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Impact of suicide and COVID-19 in different countries: Epidemiological data for 2020 自杀和COVID-19在不同国家的影响:2020年流行病学数据
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-07-19 DOI: 10.1016/j.ejpsy.2025.100316
Jimena María Merayo-Cano , Alejandro Porras-Segovia , Luis Gutiérrez-Rojas , Enrique Baca-García

Background and Objectives

Suicide is a major public health problem. The number of years of potential life lost (YPLL) provides a complementary perspective for mortality assessment and health policy development. Previous studies have compared YPLL due to suicide with YPLL due to COVID-19 in the United States and Spain. However, no previous studies have explored these data worldwide to establish an adequate comparison. We believe that suicide deaths do not receive adequate attention when compared, for example, to deaths attributable to COVID-19. 1 In this case we have performed a comparative analysis of the years of life lost due to suicide and the pandemic, based on data that have been published in recent years. This study aims to quantify the global impact of suicide versus COVID-19 in terms of YPLL.

Methods

Our source was the World Health Organization mortality database as of September 2023. We included countries that had data on all-cause mortality for ages 0-75, presented by age groups in 2020. For suicide and COVID-19, YPLL and the percentage of YPLL over total causes of death were analyzed.

Results

In 10 out of 22 countries (45 %), YPLL due to suicide exceeded those due to COVID-19.

Conclusions

The countries where the impact of suicide was greater than that produced by COVID-19 were Australia and Germany. Although all countries in the world for which data was available were analyzed, Europe was the region with the highest representation. In the case of Europe, the world region with the largest number of countries for which data are available, half of the countries analyzed have a higher number of years of potential life lost as a result of suicide than those lost due to COVID-19, the disease that became one of the leading causes of death in record time, with devastating socio-economic impact and damage. It is necessary to raise awareness about the impact of suicide. Suicide prevention requires a coordinated effort worldwide.
背景与目的自杀是一个重大的公共卫生问题。潜在寿命损失年数(YPLL)为死亡率评估和卫生政策制定提供了补充视角。之前的研究比较了美国和西班牙因自杀导致的YPLL与因COVID-19导致的YPLL。然而,以前没有研究在全球范围内探索这些数据以建立充分的比较。我们认为,与COVID-19造成的死亡相比,自杀死亡没有得到足够的关注。在这种情况下,我们根据近年来发表的数据,对自杀和流行病造成的生命损失年数进行了比较分析。本研究旨在量化自杀与COVID-19在YPLL方面的全球影响。方法本研究来源为截至2023年9月的世界卫生组织死亡率数据库。我们纳入了拥有2020年0-75岁年龄组全因死亡率数据的国家。对于自杀和COVID-19,分析YPLL和YPLL占总死亡原因的百分比。结果在22个国家中,有10个国家(45%)因自杀导致的YPLL超过了因COVID-19导致的YPLL。结论自杀的影响大于新冠肺炎的国家是澳大利亚和德国。虽然对世界上所有可获得数据的国家进行了分析,但欧洲是代表性最高的区域。欧洲是世界上可获得数据的国家最多的区域,在所分析的国家中,有一半国家因自杀而损失的潜在寿命年数高于因COVID-19而损失的寿命年数,这种疾病在创纪录的时间内成为主要死亡原因之一,造成了毁灭性的社会经济影响和损害。有必要提高人们对自杀影响的认识。预防自杀需要全世界的协调努力。
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引用次数: 0
National suicide prevention Spanish platform: Creation and components 全国预防自杀西班牙语平台:创建和组成
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-05-29 DOI: 10.1016/j.ejpsy.2025.100314
Elizabeth Suárez-Soto , Yolanda Sánchez-Carro , Andrés Pemau , Adriana García-Ramos , Marina Díaz-Marsá , Iria Grande , Pilar Alejandra Sáiz , Miguel Ruiz-Veguilla , Ángela Palao-Tarrero , Annabel Cebrià , Matilde Elices , Ana González-Pinto , José Luis Ayuso , Víctor Pérez Solà , Alejandro de la Torre-Luque

Background and Objectives

Suicide represents a significant global public health challenge, with a concerning increase in Spain, particularly among young adults. In response, the National Platform for the Study and Prevention of Suicide was established. This article provides a descriptive overview of its creation, structural components, and public engagement data.

Methods

The platform integrates multiple components, including geospatial and temporal epidemiological surveillance models, annual reports on suicide trends, and user-friendly data visualization tools that provide regional and national insights. It also addresses public interest by disseminating evidence-based information and preventive resources.

Results

Since its launch in October 2021 through January 13, 2025, the platform recorded 53,159 visits, indicating significant public interest in geographic suicide data and preventive resources. Most visitors are from Spain (86 %), with notable international interest, particularly from the United States and Latin America.

