Clinical Psychopharmacology and Neuroscience最新文献

Psychiatric disorders are common in patients on hemodialysis. To the best of our knowledge there are no reported cases of psychosis developing in hemodialysis patients in the context of nephrectomy, and there is limited data on the use of long-acting antipsychotics in hemodialysis, which are generally not recommended in chronic kidney disease. We present the case of a 40-year-old lady with bilateral nephrectomy receiving hemodialysis who developed psychosis that resulted in her refusing to continue hemodialysis and was irregularly compliant with oral antipsychotics, necessitating the use of a long-acting injection. We report on the approach to clinical reasoning in the choice of aripiprazole and the need for a long-acting injection. Based on its pharmacological and pharmacokinetic properties oral aripiprazole 20 mg was commenced and after establishing tolerability and response, the patient was switched to long-acting aripiprazole 400 mg monthly achieving full remission of psychotic symptoms after 6 months with maintained improvement after 12 months. Based on its properties, aripiprazole may be a reasonable option in the treatment of psychosis in patients on hemodialysis with nephrectomy and can be considered even as a long-acting injection in these patients.

Objective: Variants within genes encoding microRNAs (miRNAs) may alter the expression of both miRNAs and their target genes, thus contributing to the etiology of psychiatric disorders. The involvement of miRNAs in neuronal differentiation and synaptic plasticity supported this hypothesis. We aimed to investigate the links between miR-155 rs767649/miR-22 rs8076112 and the risk of panic disorder (PD) in a sample of Turkish population.

Methods: In this experimental study, 134 PD patients and 140 healthy controls were recruited. Genotyping was carried out using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method. To evaluate PD phenotypes, Panic Disorder Severity Scale (PDSS) was also administered to patients to clarify possible associations between the scale and risk variants analyzed.

Results: The genotype analysis of miR-155 rs767649 did not show an association with PD risk and it was not related to the disease severity. For miR-22 rs8076112 variant, a statistically significant association was determined; CC genotypes were lower in patients compared to controls. Logistic regression analysis proved the highly protective effect (80.4%) of CC genotype against PD (p = 0.041; OR = 0.196, 95% CI = 0.041-0.934). Though its significance in disease liability, miR-22 rs8076112 was not associated with the disease severity.

Conclusion: Our findings firstly report the combined analysis of miR-155 rs767649 and miR-22 rs8076112 in PD in terms of both disease susceptibility and severity. These findings await replication in independent cohorts with enrichment of other miRNA gene variants. Thus, certain miRNAs and their target genes involved in the etiology and phenotypes of PD could be enlightened.

Objective: We intended to investigate the relationships between visual sensory impairment (VSI) or auditory sensory impairment (ASI) and brain pathological changes associated with cognitive decline in older adults.

Methods: We primarily tried to examine whether each sensory impairment is related to Alzheimer's disease (AD) pathology, specifically beta-amyloid (Aβ) deposition, through both cross-sectional and longitudinal approaches in cognitively unimpaired older adults. Self-report questionnaires on vision and hearing status were administered at the baseline. Neuroimaging scans including brain [¹¹C] Pittsburgh Compound B PET and MRI, as well as clinical assessments, were performed at baseline and 2-year follow-up.

Results: Cross-sectional analyses showed that the VSI-positive group had significantly higher Aβ deposition than the VSI-negative group, whereas there was no significant association between ASI positivity and Aβ deposition. Longitudinal analyses revealed that VSI positivity at baseline was significantly associated with increased Aβ deposition over 2 years (β = 0.153, p = 0.025), although ASI positivity was not (β = 0.045, p = 0.518). VSI positivity at baseline was also significantly associated with greater atrophic changes in AD-related brain regions over the 2-year follow-up period (β = -0.207, p = 0.005), whereas ASI positivity was not (β = 0.024, p = 0.753). Neither VSI nor ASI positivity was related to cerebrovascular injury, as measured based on the white matter hyperintensity volume.

Conclusion: The findings suggest that VSI is probably related to AD-specific pathological changes, which possibly mediate the reported relationship between VSI and cognitive decline. In contrast, ASI appears not associated with AD pathologies but may contribute to cognitive decline via other mechanisms.

This study aimed to scrutinize existing evidence concerning the link between somatic symptoms and nervous system activity. The goal was to pinpoint areas for effective therapeutic interventions. Psychosomatic disorders, an often overlooked field of medicine, bears significance given the multitude of patients experiencing somatic symptoms due to specific emotions and experiences. The literature was explored using the methods of comparative analysis, synthesis and graphical representation. The study introduced pathological neural networks localized in brain regions such as the prefrontal cortex and hippocampus, leading to maladaptive behaviors and heightened negative focus. Activation of the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis, alongside increased cortisol levels, induces chronic distress, inflammation, and disruptions in neurotransmitter metabolism. The gut microbiota significantly influences psychosomatic reactions. Patients with psychosomatic disorders require complex treatment with cognitive-behavioural therapy and hypnosis methods. Within the framework of pathological neural networks, the MindChat technique has yielded effectiveness with the purpose of "dehypnotization" and destruction of aberrant cognitive and emotional patterns. However, it should be noted that this technique requires further empirical support.

