The relationship between types of life events and the onset of functional neurological (conversion) disorder in adults: a systematic review and meta-analysis

Adverse life events precede the onset of functional neurological disorder (FND, also known as conversion disorder) more commonly than other neuropsychiatric conditions, but their aetiological role is unclear. We conducted a systematic review and quantitative analysis of the type, timing and number of life events preceding the onset of FND in adults, and a meta-analysis of the proportions of types of events in controlled studies. Fifty-one studies of different designs, covering 4247 patients, were eligible for inclusion. There was no clear majority of any type of preceding event. Family problems were the most common category of events, followed by relationship problems. Females were more likely to experience preceding family/relationship problems than males, who reported more work problems. Family problems were the commonest type of preceding event in studies in developing countries, whereas family and health problems were equally common in developed countries. Abuse was associated with early symptom onset, while patients with later onset were more likely to report family problems. The median number of events was one, and the events occurred closer to onset than in controls. Meta-analysis found that family, relationship and work events were all relatively more common in patients than pathological controls, as were events where symptoms might provide a solution to the stressor. In conclusion, although a range of events precede the onset of FND, they do not appear to do so uniformly. This may support a different aetiological role for stressors than in other disorders, although the support is indirect and the quality generally low.

The effect of emotional ventilation on the psychosocial development of school age children during the Covid-19 Pandemic

The World Health Organization has officially declared the coronavirus as a pandemic The impact of the pandemic is also experienced by children. Children experience major changes in their lives, one of which is child psychosocial. Psychosocial support needs for the children. This study aims to determine the effect of emotional ventilation on the psychosocial development of school-age children during the Covid-19 pandemic. This research design is a quasi-experiment with a one-group pretest and posttest design approach. Respondents were 43 school-age children. Psychosocial development was assessed using the Strengths and Difficulties Questionnaire (SDQ). Emotional ventilation is done once a week and twice a week. a week after the second intervention, a post-test was performed. The results showed that before the intervention prosocial behaviour, emotional problems and hyperactivity were mostly normal, behavioural problems and relationship problems with peers before the intervention showed mostly abnormal. After prosocial behaviour intervention, emotional problems, behavioural problems and hyperactivity were mostly normal and only peer relationship problems were still mostly abnormal. There are differences between emotional problems, behavioural problems, hyperactivity before and after emotional ventilation with a p-value ≤ 0.05.

Meaning and Interpretations of Child Abuse by Abuser Parents: A Qualitative Study

Background: Child abuse has destructive consequences for the abused and the abuser which can launch a cycle of inter-generational violence. Our aim was to understand the constructions of child abuse by adult parents. Methods: The research was carried with generic (basic) qualitative research method. Participants included 12 adults who abused their children during the recent year(2020) at Yazd City. The adult participants were selected by snowball-purposeful sampling. The data were collected through semi-structured interviews and analyzed with grounded theory analysis method. Results: After analyzing transcribes, 6 main categories were constructed: abuse transmission, suffered self, normative violence, relationship problems, institutional inefficiency and pressured family. Life world of harassment emerged as the core category. Conclusion: The findings presented the cycle of abuse created through learning and transmitting.

Burnout syndrome among medical students in Kazakhstan

This study aims at investigating burnout and associated factors in a sample of medical students from Astana Medical University, using the Russian version of the Copenhagen Burnout Inventory - Student Survey (R-CBI-S). 771 medical students responded. The study included socio-demographic and personal questions and a tool to measure burnout. Statistical analyses included measures of descriptive statistics and logistic regression analysis for evaluating burnout. Overall, 28% of medical students reported burnout; R-CBI-S mean score was 40. There is no significant gender difference in burnout. On regression analysis, to be a 2nd-year student, compare to dormitory students live at home or rented a house, having suicidal ideation, having thoughts of dropping out, having interpersonal relationship problems with family or friends, smoking, using alcohol were independently associated with increased risk for burnout. Enrolling in a medical university by its own decision and having satisfaction with academic performance is associated with a decrease of developing burnout syndrome. In conclusion, factors associated with burnout were identified.

Can compliment and complaint data inform the care of individuals with chronic subdural haematoma (cSDH)?

ObjectivesTo explore the frequency and nature of complaints and compliments reported to Patient Advice and Liaison (PALS) in individuals undergoing surgery for a chronic subdural haematoma (cSDH).DesignA retrospective study of PALS user interactions.SubjectsIndividuals undergoing treatment for cSDH between 2014 and 2019.MethodsPALS referrals from patients with cSDH between 2014 and 2019 were identified. Case records were reviewed and data on the frequency, nature and factors leading up to the complaint were extracted and coded according to Healthcare Complaints Analysis Tool (HCAT).ResultsOut of 531 patients identified, 25 (5%) had a PALS interaction, of which 15 (3%) were complaints and 10 (2%) were compliments. HCAT coding showed 8/15 (53%) of complaints were relationship problems, 6/15 (33%) a management problem and 1/15 (7%) other. Of the relationship problems, 6 (75%) were classed as problems with communication and 2 (25%) as a problem with listening. Of the compliments, 9/10 (90%) related to good clinical quality and 1/10 (10%) to staff–patient relationship. Patients were more likely to register a compliment than family members, who in turn were more likely to register a complaint (p<0.005). Complaints coded as a relationship problem had 2/8 (25%) submitted by a patient and 6/8 (75%) submitted by a relative.ConclusionsUsing the HCAT, routinely collected PALS data can easily be coded to quantify and provide unique perspective on tertiary care, such as communication. It is readily suited to quality improvement and audit initiatives.

Implicit Ambivalence: A Driving Force to Improve Relationship Problems

Implicit ambivalence involves holding strong positive and negative implicit evaluations toward the same object. This state is common in close relationships because even the most satisfying partnerships involve in conflicts and other frustrating experiences that can be explained away through effortful motivated reasoning yet remain in memory as mental representations involving the partner. In fact, it appears normative for implicit measures of partner attitudes to reveal implicit ambivalence. Despite being common, however, little is known about the consequences of implicit ambivalence. The present longitudinal investigation provides initial evidence that implicit ambivalence can motivate relationship improvements. Across two studies of newlywed couples ( N = 448 individuals), multilevel dyadic modeling revealed that higher implicit ambivalence was associated with higher motivation to make efforts to improve current marital problems, which predicted reduced marital-problems severity reported by the partner and increased marital satisfaction reported by both spouses 4 months later.

Dyspareunia

Dyspareunia is persistent pain on attempted or successful vaginal penetration. It is under-reported, infrequently asked about by healthcare professionals, and affects quality of life and relationships. Dyspareunia is multifactorial and possesses biopsychosocial components. Pain may be distinct and localised, deep or persistent. Among the symptoms, women describe sensations of aching, throbbing and tearing. Disinterest in sex and relationship problems can result. This article discusses dyspareunia, its common differential diagnoses and aims to improve clinician confidence in assessing and managing dyspareunia in primary care.

Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third (39.6%) of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double (136.9% vs. 63.6%) for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance.