Principal Component Analysis of the Social and Behavioral Rhythms Scale in elderly

Background: Changes in social and behavioral rhythms (SBR) in elderly are related to health status. Nevertheless, there is no data on factor analysis of the Brief Social Rhythm Scale (BSRS) an internationally well-known tool in this field. The aim was to analyze, in elderly, the factorial structure of the Italian version of BSRS.Design and Methods: Principal Component Analysis of the BSRS carried out in elderly living at home.Results: Sample of 141 participants (83 Females, 58,9%), aged 72.3±4.8. All the items of the questionnaire were related and could compose a single factor, explaining 56% of variance. A solution adopting two factors, the first (including items 1,2,3,4,9,10), the second (including items 5,6,7,8), covered cumulatively 78.8% of the variance.Conclusion: The study confirms that the BSRS is consistent with the idea for which it was built and can be useful for the study of regularity of SBR in old adults.

Functional and Mood Outcomes in Bipolar Disorder Patients With and Without Substance Use Disorders Undergoing Psychotherapy

Objectives: Research suggests that patients with co-morbid bipolar disorder (BD) and substance use disorder (SUD) have a poorer illness course and clinical outcome. The evidence is limited as SUD patients are often excluded from BD studies. In particular, evidence regarding long term outcomes from studies using psychotherapies as an adjunctive treatment is limited. We therefore examined data from two studies of Interpersonal Social Rhythm Therapy (IPSRT) for BD to determine whether lifetime or current SUD affected outcomes.Methods: Data were analyzed from two previous clinical trials of IPSRT for BD patients. Change in scores on the Social Adjustment Scale (SAS) from 0 to 78 weeks and cumulative mood scores from 0 to 78 weeks, measured using the Life Interval Follow-Up Evaluation (LIFE), were analyzed.Results: Of 122 patients (non-SUD n = 67, lifetime SUD but no current n = 43, current SUD n = 12), 79 received IPSRT and 43 received a comparison therapy—specialist supportive care—over 18 months. Lifetime SUD had a significant negative effect on change in SAS score but not LIFE score. There was no effect of current SUD on either change in score. Secondary analysis showed no correlation between symptom count and change in SAS total score or LIFE score.Conclusion: Current SUD has no impact on mood or functional outcomes, however, current SUD numbers were small, limiting conclusions. Lifetime SUD appears to be associated with impaired functional outcomes from psychotherapy. There is limited research on co-morbid BD and SUD patients undergoing psychotherapy.

Effectiveness of Interpersonal and Social Rhythm Therapy (IPSRT) With and Without Computer-based Cognitive Rehabilitation Therapy (CRT) in Promoting Emotion Dysregulation and Response Inhibition in Methamphetamine Abusers

Background: Despite extensive evidence on cognitive deficits and difficulty in emotion regulation related to substance abuse, especially methamphetamine abuse, a few well-organized programs could have improved cognitive abilities and emotion regulation in drug users. Objectives: The present study aimed to investigate the effectiveness of Interpersonal and Social Rhythm therapy (IPSRT) alone and combined with Cognitive Rehabilitation therapy (CRT) on inhibitory response and emotion dysregulation in people with methamphetamine use disorder. Patients and Methods: The current quasi-experimental study with a pretest-posttest and follow-up design included two intervention groups. Forty methamphetamine abusers were selected based on the inclusion and exclusion criteria and assigned randomly to the IPSRT (n = 20) and IPSRT + CRT (n = 20) groups. The first group received IPSRT in 12 sessions, two 60 min sessions per week. The second group received IPSRT and 16 sessions of CRT. Subjects were assessed three times at pre-intervention, immediately after the intervention, and four weeks after the intervention. Results: Data analyzed by descriptive statistics and mixed repeated ANOVA indicated that the two interventions had significant long-term effects on increasing the inhibitory response and decreasing emotion dysregulation. In addition, IPSRT with CRT was more effective than IPSRT alone in promoting executive functions and decreasing emotion dysregulation. Conclusions: The findings of this study provide evidence that adding CRT as an adjunct intervention to psychological interventions such as IPSRT can improve emotional and cognitive performance. Therefore, a combination of psychological interventions with CRT can be considered a useful intervention in addiction treatment centers.

Disrupted rhythms of life, work and entertainment and their associations with psychological impacts under the stress of the COVID-19 pandemic: A survey in 5854 Chinese people with different sociodemographic backgrounds

Background & aim The coronavirus disease 2019 (COVID-19) pandemic has affected the life and work of people worldwide. The present study aimed to evaluate the rhythm disruptions of life, work, and entertainment, and their associations with the psychological impacts during the initial phase of the COVID-19 pandemic. Method A cross-sectional study was conducted from the 10th to 17th March 2020 in China. A structured e-questionnaire containing general information, the Chinese version of Brief Social Rhythm Scale, and Zung’s self-rating scales of depression and anxiety (SDS and SAS) was posted and collected online through a public media (i.e. EQxiu online questionnaire platform). Scores in sleeping, getting up, and socializing (SGS) rhythm and eating, physical practice, and entertainment (EPE) rhythm were compared among and between participants with different sociodemographic backgrounds including gender, age, education, current occupation, annual income, health status, and chronic disease status. Correlations of SDS and SAS with SGS-scale and EPE-scale were also analyzed. Results Overall, 5854 participants were included. There were significant differences in the scores of SGS-scale and EPE-scale among people with different sociodemographic backgrounds. The scores were significantly higher in the groups with female gender, low education level, lower or higher than average income, poor health status, ages of 26–30 years or older than 61 years, nurses and subjects with divorce or widow status. There were also significant differences in SAS and SDS scores among people with different sociodemographic backgrounds (all P< 0.05). The overall prevalence of depression and anxiety was 24.3% and 12.6%, respectively, with nurses having the highest rates of depression (32.94%) and anxiety (18.98%) among the different occupational groups. SGS-scale was moderately correlated with SDS and SAS, and disruption of SGS rhythm was an independent risk factor for depression and anxiety. Conclusion Social rhythm disruption was independently associated with depression and anxiety. Interventions should be applied to people vulnerable to the rhythm disruption during the COVID-19 pandemic.

Treatment of Bipolar Disorder

There is currently no cure for bipolar disorder (BD). However, people can recover with proper treatment and lead a satisfying, normal life. Treating BD focuses on controlling and preventing the manic and/or depressive symptoms. Mood stabilizers are the first line of treatment for BD, most often in conjunction with psychosocial therapy. This chapter presents the medications commonly prescribed for treating children and adolescents diagnosed with BD along with their possible side effects. Interpersonal and social rhythm therapy, family-focused therapy, and cognitive-behavioral therapy are also presented. Chapter 14 returns to the case studies presented in Chapter 13 and describes the real-life outcomes along with questions for class discussion.