European Psychiatry最新文献

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the development of psychosis and subthreshold psychotic symptoms commonly referred to as psychotic-like experiences (PLEs). The exact mechanisms linking the HPA axis responses with the emergence of PLEs remain unknown. The present study aimed to explore real-life associations between stress, negative affect, salivary cortisol levels (a proxy of the HPA axis activity) as well as PLEs together with their underlying cognitive biases (i.e., threat anticipation and aberrant salience). The study was based on the experience sampling method scheduled over 7 consecutive days in the sample of 77 drug-naïve, young adults (18-35 years). The saliva samples were collected with each prompt to measure cortisol levels. A temporal network analysis was used to explore the directed associations of tested variables. Altogether, 3234 data entries were analyzed. Data analysis revealed that salivary cortisol levels did not directly predict next-moment fluctuations of PLEs. However, higher salivary cortisol levels were associated with higher next-moment levels of PLEs through the effects on threat anticipation and negative affect. In turn, PLEs appeared to predict cortisol levels through the effects on negative affect and event-related stress. Negative affect and threat anticipation were the most central nodes in the network. There might be bidirectional associations between the HPA axis responses and PLEs. Threat anticipation and negative affect might be the most important mediators of these associations. Interventions targeting these mediators might hold promise for disrupting the connection between the HPA axis dysregulation and PLEs.

Background: The change in symptoms necessary to be clinically relevant in obsessive-compulsive disorder (OCD) is currently unknown. In this study, we aimed to create an empirically validated threshold for clinical significance or minimal important difference (MID).

Methods: We analyzed individual participant data from short-term, double-blind, placebo-controlled registration trials of selective serotonin reuptake inhibitors in adult OCD patients. Data were collected from baseline to week 12. We used equipercentile linking to equate changes in the Clinical Global Impression (CGI) scale to changes in the Yale-Brown Obsessive-Compulsive Scale (YBOCS). We defined the MID as the YBOCS change linked to a CGI improvement of 3 (defined as "minimal improvement").

Results: We included 7 trials with a total of 1216 patients. The CGI-scores and YBOCS were moderately to highly correlated. The MID corresponded to 4.9 YBOCS points (95% CI 4.4-5.4) for the full sample, or a 24% YBOCS-decrease compared to baseline. The MID varied with baseline severity, being lower in the group with mild symptoms and higher in the group with severe symptoms.

Conclusions: By linking the YBOCS to the CGI-I, this is the first study to propose an MID in OCD trials. Having a clearly defined MID can guide future clinical research and help interpretation of efficacy of existing interventions. Our results are clinician-based; however, there is further need for patient-reported outcomes as anchor to the YBOCS.

Background: Obesity-related cardiometabolic comorbidity is common in major depressive disorder (MDD). However, sex differences and MDD recurrence may modify the MDD-obesity-link.

Methods: Sex-specific associations of MDD recurrence (single [MDD_S] or recurrent episodes [MDD_R]) and obesity-related traits were analyzed in 4.100 adults (51.6% women) from a cross-sectional population-based cohort in Germany (SHIP-Trend-0). DSM-IV-based lifetime MDD diagnoses and MDD recurrence status were obtained through diagnostic interviews. Obesity-related outcomes included anthropometrics (weight, body mass index, waist- and hip-circumference, waist-to-hip ratio, waist-to-height ratio), bioelectrical impedance analysis of body fat mass and fat-free mass, and subcutaneous (SAT) and visceral adipose tissue (VAT) from abdominal magnetic resonance imaging. Sex-stratified linear regression models predicting obesity-related traits from MDD recurrence status were adjusted for age, education, and current depressive symptoms.

Results: 790 participants (19.3%) fulfilled lifetime MDD criteria (23.8% women vs. 14.5% men, p<0.001). In women, MDD_S was inversely associated with anthropometric indicators of general and central obesity, while MDD_R was positively associated with all obesity-related traits, except waist-to-hip ratio and fat-free mass. In women, MDD_R versus MDD_S was associated with higher levels of obesity across all outcomes except fat-free mass. In men, MDD was positively associated with SAT regardless of MDD recurrence. Additionally, lifetime MDD was positively associated with VAT in men. Results remained significant in sensitivity analyses after exclusion of participants with current use of antidepressants.

