead to novel treatment strategies. Introduction: The increased OS and formation of Reactive Oxygen Species (ROS) leads to damage to cellular macromolecules. The excessive OS is associated with several physiological processes, such as dysfunction of mitochondria and neuroglia, inflammation, underactive Nmethyl- D-aspartate (NMDA) receptors, and the abnormalities of fast-spiking Gamma- Aminobutyric Acid (GABA) interneurons. Methods: The methods adopted for the study are mainly based on the secondary search through a systemic literature review. The role of various anti-oxidants, including vitamins, is discussed in the reduction of SCZ. Results: Various preclinical and clinical studies suggest the involvement of OS and ROS in the progression of the disease. Recent human trials have shown the treatment with antioxidants to be effective in ameliorating symptoms and delaying the progression of SCZ pathology. The studies have demonstrated that innate and dietary antioxidants exert beneficial effects by reducing the severity of Positive Symptoms (PS) and/or Negative Symptoms (NS) of SCZ. Conclusion: The present review critically evaluates the effect of antioxidants and highlights the role of OS in SCZ.

Introduction: Few studies have reported the role of psychosocial risk factors by a validated scale in predicting mental disorders in women with a complicated pregnancy. This study investigated the role of a psychosocial risk assessment tool in the prediction of postnatal depression in women with a complicated pregnancy. Methods: A prospective study was performed on pregnant women with complicated pregnancies from December, 2019, to June, 2020. A total of 125 pregnant women filled the Antenatal Risk Questionnaire (ANRQ), Edinburgh Postnatal Depression Scale (EPDS), and Brief Symptom Inventory 53 items (BSI-53). Also, the patients completed EPDS for 6 weeks postpartum. An expert mental specialist conducted the interviews based on the DSM-5. Results: More than half of the women with complicated pregnancies were diagnosed to have at least one mental disorder. The mean risk scores of ANRQ, including the childhood social support from the respondent’s mother, history of mental illness, perceived level of support available postpartum, significant life events in the past 12 months, and personality traits with high anxiety, were higher in women with mental disorders than those without mental disorders. The results emphasized that the total score of ANRQ was the strongest positive predictor for postnatal depression score of EPDS (β = 0.569, p=<0.001), total score of BSI-53 (β = 0.666 p=<0.001), and GSI (β = 0.237, p=0.019). Conclusion: The study proposes that the use of a validated psychosocial risk assessment tool alongside a psychological screening tool, like EPDS, is reliable for the prediction of mental disorders and help women with complicated pregnancy at risk for the prevention of depression at antenatal visits.

Introduction: COVID-19 pandemic has been associated with increased rates of depression, anxiety, and suicidal ideation. Individuals with mental illnesses are disproportionately affected by additional complex health issues. This study aims to examine the knowledge and impact of COVID-19 among patients with mental disorders at the Harris County Psychiatric Center (HCPC). Methods: A retrospective review of surveys was conducted for patients with mental illness at HCPC. Participants were surveyed on demographics, COVID-19 knowledge, and COVID-19 healthcare impact. The data were analyzed with SPSS 20 for Windows at a 0.05 significance level. Results: A total of 46 patients were included in the study. We found that the patient population with mental disorders has different methods of obtaining information regarding COVID-19 and practices varying safety measures. To be precise, more women (52.2%) than men (21.7%) learned about COVID-19 through family and friends (p=0.032). More Hispanic (21.4%) compared to non-Hispanic (0%) patients learned about COVID-19 through resources from the World Health Organization (WHO) (p=0.032). Fewer African American (AA) patients avoided contact with people who were sick (39% vs. 81%) Caucasian (p=0.01) and (100%) Asian/Native American/Pacific Islander [ANAPI] patients (p=0.04). We found more non- Hispanic (50.0%) vs. Hispanic (7.1%) patients reported that their personal time (time outside of work) was unchanged by COVID-19 (p=0.007). More Hispanic (57.1%) vs. non-Hispanic (17.9%) patients reported increased time with family members (p=0.009). Compared to Hispanic patients, more non-Hispanic patients reported unchanged difficulty scheduling appointments (46.4% vs. 7.1%) (p=0.015), obtaining prescription (71.4% vs. 35.7%) (p=0.045), and finding housing placement (53.6% vs. 21.4%) (p=0.047). Furthermore, more Caucasian compared to AA patients reported more changes in how they feel (35.7% vs. 76.2%) (p=0.033), anxiety (52.6% vs. 0%) (p=0.002), stress (47.4% vs. 7.7%) (p=0.024), and sadness (30% vs. 0%) (p=0.031). Finally, more ANAPI (67%) compared to AA patients (0%) reported increased anxiety (p=0.025). Conclusion: Our findings suggest that African American patients report less knowledge of COVID-19 prevention and less impact on their mental health by the pandemic compared to other racial groups. Our findings suggest that African American patients may have limited knowledge of COVID-19 prevention compared to other races, Caucasian and Asian/Native American/Pacific Islander patients may have increased mood changes, and Hispanic patients may be experiencing more healthcare inequality amidst the pandemic. However, further investigation of the impending ramifications of the pandemic is warranted.

