European Journal of Psychiatry最新文献_第5页

Psychotic-like experiences in obsessive compulsive disorder 强迫症中类似精神病的经历

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-10-01 DOI: 10.1016/j.ejpsy.2023.06.001

Ulaş Korkmaz , Ahmet Rifat Şahin , Ömer Böke , Gökhan Sarısoy , Aytül Karabekiroğlu , Selçuk Özdin , Hatice Özyıldız Güz

Background and objectives

The study aims to compare individuals diagnosed with obsessive-compulsive disorder (OCD) and healthy individuals in terms of psychosis-like experiences (PLEs) and investigate the relationship between PLEs and OCD severity.

Methods

Sociodemographic information form, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the positive dimension of Community Assessment of Psychic Experiences (CAPE-P), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) were applied to 83 OCD patients and 83 healthy individuals. The 11th item of Y-BOCS (Y-BOCS-11) was used to evaluate the level of insight. The OCD group was compared with the healthy control group in terms of sociodemographic information and CAPE-P score. In the OCD group, mediation analyses were performed to evaluate the factors affecting the relationship between OCD severity and PLEs.

Results

The OCD group had higher CAPE-P scores than the healthy control group. CAPE-P scores were weakly correlated with Y-BOCS-11 and Y-BOCS total scores. It was found that the relationship between OCD severity and PLEs was mediated by poor insight; however, the scores of depression and anxiety did not.

Conclusion

The results show that the level of insight is a determinative factor for PLEs in OCD. The fact that PLEs are common in the OCD group and healthy individuals support the concept of the psychosis continuum. We emphasize that being aware of PLEs in OCD can provide new understandings of the phenomenon of OCD and psychosis.

背景与目的本研究旨在比较诊断为强迫症(OCD)的个体与健康个体在类精神病经历(ple)方面的差异，并探讨ple与强迫症严重程度的关系。方法采用社会人口学信息表、耶鲁-布朗强迫症量表(Y-BOCS)、社区心理体验评估积极维度量表(CAPE-P)、汉密尔顿抑郁评定量表(HAM-D)和汉密尔顿焦虑评定量表(HAM-A)对83名强迫症患者和83名健康者进行调查。Y-BOCS量表第11项(Y-BOCS-11)用于评估洞察力水平。比较强迫症组与健康对照组的社会人口学信息和CAPE-P评分。强迫症组采用中介分析评估强迫症严重程度与ple之间关系的影响因素。结果强迫症组CAPE-P评分高于健康对照组。CAPE-P评分与Y-BOCS-11和Y-BOCS总分呈弱相关。结果发现，强迫症严重程度与ple之间存在洞察力差的中介关系;然而，抑郁和焦虑的分数却没有变化。结论洞察力水平是强迫症患者发生ple的决定性因素。ple在强迫症患者和健康个体中都很常见，这一事实支持了精神病连续统的概念。我们强调，意识到强迫症中的ple可以提供对强迫症和精神病现象的新理解。

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引用次数: 0

The association between mental health problems and asthma among European school children 欧洲学童的心理健康问题与哮喘的关系

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-10-01 DOI: 10.1016/j.ejpsy.2023.100223

James Goldin , Florence Bodeau-Livinec , Dietmar Goelitz , Adina Bitfoi , Mauro Giovanni Carta , Ceren Koç , Sigita Lesinskiene , Zlatka Mihova , Roy Otten , Viviane Kovess-Masfety

Background and objectives

To examine the prevalence of two ISAAC (International Study of Asthma and Allergies in Childhood) asthma indicators in 7 European countries and their relationship with mental health disorders in children 6–12 years.

Methods

A cross-sectional survey of 5712 school children aged 6–12 years using a video Self-administered instrument: Dominic Interactive and the Strengths and Difficulties Questionnaire (SDQ) for parents and teachers. Asthma indicators were 12 month “Wheezing or whistling in the chest” (WWC) and “Severe Asthma” (SA) based on number of attacks of wheezing, sleep disturbance due to wheezing, and limits to speech.

Results

On average 7.31% of the children had WWC, from 15.09% in Turkey to 1.32% in Italy; SA 2.22% on average ranged from 4.78% in Turkey to 0% in Italy. Generalized Anxiety Disorder (GAD) from child self-reports was significantly associated with WWC and SA even after adjustment for covariates. Based on parent and teacher combined reports, emotional problems were found to have significant associations with 12-month WWC after adjustment, as well as “any problems” which summarized externalizing and internalizing disorders Emotional, hyperactivity, conduct disorders were not associated with SA.