Conclusion

The National Platform has proven to be a valuable tool for suicide prevention in Spain, leveraging digital innovation to enhance public awareness and epidemiological monitoring. Its focus on geospatial data and user interaction underscores its potential to inform public health responses and support evidence-based interventions.
背景和目的自杀是全球公共卫生面临的一项重大挑战,在西班牙自杀率的上升令人担忧,尤其是在年轻人中。为此,建立了国家自杀研究和预防平台。本文提供了其创建、结构组件和公众参与数据的描述性概述。方法该平台集成了多个组件,包括地理空间和时间流行病学监测模型、自杀趋势年度报告以及提供区域和国家见解的用户友好型数据可视化工具。它还通过传播循证信息和预防资源来处理公众利益。自2021年10月推出至2025年1月13日,该平台记录了53159次访问,表明公众对地理自杀数据和预防资源的重大兴趣。大多数游客来自西班牙(86%),国际游客尤其来自美国和拉丁美洲。国家平台已被证明是西班牙预防自杀的宝贵工具,利用数字创新来提高公众意识和流行病学监测。它注重地理空间数据和用户互动,强调了其为公共卫生对策提供信息和支持循证干预措施的潜力。
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引用次数: 0
Treatment-resistant depression and intranasal esketamine: Spanish clinical consensus on practical aspects 难治性抑郁症和鼻内艾氯胺酮:西班牙临床共识在实际方面
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-05-02 DOI: 10.1016/j.ejpsy.2025.100313
J. Antoni Ramos-Quiroga , Fernando Mora , Silvia Arostegui , Narcís Cardoner , Jon-Inaki Etxeandia-Pradera , Rocío Gómez-Juanes , Marcos Gómez-Revuelta , José Manuel Montes , Eduard Vieta

Background

Pharmacological management of major depressive disorder has traditionally relied on antidepressants targeting the monoaminergic pathway. Treatment-resistant depression (TRD) patients have been frequently excluded from registrational trials, resulting in a lack of clear clinical recommendations for an optimised management. In recent years, treatments based on other mechanisms of action have been developed and approved. Intranasal esketamine is a novel non-monoaminergic treatment directed to improve neuroplasticity through the modulation of the glutamatergic system. In this clinical consensus we aimed to provide expert guidance on the use of intranasal esketamine for TRD patients based in our clinical practice in Spain.

Methods

A scientific committee of nine psychiatrists, experts in TRD in Spain, reviewed the literature (grey literature and articles/scientific communications published in English or Spanish between January 2014 and January 2024 in PubMed). Statements on practical aspects of TRD management with intranasal esketamine were developed in a first meeting following a discussion group approach, refined in a second meeting with a nominal group technique, and finally drafted after consensus in a third meeting.

Results

We recommend a treatment algorithm for the management of TRD with intranasal esketamine. Recommendations were made for specific clinical profiles with other psychiatric comorbidities, which are not contraindications, and for patients who do not have at least a 50 % reduction in symptoms during the first induction phase (partial responders at the end of an induction phase). Treatment should be given in the same health centre where the patient normally receives mental care. The patient’s clinical progress will determine early optimisation of intranasal esketamine dose during the induction phase, the need for flexible doses/repeating the induction treatment phase, customisation of management, and treatment duration. We described factors impacting the use of intranasal esketamine and made recommendations on the characteristics of the ideal setting for its administration. Socio-economic aspects of intranasal esketamine were reviewed.

Conclusions

This is the first consensus developed in Spain regarding practical aspects of TRD management with intranasal esketamine, with a treatment algorithm for patients who are only partial responders at the end of the induction phase.
传统上,重度抑郁症的药理学治疗依赖于针对单胺能途径的抗抑郁药物。难治性抑郁症(TRD)患者经常被排除在注册试验之外,导致缺乏明确的临床建议来优化管理。近年来,基于其他作用机制的治疗方法得到了发展和批准。鼻内艾氯胺酮是一种新的非单胺能治疗,旨在通过调节谷氨酸能系统来改善神经可塑性。在这一临床共识中,我们的目标是根据我们在西班牙的临床实践,为TRD患者鼻内使用艾氯胺酮提供专家指导。方法由西班牙TRD专家、9名精神科医生组成的科学委员会对文献(2014年1月至2024年1月在PubMed上以英语或西班牙语发表的灰色文献和文章/科学通讯)进行综述。关于鼻内使用艾氯胺酮管理TRD的实际方面的说明是在第一次会议上根据讨论小组方法制定的,在第二次会议上使用名义上的小组技术进行了完善,最后在第三次会议上达成共识后起草的。结果我们推荐了一种鼻用艾氯胺酮治疗TRD的方法。对于具有其他精神疾病合并症的特定临床资料,非禁忌症,以及在第一诱导期症状没有至少50%减轻的患者(诱导期结束时部分应答者),提出了建议。治疗应在病人通常接受精神治疗的同一保健中心进行。患者的临床进展将决定诱导阶段鼻内埃氯胺酮剂量的早期优化、灵活剂量/重复诱导治疗阶段的需要、定制管理和治疗持续时间。我们描述了影响鼻内使用艾氯胺酮的因素,并就其施用的理想环境的特点提出了建议。综述了鼻用艾氯胺酮的社会经济方面。结论:这是西班牙首次就鼻用艾氯胺酮治疗TRD的实际方面达成共识,并为诱导期结束时仅部分缓解的患者提供了治疗算法。
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引用次数: 0
Effectiveness of a 12-month telemedicine-based follow-up in reducing suicide reattempts: A multicentre non-randomized controlled study 为期 12 个月的远程医疗随访对减少自杀再企图的效果:多中心非随机对照研究
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-23 DOI: 10.1016/j.ejpsy.2025.100311
María Irigoyen-Otiñano , Vicent Llorca-Bofí , Purificación López-Pena , Andrea Gabilondo Cuéllar , Guillermo Cano Escalera , Raquel Roca , Iñaki Zorrilla , Ana González-Pinto

