European Journal of Psychiatry最新文献

Background and Objectives

Sleep disturbances are part of the diagnostic criteria for bipolar disorder (BD). They are prodromal symptoms of the disorder and are present during relapse and euthymia. We aimed to identify the impact of sleep, as an endophenotype, on BD patients in terms of clinical features including suicidality, severity of the disorder, somatic comorbidities, and functionality.

Methods

This is a secondary analysis of a cross-sectional study including 291 outpatients during follow-up at four sites in Spain. The score on the sleep domain of the Hamilton Depression Rating Scale (HDRS_sleep) was used to evaluate current sleep disturbances. Other psychometric tests, such as the Young Mania Rating Scale or the Hamilton Anxiety Rating Scale, were used to assess clinical status. Sociodemographic and other clinical variables were collected. Statistical analysis was performed using IBM SPSS Statistics, Version 27.0. Non-parametric tests and multiple linear regression were used.

Results

Of the 291 patients included in the study, 64.3 % (n = 187) were women. Mean age was 47.86 (SD=12.693). The sample was segmented into two groups: euthymia and non-euthymia, and the analysis was carried out separately in each. We observed no differences in either of these groups in HDRS_sleep with regard to sex, age, metabolic syndrome, coffee intake, or smoking. After adjusting for covariates, anxiety and functionality were significantly related to sleep in the non-euthymia group.

Conclusions

Sleep disturbances are frequent in BD, even during euthymia. Its impact on functionality and anxiety levels highlights the importance of targeting sleep in clinical practice to improve the outcome of the disorder.

Background and Objectives

Incorporating psychotherapy into the curricula of psychiatry residency programs has been proven difficult, even in countries where it is a requirement for residents to become psychiatrists. The primary purpose of the article was to assess psychiatry trainees’ perspectives on psychotherapy training in residency programs worldwide.

Methods

The authors performed a narrative review, resulting in 19 original research studies, published between 2001 and 2021, evaluating psychiatry residents’ perspectives by the application of questionnaires.

Results

Psychiatry residents are interested in and value psychotherapy training, and some consider it should be an obligatory competency for psychiatrists, as it already occurs in some countries worldwide. Even though, most psychiatry trainees feel dissatisfaction with the existing training in residency curricula, pointing out concerns related to the quality of resources, time within the residency period, and financial constraints. In terms of personal psychotherapy, we found contrasting views of its importance in psychotherapy training for psychiatry residents. A crucial finding was that psychiatry residents tend to lose interest in psychotherapy during the years of the residency, and dissatisfaction with the quality of the psychotherapy curricula, lack of support, and low self-perceived competence in psychotherapy by trainees were factors associated with reduced interest in psychotherapy training.

Conclusions

The authors postulate that maintaining residents’ interest in psychotherapy requires improvements in the residency curricula and departmental leadership must support trainees’ goals of becoming comprehensively trained psychiatrists.

Background and Objectives

Anorexia nervosa (AN) is associated with significant physical and psychological stress. Stress causes changes at a cellular level and mitochondria may reflect this stress via changes such as alterations in DNA quantity or in their function. Mitochondria are unique in that they possess their own DNA, distinct from nuclear DNA, of which there are many copies within the cell. An indirect measure of mitochondrial function is the assessment of mitochondrial DNA copy number (mtDNAcn). Telomere length (TL) represents a marker of normal biological ageing, and TL can be shortened by stressors. We sought to test the following hypotheses: (1) that increased mtDNAcn would be found in patients with AN in comparison to healthy controls, (2) that mtDNAcn is related to duration and severity of AN, and (3) mtDNAcn is correlated with TL.

Methods

Using quantitative real-time polymerase chain reaction, we calculated mtDNAcn and TL using peripheral whole blood DNA collected from patients with AN (n = 23) compared to samples from age- and sex-matched healthy controls (n = 33). Clinical characteristics were also obtained.