Conclusion

Asthma indicators very much differ across countries. Asthma indicators are associated with childhood GAD. Childhood self-reported mental health seems more related to Asthma indicators than parents/teachers combined reports.

背景和目的研究ISAAC（国际儿童哮喘和过敏研究）哮喘指标在7个欧洲国家的患病率及其与6-12岁儿童心理健康障碍的关系。方法对5712名6-12岁的在校儿童进行横断面调查，使用视频自助工具：Dominic Interactive和家长和教师的优势和困难问卷（SDQ）。哮喘指标为12个月的“胸部喘息或吹口哨”（WWC）和“严重哮喘”（SA），基于喘息发作次数、喘息引起的睡眠障碍和言语限制。结果儿童WWC患病率平均为7.31%，土耳其为15.09%，意大利为1.32%；SA的平均2.22%介于土耳其的4.78%和意大利的0%之间。儿童自我报告中的广泛性焦虑症（GAD）与WWC和SA显著相关，即使在校正协变量后也是如此。根据家长和教师的联合报告，情绪问题与调整后12个月的WWC以及概括外化和内化障碍的“任何问题”有显著关联。情绪、多动和行为障碍与SA无关。结论各国哮喘指标差异很大。哮喘指标与儿童GAD相关。儿童自我报告的心理健康似乎比家长/教师的综合报告与哮喘指标更相关。

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引用次数: 0

Prevalence and risk factors of anxiety symptoms in first-episode and drug-naïve major depressive disorder patients with metabolic syndrome 代谢综合征首发和药物依赖型重度抑郁症患者焦虑症状的患病率和危险因素

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-10-01 DOI: 10.1016/j.ejpsy.2023.07.001

Jizhou Liu , Yonglan Yang , Yanjiang Zhang , Haifeng Wang , Wenjian Wei , Xiaoe Lang , Xiangyang Zhang

Background and objectives

Patients with major depressive disorder (MDD) have high comorbidity with metabolic syndrome (MetS), although anxiety is prevalent comorbidity in MDD patients. However, there is no study on anxiety symptoms (AS) in MDD patients with MetS. Therefore, we aimed to identify the prevalence and risk factors of AS in patients with MetS who experienced a first-episode and drug naïve (FEDN) of MDD.

Methods

In this cross-sectional study, 1718 FEDN of MDD outpatients with MetS were included. Sociodemographic data, clinical characteristics, suicidal attempts, and physical and biochemical parameters were collected. Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and Positive and Negative Syndrome Scale (PANSS) positive subscale were performed to detect the AS. Multiple linear regression analysis was used to analyze the correlation.

Results

The prevalence of AS in MDD patients with MetS was 85.96%, which was 1.79 times greater than that in patients with MDD alone (P<0.05). MDD patients with MetS had a greater rate of attempted suicide, a higher HAMD total score, and a higher diastolic blood pressure than MDD patients without AS (P<0.05). Their combination could distinguish AS in MDD patients. Moreover, HAMD score, thyroid-stimulating hormone (TSH) levels, PANSS positive score, and suicide attempts were related to HAMA scores in MDD patients with comorbid MetS (P<0.05).

Conclusion

There is a significant frequency of AS in MDD patients with MetS. Multiple clinical indicators and metabolic markers are associated with AS in patients with MDD and MetS.

背景与目的重度抑郁障碍（MDD）患者与代谢综合征（MetS）共病率较高，但焦虑是MDD患者常见的共病。然而，目前还没有关于抑郁症合并代谢综合征患者的焦虑症状（AS）的研究。因此，我们旨在确定首次经历MDD发作和药物幼稚（FEDN）的MetS患者中AS的患病率和风险因素。方法在这项横断面研究中，纳入1718名患有代谢综合征的MDD门诊患者的FEDN。收集社会形态数据、临床特征、自杀企图以及生理生化参数。采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HamMD）、阳性和阴性综合征量表（PANSS）阳性分量表检测AS，并采用多元线性回归分析其相关性。结果伴有MetS的MDD患者的AS患病率为85.96%，是单纯MDD患者的1.79倍（P<；0.05），伴有MetS患者的自杀未遂率、HAMD总分和舒张压均高于无AS的MDD患者（P<！0.05），二者的结合可分别MDD患者中的AS。此外，合并代谢综合征的MDD患者的HAMD评分、促甲状腺激素（TSH）水平、PANSS阳性评分和自杀企图与HAMA评分相关（P<；0.05）。MDD和MetS患者的多种临床指标和代谢标志物与AS相关。

