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Semantic search helper: A tool based on the use of embeddings in multi-item questionnaires as a harmonization opportunity for merging large datasets - A feasibility study. 语义搜索助手:一种基于在多条目问卷中使用嵌入的工具,作为合并大型数据集的协调机会-可行性研究。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-20 DOI: 10.1192/j.eurpsy.2024.1808
Karl Gottfried, Karina Janson, Nathalie E Holz, Olaf Reis, Johannes Kornhuber, Anna Eichler, Tobias Banaschewski, Frauke Nees

Background: Recent advances in natural language processing (NLP), particularly in language processing methods, have opened new avenues in semantic data analysis. A promising application of NLP is data harmonization in questionnaire-based cohort studies, where it can be used as an additional method, specifically when only different instruments are available for one construct as well as for the evaluation of potentially new construct-constellations. The present article therefore explores embedding models' potential to detect opportunities for semantic harmonization.

Methods: Using models like SBERT and OpenAI's ADA, we developed a prototype application ("Semantic Search Helper") to facilitate the harmonization process of detecting semantically similar items within extensive health-related datasets. The approach's feasibility and applicability were evaluated through a use case analysis involving data from four large cohort studies with heterogeneous data obtained with a different set of instruments for common constructs.

Results: With the prototype, we effectively identified potential harmonization pairs, which significantly reduced manual evaluation efforts. Expert ratings of semantic similarity candidates showed high agreement with model-generated pairs, confirming the validity of our approach.

Conclusions: This study demonstrates the potential of embeddings in matching semantic similarity as a promising add-on tool to assist harmonization processes of multiplex data sets and instruments but with similar content, within and across studies.

背景:自然语言处理(NLP)的最新进展,特别是在语言处理方法方面的进展,为语义数据分析开辟了新的途径。NLP的一个很有前途的应用是基于问卷的队列研究中的数据协调,它可以作为一种额外的方法,特别是当一个结构只有不同的工具可用时,以及用于评估潜在的新结构星座。因此,本文探讨了嵌入模型检测语义协调机会的潜力。方法:使用SBERT和OpenAI的ADA等模型,我们开发了一个原型应用程序(“语义搜索助手”),以促进在广泛的健康相关数据集中检测语义相似项目的协调过程。该方法的可行性和适用性通过用例分析进行评估,该用例分析涉及来自四个大型队列研究的数据,这些研究使用不同的工具集获得异构数据,用于常见结构。结果:通过原型,我们有效地识别了潜在的协调对,这大大减少了人工评估的工作量。专家对语义相似度候选的评级显示与模型生成的对高度一致,证实了我们方法的有效性。结论:本研究证明了嵌入在匹配语义相似性方面的潜力,作为一种有前途的附加工具,可以帮助在研究内部和跨研究中具有相似内容的多个数据集和工具的协调过程。
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引用次数: 0
Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients. 抑郁症门诊患者抗抑郁治疗后第6周观察到的症状聚类和驱动因素。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-17 DOI: 10.1192/j.eurpsy.2024.1801
Michel Danon, Daphnée Poupon, Philippe Courtet, Philip Gorwood

Background: Depressive symptoms remaining after antidepressant treatment increase the risk of relapse and recurrence. We aimed to analyze the distribution and main drivers of remaining symptoms in patients with a major depressive episode.

Methods: Two independent samples of 8,229 and 5,926 patients from two large naturalistic studies were retrospectively analyzed. DSM-IV criteria for major depressive episodes were assessed during two face-to-face visits with clinicians: before the prescription of a new antidepressant, and after 6 weeks of treatment. The Hospital Anxiety and Depression Scale (HADS) was used to assess baseline severity of anxiety and depression.

Results: In both samples, two clusters of remaining symptoms were observed. The first cluster encompassed symptoms related to a negative emotional and cognitive bias and was specifically driven by the baseline severity of depression. The second cluster encompassed neurovegetative symptoms and was specifically driven by the baseline severity of anxiety.

Conclusions: The baseline anxiety-depressive balance of patients could be considered to adapt the treatment, focusing on emotional and cognitive symptoms with patients with high baseline severity of depression, and neurovegetative symptoms with patients with high baseline anxiety severity.

