The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study

Objectives Cancer is the second leading cause of death in the Gaza Strip, Palestine, but there is an absence of evidence systematically assessing symptom burden and quality of life (QoL) using validated tools. Our objective was to assess associations between socio-demographic and disease-related characteristics, symptom burden and QoL in a sample of cancer patients accessing outpatient services in the Gaza Strip. Design A cross-sectional, descriptive survey using interviews and medical record review involving patients with cancer accessing oncology outpatient services at Al Rantisi Hospital and European Gaza Hospital (EGH) in the Gaza Strip was employed. Socio-demographic and disease-related data, the Lebanese version of the Memorial Symptom Assessment Scale (MSAS-Leb), and the Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) were collected. Multiple linear regression was used to judge the relative influence of determinants of QoL. Results Of 414 cancer patients approached, 385 patients consented to participation. The majority were women (64.7%) with a mean age of 52 years (SD = 16.7). Common cancer diagnoses were breast (32.2%), haematological (17.9%) and colorectal (9.1%). The median number of symptoms was 10 (IQR 1.5–18.5). Mean overall QoL was 70.5 (SD 19.9) with common physical and psychological symptoms identified. A higher burden of symptoms was associated with marital status, education and income. Limited access to both opioids and psychological support were reported. Conclusions A high symptom burden was identified in outpatients with cancer. Increasing provision and access to supportive care for physical and psychological symptoms should be prioritised alongside exploring routine assessment of symptom burden and QoL.

Correlation between Mild Traumatic Brain Injury-Induced Inflammatory Cytokines and Emotional Symptom Traits: A Systematic Review

Both mild traumatic brain injuries (mTBI) and systemic injuries trigger a transient neuroinflammatory response that result in similar clinical outcome. The ensuing physical, cognitive, and emotional symptoms fail to subside in approximately 15–20% of the concussed population. Emotional impairments, particularly depression, anxiety, and post-traumatic stress disorder (PTSD), are commonly associated with poor recovery following mTBI. These emotional impairments also have a significant neuroinflammatory component. We hypothesized that the inflammatory cytokines seen in mTBI patients with emotional symptoms would coincide with those commonly seen in patients with emotional symptoms without mTBI. A systematic review was conducted to identify the most common neuroinflammatory cytokines in the mTBI population with psychological symptoms (depression, anxiety, PTSD). The electronic databases EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, and PSYCINFO were searched from data inception to 31 August 2021. A systematic screening approach was employed from screening to data analysis. A total of 994 articles were screened, 108 were selected for full article review, and 8 were selected for data analysis. The included studies consisted of 875 patients of which 81.3% were male. The mean sample size of patients with at least one mTBI was 73.8 ± 70.3 (range, 9–213), with a mean age of 33.9 ± 4.8 years. The most common cytokines associated with poor psychological outcomes involving PTSD and/or depression in the chronic mTBI population were IL-6, TNFα, IL-10, and CRP.

Lingering effects of COVID-19 on the mental health of first-year university students in Japan

Background The coronavirus disease 2019 (COVID-19) pandemic is continuing unabated in Japan, as of October 2021. We aimed to compare first-year university students’ psychological distress before the pandemic in 2019, during the pandemic in 2020, and one year after the onset of the pandemic, in 2021. Methods The study conducted online surveys over three years from April to May each year. Participants were 400 first-year students in 2019, 766 in 2020, and 738 in 2021. We examined differences in scores on the Counseling Center Assessment of Psychological Symptoms—Japanese version (CCAPS-Japanese) between the three years using a one-way analysis of variance, and differences in the CCAPS-Japanese critical items using chi-squared test and residual analysis. Results The average scores on the Depression and Generalized Anxiety subscale in 2021 were significantly higher than those in 2020, but remained the same as in 2019. The Academic Distress subscale score in 2020 was the worst compared to 2019 and 2021. Meanwhile, the number of students who experienced severe suicidal ideation increased year by year from 2019 to 2021. Conclusion The mean mental health of first-year university students worsened after the onset of the COVID-19 pandemic, and recovered to the pre-pandemic level over the next two years. However, the number of high-risk students with suicidal ideation continued to increase. A system is required for early detection and support for students at high risk of mental health issues.

