European Journal of Psychiatry最新文献

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.

Background and objectives

University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students.

Methods

First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD.

Results

1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44).

Conclusions

Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.

Background and objectives

Psychomotor retardation (PMR) has been associated with worse clinical course in depressed people. Explanations for this finding remain inconclusive. This study aimed to analyse whether depressed people with subjective PMR might show a different symptomatic pattern and to describe their clinical and sociodemographic profiles.

Methods

A total of 1024 participants from Finland, Spain and Poland, part of the “COURAGE in Europe” Project who screened positive for a depressive episode according to International Classification of Diseases-10 (ICD-10) criteria using the World Health Organization Composite International Diagnostic Interview 3.0 (CIDI 3.0), were included. Two group networks of depressive symptoms were estimated according to the presence (555 people) and absence (469 people) of subjective PMR. Measures of strength and betweenness of depressive symptoms were explored.

Results

People with subjective PMR showed a higher number of symptoms (11.30 (±2.67) versus 9.26 (±2.77)) and global disability score (38.30 (±26.41) versus 19.59 (±19.31) than people without subjective PMR. Although no difference was found in the global structure (M-Test=1.531; p = 0.994) nor the global strength (S-Test=0.248; p = 0.954) of depressed symptoms between depressed people with and without subjective PMR, differences were found in the type of central symptoms; “Restlessness/Jitters” (p = 0.01) and “Early Wake-Up” (p = 0.02) were relevant for the subjective PMR group. These two symptoms worked as bridge items between other depressive symptoms specifically for depressed people with subjective PMR.

Conclusions

Our results confirm that subjective PMR in depression is associated with higher severity of symptoms and disability. Depressed People with subjective PMR might show a different pattern of nuclear symptoms. Suicidal attempt, early wake-up and restlessness could be high-priority targets in the treatment of depressed people with subjective PMR.

Background and objectives

Neurodevelopmental and clinical problems in childhood often precede adult Schizophrenia Spectrum Disorders.

We investigated if children attending a psychiatric clinic presented more psychopathology and cognitive and motor alterations if there was a family history of Schizophrenia Spectrum Disorder diagnosis. We also searched if there was a relationship between borderline/clinical scores (≥65) in Child Behavior Checklist (subscale Thought Problems) and increased problems in motor and cognitive performance.

Methods

Seventy-five children (aged 7 to 16; mean 12 y/o; 53% males) were recruited (45 reported family history -seven of them first degree-). They completed the Wechsler Intelligence Scale for Children (WISC-V), Movement Assessment Battery for Children (MABC-2), social cognition from the Developmental NEuroPSYchological Assessment (NEPSY-II) and Conners Continuous Performance Test (CPT-3). Parents completed the Child Behavior Checklist (CBCL) and Behavior Rating Inventory of Executive Function (BRIEF-2).

Results

A neurodevelopmental disorder was the primary diagnosis in 65% (mainly ADHD). Motor performance and emotion recognition were below expected by age, and IQ was average. No relevant differences in relation to family history were found. Patients with high scores (≥65) in the CBCL Thought Problems subscale (n = 38) were older, more often presented a diagnosis of combined ADHD, performed worse in Emotion Recognition (and more often made “angry” errors), had Executive Function problems and clinical symptoms in subscales Anxious/Depressed, Withdrawal/Depressed and Attention problems.

Conclusions

In children attending a psychiatric clinic, elevated scores on CBCL Thought Problems subscale associates with more urban upbringing, more internalizing clinical problems, executive function, and facial emotion recognition difficulties, with a tendency to report “angry” to other emotions.

Background and objectives

The Clock Drawing Test (CDT) is a tool to assess cognitive function. Despite its usefulness, its interpretation remains challenging, leading to a low reliability. The main objective of this study was to determine the feasibility of using the CDT with convolutional neural networks (CNNs) as a screening tool for amnestic type of mild cognitive impairment (a-MCI).

Methods

A total of 177 CDT images were obtained from 103 healthy controls (HCs) and 74 patients with a-MCI. CNNs were trained to classify MCI based on the CDT images. To evaluate the performance of the CDT with CNNs, accuracy, sensitivity, specificity, precision, and f1-score were calculated. To compare discriminant power, the area under the curve of the CDT with CNNs and the Korean version of the Montreal Cognitive Assessment (MoCA-K) was calculated by the receiving operating characteristic curve analysis.

Results

The CDT with CNNs was more accurate in discriminating a-MCI (CDT with CNNs = 88.7%, MoCA-K = 81.8%). Furthermore, the CDT with CNNs could better discriminate a-MCI than the MoCA-K (AUC: CDT with CNNs = 0.886, MoCA-K = 0.848).

Conclusion

These results demonstrate the superiority of the CDT with CNNs to the MoCA-K for distinguishing a-MCI from HCs. The CDT with CNNs could be a surrogate for a conventional screening tool for a-MCI.

Background and objectives

Almost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population.

Methods

We designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge.

Results

Sixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses.

Conclusion

Our findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions.

Background and objectives

Alterations in the molecular mechanisms of specific amino acids (AAs) may be implicated in the pathophysiology of schizophrenia (SZ). However, little is known about antipsychotic drugs influence on levels of AAs. This study aimed to further explore antipsychotics' effects on AAs and serum lipid levels in first-episode SZ.

