European Journal of Psychiatry最新文献

Background and objectives

Advances in knowledge have contributed to the global understanding of nutritional patterns' influence on mental health. The aim was to determine the impact of a high-symbiotic diet on cardio-metabolic and psychopathological outcomes in schizophrenia.

Methods

A randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) was conducted on 50 individuals diagnosed with schizophrenia spectrum disorder. The control group received conventional dietary advice individually. The intervention group received intensive dietary advice based on the increasing consumption of food with high symbiotic content (fermented foods, whole grains, green leafy vegetables and fruits high in dietary fibre, among others). Researchers collected data on cardiovascular and psychopathological status at baseline, three and six months. In addition, anthropometric parameters were analysed monthly.

Results

Forty-four subjects were analysed. Compared to the control group, the intervention group demonstrated improvements in the PANSS-GP subscale and the PSP scale scores over 3–6 months (p < 0.05). Anthropometric values were decreased in all the variables (p < 0.05). Systolic blood pressure decreased between 3 and 6 months (p = 0.049).

Conclusions

Nutrition education for increasing the consumption of foods with high symbiotic content has positively impacted the cardio-metabolic and psychopathological profile in patients with schizophrenia spectrum disorders. In addition, advanced practice mental health nurses have been shown to play a prominent role in developing nutrition education and promoting healthy lifestyles in these patients.

This study employed the Delphi method to identify the ideal characteristics of a clozapine adverse drug reaction (ADR) scale, engaging 34 clozapine specialists at the 6th NEMEA meeting. Participants emphasized the integration of clinician-rated (CROM) and patient-rated (PROM) outcomes in the scale, aiming for a balance between comprehensiveness and practicality. Key consensus points included the inclusion of specific ADRs like somnolence, sialorrhea, and compulsivity, while metabolic complications were considered less relevant. This research highlights the need for a practical, patient-inclusive tool for monitoring clozapine ADRs, reflective of both clinical expertise and patient experiences in managing treatment-resistant schizophrenia.

Currently, there is a growing interest in exploring the underlying processes that explain how and why therapeutic approaches work. This study aims to investigate whether Mindfulness-Based Cognitive Therapy (MBCT) can enhance direct experience compared to a control intervention. 72 women diagnosed with eating disorders were assigned to either MBCT or a control treatment. Pre- and post-intervention, participants were asked to eat an orange slice and write down thoughts about the eating experience, classifying the focus of each experience as either experiential or analytical. Compared with the control group, participants who underwent MBCT showed a statistically significant increase in direct experience.

Background and Objectives

Sleep disturbances are part of the diagnostic criteria for bipolar disorder (BD). They are prodromal symptoms of the disorder and are present during relapse and euthymia. We aimed to identify the impact of sleep, as an endophenotype, on BD patients in terms of clinical features including suicidality, severity of the disorder, somatic comorbidities, and functionality.

Methods

This is a secondary analysis of a cross-sectional study including 291 outpatients during follow-up at four sites in Spain. The score on the sleep domain of the Hamilton Depression Rating Scale (HDRS_sleep) was used to evaluate current sleep disturbances. Other psychometric tests, such as the Young Mania Rating Scale or the Hamilton Anxiety Rating Scale, were used to assess clinical status. Sociodemographic and other clinical variables were collected. Statistical analysis was performed using IBM SPSS Statistics, Version 27.0. Non-parametric tests and multiple linear regression were used.

Results

Of the 291 patients included in the study, 64.3 % (n = 187) were women. Mean age was 47.86 (SD=12.693). The sample was segmented into two groups: euthymia and non-euthymia, and the analysis was carried out separately in each. We observed no differences in either of these groups in HDRS_sleep with regard to sex, age, metabolic syndrome, coffee intake, or smoking. After adjusting for covariates, anxiety and functionality were significantly related to sleep in the non-euthymia group.

Conclusions

Sleep disturbances are frequent in BD, even during euthymia. Its impact on functionality and anxiety levels highlights the importance of targeting sleep in clinical practice to improve the outcome of the disorder.

Background and Objectives

Incorporating psychotherapy into the curricula of psychiatry residency programs has been proven difficult, even in countries where it is a requirement for residents to become psychiatrists. The primary purpose of the article was to assess psychiatry trainees’ perspectives on psychotherapy training in residency programs worldwide.

Methods

The authors performed a narrative review, resulting in 19 original research studies, published between 2001 and 2021, evaluating psychiatry residents’ perspectives by the application of questionnaires.

Results

Psychiatry residents are interested in and value psychotherapy training, and some consider it should be an obligatory competency for psychiatrists, as it already occurs in some countries worldwide. Even though, most psychiatry trainees feel dissatisfaction with the existing training in residency curricula, pointing out concerns related to the quality of resources, time within the residency period, and financial constraints. In terms of personal psychotherapy, we found contrasting views of its importance in psychotherapy training for psychiatry residents. A crucial finding was that psychiatry residents tend to lose interest in psychotherapy during the years of the residency, and dissatisfaction with the quality of the psychotherapy curricula, lack of support, and low self-perceived competence in psychotherapy by trainees were factors associated with reduced interest in psychotherapy training.

