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Not one thing at a time:When concomitant multiple stressors produce a transdiagnostic clinical picture

World Journal of Psychiatry 2023年第7期13卷 402-408页

作者： Sari Goldstein Ferber Gal Shoval Aron Weller Gil Zalsman Department of Psychology and Brain Sciences University of DelawareNewarkDE 19716United States Psychology and Gonda Brain Research center Bar Ilan UniversityRamat Gan 5317000Israel Department of Neuroscience Princeton UniversityNew JerseyNJ 08544United States geha mental health center Petah TiqvaIsrael and Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 77096Israel Department of Psychiatry Columbia UniversityNew YorkNY 10032United States

A condition of exposure to multiple stressors resulting in a mixed clinical picture spanning conventional categories without meeting any of them in full,encompasses a risk for a list of comorbidities preventing appropriate prevention and *** transformative transdiagnostic approaches suggest changes spanning conventional *** base their systems of classification on biomarkers as well as on brain structural and functional dysregulation as associated with behavioral and emotional *** new approaches received critiques for not being specific enough and for suggesting a few biomarkers for psychopathology as a ***,they put the value of differential diagnosis at risk of avoiding appropriate derived prevention and *** of stressors has been considered mostly during and following catastrophes,without considering the resulting mixed clinical picture and life event concomitant *** herewith suggest a new category within the conventional classification systems:The Complex Stress Reaction Syndrome,for a condition of multiplicity of stressors,which showed a mixed clinical picture for daily life in the post coronavirus disease 2019 era,in the general *** argue that this condition may be relevant to daily,regular life,across the lifespan,and beyond conditions of *** further argue that this condition may worsen without professional care and it may develop into a severe mental health disorder,more costly to health systems and the suffering *** for derived prevention and treatment are discussed.

关键词： Transdiagnostic Multiple stressors Clinical picture Prevention Treatment Interpersonal psychotherapy Cognitive behavioral therapy

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Transdiagnostic considerations of mental health for the post-COVID era:Lessons from the first surge of the pandemic

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World Journal of Clinical Cases 2023年第4期11卷 809-820页

作者： Sari Goldstein Ferber Gal Shoval Rodolfo Rossi Viviana Trezza Giorgio Di Lorenzo Gil Zalsman Aron Weller J John Mann Aron Weller Department of PsychologyBar Ilan UniversityRamat Gan 5290002Israel Department of Neuroscience Princeton UniversityPrinceton NJ 08544United States geha mental health center Petah TiqvaIsrael and Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 77096Israel Department of Systems Medicine University of Rome Tor VergataRome 00133Italy Department of Science Rome Tre UniversityRome 00154Italy Department of Psychiatry Rome University Tor VergataRome 00179Italy IRCCS-Fondazione Santa Lucia Rome 00179Italy Division of Molecular Imaging and Neuropathology Department of PsychiatryColumbia UniversityNY10032United States

BACKGROUND The Coronavirus disease 19(COVID-19)-related psychiatric burden partly results from prolonged social stress *** have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical Manual of mental Disorders,Fifth Edition(DSM 5)and International Classification of Diseases 11th Revision(ICD-11)categories,implicating multiple diagnoses,complicating clinical *** To verify whether COVID-19-related psychopathology spans multiple DSM-5 and ICD-11 diagnoses,but not in a random ***,empirical analysis of the multiple associated symptoms will better describe COVID-19-related *** We conducted a bi-national study during the first surge of the pandemic:an Italian sample(n=21217,studied March-April 2020);and three representative longitudinal samples from Israel(n=1276,1189,and 1432 respectively,studied May-July 2020).Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative *** analysis focused on the frequency and patterns of reported multiple mental health *** Combinations with all symptoms were more prevalent than combinations with fewer symptoms,with no majorities-minorities differences in both countries,demonstrating the generalizability of the transdiagnostic pattern of mental health issues in both nations.A history of previous mental disorder(Italian study)and an increase in symptom prevalence over time(Israel study)were associated with an increased number of ***:Based on finding correlated symptom diversity spanning conventional diagnostic categories,we suggest that the pattern of mental health issues associated with the COVID-19 pandemic is *** The findings have implications for improving prevention and treatment of COVID-19 related psychopathology and

