European Journal of Psychiatry最新文献

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.

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.