Objective: This study aimed to develop a Korean version of the Nonsuicidal Self-injury Inventory (K-NSSI) through the Deliberate Self-harm Inventory (DSHI) developed by Gratz for the Korean context and confirm its reliability and validity for clinical application.

Methods: A total of 188 participants were analyzed utilizing the DSHI, the Korean version of the Self-harm Inventory, the Personality Assessment Inventory-Borderline Features (PAI-BOR), and the DSM-5 Level-2-Depression scale (Level-2-Dep). Cronbach's α assessed their reliability, while frequency analysis examined the items of the K-NSSI scales. Validity of the K-NSSI was confirmed through correlation analyses between K-NSSI (tendency for and frequency of nonsuicidal self-injury [NSSI] behavior) and SHI, PAI-BOR total scale, four subscales of PAI-BOR, and Level-2-Dep scale. Polyserial correlations analyzed the correlation between the presence of NSSI behavior and other scales. Confirmatory factor analysis and structural equation modeling explored the relationship between borderline personality features and self-harm.

Results: Cronbach's α was 0.71, indicating an "acceptable" level of reliability. Statistically significant correlations were observed between the presence of NSSI behavior and the total scores of SHI and PAI-BOR, and the four subscales of PAI-BOR. The frequency of NSSI showed statistically significant correlations with the total score of SHI and PAI-BOR, and its four subscales. Notably, 13.8% of participants reported engaging in self-harm behaviors, 26.9% reported a single occurrence, and 73.1% reported two or more instances. Structural equation modeling demonstrated that self-harm adequately predicted borderline personality traits.

Conclusion: This study successfully validated the adaptation of DSHI into K-NSSI. The K-NSSI can facilitate interventions for self-harm incidents.

Tardive dyskinesia and dystonia are intractable extrapyramidal symptoms caused by the blockade of dopamine receptors by antipsychotic drugs. In addition to the reduction or discontinuation of the causative drug, valbenazine for tardive dyskinesia and botulinum toxin for tardive dystonia have been reported to be effective. However, their efficacy has not been fully demonstrated. In this study, we report the case of a female patient with bipolar disorder, valbenazine-resistant tardive dystonia, and tardive dyskinesia who achieved improvement in extrapyramidal symptoms with electroconvulsive therapy. Additionally, we conducted a narrative literature review on the safety and efficacy of electroconvulsive therapy for tardive dyskinesia and dystonia.

Objective: Schizophrenia is a severe and chronic mental disorder that significantly impacts cognitive, social, and occupational functions, leading to substantial economic burdens. Long-acting injectable (LAI) antipsychotics have been introduced to improve treatment adherence and outcomes, yet their economic impact remains debated. We aim to analyze the impact of LAIs on the medical costs of Korean schizophrenia patients.

Methods: A retrospective analysis of 164 schizophrenia patients treated with LAI antipsychotics, paliperidone palmitate, and aripiprazole monohydrate at Korea University Guro Hospital between January 2017 and July 2022 was performed. Comparisons of inpatient department (IPD) and outpatient department (OPD) healthcare expenditures one year before and after LAI initiation were conducted.

Results: LAIs led to an increase in annual OPD costs (1,437.44 ± 1,127.60 to 4,015.42 ± 1,204.59; units: 1,000 KRW) but significantly reduced IPD admission associated costs (3,826.06 ± 5,500.63 to 698.06 ± 3,619.38; units: 1,000 KRW). After LAI administration, there was an overall reduction in total annual healthcare costs (5,263.49 ± 5,333.11 to 4,713.48 ± 3,625.89; units: 1,000 KRW), but it was not statistically significant.

Conclusion: Although the use of LAIs did not significantly lower the first-year medical costs of schizophrenia patients, they offer beneficial economic impacts over time by reducing hospitalization-associated costs. Future research should focus on long-term cost analyses and the impacts of newer LAI formulations.

Objective: : This study aimed to analyze the effect of the intensified transcranial direct-current stimulation (tDCS) targeting bilateral dorsolateral prefrontal cortex (DLPFC) on craving reduction in patients with opioid use disorder.

Methods: : This quasi-experimental study was conducted on 30 individuals who participated voluntarily at Baharan Camp of Shahid Mahalati. The participants had already completed the detoxification phase and stayed at the camp to resolve their craving and gain occupational skills to reintegrate into the community. The participants were selected using convenience and purposive sampling methods and were then assigned to an experimental group (n = 15) and a control group (n = 15). The experimental group received ten 20-minute tDCS sessions twice a day for 5 consecutive days. There was a 20-minute break between the two stimulations. The DLPFC was stimulated with a current intensity of 2 mA (anode: F3 and cathode: F4). The control group received a sham stimulation. Both groups completed Franken's Desires for Drug Questionnaire at baseline and after the stimulation sessions. Additionally, they completed the questionnaires once again three months after the end of the treatment to assess treatment retention.

Results: : At the posttest stage, the intensified tDCS had significant effects on momentary opioid craving reduction in all measured factors, e.g., desire and intention, negative reinforcement, and control (p ＜ 0.001). However, the results concerning treatment retention at the 3-month follow-up stage were insignificant for all factors (p ＜ 0.001).

Conclusion: : Apparently, tDCS can be used as a tool to reduce craving. However, its application as an independent and sustainable treatment remains debatable.