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引用次数: 0

Safety and effectiveness of oral blonanserin for schizophrenia in adolescents in China: Data from a 12-week post-marketing surveillance 口服布洛南色林治疗中国青少年精神分裂症的安全性和有效性：上市后12周监测数据

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-10-01 DOI: 10.1016/j.ejpsy.2023.07.005

Yun Yu , Xijin Wang , Ruiling Zhang , Keqing Li , Gang Wang , Jindong Chen , Meijuan Sun , Zhiyuan Xun , Xiaodong Yang , Guijun Zhao , Haiyun Li , Xuejun Liu

Background and objectives

Blonanserin is a second-generation antipsychotic (SGA)for the treatment of schizophrenia and has been approved for use in Japan, South Korea and China. This analysis aimed to evaluate the effectiveness and safety of blonanserin in Chinese adolescent patients, using data from a post-marketing surveillance of blonanserin started in September 2018.

Methods

A 12-week, prospective, multi-center, open-label post-marketing surveillance was conducted. Patients in this analysis were stratified by age.

Results

78 patients with schizophrenia aged < 18 years were included. The incidence of adverse drug reactions in adolescent patients was 33.3% significantly higher than patients over 40 years old. After 12-week treatment, 8.1% of adolescent patients had a weight gain ≥ 7%, and it was not significantly different from other age groups. Mean Brief Psychiatric Rating Scale (BPRS) total score was significantly reduced at week 12, and the decline of anergia score and thought disturbance score of adolescent patients was significantly greater than in adults.

Conclusions

Blonanserin was well tolerated and effective in the treatment of schizophrenia in Chinese adolescent patients in real-world clinical practice. Blonanserin might be a reasonable choice for the treatment of schizophrenia in adolescent patients.

背景与目的博那赛林是一种治疗精神分裂症的第二代抗精神病药物，已在日本、韩国和中国被批准使用。本分析旨在利用2018年9月开始的布隆色林上市后监测数据，评估布隆色素在中国青少年患者中的有效性和安全性。方法进行为期12周的前瞻性、多中心、开放标签的上市后监测。该分析中的患者按年龄分层。结果78例精神分裂症患者年龄<；18岁。青少年患者的药物不良反应发生率显著高于40岁以上患者33.3%。经过12周的治疗，8.1%的青少年患者体重增加≥7%，与其他年龄组没有显著差异。在第12周，平均简明精神病评定量表（BPRS）总分显著降低，青少年患者的无能评分和思维障碍评分的下降幅度明显大于成年人。结论在中国青少年精神分裂症的临床实践中，克隆安西林具有良好的耐受性和有效性。Blonanserin可能是治疗青少年精神分裂症的合理选择。

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引用次数: 0

Evidence-based umbrella review of non-invasive brain stimulation in anxiety disorders 无创脑刺激治疗焦虑症的循证综述

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-07-01 DOI: 10.1016/j.ejpsy.2023.01.001

Katia Nunes Sá , Rachel Fontes Baptista , Livia Shirahige , Laís B. Razza , Mateus Nogueira , Maria Helena Faria Coura , Leonardo Afonso-Santos , Clarice Tanaka , Abrahão Fontes Baptista , Katia Monte-Silva , André R. Brunoni

Background and objectives

Although several meta-analyses have suggested the efficacy of non-invasive brain stimulation (NIBS) mainly in prefrontal brain areas to treat mental disorders, no synthetic approach has been performed for other psychiatric disorders rather than depression. The objective is to assess the available evidence of NIBS in the treatment of anxiety disorders.

Methods

An umbrella review (CRD42021239577) was performed only looking for reviews with meta-analyses of randomized clinical trials using a source strategy MeSH keywords in MEDLINE through Pubmed by two independent researchers. The effects of different methods of NIBS in anxiety disorders were assessed using the PICO strategy. The methodological quality was evaluated using AMSTAR-2 and certainty of evidence using the GRADE-pro framework.

Results

From 136 screening meta-analyses, 16 from 14 studies were included in the final analysis. Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD) respond best to low frequency repetitive transcranial magnetic stimulation (rTMS), while Posttraumatic Stress Disorder (PTSD) has the largest effect size at high frequency rTMS. Panic Disorder (PD) has no evidence for clinical use of NIBS. There were not identified meta-analyses about other anxiety disorders. In general, the included studies had good methodological quality, but low to moderate evidence for clinical recommendation.