Background and objectives

Suicide attempts are a significant public health issue, with a high risk of relapse within 3–12 months following an initial attempt. Telemedicine-based follow-up interventions have emerged as a promising low-cost strategy for preventing reattempts, but the optimal duration and structure of these programs remain unclear. This study aimed to evaluate the effectiveness of a 12-month telemedicine-based follow-up intervention in reducing suicide reattempts compared to treatment as usual (TAU).

Methods

This multicenter, prospective, non-randomized controlled study was conducted in two hospitals in the Basque Country, Spain. A total of 140 patients with a recent suicide attempt were included, with 70 receiving a structured 12-month telephone follow-up in addition to TAU, and 70 receiving TAU alone. The primary outcome was the proportion of patients who reattempted suicide within 12 months. Secondary outcomes included time to first reattempt and the impact of adherence to the intervention response.

Results

Patients in the intervention group had a significantly lower rate of reattempts (21.4 % vs. 41.4 %, p = 0.011), fewer total reattempts (p = 0.031), and a longer time to first reattempt (p = 0.032) compared to the control group. Cox regression analysis showed a 54 % reduction in the risk of reattempts in the intervention group (HR=0.46, p = 0.001).

Conclusion

A 12-month telemedicine-based follow-up significantly reduces suicide reattempts and delays relapse, supporting its integration into standard mental health care for individuals at high risk of suicide.
背景和目的自杀企图是一个重大的公共卫生问题,在首次尝试后3-12个月内复发的风险很高。基于远程医疗的随访干预已经成为一种很有前途的低成本策略,用于防止再犯,但这些计划的最佳持续时间和结构尚不清楚。本研究旨在评估与常规治疗(TAU)相比,为期12个月的基于远程医疗的随访干预在减少自杀再企图方面的有效性。方法本研究是一项多中心、前瞻性、非随机对照研究,在西班牙巴斯克地区的两家医院进行。共纳入140例近期有自杀企图的患者,其中70例在接受TAU治疗的同时接受了12个月的电话随访,70例仅接受TAU治疗。主要结果是12个月内再次企图自杀的患者比例。次要结果包括第一次再尝试的时间和坚持干预反应的影响。结果干预组患者复诊率明显低于对照组(21.4% vs. 41.4%, p = 0.011),总复诊次数明显少于对照组(p = 0.031),首次复诊时间明显长于对照组(p = 0.032)。Cox回归分析显示,干预组再尝试风险降低54% (HR=0.46, p = 0.001)。结论基于远程医疗的12个月随访可显著减少自杀再尝试和延迟复发,支持将其纳入自杀高危个体的标准精神卫生保健。
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引用次数: 0
Association of HSV2 infection and depression in adults: a cross-sectional study of NHANES from 2005–2016 成人HSV2感染与抑郁症的关联:2005-2016年NHANES的横断面研究
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-18 DOI: 10.1016/j.ejpsy.2025.100312
Mingbo Wei , Yi Feng , Hongyan Peng , Binbin Chen , Yifan Wu , Weiming Mao , Qing Cai , Jiajin Xu , Laibao Yang , Panpan Chen , Huimin Zheng , Licheng Yu

Background and objectives

Depression is a major mental system disorder, and previous studies have found an association between herpes simplex virus 2 (HSV-2) infection and depression. However, recently researches report that depression can be divided into two categories, cognitive symptoms and somatic symptoms, but the relationship between the subtypes of depression is still unknown.