背景:抗抑郁药物治疗后仍存在的抑郁症状增加了复发和复发的风险。我们的目的是分析重性抑郁发作患者剩余症状的分布和主要驱动因素。方法:回顾性分析来自两项大型自然主义研究的8,229和5,926例独立样本。在与临床医生的两次面对面访问中评估DSM-IV重度抑郁发作的标准:在处方新的抗抑郁药之前和治疗6周后。医院焦虑抑郁量表(HADS)用于评估焦虑和抑郁的基线严重程度。结果:在两个样本中,观察到两组剩余症状。第一组包括与消极情绪和认知偏见相关的症状,并特别受到抑郁症基线严重程度的驱动。第二组包括神经植物症状,并特别受到焦虑基线严重程度的驱动。结论:可以考虑患者的基线焦虑抑郁平衡,以适应治疗,对基线抑郁严重程度高的患者,重点关注情绪和认知症状,对基线焦虑严重程度高的患者,重点关注神经植物症状。
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引用次数: 0
Comparison of the efficacy and safety of bupropion versus aripiprazole augmentation in adults with treatment-resistant depression: a nationwide cohort study in South Korea. 安非他酮与阿立哌唑增强治疗成人难治性抑郁症的疗效和安全性比较:韩国一项全国性队列研究
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-17 DOI: 10.1192/j.eurpsy.2024.1815
Dong Yun Lee, Rae Woong Park, Soo Min Jeon

Background: Treatment-resistant depression (TRD) affects 10-30% of patients with major depressive disorder, leading to increased comorbidities, higher mortality, and significant economic and social burdens. This study aimed to compare the efficacy and safety of bupropion and aripiprazole as augmentation therapies for TRD.

Methods: This population-based, retrospective cohort study included adults aged ≥18 years with a diagnosis of depressive disorder who met the criteria for TRD. Data were collected from a nationwide claims database in South Korea. Patients prescribed bupropion were matched 1:1 with those prescribed aripiprazole. Subgroup analyses were performed according to age. An as-treated analysis was performed as the primary analysis, and an intention-to-treat analysis was performed to identify different risk windows. The primary outcome was depression-related hospitalization, and the secondary outcomes were first-time diagnoses of movement disorder and seizure.

Results: A total of 5,619 patients (bupropion: n = 1,568; aripiprazole: n = 4,051) were included in this study. Bupropion was associated with lower risks of hospitalization (hazard ratio [HR]: 0.51; 95% confidence interval [CI] 0.29-0.86) and movement disorders (HR: 0.56; 95% CI 0.36-0.85) than aripiprazole. No significant difference in seizure risk (HR: 0.65; 95% CI 0.30-1.31) was observed between the two treatments. The subgroup analysis of participants aged ≥60 years revealed no significant differences in the three outcomes between the two medications.

Conclusions: Bupropion augmentation is associated with a significantly lower risk of depression-related re-hospitalization and movement disorders in patients with TRD. Therefore, bupropion augmentation can be a comprehensive treatment strategy for TRD.

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引用次数: 0
Efficacy and safety of home-based transcranial direct current stimulation as adjunct treatment for cognitive improvement in major depressive disorder: A double-blind, randomized, multi-site clinical trial. 家庭经颅直流刺激辅助治疗重度抑郁症认知改善的有效性和安全性:一项双盲、随机、多地点临床试验
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-15 DOI: 10.1192/j.eurpsy.2024.1811
C W Lee, K Park, J E Ahn, Y Jang, Y S Park, H Yu, D Lee, H K Ihm, J Lee, J Kim, Y I Lee, S-E Lim, S S Kwon, H Y Park, T H Ha, I-Y Yoon, Woojae Myung, Ji Hyun Baek

Background: Transcranial direct current stimulation (tDCS) is a promising treatment for major depressive disorder (MDD). This study evaluated its antidepressant and cognitive effects as a safe, effective, home-based therapy for MDD.

