European Journal of Psychiatry最新文献

Background and objectives

This pilot study tested the feasibility of tracking e-cigarette initiation over three months using a burst-of-measurement approach and examined reactivity to the ecological momentary assessment (EMA) data capture technique in this context.

Methods

Adults who smoked daily and were interested in trying e-cigarette use received an e-cigarette starter kit and were randomized to complete EMA reports (n = 30) vs. not (n = 29). Participants (M_age=44.1 years [SD=12.6], 61.0 % male, 54.3 % White, 38.9 % Black/African American) smoked 13.0 cigarettes per day on average (SD=8.4) and reported mild-to-moderate nicotine dependence (M_FTND=4.0 [SD=2.3]). Biochemical assessment and surveys were conducted at enrollment, e-cigarette initiation (1 week later), and 1-week, 1-month, and 3-month post e-cigarette initiation.

Results

A subset (17 %) of participants did not achieve the minimum 75 % EMA adherence at Week 1. The remaining participants showed excellent adherence with the EMA protocol, with a consistently high response rate to audibly prompted mini-surveys during screening (93 %) and follow-up weeks (93 %, 93 %, and 92 %, respectively). No consistent trend emerged in comparing the two randomized groups, either on variables relevant to the public health impact of e-cigarette initiation (i.e., cigarettes/day, exposure to smoke, exposure to nicotine, motivation to quit smoking), or in e-cigarette use (i.e., bouts/day, puffs/bout), with average Cohen's d values across timepoints ranging from d = 0.02 for exposure to smoke to d = 0.06 for cigarettes per day.

Conclusions

Conducting EMA with adults who smoke daily and are initiating e-cigarette use appears feasible, with some caveats. Reactivity to EMA during e-cigarette initiation appears to be small or non-significant.

Background and objectives

Heatwaves pose an increasing threat. However, there is a significant gap in understanding the impact of extreme temperatures on mental health. This study aimed to examine the associations between extreme temperatures and emergency visits for psychiatric disorders.

Method

We conducted quasi-Poisson regressions on emergency visits’ rate for psychiatric reasons in French hospitals on days exceeding the percentiles 90, 95, 97.5, 99.5, and 99.9, between June 1st and September 15th, from 2015 to 2022, compared to days whose temperatures were below the 50th percentile during the two fortnights before and after our period of interest. We also examined the cumulative effect of three consecutive days exceeding the specified percentiles.

Results

Among the analyzed 1,198,953 psychiatric visits, we found an increased relative risk (RR) for dementia ranging from 5 % to 17 % on days exceeding percentiles 90 (RR=1.05, CI=1.02–1.07), 95 (RR=1.05, CI=1.02–1.08), 97.5 (RR=1.07, CI=1.03–1.11), 99.5 (RR=1.09, CI=1.01–1.17), and 99.9 (RR=1.17, CI=1.03–1.32). The cumulative heat effect also showed an increased risk ranging from 4 % to 44 %. For psychoses, we observed increases from 5 % to 7 % for the cumulative heat effect of percentiles 90 (RR=1.05, CI=1.01–1.08), 95 (RR=1.06, CI=1.02–1.11), and 97.5 (RR=1.07, CI=1.01–1.15). Conversely, mood disorders exhibited a decreased RR from 14 % to 7 % for percentiles 90 (RR=0.93, CI=0.91–0.95), 95 (RR=0.92, CI=0.89–0.94), and 97.5 (RR=0.90, CI=0.87–0.93), as well as for the cumulative effects.

Conclusion

This study highlights the associations between weather conditions, extreme temperatures and psychiatric disorders and emphasize the importance of considering mental health management during future heatwaves.

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

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 postpartum period appears to be a vulnerable period for the development of obsessive-compulsive disorder in parents; yet it is often overlooked. This work aims to synthesize clinical data available on Postpartum Obsessive-Compulsive Disorder (PP-OCD) and to highlight its psychopathological significance and implications in clinical practice using a systematic approach.

Methods

We conducted a systematic research according to PRISMA guidelines in three databases – MEDLINE, Scopus and Web of Science. The references obtained were then screened and scanned for eligibility by two investigators. Risk of bias was assessed for each study with NIH tools.

Results

The found prevalence of postpartum OCD ranged from 2.43 %-9 % among women and 1,7 % among men. Other epidemiological and clinical data were reviewed including particular symptomatology, characterized by a swift onset of primarily aggressive and contamination obsessions, as well as situational avoidance.

Conclusion

It is a clinical entity frequently underdiagnosed, which perinatal health practitioners should be familiar with, as it can interfere with parent-infant bonding if left untreated. Mothers with an history of depression, anxiety, insomnia, obsessive compulsive, and avoidant personality disorder or presenting inappropriate interpretation of infant related intrusive thoughts are particularly at risk of developing OCD in the postpartum period. These mothers should be informed about the nature of their infant centered obsessions and could be a target of prevention programs.

Background and objectives

People with psychotic disorders can experience a lack of active involvement in their decisional process. Clinical decision aids are shared decision-making tools which are currently rarely used in mental healthcare. We examined the effects of Treatment E-Assist (TREAT), a computerized clinical decision aid in psychosis care, on shared decision-making and satisfaction with consultations as assessed by patients.

Methods

A total of 187 patients with a psychotic disorder participated. They received either treatment as usual in the first phase (TAU1), TREAT in the second phase or treatment as usual in the third phase of the trial (TAU2). The Decisional Conflict Scale was used as primary outcome measure for shared decision-making and patient satisfaction as secondary outcome.

Results

A linear mixed model analysis found no significant effects between TAU 1 (β = −0.54, SE = 2.01, p = 0.80) and TAU 2 (β = −1.66, SE = 2.63, p = 0.53) compared to TREAT on shared decision-making. High patient rated satisfaction with the consultations was found with no significant differences between TAU 1 (β = 1.48, SE = 1.14, p = 0.20) and TAU 2 (β = 2.26, SE = 1.33, p = 0.09) compared to TREAT.

Conclusion

We expected TREAT to enhance shared decision-making without decreasing satisfaction with consultations. However, no significant differences on shared decision-making or satisfaction with consultations were found. Our findings suggest that TREAT is safe to implement in psychosis care, but more research is needed to fully understand its effects on the decisional process.

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.

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

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.