Conclusions: The MDD-obesity association is modified by MDD recurrence and sex independent of current depressive symptoms. Accounting for sex and MDD recurrence may identify individuals with MDD at increased cardiometabolic risk.

Objective: This prospective study aimed to assess couples' psychological status during the perinatal period to identify those at risk for postpartum depression.

Methods: Conducted at Lyon University Hospital from March to July 2022, the study enrolled pregnant women without progressive psychiatric disorders or obstetric risk factors, and their partners. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) at three points: during the 9th month of pregnancy, immediate postpartum, and 6-8 weeks after delivery. A score ≥10 on the EPDS indicated depression risk. A score ≥10 on the EPDS indicate depression risk. The primary endpoint was EPDS scores throughout the perinatal period.

Results: Ninety-five couples participated; 96% of patients and 68% of partners completed pre-delivery questionnaires, 81% and 71% during maternity stay, and 64% and 46% postpartum, respectively. Overall, 15% of patients and 1% of partners had EPDS scores >10 in the postpartum period. Psychiatric history and emergency cesarean sections were associated with higher immediate postpartum EPDS scores in patients [Beta 3.7 points, 95% CI 0.91; 6.4 and Beta 5.2 points, 2.2; 8.1, respectively]. Episiotomy was associated with higher EPDS scores in partners. No significant association between the different factors studied and the EPDS score was found at 6-8 weeks postpartum in patients nor their partners.

Conclusions: While specific risk factors for persistent perinatal depression in couples were not identified, a notable proportion of patients exhibited high EPDS scores. Screening all couples during prepartum and postpartum periods is crucial, regardless of identified risk factors.

Domestic violence is a universal phenomenon that destroys the fabric of society and threatens the lives, health and prosperity of all.

It can take different forms, including physical abuse. This is one of the most serious form of violence, as it can range from a simple shove to homicide.

To determine the prevalence and describe the various forms of physical violence perpetrated by husbands against their wives.

We contacted women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022.

A questionnaire regarding the violence was asked to responders. It included a section for collecting socio-demographic and clinical data on the woman, and a section for assessing the various forms of domestic violence.

122 women were surveyed. The average age of victims was 35.66 years with extremes of 18 and 64 years. 78.7% (n=96) of ladies were of urban origin. The majority of them (44,3%) had secondary level education.

The half of the population (51.6%) had an average socio-economic level and 43.4% (n=53) lived in rented houses.

All the women of our population were married: it was the first marriage in (89.3%) and the majority (86.1%) had children.

Almost all women (95.1%; n=116) were victims of physical violence.

Different types of physical violence were reported with decreasing prevalence: slap (65,6%), punch (58,2%), strangle (46,7%), kicking (38,1%), stabbing threat (28,7%), kidnapping (4,9%), and gun threat (3,3%).

Should be noted that some women experience different forms of violence simultaneously.

Our study showed a high prevalence of physical violence with different shapes.

These figures must be taken into account by the authorities given the gravity of physical and psychological consequences of this form of violence.

None Declared

Research into dreams, have shown the association between increased frequency of distressing dreams, specific content themes (analysed using the Hall Van de Castle system) and greater incidence of progression of neurological conditions and dementia. The history of predicting illnesses by the content of dreams, in the western world is popularly traced backed to the ancient Greek medicine. This stimulates the curiosity if any such practices existed in the ancient medical practises of the eastern world. Ayurveda is one such traditional system of medicine, that is native to the Indian subcontinent. Charaka Samhita is one of the oldest texts on Ayurveda consisting of 8 sections and 120 chapters totally. This text was selected for the purpose of this review, with the line of enquiry such as what does Ayurveda say about dreams associated with illnesses? What are the contents of such dreams? Furthermore, the dream content analysis was done using the Hall Van de Castle system, which is probably the first time being done on an Ayurveda text content.

1) To explore if, Charaka Samhita mentions, describes dreams in relation to illnesses, stages of illnesses and their prognosis. 2) To analyse content of the dreams seen in prodromal stage of illnesses.

1-The Charaka Samhita text was scanned chapter by chapter, to answer the questions- a) What are the types of dreams? b) Are any associated with illnesses? c)Are any dreams mentioned in the prodromal stage of illnesses? d)What do they imply? e)What are their contents? 2- The contents of prodromal dreams were analysed against the categories of Hall Van de Castle system.