Conclusion

Available evidence reveals NIBS as an effective and safe approach to treat GAD, PTSD and OCD with low recommendation level to clinical application. A great heterogeneity of studies indicates the necessity to develop new randomized clinical trials applying NIBS to treat those and other mental disorders.

背景和目的尽管几项荟萃分析表明，主要在前额叶区域进行无创脑刺激（NIBS）治疗精神障碍的疗效，但除抑郁症外，还没有对其他精神障碍进行综合治疗。目的是评估NIBS在治疗焦虑症方面的可用证据。方法由两名独立研究人员在MEDLINE和Pubmed中使用源策略MeSH关键字，进行了一项总括性综述（CRD42021239577），仅寻找随机临床试验的荟萃分析综述。使用PICO策略评估不同NIBS方法对焦虑症的影响。方法学质量使用AMSTAR-2进行评估，证据确定性使用GRADE pro框架进行评估。结果在136项筛选荟萃分析中，14项研究中有16项纳入最终分析。广泛性焦虑症（GAD）和强迫症（OCD）对低频重复性经颅磁刺激（rTMS）的反应最好，而创伤后应激障碍（PTSD）在高频rTMS下的影响最大。惊恐障碍（PD）没有NIBS临床应用的证据。没有关于其他焦虑症的荟萃分析。总体而言，纳入的研究具有良好的方法学质量，但临床推荐的证据较低至中等。结论现有证据表明，NIBS是治疗GAD、PTSD和OCD的一种有效、安全的方法，临床应用推荐水平较低。研究的巨大异质性表明，有必要开发新的随机临床试验，应用NIBS治疗这些和其他精神障碍。

{"title":"Evidence-based umbrella review of non-invasive brain stimulation in anxiety disorders","authors":"Katia Nunes Sá , Rachel Fontes Baptista , Livia Shirahige , Laís B. Razza , Mateus Nogueira , Maria Helena Faria Coura , Leonardo Afonso-Santos , Clarice Tanaka , Abrahão Fontes Baptista , Katia Monte-Silva , André R. Brunoni","doi":"10.1016/j.ejpsy.2023.01.001","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2023.01.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p><span>Although several meta-analyses have suggested the efficacy of non-invasive brain stimulation (NIBS) mainly in prefrontal brain areas to treat </span>mental disorders<span>, no synthetic approach has been performed for other psychiatric disorders rather than depression. The objective is to assess the available evidence of NIBS in the treatment of anxiety disorders.</span></p></div><div><h3>Methods</h3><p>An umbrella review (CRD42021239577) was performed only looking for reviews with meta-analyses of randomized clinical trials using a source strategy MeSH keywords in MEDLINE through Pubmed by two independent researchers. The effects of different methods of NIBS in anxiety disorders were assessed using the PICO strategy. The methodological quality was evaluated using AMSTAR-2 and certainty of evidence using the GRADE-pro framework.</p></div><div><h3>Results</h3><p><span><span>From 136 screening meta-analyses, 16 from 14 studies were included in the final analysis. Generalized Anxiety Disorder (GAD) and </span>Obsessive Compulsive Disorder<span> (OCD) respond best to low frequency repetitive transcranial magnetic stimulation (rTMS), while </span></span>Posttraumatic Stress Disorder (PTSD) has the largest effect size at high frequency rTMS. Panic Disorder (PD) has no evidence for clinical use of NIBS. There were not identified meta-analyses about other anxiety disorders. In general, the included studies had good methodological quality, but low to moderate evidence for clinical recommendation.</p></div><div><h3>Conclusion</h3><p>Available evidence reveals NIBS as an effective and safe approach to treat GAD, PTSD and OCD with low recommendation level to clinical application. A great heterogeneity of studies indicates the necessity to develop new randomized clinical trials applying NIBS to treat those and other mental disorders.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50204278","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: 2

Psychosis in adults with autism spectrum disorder and attention deficit hyperactivity disorder at acute psychiatric wards 急性精神科病房中患有自闭症谱系障碍和注意力缺陷多动障碍的成年人的精神病

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-07-01 DOI: 10.1016/j.ejpsy.2022.12.001

Hiromitsu Uno , Wakaho Hayashi , Akari Nakagawa , Takeshi Otowa , Hiroki Yamada , Akira Iwanami

Background and objectives

Psychotic symptoms, such as delusions and hallucinations, in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) have been increasingly reported in recent literature. In the present study, the prevalence and duration of psychotic symptoms, comorbid psychotic disorders, and clinical characteristics of adults with ASD and ADHD were retrospectively examined via a chart review.