关键词： Post-COVID-19 Diagnosis Stress mental disorders Transdiagnosis Reactive psychiatric disorders

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International study of the Complex Stress Reaction Syndrome:Implications for transdiagnostic clinical practice

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World Journal of Psychiatry 2023年第10期13卷 803-815页

作者： Sari Goldstein Ferber Aron Weller Adele M Hayes Tracy D Vannorsdall Yaroup Ajlouni Mo'nes Qudah Gil Zalsman Gal Shoval Tommaso Benedetto Jannini Racquel Fiedler Lily X Chen Danielle R Shayani Elin Kachuki Dory Dana Stolowicz-Melman Connor Evans Megan Trow Giorgio Di Lorenzo Rodolfo Rossi Department of Psychological and Brain Sciences University of DelawareNewarkDE 19716United States Department of Psychology Bar Ilan UniversityRamat Gan 5290002Israel Department of Psychology and The Gonda Brain Research center Bar Ilan UniversityRamat Gan 5290002Israel Department of Psychiatry and Behavioral Sciences Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD 21287United States Jordan health Aid-International Amman 1234Jordan geha mental health center Petah TiqvaIsrael and Faculty of MedicineTel Aviv UniversityRamat Aviv 6997801Israel Division of Molecular Imaging and Neuropathology Department of PsychiatryColumbia UniversityNew YorkNY 10032United States Department of Neuroscience Princeton UniversityPrincetonNJ 08544United States Department of Systems Medicine Tor Vergata University of RomeRome 00133Italy UNSW School of Psychology UNSW SydneySydney 2052Australia Department of Biology Pacific UniversityForest GroveOR 97116United States Oregon Chapter of Fulbright Association OregonOR 97045United States Department of Systems Medicine Tor Vergata University of RomeRome 00179Italy IRCCS Fondazione Santa LuciaRome 00179Italy

BACKGROUND The debate regarding diagnostic classification systems in psychiatry(categorial vs dimensional systems)has essential implications for the diagnosis,prevention and treatment of stress *** previously found a unique pattern of stress reaction in a study executed during the coronavirus disease 2019 pandemic using large representative samples in two countries,and termed it the Complex Stress Reaction Syndrome(CSRS).AIM To investigate CSRS,Type A(psychiatric symptoms,spanning anxiety,depression,stress symptoms,and posttraumatic stress disorder(PTSD)),with or without long-coronavirus disease(COVID)residuals(CSRS,Type B,neuropsychiatric symptoms spanning cognitive deficits and fatigue,excluding systemic symptoms).Our two-tailed hypothesis was that CSRS is a condition related to an unrecognized type of stress reaction in daily life in the general population(Type A)or that it is related to the severe acute respiratory syndrome coronavirus 2 infection and its long-COVID residuals(Type B).METHODS 977 individuals in four continents(North America,Europe,Australia and the Middle East)completed the online study questionnaire in six languages using the Qualtrics *** study was managed by six teams in six countries that promoted the study on social *** questionnaire assessed anxiety,depression,stress symptoms and PTSD(CSRS,Type A),cognitive deficits and fatigue(CSRS,Type B).The data were analyzed using Proportion Analyses,Multivariate Analysis of Co-Variance(MANCOVA),linear regression analyses and validated clinical cutoff *** The results of the Proportion Analyses showed that the prevalence of 4 symptoms spanning anxiety,depression,stress symptoms,and PTSD was significantly higher than the most prevalent combinations of fewer symptoms across 4 continents,age groups,and *** supports the transdiagnostic argument embedded in the CSRS(Type A).The same pattern of results was found in infected/recovered *** prevalence of the

关键词： Transdiagnostic Complex Stress Reaction Syndrome Stress reactivity Affective disorders Debate in psychiatry

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