As per Charaka Samhita, the types of dreams are, i) those based on what was seen ii) heard iii) reflected upon iv) desired v) imagined vi) those of prophetic type and vii) those caused by illnesses. Specific dreams in the prodromal stage, predict manifestation of specific illnesses (mild or fatal). In the diverse dream contents (18 themes mentioned) ranging from things animals to gods and demons, except the elements of the past, rest of the general categories occur, at least once. The categories characters, objects, activities and social interactions were more common than the rest.

Thus akin to the ancient Greek medicine, Ayurveda too had the practice of predicting illnesses based on the dream contents.

None Declared

The Gaza-Israel conflict has far-reaching consequences that extend beyond the immediate geographic confines of the conflict zone.This war certainly has repercussions on people who follow it via the media.

To study the prevalence of acute stress disorder among Tunisian people and determinate the factors associated to it.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform.

We used the the National stressful Events survey acute Stress Disorder Short scale (NSESSS) to assess the severity symptoms of acute stress disorder .

The National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) is a 7-item patient assessment measures that assesses the severity symptoms of acute stress disorder in individuals age 18 and older following an extremely stressful event or experience.

A total of 1091 participants completed the questionnaire. The participants had a mean age of 32.7 ± 9.8 years. More females (77.7%) than males (22.3%) participated in the study with a sex ratio (F/M) = 3.5. They were divorced in 2.1% .A history of psychiatric follow-up was found in 19,5% of case.

Results demonstrated that 100% of the respondents closely monitored the war, primarily relying on social media (98.6%) as their primary source of information.

According to the NSESSS ,83.4% of the participants had an acute stress disorder. The breakdown of acute stress disorder severity indicated that 29.7% experienced mild symptoms, 27.5% moderate, 21.6% severe, and 4.6% extreme symptoms.

The factors associated with high score of NSESSS were: female sex ( p=0.000), the divorced people (p=0.001)and previous history of psychiatric follow-up (p=0.000)

These findings indicate a substantial impact of the Palestine-Israel conflict on the mental well-being of the Tunisian population, as evidenced by high rates of acute stress disorder.

Understanding the heightened prevalence of acute stress disorder among different demographic groups following such international conflicts is crucial for developing tailored interventions to support the mental health and well-being of affected individuals.

None Declared

Traumatic childhood has increasingly high incidence rates and can be predictive of negative health outcomes. There is a large consensus indicating that childhood trauma is significantly involved in the development of mood disturbances in adulthood.

The aim of this study was to examine the relationship between retrospectively recalled childhood trauma and adulthood anxiety and depression in a sample of undergraduate university students.

A cross-sectional study was conducted among a sample of 365 university students randomly selected from 8 universities in Sfax (Tunisia). Information about childhood maltreatment, depressive and anxiety symptoms were gathered through the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Hospital Anxiety and Depression Scale (HADS) respectively. To test the hypothesis, examining the relationship between anxiety, depression, and childhood trauma, we used Spearman’s correlation test. Multivariate logistic regression models were used as well.

The mean age of our participants was 20.3 years. More females (68.2%) than males participated in the study. Our findings showed that the five childhood trauma subtypes (emotional abuse and neglect, physical abuse and neglect, sexual abuse) were significantly correlated with anxiety and depression symptoms severity (p<0.01). Emotional abuse was the strongest risk factor for adulthood anxiety symptoms (OR=6.002, 95% CI= [3.238; 11.125]) while emotional neglect was the strongest risk factor for depressive symptoms in adulthood (OR=6.214, 95% CI= [3.428; 11.267]). Multivariate analysis revealed that, in subjects with childhood trauma, scores of anxiety symptoms were positively and highly associated with the severity of emotional abuse (adjusted B=1.438, 95% CI= [1.951; 9.092], p=0.000). Depression symptoms severity were as well positively correlated with severity of emotional abuse (adjusted B=0.848, 95% CI= [1.043; 5.224], p=0.039), and severity of emotional neglect (adjusted B=1.044, 95% CI= [1.263; 6.389], p=0.012).

This study highlighted the relevance of childhood trauma as a factor contributing to anxiety and depression in adulthood. Thus, early psychological support of victims of childhood trauma can reduce the rate of anxiety and depression among these subjects.

None Declared