Methods

We obtained NHANES data from cycles 2005–2016, and a total of 1124 depressed cases and 4253 matched controls were selected achieving a 1:4 matching ratio. Logistic regression was used to explore the association of HSV-2 infection with depression status and severity. Zero-inflated negative binomial regression was employed to assess associations between HSV-2 infection and specific cognitive/somatic symptoms of depression.

Results

HSV2 infection was positively associated with depression status (OR=1.33, 1.11∼1.59) and severity (OR=1.24, 1.05∼1.45), but these associations were only observed in female, not in male. Furtherly, result of Zero-inflated negative binomial regression suggested that HSV2 infection increased total score of somatic symptoms (RR=1.15, 1.16∼1.25) rather than cognitive symptoms in female. Moreover, HSV2 infection was related to increasing somatic symptoms, including sleeping difficulties, fatigue and appetite problems, but not any cognitive symptoms.

Conclusion

HSV-2 infection is positively associated with depression status only in females, but not in males. HSV-2 infection appears to be primarily related to somatic symptoms rather than cognitive symptoms in the female population.
背景和目的抑郁症是一种主要的精神系统疾病,以往的研究发现单纯疱疹病毒 2(HSV-2)感染与抑郁症之间存在关联。方法我们获得了 2005-2016 年 NHANES 数据,共选取了 1124 例抑郁症病例和 4253 例匹配对照,匹配比例为 1:4。采用逻辑回归法探讨 HSV-2 感染与抑郁状态和严重程度的关系。结果HSV2感染与抑郁状态(OR=1.33, 1.11∼1.59)和严重程度(OR=1.24, 1.05∼1.45)呈正相关,但这些关联仅在女性中观察到,在男性中没有观察到。此外,零膨胀负二项回归结果表明,HSV2 感染会增加女性的躯体症状总分(RR=1.15, 1.16∼1.25),而不是认知症状。此外,HSV2 感染与睡眠困难、疲劳和食欲问题等躯体症状的增加有关,但与任何认知症状无关。在女性人群中,HSV-2 感染似乎主要与躯体症状而非认知症状有关。
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引用次数: 0
Functional impairments in attention-deficit/hyperactivity disorder and emotional dysregulation subgroups: A latent profile analysis in a large cohort of 13,207 children and adolescents 注意缺陷/多动障碍和情绪失调亚组的功能障碍:13,207名儿童和青少年的潜在特征分析
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-11 DOI: 10.1016/j.ejpsy.2025.100310
Wenyan Zhang , Xiaohui Song , Xianbin Wang , Zhongliang Jiang , Xu Hong , Tianyuan Lei , Yonghua Cui

Background and objectives

The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) symptoms and emotional dysregulation is highly prevalent. This study aims to explore potential subgroups within child and adolescent cohorts concerning ADHD symptoms and emotional dysregulation.

Methods

The sample comprised 13,207 children and adolescents aged 4–16 years diagnosed with ADHD recruited from outpatient services at the Beijing Children's Hospital. Latent profile analysis (LPA) was used to identify subgroups based on ADHD symptoms and emotional dysregulation across different age groups (children, 4–9 years, vs. adolescents, 10–16 years). Furthermore, analysis of covariance (ANCOVA) was employed to compare differences in behavioral problems, cognitive impairments, and social dysfunctions among these subgroups.

Results

We identified four distinct latent subgroups in children and three in adolescents. Significant differences in behavioral problems, cognitive impairments, and social dysfunctions were observed across these subgroups in both cohorts. Subgroups with high levels of ADHD symptoms and emotional dysregulation exhibited more severe functional impairments across both age groups.

Conclusions

This study highlights developmental variations in the relationship between ADHD symptoms and emotional dysregulation, underscoring the need for tailored interventions based on age-specific profiles.
背景与目的注意缺陷/多动障碍(ADHD)症状与情绪调节障碍的共存是非常普遍的。本研究旨在探索儿童和青少年群体中与ADHD症状和情绪失调有关的潜在亚群。方法选取北京儿童医院门诊诊断为ADHD的4-16岁儿童和青少年13207名。使用潜在特征分析(LPA)来确定不同年龄组(儿童,4-9岁,与青少年,10-16岁)的ADHD症状和情绪失调亚组。此外,采用协方差分析(ANCOVA)比较这些亚组在行为问题、认知障碍和社会功能障碍方面的差异。结果我们在儿童中发现了4个不同的潜在亚群,在青少年中发现了3个。在两个队列中,这些亚组在行为问题、认知障碍和社会功能障碍方面观察到显著差异。高水平ADHD症状和情绪失调的亚组在两个年龄组中都表现出更严重的功能障碍。结论:本研究强调了ADHD症状和情绪失调之间关系的发育变化,强调了基于年龄特征的量身定制干预的必要性。
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引用次数: 0
Impact of pet ownership and animal-assisted therapy on suicidal ideation and suicide deaths: A scoping review 宠物饲养和动物辅助治疗对自杀意念和自杀死亡的影响:范围综述
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-10 DOI: 10.1016/j.ejpsy.2025.100309
Carl Zhou , Nicholas Fabiano , Stanley Wong , Philip Yu , Henry Cheng , Risa Shorr , Marco Solmi