Conclusions

The authors postulate that maintaining residents’ interest in psychotherapy requires improvements in the residency curricula and departmental leadership must support trainees’ goals of becoming comprehensively trained psychiatrists.

Background and Objectives

Anorexia nervosa (AN) is associated with significant physical and psychological stress. Stress causes changes at a cellular level and mitochondria may reflect this stress via changes such as alterations in DNA quantity or in their function. Mitochondria are unique in that they possess their own DNA, distinct from nuclear DNA, of which there are many copies within the cell. An indirect measure of mitochondrial function is the assessment of mitochondrial DNA copy number (mtDNAcn). Telomere length (TL) represents a marker of normal biological ageing, and TL can be shortened by stressors. We sought to test the following hypotheses: (1) that increased mtDNAcn would be found in patients with AN in comparison to healthy controls, (2) that mtDNAcn is related to duration and severity of AN, and (3) mtDNAcn is correlated with TL.

Methods

Using quantitative real-time polymerase chain reaction, we calculated mtDNAcn and TL using peripheral whole blood DNA collected from patients with AN (n = 23) compared to samples from age- and sex-matched healthy controls (n = 33). Clinical characteristics were also obtained.

Results

We found no difference between mtDNAcn in patients with AN in comparison to controls. mtDNAcn was positively associated with duration of illness, but not with illness severity. There was no association between mtDNAcn and TL.

Conclusions

Further investigations may clarify whether compensatory mechanisms increase mtDNAcn with increased illness duration.

Background and Objectives

This study aimed to examine sociodemographic and clinical characteristics between pregnant women infected (cases) and non-infected (controls) with COVID-19 and their offspring, focusing on the trimester in which the infection occurred

Methods

A total of 115 mother-infant dyads (64 cases and 51 controls), were analysed to evaluate maternal, delivery and new-borns’ characteristics. In particular, anxiety and depressive symptoms, sleep satisfaction, perinatal stress, bonding, social support or fear of COVID-19, during pregnancy and 6-weeks after delivery were explored. Student's t-test, chi-square and repeated measure analysis of variance were used for comparisons when appropriate

Results

No significant differences were observed between the two groups in any of the variables analysed, except for the mothers’ education, which was higher in the control group. Regarding the timing of infection, those who were infected during the first trimester reported lower levels of perceived social support and higher levels of anxiety

Conclusions

These findings suggest that the emotional impact of the pandemic may be similar throughout the population, regardless of infection status. However, the impact of the COVID-19 on mental health of future mothers appears to be more significant during the early stages of pregnancy. These results underscore the relevance of providing adequate support from the early stages of pregnancy, in order to enhance women well-being.

Background and Objectives

Growing attention has been given in the last few years to psychological predictors of love addiction (LA)¹ broadening the understanding of developing effective therapeutic measures. Emotional dysregulation, attachment style and trait impulsivity were examined in this study.

Methods

Participants (N = 249) completed a survey assessing the predictors of LA: impulsivity, emotional dysregulation, attachment styles and the Love Addiction Inventory Short Form² (LAI-SF).

Results

Regression analyses indicated that negative urgency (NU), anxious attachment, and emotional dysregulation (impulse) all significantly predicted LA (p < 0.001). Moreover, impulse moderated the relationship between LA and negative urgency (NU).³

Conclusions

Further qualitative research is suggested to provide a richer picture to the current findings and the use of neural correlates to ascertain the neuro-biological basis of LA. The present findings may inform treatment plans and suggests the use of psychotherapy to identify indicators of potential LA, manage emotions and to avoid addiction replacement.

Background and objectives

Hyperprolactinaemia is a significant side effect of antipsychotic medications and may cause sexual dysfunction. Although risperidone and paliperidone can induce prolactin elevation, previous studies suggest that switching from risperidone long-acting injectable (LAI) to paliperidone palmitate (PP) might reduce prolactin concentrations in early psychosis patients. We aimed to evaluate the effect of switching from risperidone to PP on sexual functionality and prolactin levels in patients with schizophrenia.

Methods

We studied 38 patients with schizophrenia who were treated with risperidone (oral or R-LAI) monotherapy at stable doses for at least two months and had an indication to be switched to PP by their psychiatrists. Three assessments were completed: 1) baseline (preswitch), 2) 3 months post-switch, and 3) 6 months post-switch. Prolactin concentrations in plasma were determined. Sexual functioning was assessed with the Arizona Sexual Experience Scale (ASEX). Statistical analyses were conducted in 27 patients who had at least one follow-up visit. Longitudinal changes in prolactin levels and sexual function after switching from risperidone to PP were analysed with linear mixed models. Significance was set at p < 0.05.

Results

Prolactin concentrations were reduced in women after the switch, with a significant time by sex effect (p = 0.035). Antipsychotic doses influenced prolactin levels (p = 0.006), such that higher antipsychotic doses were associated with higher prolactin concentrations. No significant differences were found in ASEX total scores at 6 months after the switch.

Conclusions

In patients with schizophrenia, switching from risperidone to PP was associated with a reduction in prolactin concentrations in women but not men.