BACKGROUND: Over the past 25 years, the development of multiuser applications has seen considerable advancements and challenges. The technological development in this field has emerged from simple chat rooms through videoconferencing tools to the creation of complex, interactive, and often multisensory virtual worlds. These multiuser technologies have gradually found their way into mental health care, where they are used in both dyadic counseling and group interventions. However, some limitations in hardware capabilities, user experience designs, and scalability may have hindered the effectiveness of these applications. OBJECTIVE: This systematic review aims at summarizing the progress made and the potential future directions in this field while evaluating various factors and perspectives relevant to remote multiuser interventions. METHODS: The systematic review was performed based on a Web of Science and PubMed database search covering articles in English, published from January 1999 to March 2024, related to multiuser mental health interventions. Several inclusion and exclusion criteria were determined before and during the records screening process, which was performed in several steps. RESULTS: We identified 49 records exploring multiuser applications in mental health care, ranging from text-based interventions to interventions set in fully immersive environments. The number of publications exploring this topic has been growing since 2015, with a large increase during the COVID-19 pandemic. Most digital interventions were delivered in the form of videoconferencing, with only a few implementing immersive environments. The studies used professional or peer-supported group interventions or a combination of both approaches. The research studies targeted diverse groups and topics, from nursing mothers to psychiatric disorders or various minority groups. Most group sessions occurred weekly, or in the case of the peer-support groups, often with a flexible schedule. CONCLUSIONS: We identified many benefits to multiuser digital interventions for mental health care. These approaches provide distributed, always available, and affordable peer support that can be used to deliver necessary help to people living outside of areas where in-person interventions are easily available. While immersive virtual environments have become a common tool in many areas of psychiatric care, such as exposure therapy, our results suggest that this technology in multiuser settings is still in its early stages. Most identified studies investigated mainstream technologies, such as videoconferencing or text-based support, substituting the immersive experience for convenience and ease of use. While many studies discuss useful features of virtual environments in group interventions, such as anonymity or stronger engagement with the group, we discuss persisting issues with these technologies, which currently prevent their full adoption.
- MeSH
- duševní poruchy terapie MeSH
- duševní zdraví MeSH
- lidé MeSH
- služby péče o duševní zdraví * MeSH
- telemedicína MeSH
- videokonferování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
Previous studies have found that threatening stimuli are more readily perceived and more intensely experienced when presented during cardiac systole compared with diastole. Also, threatening stimuli are judged as physically closer than neutral ones. In a pre-registered study, we tested these effects and their interaction using a naturalistic (interactive and three-dimensional) experimental design in immersive virtual reality: we briefly displayed threatening and non-threatening animals (four each) at varying distances (1.5-5.5 m) to a group of young, healthy participants (n = 41) while recording their electrocardiograms (ECGs). Participants then pointed to the location where they had seen the animal (approx. 29 000 trials in total). Our pre-registered analyses indicated that perceived distances to both threatening and non-threatening animals did not differ significantly between cardiac phases-with Bayesian analysis supporting the null hypothesis. There was also no evidence for an association between subjective fear and perceived proximity to threatening animals. These results contrast with previous findings that used verbal or declarative distance measures in less naturalistic experimental conditions. Furthermore, our findings suggest that the cardiac phase-related variation in threat processing may not generalize across different paradigms and may be less relevant in naturalistic scenarios than under more abstract experimental conditions.