Methods: This double-blind, sham-controlled, randomized trial divided participants into low-intensity (1 mA, n = 47), high-intensity (2 mA, n = 49), and sham (n = 45) groups, receiving 42 daily tDCS sessions, including weekends and holidays, targeting the dorsolateral prefrontal cortex for 30 minutes. Assessments were conducted at baseline and weeks 2, 4, and 6. The primary outcome was cognitive improvement assessed by changes in total accuracy on the 2-back test from baseline to week 6. Secondary outcomes included changes in depressive symptoms (HAM-D), anxiety (HAM-A), and quality of life (QLES). Adverse events were monitored. This trial was registered with ClinicalTrials.gov (NCT04709952).

Results: In the tDCS study, of 141 participants (102 [72.3%] women; mean age 35.7 years, standard deviation 12.7), 95 completed the trial. Mean changes in the total accuracy scores from baseline to week 6 were compared across the three groups using an F-test. Linear mixed-effects models examined the interaction of group and time. Results showed no significant differences among groups in cognitive or depressive outcomes at week 6. Active groups experienced more mild adverse events compared to sham but had similar rates of severe adverse events and dropout.

Conclusions: Home-based tDCS for MDD demonstrated no evidence of effectiveness but was safe and well-tolerated. Further research is needed to address the technical limitations, evaluate broader cognitive functions, and extend durations to evaluate its therapeutic potential.

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引用次数: 0
Prevalence and comorbidity rates of disruptive mood dysregulation disorder in epidemiological and clinical samples: systematic review and meta-analysis. 流行病学和临床样本中破坏性情绪失调障碍的患病率和合并率:系统回顾和荟萃分析。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-15 DOI: 10.1192/j.eurpsy.2024.1813
Xavier Benarous, Hélène Lahaye, Angèle Consoli, David Cohen, Réal Labelle, Jean-Marc Guilé

Background: This systematic review and meta-analysis evaluates the prevalence of disruptive mood dysregulation disorders (DMDD) in community-based and clinical populations.

Methods: PubMed and PsychINFO databases were searched, using terms specific to DMDD, for studies of prevalence and comorbidity rates conducted in youths below 18.

Results: Fourteen studies reporting data from 2013 to 2023 were included. The prevalence of DMDD in the community-based samples was 3.3% (95% confidence interval [CI], 1.4-6.0) and 21.9% (95% CI, 15.5-29.0) in the clinical population. The differences in the identification strategy of DMDD were associated with significant heterogeneity between studies in the community-based samples, with a prevalence of 0.82% (95% CI, 0.11-2.13) when all diagnosis criteria were considered. Anxiety, depressive disorders, and ADHD were the most frequent comorbidity present with DMDD. The association with other neurodevelopmental disorders remained poorly investigated.

Conclusions: Caution is required when interpreting these findings, considering the quality of the reviewed data and the level of unexplained heterogeneity among studies. This review stresses the importance of considering a strict adhesion to DMDD criteria when exploring its clinical correlates.

背景:本系统综述和荟萃分析评估了社区和临床人群中破坏性情绪失调障碍(DMDD)的患病率。方法:检索PubMed和PsychINFO数据库,使用DMDD特有的术语,对18岁以下青少年的患病率和合并率进行研究。结果:纳入了2013 - 2023年的14项研究。社区样本中DMDD的患病率为3.3%(95%置信区间[CI], 1.4-6.0),临床人群中为21.9% (95% CI, 15.5-29.0)。在社区样本中,DMDD识别策略的差异与研究之间的显著异质性相关,当考虑所有诊断标准时,患病率为0.82% (95% CI, 0.11-2.13)。焦虑、抑郁和ADHD是DMDD最常见的合并症。与其他神经发育障碍的关联研究仍然很少。结论:在解释这些发现时需要谨慎,考虑到所回顾数据的质量和研究之间无法解释的异质性水平。本综述强调了在探索其临床相关性时考虑严格粘附于DMDD标准的重要性。
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引用次数: 0
International perspective on social cognition in schizophrenia: current stage and the next steps. 精神分裂症社会认知的国际视角:当前阶段和下一步。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-15 DOI: 10.1192/j.eurpsy.2024.1776
Silvia Corbera, Matthew M Kurtz, Amélie M Achim, Giulia Agostoni, Isabelle Amado, Michal Assaf, Stefano Barlati, Margherita Bechi, Roberto Cavallaro, Satoru Ikezawa, Hiroki Okano, Ryo Okubo, Rafael Penadés, Takashi Uchino, Antonio Vita, Yuji Yamada, Morris D Bell

