Background The incidence of paediatric cancers has increased in recent years;however,with advances in the treatment of paediatric cancer,almost 80%of children and adolescents who receive a diagnosis of cancer become l...Background The incidence of paediatric cancers has increased in recent years;however,with advances in the treatment of paediatric cancer,almost 80%of children and adolescents who receive a diagnosis of cancer become long-term survivors.Given the high stress levels associated with cancer,it becomes important to ascertain the risk and likelihood of psychiatric disorders in adult paediatric cancer survivors.Aims This study aims to investigate the relationship between defence styles and predisposition to psychiatric diseases in adults with a history of paediatric cancer.Methods We performed an explorative study on a sample of 66 clinically healed adults with a history of paediatric cancer(survivors)during follow-up visits at the University Hospital‘Policlinico G Rodolico’of Catania(Italy)and 98 healthy controls among medicine students.We administered the Defence Mechanism Inventory(DMI)to assess defence styles.The Symptom Checklist-90-Revised(SCL-90-R)and the Davidson Trauma Scale(DTS)were administered to assess psychopathological indices.We conducted comprehensive statistical analysis based on correlation analysis and mediation analysis to investigate the relationship between defence styles and psychopathological outcomes in survivors compared with controls.Results The survivors obtained statistically significant lower values in TAO,PRO and TAS defence styles and a higher value in REV.Both groups showed non-pathlogical mean scores in DTS and SCL-90-R(with an exception of the obsessive-compulsive subscale),with lower mean values among survivors.The results of mediation analysis showed that TAS had mediation effects on interpersonal sensitivity,anxiety,PSDI,GSI and avoidance,while TAO had mediation effects on DTS total score and intrusivity.Thus,for these psychopathological indices,the effect of the oncological pathology was indirect and mediated by TAO or TAS.Our analysis exlcluded mediation effects between the remaining variables and defence styles.Conclusion Integrating data from mediation and correlation analysis,we found how the decreasing of TAS utilization in survivors as the consequence of cancer history,has decreased interpersonal sensitivity,anxiety and GSI score in these subjects compared with controls.Similary,the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale.Unexpectedly,our analysis excluded relationships between cancer history,other defence styles and psycopathological scores as we initially assumed.展开更多
We have read with interest the publication that describes the available data related to the use of neuromodulation strategies for the treatment of posttraumatic stress disorder(PTSD).Despite treatment advances,however...We have read with interest the publication that describes the available data related to the use of neuromodulation strategies for the treatment of posttraumatic stress disorder(PTSD).Despite treatment advances,however,a substantial proportion of PTSD patients receiving psychological and/or pharmacological treatment do not reach an adequate clinical response.In their paper,the authors draw attention to the current understanding of the use of repetitive transcranial magnetic stimulation(rTMS)as a potential treatment for PTSD.Most of the previous studies indeed applied both inhibitory(1 Hz)and excitatory(>1 Hz,up to 20 Hz)rTMS to the right and/or left dorsolateral prefrontal cortex.Despite larger therapeutic effects observed when high-frequency stimulation was applied,the question of which side and frequency of stimulation is the most successful is still debated.The authors also reported on the after-effect of rTMS related to neuroplasticity and identified the intermittent theta burst stimulation as a technique of particular interest because of it showed the most effective improvement on PTSD symptoms.However,although numerous studies have highlighted the possible beneficial use of rTMS protocols for PTSD,the exact mechanism of action remains unclear.In their conclusions,the authors stated that rTMS has been demonstrated to be effective for the treatment of PTSD symptoms.Nevertheless,we believe that further research with homogeneous samples,standardized protocols,and objective outcome measures is needed to identify specific therapeutic targets and to better define significant changes when active and sham stimulation procedures are compared.展开更多
文摘Background The incidence of paediatric cancers has increased in recent years;however,with advances in the treatment of paediatric cancer,almost 80%of children and adolescents who receive a diagnosis of cancer become long-term survivors.Given the high stress levels associated with cancer,it becomes important to ascertain the risk and likelihood of psychiatric disorders in adult paediatric cancer survivors.Aims This study aims to investigate the relationship between defence styles and predisposition to psychiatric diseases in adults with a history of paediatric cancer.Methods We performed an explorative study on a sample of 66 clinically healed adults with a history of paediatric cancer(survivors)during follow-up visits at the University Hospital‘Policlinico G Rodolico’of Catania(Italy)and 98 healthy controls among medicine students.We administered the Defence Mechanism Inventory(DMI)to assess defence styles.The Symptom Checklist-90-Revised(SCL-90-R)and the Davidson Trauma Scale(DTS)were administered to assess psychopathological indices.We conducted comprehensive statistical analysis based on correlation analysis and mediation analysis to investigate the relationship between defence styles and psychopathological outcomes in survivors compared with controls.Results The survivors obtained statistically significant lower values in TAO,PRO and TAS defence styles and a higher value in REV.Both groups showed non-pathlogical mean scores in DTS and SCL-90-R(with an exception of the obsessive-compulsive subscale),with lower mean values among survivors.The results of mediation analysis showed that TAS had mediation effects on interpersonal sensitivity,anxiety,PSDI,GSI and avoidance,while TAO had mediation effects on DTS total score and intrusivity.Thus,for these psychopathological indices,the effect of the oncological pathology was indirect and mediated by TAO or TAS.Our analysis exlcluded mediation effects between the remaining variables and defence styles.Conclusion Integrating data from mediation and correlation analysis,we found how the decreasing of TAS utilization in survivors as the consequence of cancer history,has decreased interpersonal sensitivity,anxiety and GSI score in these subjects compared with controls.Similary,the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale.Unexpectedly,our analysis excluded relationships between cancer history,other defence styles and psycopathological scores as we initially assumed.
文摘We have read with interest the publication that describes the available data related to the use of neuromodulation strategies for the treatment of posttraumatic stress disorder(PTSD).Despite treatment advances,however,a substantial proportion of PTSD patients receiving psychological and/or pharmacological treatment do not reach an adequate clinical response.In their paper,the authors draw attention to the current understanding of the use of repetitive transcranial magnetic stimulation(rTMS)as a potential treatment for PTSD.Most of the previous studies indeed applied both inhibitory(1 Hz)and excitatory(>1 Hz,up to 20 Hz)rTMS to the right and/or left dorsolateral prefrontal cortex.Despite larger therapeutic effects observed when high-frequency stimulation was applied,the question of which side and frequency of stimulation is the most successful is still debated.The authors also reported on the after-effect of rTMS related to neuroplasticity and identified the intermittent theta burst stimulation as a technique of particular interest because of it showed the most effective improvement on PTSD symptoms.However,although numerous studies have highlighted the possible beneficial use of rTMS protocols for PTSD,the exact mechanism of action remains unclear.In their conclusions,the authors stated that rTMS has been demonstrated to be effective for the treatment of PTSD symptoms.Nevertheless,we believe that further research with homogeneous samples,standardized protocols,and objective outcome measures is needed to identify specific therapeutic targets and to better define significant changes when active and sham stimulation procedures are compared.