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The main aim of the present study is to determine the role of metabolites observed using proton magnetic resonance spectroscopy (1H-MRS) in obsessive-compulsive disorder (OCD). As the literature describing biochemical changes in OCD yields conflicting results, we focused on accurate metabolite quantification of total N-acetyl aspartate (tNAA), total creatine (tCr), total choline-containing compounds (tCh), and myo-inositol (mI) in the anterior cingulate cortex (ACC) to capture the small metabolic changes between OCD patients and controls and between OCD patients with and without medication. METHODS: In total 46 patients with OCD and 46 healthy controls (HC) matched for age and sex were included in the study. The severity of symptoms in the OCD was evaluated on the day of magnetic resonance imaging (MRI) using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Subjects underwent 1H-MRS from the pregenual ACC (pgACC) region to calculate concentrations of tNAA, tCr, tCho, and mI. Twenty-eight OCD and 28 HC subjects were included in the statistical analysis. We compared differences between groups for all selected metabolites and in OCD patients we analyzed the relationship between metabolite levels and symptom severity, medication status, age, and the duration of illness. RESULTS: Significant decreases in tCr (U = 253.00, p = 0.022) and mI (U = 197.00, p = 0.001) in the pgACC were observed in the OCD group. No statistically significant differences were found in tNAA and tCho levels; however, tCho revealed a trend towards lower concentrations in OCD patients (U = 278.00, p = 0.062). Metabolic concentrations showed no significant correlations with the age and duration of illness. The correlation statistics found a significant negative correlation between tCr levels and YBOCS compulsions subscale (cor = -0.380, p = 0.046). tCho and YBOCS compulsions subscale showed a trend towards a negative correlation (cor = -0.351, p = 0.067). Analysis of subgroups with or without medication showed no differences. CONCLUSIONS: Patients with OCD present metabolic disruption in the pgACC. The decrease in tCr shows an important relationship with OCD symptomatology. tCr as a marker of cerebral bioenergetics may also be considered as a biomarker of the severity of compulsions. The study failed to prove that metabolic changes correlate with the medication status or the duration of illness. It seems that a disruption in the balance between these metabolites and their transmission may play a role in the pathophysiology of OCD.
- MeSH
- cingulární gyrus diagnostické zobrazování metabolismus MeSH
- glutamin * metabolismus MeSH
- inositol metabolismus terapeutické užití MeSH
- kreatin metabolismus terapeutické užití MeSH
- kyselina aspartová metabolismus terapeutické užití MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- obsedantně kompulzivní porucha * diagnóza MeSH
- protonová magnetická rezonanční spektroskopie metody MeSH
- receptory antigenů T-buněk metabolismus terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Cancer-related cognitive impairment (CRCI) is one of the most serious side effects of cancer that negatively impacts the quality of life of cancer patients and survivors. There is evidence of CRCI in Hodgkin lymphoma patients (HL); however, there is a lack of studies examining the presence of cognitive deficits before starting any treatment in HL patients. METHODS: Forty adult patients (N = 40) newly diagnosed with HL (with no previous cancer diagnoses) and 40 healthy controls (N = 40) matched for age, sex, education, and premorbid intellect completed the neuropsychological battery and subjective and objective measures of affective distress and quality of life. RESULTS: The results showed impairment in three out of six cognitive domains: verbal memory and learning, speed of processing/psychomotor speed, and abstraction/executive functions in the HL patients before the initiation of any treatment. The speed of processing/psychomotor speed domain is negatively correlated with depression. CONCLUSION: Cognitive deterioration in verbal memory and learning and abstraction/executive functions domains in HL patients seems to occur before the initiation of treatment independently of anxiety, depression, or physical symptoms. This suggests that HL itself may cause cognitive deficits in these cognitive domains. However, the underlying causes of CRCI still remain unclear.
In this study, we utilized proton magnetic resonance spectroscopy (MRS) to understand the role of glutamate (Glu), glutamine (Gln), and gamma-aminobutyric acid (GABA) of OCD patients in the pregenual anterior cingulate cortex (pgACC). In total, 54 patients with OCD and 54 healthy controls (HC) matched for age and sex were included in the study. They underwent MRS in the pgACC region to calculate the concentrations of Glu, Gln, GABA, and Glu + Gln (Glx). After quality control of the MRS data, 21 OCD and 21 HC were statistically analyzed. The severity of symptoms were evaluated using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). In the statistical analysis, we compared differences between groups for the metabolites; in the OCD we analyzed the correlations with symptom severity, medication status, age, and duration of illness. A significant decrease in Glx, in Glu, and in Gln in the pgACC were observed in the OCD compared to HC. The correlation statistics showed a significant positive correlation between Glu levels and the YBOCS compulsions subscale. The results indicate that patients with OCD present a disturbance in glutamatergic metabolism in the pgACC. The results also demonstrate that these changes correlate with the severity of compulsions.