In the last decades, research from cognitive science, clinical psychology, psychiatry, and social neuroscience has provided mounting evidence that several social cognitive abilities are impaired in people with schizophrenia and contribute to functional difficulties and poor clinical outcomes. Social dysfunction is a hallmark of the illness, and yet, social cognition is seldom assessed in clinical practice or targeted for treatment. In this article, 17 international experts, from three different continents and six countries with expertise in social cognition and social neuroscience in schizophrenia, convened several meetings to provide clinicians with a summary of the most recent international research on social cognition evaluation and treatment in schizophrenia, and to lay out primary recommendations and procedures that can be integrated into their practice. Given that many extant measures used to assess social cognition have been developed in North America or Western Europe, this article is also a call for researchers and clinicians to validate instruments internationally and we provide preliminary guidance for the adaptation and use of social cognitive measures in clinical and research evaluations internationally. This effort will assist promoting scientific rigor, enhanced clinical practice, and will help propel international scientific research and collaboration and patient care.

在过去的几十年里,来自认知科学、临床心理学、精神病学和社会神经科学的研究提供了越来越多的证据,证明精神分裂症患者的几种社会认知能力受损,并导致功能障碍和不良的临床结果。社会功能障碍是该疾病的一个标志,然而,社会认知在临床实践中很少被评估或靶向治疗。在这篇文章中,来自三个不同大洲和六个国家的17位国际专家在精神分裂症的社会认知和社会神经科学方面拥有专业知识,他们召开了几次会议,为临床医生提供了精神分裂症社会认知评估和治疗的最新国际研究总结,并提出了可以整合到他们实践中的主要建议和程序。鉴于北美或西欧已经开发了许多用于评估社会认知的现有措施,本文也呼吁研究人员和临床医生在国际上验证这些工具,并为社会认知措施在国际临床和研究评估中的适应和使用提供初步指导。这一努力将有助于提高科学严谨性,加强临床实践,并将有助于推动国际科学研究和合作以及患者护理。
{"title":"International perspective on social cognition in schizophrenia: current stage and the next steps.","authors":"Silvia Corbera, Matthew M Kurtz, Amélie M Achim, Giulia Agostoni, Isabelle Amado, Michal Assaf, Stefano Barlati, Margherita Bechi, Roberto Cavallaro, Satoru Ikezawa, Hiroki Okano, Ryo Okubo, Rafael Penadés, Takashi Uchino, Antonio Vita, Yuji Yamada, Morris D Bell","doi":"10.1192/j.eurpsy.2024.1776","DOIUrl":"10.1192/j.eurpsy.2024.1776","url":null,"abstract":"<p><p>In the last decades, research from cognitive science, clinical psychology, psychiatry, and social neuroscience has provided mounting evidence that several social cognitive abilities are impaired in people with schizophrenia and contribute to functional difficulties and poor clinical outcomes. Social dysfunction is a hallmark of the illness, and yet, social cognition is seldom assessed in clinical practice or targeted for treatment. In this article, 17 international experts, from three different continents and six countries with expertise in social cognition and social neuroscience in schizophrenia, convened several meetings to provide clinicians with a summary of the most recent international research on social cognition evaluation and treatment in schizophrenia, and to lay out primary recommendations and procedures that can be integrated into their practice. Given that many extant measures used to assess social cognition have been developed in North America or Western Europe, this article is also a call for researchers and clinicians to validate instruments internationally and we provide preliminary guidance for the adaptation and use of social cognitive measures in clinical and research evaluations internationally. This effort will assist promoting scientific rigor, enhanced clinical practice, and will help propel international scientific research and collaboration and patient care.</p>","PeriodicalId":12155,"journal":{"name":"European Psychiatry","volume":" ","pages":"e9"},"PeriodicalIF":7.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hospitalizations with post-traumatic stress disorder in France between 2013 and 2022: a nationwide retrospective study. 2013年至2022年法国创伤后应激障碍住院:一项全国性的回顾性研究。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-15 DOI: 10.1192/j.eurpsy.2024.1810
Alice Demesmaeker, Florian Dufrenois, Chloé Saint-Dizier, Guillaume Vaiva, Antoine Lamer, Mathilde Horn, Fabien D'Hondt

Introduction: The lifetime prevalence of PTSD ranges from 6 to 20% and is often associated with comorbid disorders. Despite the significant impact of PTSD, specific data on healthcare utilization related to PTSD remain limited. This study aims to characterize PTSD-related hospitalizations in France over the past decade.