Background

There is growing research on therapeutic benefits of animals. However, their impact on suicide-related outcomes such as suicidal ideation (SI), suicide attempts (SA), and suicide deaths remains unclear. This scoping review consolidates existing literature on the role of pet ownership and animal assisted therapy (AAT) on suicide-related outcomes.

Methods

A PRISMA-compliant systematic search of MEDLINE, EMBASE, and PsycINFO was conducted up to March 10, 2025. Articles reporting the impact of pet ownership or AAT on SI, SA, or suicide deaths were included. Screening and data extraction were performed in duplicate, with risk of bias assessed using appropriate tools for each study design except for case reports and interviews. Study findings were descriptively summarized.

Results

25 studies were included: one RCT, five pre- and post-studies, two cohort studies, one case-control study, three case reports/series, and 13 surveys/interviews. For pet ownership, a cohort study (n=709) found a positive association between time with dog and SI (r=0.17, p<0.001). Two other observational studies yielded non-significant results against suicide deaths. For AAT, one pre- and post-study of veterans (n=71) reported significant SI reductions (t(54)=4.87, p<0.001) while another pre- and post-study of adolescents (n=30) also found significant SI reductions (χ² McNemar=6.75; p<0.05). Four other experimental studies, including one RCT, yielded non-significant results. Qualitative findings suggested pet ownership and AAT may have a perceived protective effect against SI. No articles reported on SA. Most articles had a high or moderate risk of bias.

Conclusion

While there is a reported perceived protective effect of pet ownership and AAT against SI, the evidence for pet ownership and AAT remains inconclusive in relations to SI, SA, and suicide deaths. Future research should focus on high-quality with stringent methodology, large-scale, experimental studies with standardized outcome measures to clarify the role of animals in suicide prevention.
关于动物治疗益处的研究越来越多。然而,它们对自杀相关结果(如自杀意念(SI)、自杀企图(SA)和自杀死亡)的影响尚不清楚。本综述整合了现有的关于宠物所有权和动物辅助治疗(AAT)对自杀相关结果的作用的文献。方法截至2025年3月10日,对MEDLINE、EMBASE和PsycINFO进行符合prisma标准的系统检索。文章报道了养宠物或AAT对SI、SA或自杀死亡的影响。筛选和数据提取分两份进行,除病例报告和访谈外,每个研究设计使用适当的工具评估偏倚风险。对研究结果进行描述性总结。结果纳入25项研究:1项随机对照试验、5项前后研究、2项队列研究、1项病例对照研究、3项病例报告/系列研究和13项调查/访谈。对于养宠物,一项队列研究(n=709)发现与狗相处的时间与SI呈正相关(r=0.17, p<0.001)。另外两项观察性研究对自杀死亡没有显著影响。对于AAT,一项退伍军人(n=71)的研究前和研究后报告了显著的SI降低(t(54)=4.87, p<0.001),而另一项青少年(n=30)的研究前和研究后也发现了显著的SI降低(χ 2 McNemar=6.75;术中,0.05)。其他四项实验研究,包括一项随机对照试验,得出了不显著的结果。定性研究结果表明,养宠物和AAT可能对SI有明显的保护作用。没有关于SA的文章报道。大多数文章具有高或中等偏倚风险。结论:虽然有报道认为养宠物和AAT对自杀有保护作用,但养宠物和AAT与自杀、SA和自杀死亡之间的关系尚无定论。未来的研究应该集中在高质量的、严格的方法、大规模的、具有标准化结果测量的实验研究上,以阐明动物在自杀预防中的作用。
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引用次数: 0
Hyperprolactinemia in drug-naïve first episode psychosis and its association with BDNF levels drug-naïve首发精神病患者的高催乳素血症及其与BDNF水平的关系
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-09 DOI: 10.1016/j.ejpsy.2025.100307
A Toll , D Bergé , L Martínez-Sadurní , A Trabsa , V Perez-Sola , A Mané

Background and Objectives

Hyperprolactinemia is a common and well-known side effect of antipsychotic treatment. However, prolactin levels are elevated in drug-naïve first-episode psychosis (FEP) patients, which suggests that the association between prolactin and psychosis may be more complex than previously thought. One possible hypothesis to explain this association is that prolactin has a neuroprotective effect mediated by BDNF.