- MeSH
- cingulární gyrus * metabolismus MeSH
- GABA metabolismus MeSH
- glutamin metabolismus MeSH
- kyselina glutamová metabolismus MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie metody MeSH
- obsedantně kompulzivní porucha * metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Vytvořili jsme gamifikovanou mobilní aplikaci Limoterapie se záměrem poskytnout hlavně mladším generacím nástroj pro zábavnou edukaci a samoléčbu subsyndromálních až mírných příznaků obsedantně-kompulzivní poruchy. Cílem článku je shrnout zkušenosti z testování této hry v obecné populaci s důrazem na její použitelnost a efektivitu.
We developed a gamified mobile application Limoterapie with the intention to provide younger generations with an entertaining tool for education and self-management of subsyndromal to mild symptoms of obsessive-compulsive disorder. This article aims to summarize data from testing the game in the general population, with an emphasis on its usability and effectivity.
- Klíčová slova
- Limoterapie,
- MeSH
- chytrý telefon MeSH
- lidé MeSH
- mobilní aplikace * klasifikace statistika a číselné údaje MeSH
- obsedantně kompulzivní porucha * diagnóza prevence a kontrola MeSH
- pilotní projekty MeSH
- průzkumy a dotazníky statistika a číselné údaje MeSH
- vzdělávání pacientů jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- hodnotící studie MeSH
- práce podpořená grantem MeSH
- MeSH
- exekutivní funkce MeSH
- kognitivní remediace metody MeSH
- lidé MeSH
- neuropsychologické testy * MeSH
- percepce MeSH
- prostorová navigace MeSH
- sociální dovednosti MeSH
- virtuální realita * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Úvod: Obsedantně-kompulzivní porucha (OCD) je chronické neuropsychiatrické onemocnění s heterogenními symptomy v podobě obsesivních myšlenek a kompulzivního jednání. Kompulzivní chování charakterizované maladaptivními opakujícími se, nepružnými vzorci myšlení a jednání, poukazuje na nedostatek kognitivní flexibility u pacientů s OCD. V souladu s tímto klinickým pozorováním poukazuje mnoho studií na abnormality v kognitivní flexibilitě u pacientů s OCD v behaviorální i neurobiologické rovině. Kognitivní flexibilita je schopnost měnit své chování na základě vnějších podmínek, a uzpůsobovat ho tak potřebám svým i okolí. Cílem tohoto přehledu je zmapovat studie, které se zabývají efektivitou intervencí zaměřených na kognitivní flexibilitu u pacientů s OCD. Metoda: Pro účely přehledu literatury byla provedena systematická rešerše v databázi PubMed dle předem zvolených klíčových slov. Použity byly klinické a randomizované klinické studie zaměřující se se na intervenci cílenou na kognitivní flexibilitu. výsledky: Nálezy sledovaných studií se shodují ve smyslu oslabené kognitivní flexibility u OCD pacientů, jsou však rozporuplné s ohledem na efektivitu použitých intervencí. Zatímco některé studie reportují zlepšení kognitivní flexibility u pacientů s OCD po aplikované intervenci (zejména v případě metod využívajících postupy zaměřené přímo na kognitivní funkce), jiné očekávanou změnu v měřené kognitivní flexibilitě nenachází. Srovnatelnost nálezů je navíc značně limitovaná zejména s ohledem na variabilitu použitých metod při posuzování kognitivní flexibility, ale také s ohledem na mnohdy nízký počet testovaných participantů. Závěr: Kognitivní flexibilita je u pacientů s OCD oslabena. Její zlepšení by mohlo vést ke zvýšení kvality života, nicméně se zdá být vhodnější využití intervencí přímo cílících na kognitivní flexibilitu. Při hodnocení efektivity těchto terapeutických intervencí je však nutné v budoucnu využívat validované metody přímo hodnotící tuto kognitivní schopnost.