Methods: This nationwide longitudinal retrospective study analyzed PTSD-related hospitalizations in France from 2013 to 2022 using the French National Hospitals Database. Data included discharge records from general and psychiatric hospitals, detailing demographics, admission/discharge dates, ICD-10 diagnoses, and hospitalization specifics.

Results: Between 2013 and 2022, 69,108 patients underwent 125,349 hospitalizations with a PTSD diagnosis (0.4% of all inpatient cases) in France. Psychiatric facilities accounted for 74,988 hospitalizations (1% of all psychiatric inpatient cases in France), while general hospitals recorded 50,361 hospitalizations (0.02% of all non-psychiatric inpatient cases). The percentage of inpatients diagnosed with PTSD increased from 0.68 to 2.22% in psychiatric facilities and from 0.02 to 0.04% in general hospitals over the study period. Females were younger in both settings and had longer stays compared to males in psychiatric facilities. Over time, there was a decrease in median age and an increase in part-time hospitalizations in psychiatric facilities. Mood disorders, stress-related disorders, and substance use disorders were prevalent comorbidities in both settings.

Conclusions: This study highlights a rise in PTSD-related hospitalizations in France, particularly in psychiatric facilities and after 2019, with high rates among women and an increase in hospitalization of younger individuals. These findings highlight the necessity for improved care strategies tailored to the increasing number of younger patients with PTSD.

简介:PTSD的终生患病率从6%到20%不等,通常伴有共病性疾病。尽管创伤后应激障碍有重大影响,但与创伤后应激障碍相关的医疗保健利用的具体数据仍然有限。本研究的目的是表征ptsd相关住院在法国在过去的十年。方法:这项全国性的纵向回顾性研究使用法国国家医院数据库分析了2013年至2022年法国ptsd相关住院情况。数据包括普通医院和精神病院的出院记录、详细的人口统计、入院/出院日期、ICD-10诊断和住院细节。结果:2013年至2022年间,法国69108名患者因PTSD诊断住院125349例(占所有住院病例的0.4%)。精神病院有74 988人住院(占法国所有精神科住院病例的1%),而综合医院有50 361人住院(占所有非精神科住院病例的0.02%)。在研究期间,精神病院诊断为PTSD的住院患者比例从0.68%增加到2.22%,综合医院从0.02增加到0.04%。在这两种情况下,女性都比男性更年轻,在精神病院的停留时间也更长。随着时间的推移,中位年龄有所下降,而在精神病院兼职住院的人数有所增加。情绪障碍、压力相关障碍和物质使用障碍是两种情况下普遍存在的合并症。结论:这项研究强调了法国与创伤后应激障碍相关的住院率上升,特别是在精神病院和2019年之后,女性的住院率很高,年轻人的住院率增加。这些发现强调了改进护理策略的必要性,以适应越来越多的年轻PTSD患者。
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引用次数: 0
Early career psychiatrists' perceptions of and training experience in electroconvulsive therapy: A cross-sectional survey across Europe. 早期职业精神科医生对电休克疗法的认知和培训经验:一项横跨欧洲的横断面调查。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-13 DOI: 10.1192/j.eurpsy.2024.1798
Cristiana Țăpoi, Laith Alexander, Renato de Filippis, Agorastos Agorastos, Diogo Almeida, Gautam Bhatia, Gamze Erzin, Martyna Ewa Gołębiewska, Enita Metaj, Sara Medved, Krista Mieze, Miloš Milutinović, Camille Noël, Antonina Pushko, David Gurrea Salas, Alejandro Compaired Sanchez, Alina Wilkowska, Rick P F Wolthusen, Mariana Pinto da Costa

Background: Electroconvulsive therapy (ECT) is a safe and effective treatment for several major psychiatric conditions, including treatment-resistant depression, mania, and schizophrenia; nevertheless, its use remains controversial. Despite its availability in some European countries, ECT is still rarely used in others. This study aims to investigate the experiences and attitudes of early career psychiatrists (ECPs) across Europe towards ECT and to examine how their exposure to ECT influences their perceptions.