Methods

50 drug- naïve FEP were included and clinical characteristics as DUP; tobacco and cannabis use; and BMI were assessed. The PANSS and GAF questionnaires were administered. Fasting blood samples were obtained to determine prolactin, TSH, and BDNF levels. All statistical analyses were performed in the whole sample and stratified by sex.

Results

Of the 50 patients, 42 % had hyperprolactinemia (33.3 % of males and 55 % of females). Prolactin levels were negatively correlated with baseline GAF scores in the whole sample and in females but not in males. Prolactin levels were positively and independently associated (regardless of sex, age, BMI, TSH level, tobacco or cannabis use) with BDNF levels.

Conclusions

Prolactin secretion may be dysregulated in drug-naïve FEP, which implies that hyperprolactinemia—a common condition in FEP —may not be solely attributable to antipsychotic treatment. Elevated prolactin levels could reflect a physiological response designed to protect the central nervous system in certain critical situations. This neuroprotective effect could be mediated by increasing BDNF levels. Hyperprolactinemia is common in antipsychotic-naïve FEP. This study shows that higher prolactin levels are associated with elevated BDNF levels, suggesting a neuroprotective effect mediated through BDNF in this patient population.
背景与目的高催乳素血症是抗精神病药物治疗中常见且众所周知的副作用。然而,在drug-naïve首发精神病(FEP)患者中,催乳素水平升高,这表明催乳素与精神病之间的关系可能比以前认为的更复杂。一种可能解释这种关联的假设是,催乳素具有由BDNF介导的神经保护作用。方法纳入50例药物naïve FEP,临床特征为DUP;烟草和大麻的使用;和BMI进行评估。进行PANSS和GAF问卷调查。获得空腹血液样本以测定催乳素、TSH和BDNF水平。所有统计分析均在整个样本中进行,并按性别分层。结果50例患者中,高泌乳素血症发生率为42%(男性33.3%,女性55%)。在整个样本和女性中,泌乳素水平与基线GAF评分呈负相关,但在男性中没有。泌乳素水平与BDNF水平呈正相关且独立相关(与性别、年龄、BMI、TSH水平、吸烟或吸食大麻无关)。结论drug-naïve FEP中催乳素分泌可能失调,这意味着高催乳素血症- FEP的常见情况-可能不仅仅归因于抗精神病药物治疗。催乳素水平升高可能反映了在某些危急情况下保护中枢神经系统的生理反应。这种神经保护作用可以通过增加BDNF水平来调节。高催乳素血症在antipsychotic-naïve FEP中很常见。本研究表明,催乳素水平升高与BDNF水平升高有关,提示在该患者群体中,BDNF介导了神经保护作用。
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引用次数: 0
Association between neutrophil-to-lymphocyte ratio and bipolar disorder: A systematic review and meta-analysis 中性粒细胞与淋巴细胞比率与双相情感障碍之间的关系:一项系统综述和荟萃分析
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-01 DOI: 10.1016/j.ejpsy.2025.100308
Ling Gui , Haiyan Yu , Yuxin Wei , Qichao Huang , Yuyao Liu , Yixiao Fu

Objective

The neutrophil-to-lymphocyte ratio (NLR), a systemic indicator of inflammation and stress, shows inconsistent associations with bipolar disorder (BD). This meta-analysis will investigate NLR's diagnostic, prognostic, and therapeutic relevance in BD.

Methods

A systematic search across PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library, using key terms ‘bipolar disorder’, ‘neutrophils’, ‘lymphocytes’, and ‘ratio’ yielded 31 studies assessed via Newcastle-Ottawa Scale. Sensitivity analyses, subgroup analyses and publication bias assessments were conducted to explore heterogeneity sources and result stability.

Results

The NLR values in BDs were significantly higher than those in healthy controls (HCs) (standardized mean difference [SMD] = 0.51, 95 % confidence interval [CI]: 0.40–0.62, p < 0.0001; odds ratio [OR] = 1.87, 95 % CI: 1.27–2.74, p = 0.001). The association was most pronounced between bipolar mania (BDM) and HC (SMD = 0.67, 95 % CI: 0.57–0.76, p < 0.0001, I² = 47 %). Additionally, BDM exhibited higher NLR than bipolar depression (BDD) and bipolar patients in euthymic episode (BDE) (SMD = 0.22, 95 % CI: 0.07–0.38, p = 0.04, I² = 42 %; SMD = 0.31, 95 % CI: 0.15–0.48, p = 0.0001, I² = 60 %, respectively). No significant differences were observed between BDD and HC (SMD = 0.30, 95 % CI: -0.05–0.64, p = 0.09). Subgroup analyses suggested that age may influence the association between NLR and BD.