Results

We found no difference between mtDNAcn in patients with AN in comparison to controls. mtDNAcn was positively associated with duration of illness, but not with illness severity. There was no association between mtDNAcn and TL.

Conclusions

Further investigations may clarify whether compensatory mechanisms increase mtDNAcn with increased illness duration.

Background and Objectives

This study aimed to examine sociodemographic and clinical characteristics between pregnant women infected (cases) and non-infected (controls) with COVID-19 and their offspring, focusing on the trimester in which the infection occurred

Methods

A total of 115 mother-infant dyads (64 cases and 51 controls), were analysed to evaluate maternal, delivery and new-borns’ characteristics. In particular, anxiety and depressive symptoms, sleep satisfaction, perinatal stress, bonding, social support or fear of COVID-19, during pregnancy and 6-weeks after delivery were explored. Student's t-test, chi-square and repeated measure analysis of variance were used for comparisons when appropriate

Results

No significant differences were observed between the two groups in any of the variables analysed, except for the mothers’ education, which was higher in the control group. Regarding the timing of infection, those who were infected during the first trimester reported lower levels of perceived social support and higher levels of anxiety

Conclusions

These findings suggest that the emotional impact of the pandemic may be similar throughout the population, regardless of infection status. However, the impact of the COVID-19 on mental health of future mothers appears to be more significant during the early stages of pregnancy. These results underscore the relevance of providing adequate support from the early stages of pregnancy, in order to enhance women well-being.

Background and Objectives

Growing attention has been given in the last few years to psychological predictors of love addiction (LA)¹ broadening the understanding of developing effective therapeutic measures. Emotional dysregulation, attachment style and trait impulsivity were examined in this study.

Methods

Participants (N = 249) completed a survey assessing the predictors of LA: impulsivity, emotional dysregulation, attachment styles and the Love Addiction Inventory Short Form² (LAI-SF).

Results

Regression analyses indicated that negative urgency (NU), anxious attachment, and emotional dysregulation (impulse) all significantly predicted LA (p < 0.001). Moreover, impulse moderated the relationship between LA and negative urgency (NU).³

Conclusions

Further qualitative research is suggested to provide a richer picture to the current findings and the use of neural correlates to ascertain the neuro-biological basis of LA. The present findings may inform treatment plans and suggests the use of psychotherapy to identify indicators of potential LA, manage emotions and to avoid addiction replacement.

Background and objectives

Hyperprolactinaemia is a significant side effect of antipsychotic medications and may cause sexual dysfunction. Although risperidone and paliperidone can induce prolactin elevation, previous studies suggest that switching from risperidone long-acting injectable (LAI) to paliperidone palmitate (PP) might reduce prolactin concentrations in early psychosis patients. We aimed to evaluate the effect of switching from risperidone to PP on sexual functionality and prolactin levels in patients with schizophrenia.

Methods

We studied 38 patients with schizophrenia who were treated with risperidone (oral or R-LAI) monotherapy at stable doses for at least two months and had an indication to be switched to PP by their psychiatrists. Three assessments were completed: 1) baseline (preswitch), 2) 3 months post-switch, and 3) 6 months post-switch. Prolactin concentrations in plasma were determined. Sexual functioning was assessed with the Arizona Sexual Experience Scale (ASEX). Statistical analyses were conducted in 27 patients who had at least one follow-up visit. Longitudinal changes in prolactin levels and sexual function after switching from risperidone to PP were analysed with linear mixed models. Significance was set at p < 0.05.

Results

Prolactin concentrations were reduced in women after the switch, with a significant time by sex effect (p = 0.035). Antipsychotic doses influenced prolactin levels (p = 0.006), such that higher antipsychotic doses were associated with higher prolactin concentrations. No significant differences were found in ASEX total scores at 6 months after the switch.

Conclusions

In patients with schizophrenia, switching from risperidone to PP was associated with a reduction in prolactin concentrations in women but not men.

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.