Methods: In Europe, a cross-sectional survey was conducted among ECPs, including psychiatric trainees and recently fully qualified psychiatrists.

Results: A total of 573 participants from 30 European countries were included in the study, of whom more than half (N = 312; 54.5%) received ECT training. Overall, ECPs had a positive attitude towards ECT, with the vast majority agreeing or strongly agreeing that ECT is an effective (N = 509; 88.8%) and safe (N = 464; 81.0%) treatment and disagreeing or strongly disagreeing that ECT was used as a form of control or punishment (N = 545; 95.1%). Those who had received ECT training during their psychiatry training were more likely to recommend ECT to their patients (p < 0.001, r = 0.34), and held more positive views on its safety (p < 0.001, r = 0.31) and effectiveness (p < 0.001, r = 0.33). Interest in further education about ECT was moderately high (modal rating on Likert scale: 4, agree), irrespective of prior training exposure.

Conclusions: ECT training is associated with more favorable perceptions of its safety and effectiveness among ECPs. There is a general willingness among ECPs to expand their knowledge and training on ECT, which could enhance patients' access to this treatment.

背景:电休克疗法(ECT)是治疗几种主要精神疾病(包括耐药抑郁症、躁狂症和精神分裂症)的一种安全有效的方法,但其使用仍存在争议。尽管在一些欧洲国家可以使用电痉挛疗法,但在其他国家仍很少使用。本研究旨在调查欧洲早期职业精神科医生(ECPs)对电痉挛疗法的经验和态度,并研究他们接触电痉挛疗法的经历如何影响他们的看法:方法:在欧洲对 ECP(包括精神科实习生和刚获得正式资格的精神科医生)进行了横断面调查:结果:共有来自 30 个欧洲国家的 573 名参与者参与了研究,其中一半以上(N = 312;54.5%)接受过 ECT 培训。总体而言,ECPs对ECT持积极态度,绝大多数同意或非常同意ECT是一种有效(N = 509;88.8%)和安全(N = 464;81.0%)的治疗方法,不同意或非常不同意ECT被用作一种控制或惩罚形式(N = 545;95.1%)。那些在接受精神病学培训期间接受过电疗法培训的人更有可能向他们的病人推荐电疗法(p 结论:电疗法培训与病人对电疗法的更多好感有关:接受过电疗培训的 ECP 对电疗的安全性和有效性更有好感。ECPs普遍愿意扩大他们在ECT方面的知识和培训,这可以增加患者获得这种治疗的机会。
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引用次数: 0
An intersectional examination of the relationship between racial/ethnic discrimination and psychotic-like experiences: the role of other psychiatric symptoms. 种族/民族歧视与类精神病经历之间关系的交叉检验:其他精神症状的作用。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-13 DOI: 10.1192/j.eurpsy.2024.1796
Arielle Ered, Emily Lipner, Kathleen J O'Brien, Zeeshan M Huque, Deidre M Anglin, Lauren M Ellman

Background: Racial and ethnic experiences of discrimination (EODs) are associated with numerous psychiatric symptoms, including outcomes along the psychosis spectrum; however, less is known about mechanisms by which EODs confer risk for psychotic-like experiences (PLEs; common subthreshold psychotic symptoms). Furthermore, work on gendered racism asserts that the intersection of race and gender impacts the nature of EODs experienced and, in turn, may impact the relationship between EODs and PLEs.

Aims: To utilize an intersectional lens (race and gender) to examine whether psychological correlates of EODs (post-traumatic stress, anxiety, depression, and dissociation) mediate the EOD-PLE relationship.

Methods: Undergraduates at a diverse, semipublic university (N = 1,759) completed self-report questionnaires (Experiences of Discrimination Scale, Prodromal Questionnaire, Center for Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory, Dissociative Experiences Scale, and Post-Traumatic Stress Disorder Checklist - Civilian Version). Analyses stratified the sample by race (non-Hispanic White, Black, and Asian) and examined three multiple mediation models, moderated by gender, examining the pathway from EODs to PLEs, through other psychiatric symptoms.