Background: Given the side effect of weight gain in many psychiatric medications, a patient’s body image concerns may influence medication compliance, which can be critical in the psychiatric population. Objective: The aim of this study was to investigate whether demographic factors, including age, race, and BMI, have specific associations with body image satisfaction and medication adherence among women with severe psychiatric disorders. Clinical factors, such as diagnosis and type of current psychiatric medications, were also examined. Methods: Study participants included 112 women aged 18 to 88 who were admitted to a psychiatric inpatient unit in New Orleans, Louisiana. Participants completed a brief questionnaire on body image and medication adherence, specifically developed for this study. Collected data were analyzed using T-tests, analysis of variance, correlations, and multivariable regression analysis to compare differences in body image score and medication adherence score by demographic and clinical factors. Results: Age was associated with significant differences in body image score (F(2, 109) = 5.736, p = 0.004). African American race was associated with higher average BMI (t(39.99) = 3.375, p = 0.002) and self-esteem subscore (t(106) = 2.254, p = 0.026), but not associated with differences in body image score or medication adherence. Regression analysis showed that body image score significantly predicted medication adherence (β = 0.208, p = 0.037). Conclusion: Assessing how a patient feels about their weight while considering the potential differences in demographic groups may facilitate optimal medication selections and communication of treatment plans with psychiatric patients, which has implications in treatment adherence, disease course, and prognosis.

Background: While more than a year has passed since the COVID-19 outbreak, it is still a growing health concern. Moreover, ample consensus exists for the presence of not only a physical but also a psychological impact of the COVID-19 pandemic. Those reported as hardest hit were individuals who had been infected with COVID-19. Survivors have exhibited a higher prevalence of psychological morbidity i.e., PTSD, depression, and anxiety- as compared with the general population and health workers. Additionally, COVID-19 patients and survivors have been psychologically impacted by a staggering number of disease-related stressors. Objective: The study was aimed at analyzing COVID-19's impact on the psychological state of Argentinian disease survivors. Method: Two hundred and ninety-six COVID-19 survivors (67.2% female; Mage = 44.81; SDage = 12.16) from a major Buenos Aires hospital completed a questionnaire and a set of psychological measures - COVID-19 emotional impact, psychological sequelae, disease-related stressors, PTSD, and psychological distress. Results: The most impactful psychological sequelae and disease stressors revolved around having the disease awaiting test results, fear of infecting loved ones, being apart from family and friends during the disease, fear of physical sequelae and symptoms, and returning to isolation. PTSD prevalence rates were 33.8%. Survivor's psychological distress levels were moderately higher than pre-COVID-era general population levels, yet not significantly different from pre- COVID-era clinical inpatients. Female gender, age, and hospital admission emerged as significant predictors of increased adverse psychological outcomes. Conclusion: Intervention for COVID-19 survivors is urgently needed, with particular attention to the alarming PTSD prevalence rates, as discussed in the study.