Conclusion

An elevated NLR value is found in BD, particularly in BDM. However, the difference between BDD and HC is not statistically significant. NLR may be a potent biomarker for the identification and evaluation of BD.
目的中性粒细胞与淋巴细胞比率(NLR)是炎症和应激的系统性指标,与双相情感障碍(BD)的相关性不一致。本荟萃分析将调查NLR在bd中的诊断、预后和治疗相关性。方法系统搜索PubMed、Embase、Web of Science、PsycINFO和Cochrane图书馆,使用关键词“双相情感障碍”、“中性粒细胞”、“淋巴细胞”和“比率”,获得31项研究,通过纽卡斯尔-渥太华量表进行评估。通过敏感性分析、亚组分析和发表偏倚评估来探索异质性来源和结果稳定性。结果bd组NLR值显著高于健康对照组(HCs)(标准化平均差值[SMD] = 0.51, 95%可信区间[CI]: 0.40 ~ 0.62, p <;0.0001;优势比[OR] = 1.87, 95% CI: 1.27-2.74, p = 0.001)。双相躁狂症(BDM)与HC的相关性最为显著(SMD = 0.67, 95% CI: 0.57-0.76, p <;0.0001, i²= 47%)。此外,BDM患者的NLR高于双相抑郁症(BDD)和双相心境发作(BDE)患者(SMD = 0.22, 95% CI: 0.07-0.38, p = 0.04, I²= 42%;SMD = 0.31, 95% CI: 0.15 ~ 0.48, p = 0.0001, I²= 60%)。BDD与HC之间无显著差异(SMD = 0.30, 95% CI: -0.05 ~ 0.64, p = 0.09)。亚组分析显示,年龄可能影响NLR与BD之间的关系。结论NLR值在BD中升高,尤其是在BDM中。然而,BDD和HC之间的差异没有统计学意义。NLR可能是识别和评估双相障碍的有效生物标志物。
{"title":"Association between neutrophil-to-lymphocyte ratio and bipolar disorder: A systematic review and meta-analysis","authors":"Ling Gui ,&nbsp;Haiyan Yu ,&nbsp;Yuxin Wei ,&nbsp;Qichao Huang ,&nbsp;Yuyao Liu ,&nbsp;Yixiao Fu","doi":"10.1016/j.ejpsy.2025.100308","DOIUrl":"10.1016/j.ejpsy.2025.100308","url":null,"abstract":"<div><h3>Objective</h3><div>The neutrophil-to-lymphocyte ratio (NLR), a systemic indicator of inflammation and stress, shows inconsistent associations with bipolar disorder (BD). This meta-analysis will investigate NLR's diagnostic, prognostic, and therapeutic relevance in BD.</div></div><div><h3>Methods</h3><div>A systematic search across PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library, using key terms ‘bipolar disorder’, ‘neutrophils’, ‘lymphocytes’, and ‘ratio’ yielded 31 studies assessed via Newcastle-Ottawa Scale. Sensitivity analyses, subgroup analyses and publication bias assessments were conducted to explore heterogeneity sources and result stability.</div></div><div><h3>Results</h3><div>The NLR values in BDs were significantly higher than those in healthy controls (HCs) (standardized mean difference [SMD] = 0.51, 95 % confidence interval [CI]: 0.40–0.62, <em>p</em> &lt; 0.0001; odds ratio [OR] = 1.87, 95 % CI: 1.27–2.74, <em>p</em> = 0.001). The association was most pronounced between bipolar mania (BDM) and HC (SMD = 0.67, 95 % CI: 0.57–0.76, <em>p</em> &lt; 0.0001, I² = 47 %). Additionally, BDM exhibited higher NLR than bipolar depression (BDD) and bipolar patients in euthymic episode (BDE) (SMD = 0.22, 95 % CI: 0.07–0.38, <em>p</em> = 0.04, I² = 42 %; SMD = 0.31, 95 % CI: 0.15–0.48, <em>p</em> = 0.0001, I² = 60 %, respectively). No significant differences were observed between BDD and HC (SMD = 0.30, 95 % CI: -0.05–0.64, <em>p</em> = 0.09). Subgroup analyses suggested that age may influence the association between NLR and BD.</div></div><div><h3>Conclusion</h3><div>An elevated NLR value is found in BD, particularly in BDM. However, the difference between BDD and HC is not statistically significant. NLR may be a potent biomarker for the identification and evaluation of BD.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100308"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gender differences in 4466 mood disorder patients 4466例情绪障碍患者的性别差异
IF 2.5 4区 医学 Q2 PSYCHIATRY Pub Date : 2025-03-29 DOI: 10.1016/j.ejpsy.2025.100303
Alessandro Miola , Leonardo Tondo , Ross J. Baldessarini

Background and Objectives

Characteristics of women and men with bipolar disorder (BD) or major depressive disorder (MDD) have been described with inconsistent findings requiring additional assessment.