Introduction: Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder with heterogeneous symptoms of obsessive thoughts and compulsive behaviour. Compulsive behaviour, which is characterised by maladaptive patterns of repetitive, inflexible cognition and behaviour, indicates a lack of cognitive flexibility in OCD patients. Consistent with this clinical observation, many studies show abnormalities in cognitive flexibility in OCD patients at both behavioral and neurobiological levels. Cognitive flexibility, in brief, is the ability to change one’s behavior based on external conditions and thus adapt it to one’s needs and those of the environment. The aim of this review is to map studies that address the effectiveness of interventions targeting cognitive flexibility in patients with OCD. Method: A systematic search of the PubMed database was performed according to pre-selected keywords for the literature review. Clinical and randomized clinical trials focusing on an intervention targeting cognitive flexibility were used. Results: The findings of the reviewed studies are consistent in terms of impaired cognitive flexibility in OCD patients, but inconsistent with regard to the effectiveness of the interventions used. While some studies report an improvement in cognitive flexibility in OCD patients after the applied intervention (especially in the case of methods using procedures directly targeting cognitive functions), other studies do not find the expected change in measured cognitive flexibility. Moreover, the comparability of findings is severely limited, particularly with regard to the variability of the methods used to assess cognitive flexibility, but also with regard to the often small number of participants tested. Conclusion: Cognitive flexibility is impaired in OCD patients. Its improvement could lead to increased quality of life, but interventions directly targeting cognitive flexibility seem to be more preferable. However, validated methods directly assessing this cognitive ability should be used to evaluate the effectiveness of these therapeutic interventions in future studies.
- Klíčová slova
- kognitivní flexibilita,
- MeSH
- antidepresiva aplikace a dávkování terapeutické užití MeSH
- copingové dovednosti metody MeSH
- hodnocení výsledků zdravotní péče MeSH
- kognitivní trénink metody MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- obsedantně kompulzivní porucha * diagnóza farmakoterapie terapie MeSH
- randomizované kontrolované studie jako téma MeSH
- transkraniální magnetická stimulace metody přístrojové vybavení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Chemotherapy-related cognitive impairment (CRCI) is a well-documented side effect of cancer treatment in various types of tumors including Hodgkin's lymphoma (HL). However, a longitudinal study evaluating the cognitive performance of HL patients has been completely lacking. The aim of the study was to determine the presence of CRCI in HL patients before, promptly after, and 6 months after treatment. Thirty-six patients newly diagnosed with HL and 45 healthy controls (HC) completed the neuropsychological battery and psychological measures of affective distress and quality of life. The results indicate that HL patients have impaired performance compared to HC which cannot be explained by emotional factors. Cognitive impairments prior to treatment were found in 3 of 6 cognitive domains, i.e., verbal memory and learning, speed of processing/psychomotor speed, and abstraction/executive function. Promptly after the chemotherapy, deficits were found in the domains of memory and learning, verbal memory, speed of processing/psychomotor speed, and abstraction/executive function. Weaker cognitive performance persist even 6 months after the end of chemotherapy, specifically in domains of verbal memory and learning, and abstraction/executive function. Our results indicate the presence of cognitive impairment in HL patients already prior to treatment and increased damages caused by chemotherapy, while some of them may last for up to 6 months after the treatment.
- MeSH
- exekutivní funkce MeSH
- Hodgkinova nemoc * komplikace farmakoterapie MeSH
- kognitivní dysfunkce * chemicky indukované komplikace MeSH
- kvalita života MeSH
- lidé MeSH
- longitudinální studie MeSH
- neuropsychologické testy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
