Psychological distress
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Understanding Psychological Distress: A Comprehensive Overview
Concept and Definition of Psychological Distress
Psychological distress is a multifaceted construct that encompasses a range of emotional suffering often associated with stressors that are difficult to manage in daily life. It is frequently used in healthcare literature but remains poorly defined, leading to confusion among healthcare professionals . Psychological distress includes non-specific symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and general stress . It is distinct from general distress, strain, and stress, and understanding this distinction is crucial for effective clinical interventions .
Psychological Distress in Different Contexts
Psychological Distress in ICU Family Members
Family members of patients in the Intensive Care Unit (ICU) often experience high levels of psychological distress, including anxiety, depression, and stress. This distress can negatively impact both the family members and the patient's recovery . Factors contributing to this distress include the critical condition of the patient and the stressful ICU environment .
Psychological Distress in Refugee Children
Refugee children are particularly vulnerable to psychological distress due to their exposure to traumatic pre-migration experiences and post-migration stressors. Studies have reported varying levels of PTSD, depression, and emotional and behavioral problems among these children . Factors such as demographic variables and cumulative traumatic experiences significantly influence the levels of distress .
Psychological Distress in Advanced Cancer Patients
Patients with advanced cancer frequently experience psychological distress, characterized by anxiety, depression, demoralization, death anxiety, and a perceived inability to cope effectively 57. The complexity of treatment is a primary antecedent, and the consequences can range from a positive appreciation of life to negative outcomes like hopelessness and reduced quality of life 57.
Psychological Distress and Interpersonal Violence
Interpersonal violence, including childhood abuse, rape, and domestic violence, has a significant impact on psychological distress. Victims often experience severe emotional suffering, with subjective factors like self-blame and perceived life threat contributing more to distress than objective factors like physical injury .
Biological and Psychological Markers of Psychological Distress
Metabolomic Markers
Research into metabolomic markers has shown potential in understanding the molecular mechanisms linking psychological distress to adverse health outcomes. However, studies have been heterogeneous, with inconsistent patterns of association between distress and metabolites . Future research should focus on large, diverse populations and comprehensive metabolomic profiling to improve the reproducibility of findings .
Psychological Distress and Cardiovascular Outcomes
A general propensity to psychological distress, such as that seen in Type D (distressed) personality, has been linked to adverse cardiovascular outcomes. This personality type, characterized by high negative affectivity and social inhibition, is associated with a significantly increased risk of adverse cardiac events and long-term psychological distress . This highlights the importance of considering both specific and general measures of distress in cardiovascular research and practice .
Screening and Management of Psychological Distress
Screening in Palliative Care
Screening for psychological distress in palliative care is crucial but often underdetected and undertreated. Various screening questionnaires have been evaluated for their effectiveness, with unidimensional scales performing comparably to longer versions . Routine screening, as recommended by national and international guidelines, can improve the detection and management of distress in terminally ill patients .
Primary Health Care
In primary health care, psychological distress is often associated with an imbalance between the self and the ideal self, leading to poor self-esteem and a sense of losing control over life . Early interventions and person-centered dialogues with health professionals can help patients regain their capacities and improve their well-being .
Conclusion
Psychological distress is a complex and pervasive issue affecting various populations, from ICU family members and refugee children to advanced cancer patients and victims of interpersonal violence. Understanding its multifaceted nature, identifying biological and psychological markers, and implementing effective screening and management strategies are essential steps in addressing this significant health concern. Future research should aim to refine the definitions and measurements of psychological distress to enhance clinical practice and patient outcomes.
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