Methods

We evaluated clinical characteristics in 4466 consecutive, extensively evaluated mood disorder patients (1491 BD, 2975 MDD; 2795 women, 1671 men) using standard bivariate statistics and multivariable logistic regression modeling.

Results

Diagnosis of MDD occurred 2.28- (women) to 1.62- (men) times more than BD, but prevalence of type II BD (BD2) and type I (BD1) did not differ by gender. BD women had more familial mood disorders, early sexual abuse, anxious or cyclothymic temperament, depressive first episodes, depression–[hypo]mania–interval (DMI) and rapid-cycling course, as well as greater %-time depressed in prospective follow-up, with more suicide attempts but fewer suicides than BD men. BD women also showed more co-occurring anxiety disorder, eating disorder and medical comorbidity, including metabolic disorders and cancer, but lower rates of ADHD and substance-abuse than BD men. MDD women experienced more religious activity, sexual abuse, anxious or cyclothymic temperament, co-occurring eating disorder and medical comorbidity as well as less substance-abuse and ADHD than MDD men but did not differ from men in measures of prospective morbidity.

Conclusions

Many characteristics were selectively associated with women with mood disorders, but prospective morbidity was similar by gender except for greater %-time depressed among BD women. Limited ethnic diversity and treatment in specialized centers may affect generalizability of these findings to other settings.
背景和目的双相情感障碍(BD)或重度抑郁症(MDD)的女性和男性的特征已被描述,但发现不一致,需要进一步评估。方法对4466例连续、广泛评估的心境障碍患者的临床特征进行评估(1491例BD, 2975例MDD;2795名女性,1671名男性),采用标准双变量统计和多变量logistic回归模型。结果MDD的诊出率是BD的2.28- 1.62倍(女性),但II型(BD2)和I型(BD1)的患病率无性别差异。在前瞻性随访中,BD女性有更多的家族性情绪障碍、早期性虐待、焦虑或循环性气质、抑郁首发、抑郁-[低]躁狂间歇期(DMI)和快速循环病程,抑郁的百分比时间更长,自杀企图多于BD男性,自杀率低于BD男性。患有双相障碍的女性也表现出更多的焦虑障碍、饮食障碍和医疗共病,包括代谢障碍和癌症,但ADHD和药物滥用的比例低于患有双相障碍的男性。与MDD男性相比,MDD女性经历了更多的宗教活动、性虐待、焦虑或周期性气质、同时发生的饮食失调和医疗共病,以及更少的药物滥用和ADHD,但在预期发病率方面与男性没有差异。结论许多特征选择性地与女性情绪障碍相关,但除了双相障碍女性抑郁时间较高外,性别间的预期发病率相似。有限的种族多样性和专业中心的治疗可能会影响这些发现在其他情况下的普遍性。
{"title":"Gender differences in 4466 mood disorder patients","authors":"Alessandro Miola ,&nbsp;Leonardo Tondo ,&nbsp;Ross J. Baldessarini","doi":"10.1016/j.ejpsy.2025.100303","DOIUrl":"10.1016/j.ejpsy.2025.100303","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Characteristics of women and men with bipolar disorder (BD) or major depressive disorder (MDD) have been described with inconsistent findings requiring additional assessment.</div></div><div><h3>Methods</h3><div>We evaluated clinical characteristics in 4466 consecutive, extensively evaluated mood disorder patients (1491 BD, 2975 MDD; 2795 women, 1671 men) using standard bivariate statistics and multivariable logistic regression modeling.</div></div><div><h3>Results</h3><div>Diagnosis of MDD occurred 2.28- (women) to 1.62- (men) times more than BD, but prevalence of type II BD (BD2) and type I (BD1) did not differ by gender. BD women had more familial mood disorders, early sexual abuse, anxious or cyclothymic temperament, depressive first episodes, depression–[hypo]mania–interval (DMI) and rapid-cycling course, as well as greater %-time depressed in prospective follow-up, with more suicide attempts but fewer suicides than BD men. BD women also showed more co-occurring anxiety disorder, eating disorder and medical comorbidity, including metabolic disorders and cancer, but lower rates of ADHD and substance-abuse than BD men. MDD women experienced more religious activity, sexual abuse, anxious or cyclothymic temperament, co-occurring eating disorder and medical comorbidity as well as less substance-abuse and ADHD than MDD men but did not differ from men in measures of prospective morbidity.</div></div><div><h3>Conclusions</h3><div>Many characteristics were selectively associated with women with mood disorders, but prospective morbidity was similar by gender except for greater %-time depressed among BD women. Limited ethnic diversity and treatment in specialized centers may affect generalizability of these findings to other settings.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100303"},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
European Journal of Psychiatry
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