Methods

The participants were 98 adults (mean age, 28.5 years; 72 men) who were admitted to the psychiatric emergency wards of Showa University Karasuyama Hospital, and who were diagnosed with ASD and/or ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria.

Results

Among 69 individuals with ASD, 21 (30.4%) experienced psychotic symptoms, and among 29 individuals with ADHD, 5 (17.2%) exhibited psychosis. While all psychotic symptoms were classified as transient and none had comorbidity with schizophrenia and other psychotic disorders in adults with ADHD, 38.1% of psychosis was classified as prolonged and 10.3% had comorbidity with schizophrenia and other psychotic disorders in adults with ASD.

Conclusion

The results showed that a significant proportion of adults with ASD and ADHD experience psychosis during their course of illness, and provide evidence for the existence of a shared etiology between neurodevelopmental and psychotic disorders.

背景与目的近年来，自闭症谱系障碍（ASD）和注意力缺陷多动障碍（ADHD）的精神症状如妄想和幻觉的报道越来越多。在本研究中，通过图表回顾对患有ASD和ADHD的成年人的精神病症状、合并精神病障碍的患病率和持续时间以及临床特征进行了回顾性检查。方法受试者为98名（平均年龄28.5岁；72名男性），入住昭和大学卡拉苏山医院精神科急诊病房，根据《精神障碍诊断与统计手册》第四版文本修订标准被诊断为ASD和/或ADHD。结果69例ASD患者中有21例（30.4%）出现精神症状，29例ADHD患者中有5例（17.2%）出现精神病。虽然所有的精神病症状都被归类为短暂性症状，并且在患有多动症的成年人中没有一种症状与精神分裂症和其他精神病性障碍共病，在患有ASD的成年人中，38.1%的精神病被归类为长期精神病，10.3%的人与精神分裂症和其他精神病性障碍共病。结论研究结果表明，相当一部分患有ASD和ADHD的成年人在病程中经历过精神病，并为神经发育障碍和精神病性疾病之间存在共同的病因提供了证据。

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引用次数: 0

Diminished prefrontal hemodynamic response in adult attention deficit hyperactivity disorder: a multi-channel functional near-infrared spectroscopy study 成人注意力缺陷多动障碍前额叶血流动力学反应减弱的多通道功能性近红外光谱研究

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-07-01 DOI: 10.1016/j.ejpsy.2023.02.001

Y. Zhang, M. Ran, X. Zhang, M. Wang, M. Wang, G. Jiang

Background and aims

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Adult ADHD is currently diagnosed based only on subjective clinical and scoring measures, which inevitably lead to a low correct diagnosis rate. Hence, an effective auxiliary examination with higher sensitivity is needed.

Method

Twenty healthy controls (HC) subjects and 20 adults with ADHD were included in this study. The functional near-infrared spectroscopy (fNIRS) under verbal fluency test (VFT) was performed to detect cerebral cortex hemodynamics. Correlation and Receiver operating characteristic (ROC) curve analysis were employed to reveal the relationship between differences in hemodynamic response and clinical characteristics.

Results

The HbO response of adult ADHD in the prefrontal cortex (PFC) was significantly smaller than that of HC. HbO concentration changes in the corresponding channels were negatively correlated with the ASRS-inattention score. HbO concentration changes of channels 16 and 26 corresponding to the medial PFC might be helpful for the diagnosis of adult ADHD.

Conclusion

Adult ADHD patients have low activation of the PFC, changes of whose corresponding channels were significantly associated with attention deficit, indicating that fNIRS under VFT may be an effective auxiliary examination for adult ADHD.