Methods

Eighty subjects with the International Classification of Diseases, Tenth Edition (ICD-10) criteria-defined SZ were enrolled. The levels of 31 AAs were measured in plasma samples using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).

Results

Ten AAs (i.e., citrulline, sarcosine, tyrosine, leucine, proline, hydroxyproline, kynurenine, tryptophan, valine and isoleucine) were observed to be higher and three AAs (i.e., GABA, aminobutyric acid and asparaginic acid) were lower in 80 patients with first-episode SZ after various antipsychotics treatment. In addition, there were 1 out of 31 AAs altered after olanzapine treatment and there were only 2 out of 31 AAs altered after risperidone treatment. Furthermore, serum triglyceride (TG) was markedly upregulated after olanzapine treatment, while Apolipoprotein A1 (ApoA1) was generally upregulated after risperidone treatment in patients with first-episode SZ.

Conclusions

Taken together, antipsychotic treatment can affect the plasma levels of AAs in patients with first-episode SZ, and olanzapine and risperidone have differential effects on the levels of AAs.

Bacground

Pregnancy and postpartum are sensitive periods for mental health problems due to increased stressors and demands, and the prevalence of intentional self-harming behaviors such as suicidal behavior and ideation may increase. Changes in the provision of prenatal care services and utilization of health services and adverse living conditions during the COVID-19 epidemic may also trigger or exacerbate mental illnesses.

Aims

To investigate the prevalence of suicidal behavior and ideation encountered during pregnancy and postpartum period, its change in the COVID-19 pandemic, and the related factors.

Methods

A systematic review and meta-analysis of observational studies was conducted. A search was conducted in April 2021 and updated in April 2023 on Web of Science, PubMed, PsycINFO, EBSCO, Turk Medline, Turkish Clinics, and ULAKBIM databases. Two authors independently conducted the search, selection of articles, data extraction, and quality assessment procedures, and an experienced researcher controlled all these steps. Joanna Briggs Institute's Critical Appraisal Checklists were used to assess the quality of the studies.

Results

The meta-analysis included 38 studies and the total sample size of the studies was 9 044 991. In this meta-analysis, the prevalence of suicidal behavior in women during pregnancy and postpartum periods was 5.1 % (95 % CI, 0.01–1.53), suicidal ideation 7.2 % (95 % CI, 0.03–0.18), suicide attampt 1 % (95 % CI, 0.00–0.07) and suicidal plan 7.8 % (95 % CI, 0.06–0.11). Rate of suicidal behavior, ideation/thought increased and attempts in the pandemic process (2.5% vs 19.7 %; 6.3% vs 11.3 %; 3.6% vs 1.4 %, respectively). Prevalences of suicidal behavior, ideation, attempts, and plan in the postpartum period was higher than during pregnancy (1.1% vs 23.4 %; 6.1% vs 9.2 %; 0.5% vs 0.7 %; 7.5% vs 8.8 %, respectively). This systematic review showed that suicidal behavior increases due to many factors such as individual and obstetric characteristics, economic and socio-cultural factors, domestic violence, and a history of physical and mental illness.

Conclusion

This study revealed that suicidal behavior in the perinatal period is quite common, especially in high-risk groups, and it increases even more during the pandemic period. Being aware of the sensitivity of the perinatal period in terms of suicidal behavior, healthcare professionals can improve mother-baby health by identifying high-risk groups and providing preventive and health-promoting services.

Registration number: CRD42021246334.

Background and Objectives

The Economic Activity Restriction (EAR) due to health conditions is being utilized as a foundational measure for the European indicator Healthy Life Years (HLY). The EAR group is experiencing limitations not only in economic activities but also in overall activities, and it is a population with a high likelihood of transitioning to mental illness due to health condition. However, few studies have investigated the relationship between EAR and mental illness. Therefore, the purpose of this study was to identify the association between EAR due to health conditions and mental illness for those aged 45 and older in South Korea.

Methods

We obtained data from the 2006–2020 Korean Longitudinal Study of Aging. EAR was assessed using self-reported questionnaires based on the Global Activity Limitation Indicator. mental illness was assessed based on the diagnosis data for participants who had been diagnosed. After excluding missing values, the data of 9,574 participants were analyzed using the chi-square test, log-rank tests, and time-dependent Cox proportional hazard model to evaluate the association between EAR and mental illness.

Results

Out of the 9,574 participants gathered at baseline, the mental illness rate was 4.8 %. The hazard ratio (HR) of mental illness in those in the “very probable” of EAR was 2.351 times higher (p-value <0.0001) compared with “not at all” of EAR. In model 1 which includes under 64 years, HR of mental illness in “very probable” of EAR was 3.679 times higher (p-value: 0.000) and in “probable” of EAR was 2.535 time higher (p-value: 0.001) compared with “not at all” of EAR.

Conclusion

If we provide opportunities to participate in community activities or provide the mental health promotion programs for middle-aged population who are experiencing EAR due to health condition, it is expected to prevent the deterioration of mental health and reduce the incidence of mental illness among the middle-aged Korean population.