European Journal of Psychiatry最新文献

Background and objectives

The presence of substantial evidence regarding the association between dietary niacin intake and cognitive impairment among the elderly remains limited, with inconsistent findings. Thus, the objective of this study was to assess the aforementioned relationship, utilizing data obtained from the National Health and Nutrition Examination Survey (NHANES).

Methods

This cross-sectional study analyzed 2255 participants aged ≥60 years from NHANES 2011–2014.The assessment of dietary niacin intake was conducted through two 24-hour dietary recalls, while cognitive function was evaluated using a battery of five tests. Multivariable logistic regression models and generalized additive model (GAM) was utilized to investigate the association between dietary niacin intake and cognitive impairment. Furthermore, subgroup analysis was conducted to assess the robustness of the primary findings.

Results

A total of 2255 old adults were included in this study, of whom 47.9% were male. In the fully adjusted model, we observed a significant inverse association between dietary niacin intake and cognitive decline [as a quartile variable, Q4 vs. Q1, odds ratio (OR):0.5 and 95% confidence interval (CI): (0.35∼0.72), p < 0.001; as a continuous variable, per 1 mg/day increment, OR (95%CI):0.97(0.95∼0.98), p < 0.001].The smooth curve fitting results revealed that A linear relationship was found between niacin intake and cognitive impairment in elderly people. The results of the sensitivity analysis remained stable.

Conclusions

Dietary niacin intakes might be inversely associated with the prevalence of cognitive impairment. Further research is required to confirm this association.

Background and Objectives

Major Depressive Disorder (MDD) is characterized by cognitive dysfunction and neurotropic and inflammatory factors linked to its pathophysiology and cognitive impairment. This study aims to identify the prodromal serum biomarkers correlated to cognitive impairment in individuals diagnosed with MDD, including variation between sexes.

Methods

This study is part of a larger two-stage research. The initial stage involved the sample of participants aged between 18 and 60 years old, diagnosed with MDD. The second phase took place three years later. The baseline assessments included a biomarker blood test (BDNF, GDNF, NGF, IL-6 and TNF-α). Follow-up assessments used the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) for subjective cognition and the number-letter sequence of the Wechsler Adult Intelligence Scale (WAIS-III) for objective cognition.

Results

The sample consisted of 155 subjects, 30 males and 125 females. In the sex-stratified sample, a correlation was found between COBRA and GDNF biomarkers in males (r= -0.339; p = 0.039). When COBRA was applied as a dependent variable in the multiple linear regression, the overall model was significant (Z (9, 50) = 2.611, p = 0.032; adjusted R² = 0.620), with the highest impact on sex (β = 0.442, p = 0.003, p_adjFDR = 0.019), symptom severity (β = 0.605, p < 0.001, p_adjFDR = 0.013) and GDNF levels (β = -0.414, p = 0.005, p_adjFDR = 0.021).

Conclusions

Our results suggest that GDNF might be a prodromal biomarker for the early detection of subjective cognitive complaints only when targeting males with MDD.

Treatment-resistant depression (TRD) poses a significant societal challenge, with gender-specific treatment gaps. In a clinical trial targeting TRD, we introduced lifestyle-based interventions. Analyzing data from 24 men and 70 women with TRD, the current study aimed to assess gender-related efficacy differences. Descriptive and univariate analyses unveiled variations in sociodemographic and clinical factors. Utilizing repeated measures ANOVA while controlling for baseline values and age, results indicated a notable gender disparity. Specifically, women exhibited a significantly poorer progression of depressive symptoms. This underscores the need for tailored interventions addressing gender-specific nuances in TRD treatment.

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

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.

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

Substance use disorder (SUD) has become a major concern in public health globally, and there is an urgent need to develop an integrated psychosocial intervention. The aims of the current study are to test the efficacy of the integrated treatment with neurofeedback and mindfulness-based therapy for SUD and identify the predictors of the efficacy.

Methods

This study included 110 participants with SUD into the analysis. Outcome of measures includes demographic characteristics, severity of dependence, quality of life, symptoms of depression, and anxiety. Independent t test is used to estimate the change of scores at baseline and three months follow-up. Generalized estimating equations are applied to analyze the effect of predictors on the scores of dependence severity over time by controlling for the effects of demographic characteristics.

Results

A total of 22 (20 %) participants were comorbid with major mental disorder (MMD). The decrement of the severity in dependence, anxiety, and depression after treatment are identified. Improved scores of qualities of life in generic, psychological, social, and environmental domains are also noticed. After controlling for the effects of demographic characteristics, the predictors of poorer outcome are comorbid with MMD, lower quality of life, and higher level of depression and anxiety.

Conclusion

The present study implicates the efficacy of integrated therapy. Early identification of predictors is beneficial for healthcare workers to improve the treatment efficacy

Background and objectives

The efficacy of antipsychotic drugs in improving negative symptoms of schizophrenia remains controversial. Psychological interventions, such as Social Skills Training (SST) and Social Cognition and Interaction Training (SCIT), have been developed and applied in clinical practice. The current meta-analysis was therefore conducted to evaluate the efficacy of controlled clinical trials using SST and SCIT on treating negative symptoms.

Methods

Systematical searches were carried out on PubMed, Web of Science, and PsycINFO databases. The standardized mean difference (SMD) with 95% confidence intervals (CI) was calculated to assess the effect size of SST/SCIT on negative symptoms. Subgroup and meta-regression analyses were conducted to explore sources of heterogeneity and identify potential factors that may influence their efficacy.

Results

A total of 23 studies including 1441 individuals with schizophrenia were included. The SST group included 8 studies with 635 individuals, and the SCIT group included 15 studies with 806 individuals. The effect size for the efficacy of SST on negative symptoms was -0.44 (95% CI: -0.60 to -0.28; p < 0.01), while SCIT was -0.16 (95% CI: -0.30 to -0.02; p < 0.01).

Conclusions

Our findings suggest that while both SST and SCIT can alleviate negative symptoms, the former appears to be more effective. Our results provide evidence-based guidance for the application of these interventions in both hospitalized and community individuals and can help inform the treatment and intervention of individuals with schizophrenia.