背景与目的注意力缺陷多动障碍（ADHD）是一种常见的神经发育障碍。目前，成人多动症的诊断仅基于主观的临床和评分标准，这不可避免地导致诊断正确率低。因此，需要一种具有更高灵敏度的有效辅助检查。方法选择20名健康对照（HC）受试者和20名成人ADHD患者。采用功能性近红外光谱法（fNIRS）在语言流利性测试（VFT）下检测大脑皮层血流动力学。采用相关性和受试者操作特征（ROC）曲线分析来揭示血液动力学反应差异与临床特征之间的关系。结果成人ADHD前额叶皮层HbO反应明显小于HC。相应通道的HbO浓度变化与ASRS注意力不集中评分呈负相关。内侧PFC对应的16和26通道的HbO浓度变化可能有助于成人ADHD的诊断。结论成人ADHD患者PFC激活率较低，其对应通道的变化与注意力缺陷显著相关，表明VFT下的fNIRS可能是成人ADHD有效的辅助检查。

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引用次数: 0

High molar ratios of tumor necrosis factor α (TNF α) soluble receptors I and II to the TNF ligand in human plasma from male veterans with comorbid posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) 患有创伤后应激障碍（PTSD）和轻度创伤性脑损伤（mTBI）的男性退伍军人血浆中肿瘤坏死因子α（TNFα）可溶性受体I和II与TNF配体的高摩尔比率

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-07-01 DOI: 10.1016/j.ejpsy.2023.03.003

T.I. Morales , C.E. Stamper , L.A. Brenner

Background and Objectives

Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are associated with chronic inflammation, as inferred from increased, but variable, peripheral levels of cytokines. We sought proof of concept for the notion that peripheral cytokine binding proteins and/or soluble receptors can confound measures of cytokines in those with a history of physical and psychological traumatic exposures. Efforts were focused on one of the major cytokines involved in inflammation, tumor necrosis factor-α (TNF- α).

Methods

We examined blood plasma concentrations of TNF-α, its soluble receptors (TNF-soluble receptors (sR) I and TNFsRII), and C-reactive protein (CRP-1) in a cohort of US Veterans. In a previous study, CRP-1 was shown to be reduced by probiotic anti-inflammatory treatment in this patient cohort. All participants (n = 22) were diagnosed with PTSD and had a history of mild TBI with persistent post-concussive symptoms. Exclusion criteria included medications directly targeting inflammation.

Results

Molar concentrations of soluble TNFsRI and II exceeded concentrations of the TNF-α ligand. TNFsRI, but not TNFsRII, was significantly associated with CRP-1 (Spearman Rho correlations = 0.518; p=.016 and 0.365; p = .104, respectively).

Conclusions

TNF soluble receptors may bind to and sequester free TNF-α, suggesting that only measuring ligand concentrations may not provide a fully comprehensive view of inflammation, and potentially lead to inaccurate conclusions. TNFsRI concentration may provide a better estimate of inflammation than TNF-α for those with PTSD and post-acute mTBI with post-concussive symptoms, a hypothesis that invites further testing in larger studies.

背景和目的创伤后应激障碍（PTSD）和创伤性脑损伤（TBI）与慢性炎症有关，这是从外周细胞因子水平增加但可变推断的。我们试图证明外周细胞因子结合蛋白和/或可溶性受体可以混淆那些有身体和心理创伤暴露史的人的细胞因子测量。研究的重点是参与炎症的主要细胞因子之一，肿瘤坏死因子-α（TNF-α）。方法我们检测了一组美国退伍军人的血浆TNF-α、其可溶性受体（TNF可溶性受体（sR）I和TNFsRII）和C反应蛋白（CRP-1）的浓度。在之前的一项研究中，在该患者队列中，益生菌抗炎治疗可降低CRP-1。所有参与者（n=22）均被诊断为创伤后应激障碍，有轻度脑外伤病史，并伴有持续的脑震荡后症状。排除标准包括直接针对炎症的药物。结果可溶性TNFsRI和II的摩尔浓度超过了TNF-α配体的浓度。TNFsRI，而不是TNFsRII，与CRP-1显著相关（Spearman-Rho相关性=0.518；分别为p=0.016和0.365；p=.104）。结论sTNF可溶性受体可能与游离TNF-α结合并螯合，这表明仅测量配体浓度可能无法全面了解炎症，并可能导致不准确的结论。对于患有创伤后应激障碍和急性mTBI后伴有脑震荡症状的患者，TNFsRI浓度可能比TNF-α更好地估计炎症，这一假设值得在更大规模的研究中进行进一步的检验。

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引用次数: 0

Suicide survivors. A population at risk 自杀幸存者。处于危险中的人群

IF 1.8 4区医学 Q3 Medicine

European Journal of Psychiatry

Pub Date : 2023-07-01 DOI: 10.1016/j.ejpsy.2022.11.001

María Irigoyen-Otiñano , Carla Albert-Porcar , Cecilia Borrás , Margarita Puigdevall-Ruestes , Ana González-Pinto