Herbs’ Disease-matched Pharmacological Mechanisms of HuanglianJiedu Decoction in Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease

Along with cognitive deficit, behavioral and psychological symptoms in dementia (BPSD) is another characteration of Alzheimer's disease that hamper clinical management and exacerbate burden for caregivers. However, therapeutic management of BPSD remains challenging. HuanglianJiedu decoction (HLJDD), a traditional Chinese prescription which contains Coptidis rhizome(Huang lian), Scutellariae radix (Huang-qin), Phellodendri chinrnsis cortex (Huang-bai) and Gardeniae fructus (Zhi-zi), is applied to treat BPSD. So elucidating the herbs’ disease-matched pharmacological mechanisms underlying HLJDD, further put forward each herbs’ disease-matched combination are critical to the application of HLJDD. In this study, network pharmacology was used to determine the targets and biological processes regulated by HLJDD in the treatment of BPSD. Moreover, molecular docking was utilized to evaluate the binding activity between the herbs' main active ingredients and neurotransmitter receptors. The results showed that the KEGG signaling pathway of HLJDD in treating BPSD mainly lies in TNF signaling pathway and AGE-RAGE signaling pathway in diabetic complications. Scutellariae radix and Phellodendri chinrnsis cortex exhibited better anti-BPSD effects when compared to Coptidis rhizoma and Gardeniae fructus. Scutellariae radix exhibited superior anti-neuroinflammation functions, with better blood vessel regulation effects. Phellodendri chinrnsis cortex showed a higher binding affinity to the dopamine D2 receptor (DRD2) and 5-hydroxytryptamine receptor 2A (HTR2A). Coptidis rhizoma and Gardeniae fructus were better in neuronal signaling. In conclusion, for treating BPSD, Scutellariae radix and Phellodendri chinrnsis cortex are the principal herbs while Coptidis rhizoma and Gardeniae fructus are the ancillary herbs. Beta-sitosterol, stigmasterol, chelerythrine, campesterol and berberine are the potential effective ingredients in treating BPSD.

Efficacy and Safety of Citalopram Compared to Atypical Antipsychotics on Agitation in patients with BPSD

Background: The psychomotor agitation of the behavioural and psychological symptoms of dementia (BPSD) is one of the common issues in aged care facilities, leading to the poor functional and medical consequences. Psychotropic interventions are the preferred choice of treatment, but which medication should be the prescribers first preference? This review aims to compare pharmacological interventions for psychomotor agitation, judging them according to their effectuality and justifiability profiles. This is to be achieved by retrieving information from Randomised Control Trials (RCTs) and systematic reviews. Objectives: This review evaluates evidence from RCTs, systematic reviews, and meta-analyses of BPSD patients who have taken agitation treatments. Assessing the efficacy of selective serotonin reuptake inhibitors (SSRI) and antipsychotic treatments when compared to each other for the purpose of improving agitation outcomes. Methods: This review includes RCT that compared one or more active ingredient medications with another medication or with a placebo, along with systematic reviews comparing citalopram (SSRI) with antipsychotics such as quetiapine, olanzapine, and risperidone. Studies were extracted by searching and accessing databases, such as PubMed, OVID, and Cochrane with restrictions of date from 2000 to 2021 and English language. Conclusion: There is still limited studies of SSRIs for the treatment of agitation in BPSD. SSRIs such as citalopram were associated with a reduction in symptoms of agitation, and lower risk of adverse effects compared to antipsychotics. Future studies are required to assess the long-term safety and efficacy of SSRI treatments for agitation in BPSD.

Correlations between Psychiatric Symptoms and Quality of Life in Patients with Psychological Disorders: Hospital-Based Retrospective Study

Little research has been conducted on the relationship between the five-item Brief Symptom Rating Scale (BSRS-5) and quality of life in patients with mood disorders. The purpose of this study was to investigate potential effects of psychological symptoms on quality of life in patients with psychological disorders. We recruited 124 patients with psychological disorders from a psychological teaching hospital in northern Taiwan. Data were obtained from medical records of all patients with a diagnosis of mood or adjustment disorder. We assessed psychological symptoms on the BSRS-5 and examined quality of life by using the Taiwanese version of the abbreviated World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). We performed hierarchical linear regression analysis to explore the relationship between psychological symptoms and quality of life. The analysis revealed a significant correlation between the items on the BSRS-5 and WHOQOL and their correlations with the total scores on these assessments (p < 0.01 and p < 0.05). Our findings indicated that scores on the BSRS-5 can predict scores on quality of life. This suggests that psychometrically measured psychological symptoms constitute critical determinants of quality of life.