Results: In the full sample, all psychiatric symptoms significantly mediated the relationship between EODs and PLEs. Only depression varied by gender, such that the indirect effect was only significant in female participants (β = 0.09; 95% CI [0.02, 0.16]). Across race-stratified groups, significant mediators varied by both race and gender.

Conclusions: These findings underscore the importance of accounting for intersectionality and multiple psychological symptoms in understanding the EOD-PLE associations, which differ by race and ethnicity as well as gender, and should be considered in clinical treatment of individuals with PLEs and history of EODs.

背景:种族和民族歧视经历(EODs)与许多精神症状有关,包括沿精神病谱的结果;然而,对于爆炸装置如何导致类似精神病的经历(ple;常见阈下精神病症状)。此外,关于性别种族主义的研究表明,种族和性别的交集会影响所经历的爆炸事件的性质,进而可能影响爆炸事件与生命周期之间的关系。目的:利用交叉视角(种族和性别)来检验爆炸事件的心理相关因素(创伤后应激、焦虑、抑郁和分离)是否介导了爆炸事件与爆炸事件之间的关系。方法:1759名来自一所不同类型的半公立大学的大学生完成了自我报告问卷(歧视经历量表、前驱症状问卷、流行病学研究中心抑郁量表、状态-特质焦虑量表、分离体验量表和创伤后应激障碍平民版)。分析按种族(非西班牙裔白人、黑人和亚洲人)对样本进行分层,并检验了三种多重中介模型(由性别调节),通过其他精神症状检验了从eod到ple的途径。结果:在全样本中,所有精神症状均显著介导了爆炸发生率与爆炸发生率之间的关系。只有抑郁因性别而异,因此间接效应仅在女性参与者中显著(β = 0.09;95% ci[0.02, 0.16])。在种族分层的群体中,重要的中介因素因种族和性别而异。结论:这些研究结果强调了在理解排爆与ple之间的关联时,考虑交叉性和多种心理症状的重要性,这些症状因种族、民族和性别而异,在临床治疗排爆与ple病史的个体时应予以考虑。
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引用次数: 0
Predictive accuracy of the Violence Risk Assessment Checklist for Youth in acute institutions: A prospective naturalistic multicenter study. 急性机构青少年暴力风险评估清单的预测准确性-一项前瞻性自然主义多中心研究。
IF 7.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2025-01-13 DOI: 10.1192/j.eurpsy.2025.3
Anniken Lucia Willumsen Laake, John Olav Roaldset, Tonje Lossius Husum, Stål Kapstø Bjørkly, Carina Chudiakow Gustavsen, Sara Teresia Grenabo, Øyvind Lockertsen

Background: Acute health and social services for children and adolescents often struggle with youth aggression and violence. Early identification of violence risk during institutional stay can help prevent violent incidents. As such, this study assessed the predictive accuracy of the Violence Risk Assessment Checklist for Youth (V-RISK-Y) aged 12-18 in two different juvenile settings providing 24-hour services for youth. Institutions were included from child and adolescent inpatient psychiatry and residential youth care under child protective services.

Methods: A prospective, naturalistic observational study design was employed. V-RISK-Y was administered for youth admitted to four acute inpatient psychiatric units and four acute residential youth care institutions. Incidents of violence and threats during the youth's stay were registered by institutional staff. In total, 517 youth were included in analyses, 59 of whom were registered with at least one incident of violence or threats during their stay. Area under curve (AUC) and logistic regression analyses were used to assess predictive accuracy and validity of V-RISK-Y.

Results: For the overall sample, V-RISK-Y had good predictive accuracy, and the sum score of V-RISK-Y significantly predicted registered violent incidents. Stratified analyses indicated good predictive accuracy of V-RISK-Y for the inpatient units, but not for the residential youth care institutions.

Conclusions: Findings imply that V-RISK-Y is accurate in identifying violence risk for youth admitted to inpatient psychiatric units but has limited predictive accuracy in residential youth care institutions. Future research should explore approaches to correctly identify violence risk in residential care settings.

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European Psychiatry
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