European Archives of Psychiatry and Clinical Neuroscience最新文献

Background: Individuals with schizophrenia experience premature aging, leading to balance deficits and higher fall risk. Dual-task training integrating balance and cognitive training has emerged as a novel intervention.

Purpose: This study examined the effectiveness of CogBals (i.e., Cognitive and Balance training Simultaneously software), a researcher-developed novel software designed for dual-task training, on balance function, walking performance, lower extremities muscle strength and cognitive function in individuals with schizophrenia.

Method: In a single-blind, parallel-group trial, 84 participants (50.18 ± 7.32 years old; 31 females) were recruited from psychiatric rehabilitation centers in Taiwan and randomly assigned (1:1:1) to a COG&BAL group, balance-only (BAL) group, or treatment as usual control group (TAU). Both training groups received the intervention 2x/week, 60 min/session, 12weeks. The primary outcome was balance functions. Data analysis was conducted using Generalized Estimating Equations.

Result: The mini-BESTest showed improvement in both training groups compared to TAU. The COG&BAL group demonstrated superior improvements in Timed Up and Go Test motor dual-task performance (p=.009), walking speed (p=.010) and stride length (p=.014) under fast walking condition compared to the BAL group. Notably, the TAU group showed significantly decline in balance function. No harms events were identified.

Conclusion: The dual-task training with CogBals enhanced balance and walking performance in middle-aged and older adults with schizophrenia. This intervention shows potential as an effective dual-task balance training approach for fall risk reduction. Future research is suggested to investigate its long-term effects and applicability in various populations.

Background: Antipsychotic therapy in schizophrenia is associated with metabolic and cardiac adverse effects. However, the short-term trajectory of these parameters during controlled inpatient stabilization, and the moderating roles of age and sex, remain less clear.

Methods: This study enrolled 586 inpatients with schizophrenia; all stabilized on an unchanged antipsychotic regimen. Fasting blood glucose (FBG), lipid profiles [triglycerides (TG), Cholesterol (CHOL), high-density lipoprotein (HDL), low density lipoprotein (LDL)], and electrocardiogram (ECG) parameters (heart rate, QRS, PR, QTc) were measured at admission and discharge. Changes were analyzed using paired t-tests and multiple linear regression to assess the influence of age and sex.

Results: From admission to discharge, significant improvements were observed in FBG (mean change: - 0.56 ± 0.07 mmol/L, pFDR < 0.01) and heart rate (mean change: - 3.81 ± 0.92 bpm, pFDR < 0.01). A significant reduction in HDL was also found (mean change: - 0.11 ± 0.02 mmol/L, pFDR < 0.01). Age-stratified analysis revealed a significant QTc shortening exclusively in patients > 45 years old (p < 0.05). Regression analysis identified sex as a significant independent predictor of HDL change (β = 0.068, p = 0.016).

Conclusion: The inpatient stabilization phase is a dynamic period marked by both beneficial (improved glycemia, lower heart rate) and adverse (reduced HDL) physiological changes. The differential effects based on age (QTc shortening) and sex (HDL change) underscore the necessity for personalized cardiometabolic monitoring and risk mitigation strategies in patients with schizophrenia.

Background: Drug use disorders (DUD) pose a serious threat to the health of women of childbearing age (15-49 years), and their disease burden has not been systematically assessed at the global level. This study aimed to analyze the trends in the disease burden of DUD among women of childbearing age worldwide from 1990 to 2021, the distribution by specific substance, and its relationship with socio-economic development levels, and the relationship between drug use and health status.

Methods: Using the 2021 Global Burden of Disease (GBD) data, we obtained the incidence and disability-adjusted life years (DALYs) and calculated the age-standardized rates (ASR) of DUD among women of childbearing age in 204 countries and territories worldwide. The estimated annual percentage change (EAPC) was used to assess temporal trends. Socio-economic disparities and health system performance were examined using the Socio-demographic Index (SDI) and efficiency frontier analysis. Furthermore, integrating NHANES 2013-2018 data, the relationship between drug use and self-reported health status was analyzed using multivariable ordered logistic regression.

Results: In 2021, the global age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) for DUD among women of childbearing age were 265.9 per 100,000 (95% UI: [265.7-266.1]) and 241.8 per 100,000 (95% UI:[241.5-242.0]), respectively. The burden was highly concentrated in high-SDI countries (such as the United States, Canada, Australia), where ASIR and ASDR were significantly higher than in low- and middle-SDI countries, and most showed an increasing trend (EAPC for ASIR = 0.82, 95% UI: [0.70-0.94]; EAPC for ASDR = 4.35, 95% UI: [3.93-4.77]). Opioid use disorder (OUD) was the leading cause of the disease burden, accounting for 74.14% of DALYs. The age distribution showed a bimodal pattern, with incidence peaks at 20-24 and 35-39 years, while the DALY peak was delayed until 25-29 years. NHANES analysis revealed that after adjusting for socio-economic confounders, drug use was significantly associated with poorer health status (OR = 1.36, 95% CI: 1.15-1.62, P < 0.001).

Conclusion: The burden of DUD among women of childbearing age shows significant socio-economic and geographical inequalities, with high-income countries facing a persistently growing crisis related to opioids and amphetamines. The true health impact of substance use becomes apparent only after adjusting for socio-economic factors. The results call for strengthened screening and early intervention in high-burden countries, the development of gender-sensitive drug policies, and improved risk communication and treatment accessibility.