New Hope for Behavioural and Psychological Symptoms in Dementia (BPSD): A Narrative Review of Clinical Studies Conducted in the Symptomatic Treatments for Agitation and Psychosis Episodes in Alzheimer’s Disease/Dementia

Background: The psychomotor agitation of the BPSD is one of the common issues in aged care facilities, leading to the poor functional and medical consequences. Psychotropic interventions are the preferable choice of treatment. But which medication should be the prescribers first preference? This review aims to compare pharmacological interventions for psychomotor agitation, judging them according to their effectuality and justifiability profiles. This is to be achieved by retrieving information from RCTs and systematic reviews. Objectives: This review evaluates evidence from RCTs, systematic reviews, and meta-analyses of BPSD patients who had taken agitation treatments. Assessing the efficacy of antidepressants and antipsychotic treatments when compared to each other for the purpose of improving agitation outcomes. Methods: This narrative review includes RCTs and retrospective studies that were comparing one or more active ingredient medications with another or with a placebo, along with sys-tematic reviews comparing antidepressants with antipsychotics such as quetiapine, olanzapine, and risperidone. Studies extracted by searching accessing databases, such as PubMed, OVID, and Cochrane with restrictions of date from 2000 to 2021 and English language. Quality of evidence: The quality of systematic reviews was judged against AMSTAR score, and RCTs were judged according to CONSORT checklist for RCT protocols. Conclusion: There are still few studies of serotonin targeting treatment of agitation in BPSD. The SSRIs such as citalopram were associated with a reduction in symptoms of agitation, and lower risk of adverse effects compared to antipsychotics. This review also illustrates brexpiprazole as a target of multimodal neurotransmitters such as dopamine, serotonin, and norepinephrine; and dextromethorphan, OR dextromethorphan associated with bupropion or quinidine as a blockade of NMDA receptors. The outcome of this review suggests that further studies involving more dementia/Alzheimer&rsquo;s participants should be conducted. Future studies are required also to assess the long-term safety and efficacy of SSRI, brexpiprazole, dextromethorphan treatments for agitation in BPSD.

Validation of the South Korean Version of the Beliefs about Emotions Scale

Background Beliefs about the unacceptability of experiencing or expressing negative emotions can contribute to diverse psychological symptoms and associated with poor treatment outcomes and low treatment attempts. The Beliefs about Emotions Scale (BES) was developed to assess such beliefs based on the cognitive-behavioral models; however, no study has reported on the psychometric properties of the BES in Korea. The present study aimed to cross-culturally adapt and validate the BES for the Korean population (BES-K). Methods The BES-K was administered to 592 Korean adults (323 men and 269 women) aged 20–59 years. Exploratory and confirmatory factor analysis were used to assess the factor model of the scale. Pearson correlation coefficients were used to evaluate the relationships between the BES-K and other psychological measures. Results The result showed a two-factor model of the BES-K, with Factor 1 relating to Interpersonal and Factor 2 representing Intrapersonal aspects. The scale had significant yet moderately low correlations with measures of depression, anxiety, and difficulties in emotion regulation. Conclusion The BES-K is a useful instrument in evaluating the beliefs about emotions in the Korean population.

Psychological Health Conditions and COVID-19-Related Stressors Among University Students: A Repeated Cross-Sectional Survey

The Coronavirus Disease 2019 (COVID-19) pandemic has broadly impacted university students’ customary life, resulting in remarkable levels of stress and psychological suffering. Although the acute phase of the crisis has been overcome, it does not imply that perceived stress related to the risk of contagion and to the changes in the relational life experienced over more than 1 year of the pandemic will promptly and abruptly decrease. This study aims at comparing university students’ psychological health conditions before and during the COVID-19 pandemic, but also at providing information on how psychological health conditions evolved over the 1 year of the pandemic. We analyzed data from a repeated cross-sectional survey on different samples of university students before the pandemic in 2017 (n = 545) and during the pandemic (n = 671). During the pandemic, data were collected at three stages (Stage 1, April 2020 n = 197; Stage 2, November 2020 n = 274; and Stage 3, April 2021 n = 200). The COVID-19 Student Stress Questionnaire (CSSQ) and the Symptom-Checklist-90-Revised (SCL-90-R) were used to assess, respectively, COVID-19-related stressors (Relationships and Academic Life, Isolation, and Fear of Contagion) and the presence of psychological symptoms. Psychological health conditions were compared at baseline and during the pandemic, whereas both psychological health conditions and perceived levels of COVID-19-related stressors were compared over the three pandemic stages. In addition, Logistic Regression was used to explore the associations between COVID-19-related stressors and psychological symptoms. Findings revealed a significant increase in symptoms of Depression (DEP), Phobic-Anxiety (PHOB), Obsessive-Compulsive (O-C), and Psychoticism (PSY) from pre to during the pandemic. Perceived levels of COVID-19-related stress and specific psychological symptoms significantly increased as the pandemic was progressing. COVID-19-related stressors emerged as significantly associated with several psychopathological symptoms. Findings are discussed with the aim of providing tailored interventions to prevent mental disease and promote psychological adjustment in this specific stage of transition within this exceptional global emergency.