Background: The COVID-19 pandemic has significantly impacted people's psychological functioning, including how they cope with anxiety. This study aimed to assess the role of coping styles in the relationship between COVID-19 anxiety and Washing Obsessive- Compulsive Disorder (W-OCD) symptoms. Methods: A cross-sectional study was performed on 420 people living in Kashan city (Iran) from March to April, 2020. Participants were selected by the convenience sampling method due to the difficulties brought about by COVID-19 and completed the contamination subscale of the Padua Inventory, COVID-19 anxiety inventory, and coping strategies scale. Data were analyzed by structural equation modeling (SEM) using AMOS- 22. Results: The results revealed that emotion-focused, somatization and social support coping strategies were significantly associated with W-OCD symptoms. Also, there was a significant correlation between COVID-19 anxiety and the W-OCD symptoms. SEM results revealed that emotion-focused and somatization coping strategies positively mediated the relationship between COVID-19 and W-OCD symptoms. Conclusion: Emotion-focused and somatization coping strategies increase W-OCD symptoms following COVID-19 anxiety. Psychoeducation interventions addressing COVID-19's physical and psychological impacts on health, discriminating the rational and adaptive behavior and obsessive and compulsive behaviors, and restricting the information gathering from numerous sources, which may lead to increased negative emotions, might be helpful.

Background: There are few studies in the world on the duration of breastfeeding and the risk of autism. To our knowledge, no study has yet explained the association between breastfeeding duration and ASD in Iran. Aims: The present study evaluated the association between breastfeeding and the risk of ASD in offspring in the west of Iran. Methods: This case-control study was performed on 100 children aged 3-14 years who had a medical record in the Autism Spectrum Disorder Research Center and the Autism Association of Hamadan and were diagnosed with autism according to the Diagnostic and Statistical Manual of mental disorders (DSM-5) criteria. The control group included healthy children who had active family record in comprehensive health service centers. All the analyses were performed using Stata software version 14. The significance level was considered less than 0.05. Results: After adjusting for other variables, each increase in the month of breastfeeding was associated with a 5% decrease in odds of ASD (OR=0.95 (95% CI: 0.91, 0.99), p=0.03). The odds of ASD in boys were significantly higher (OR=3.85 (95% CI: 1.91, 7.76), p<0.001). Moreover, drug use (OR=0.01), history of autism (OR=6.62), and history of psychiatry disorder (OR=7.2) were significantly associated with increased odds of ASD (p<0.05). Conclusion: These findings showed that breastfeeding duration can be a protective factor for ASD. Therefore, policymakers and health staff can reduce the risk of autism by promoting increased breastfeeding duration, especially for children with a high risk for autism.

Background: The use of psychedelic compounds to treat psychiatric disorders has become a very significant topic of research over the past several years. Psilocybin has risen to prominence as one of the most studied among these psychedelic compounds. Multiple trials have already shown that it can be a safe and efficacious treatment for various medical conditions. This study intends to perform a meta-analysis of data reported in clinical trials studying psilocybin’s effect on depression and anxiety. Methods: Articles were searched, screened, and ultimately selected using predetermined inclusion criteria. Data was collected from commonly used psychometric tests that measured mood and anxiety symptoms. Effect sizes were calculated by comparing scores in these tests at baseline and control to experimental groups. Sub-group analysis was performed to assess psilocybin’s effect on depression and anxiety during short, medium, and long-term time frames. Results: Statistical significance was achieved in reducing depression and anxiety symptoms compared to controls in multiple subgroups. Heterogeneity of the effect sizes was calculated using an I2 value which showed low to moderate values. Multiple tools were used to assess publication bias, and none could be found. Conclusion: Although research on psilocybin continues to show promise, the evidence is still at a preliminary phase, and more trials need to be conducted with larger patient populations over longer periods for psilocybin to potentially be approved in a community setting.