Pub Date : 2024-04-01DOI: 10.1136/gpsych-2023-101288
Xiaohan Liu, Fan Yang, Ning Huang, Shan Zhang, Jing Guo
Background Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson’s correlation was used to investigate country-level risk factors for incidence and DALYs. Results Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country. Data are available in a public, open access repository. The GBD database provides a tool to quantify health loss from hundreds of diseases, injuries and risk factors.The data can be reused by registering on the website:.
{"title":"Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study","authors":"Xiaohan Liu, Fan Yang, Ning Huang, Shan Zhang, Jing Guo","doi":"10.1136/gpsych-2023-101288","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101288","url":null,"abstract":"Background Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson’s correlation was used to investigate country-level risk factors for incidence and DALYs. Results Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country. Data are available in a public, open access repository. The GBD database provides a tool to quantify health loss from hundreds of diseases, injuries and risk factors.The data can be reused by registering on the website:<http://ghdx.healthdata.org>.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"9 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/gpsych-2023-101434
Yuan Yuan Li, Juan Peng, Yuan Yang Ping, Weng Jia Jun, Yan'e Lu, Jia Jia Liu, Shi Kun Xu, Li Hua Guan, Dong Huang, Qi Bing Wang, Ju Ying Qian, Ze Xin Zhao, Ya Bin Wei, Jun Bo Ge, Xiao Huang
Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction (AMI), significantly disrupting their recovery. Providing timely and easily accessible psychological interventions using virtual reality-based cognitive–behavioural therapy (VR-CBT) could potentially improve both acute and long-term symptoms affecting their mental health. Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit (ICU) during the acute stage of their illness. Methods In this single-blind randomised clinical trial, participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023. Patients who were Han Chinese aged 18–75 years were randomly assigned (1:1) via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support, or the control group to receive standard mental health support only. VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period. Assessments were done at baseline, immediately after treatment and at 3-month follow-up. The intention-to-treat analysis began in June 2023. The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale (HAM-A). Results Among 148 randomised participants, 70 were assigned to the VR-CBT group and 78 to the control group. The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention (Cohen’s d=−1.27 (95% confidence interval (CI): −1.64 to −0.90, p<0.001) and 3-month follow-up (Cohen’s d=−0.37 (95% CI: −0.72 to −0.01, p=0.024). Of the 70 participants who received VR-CBT, 62 (88.6%) completed the entire intervention. Cybersickness was the main reported adverse event (n=5). Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness; the improvement was maintained at the 3-month follow-up. Trial registration number The trial was registered at [www.chictr.org.cn][1] with the identifier: ChiCTR2200066435. Data are available on reasonable request. Not applicable. [1]: http://www.chictr.org.cn
{"title":"Virtual reality-based cognitive–behavioural therapy for the treatment of anxiety in patients with acute myocardial infarction: a randomised clinical trial","authors":"Yuan Yuan Li, Juan Peng, Yuan Yang Ping, Weng Jia Jun, Yan'e Lu, Jia Jia Liu, Shi Kun Xu, Li Hua Guan, Dong Huang, Qi Bing Wang, Ju Ying Qian, Ze Xin Zhao, Ya Bin Wei, Jun Bo Ge, Xiao Huang","doi":"10.1136/gpsych-2023-101434","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101434","url":null,"abstract":"Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction (AMI), significantly disrupting their recovery. Providing timely and easily accessible psychological interventions using virtual reality-based cognitive–behavioural therapy (VR-CBT) could potentially improve both acute and long-term symptoms affecting their mental health. Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit (ICU) during the acute stage of their illness. Methods In this single-blind randomised clinical trial, participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023. Patients who were Han Chinese aged 18–75 years were randomly assigned (1:1) via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support, or the control group to receive standard mental health support only. VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period. Assessments were done at baseline, immediately after treatment and at 3-month follow-up. The intention-to-treat analysis began in June 2023. The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale (HAM-A). Results Among 148 randomised participants, 70 were assigned to the VR-CBT group and 78 to the control group. The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention (Cohen’s d=−1.27 (95% confidence interval (CI): −1.64 to −0.90, p<0.001) and 3-month follow-up (Cohen’s d=−0.37 (95% CI: −0.72 to −0.01, p=0.024). Of the 70 participants who received VR-CBT, 62 (88.6%) completed the entire intervention. Cybersickness was the main reported adverse event (n=5). Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness; the improvement was maintained at the 3-month follow-up. Trial registration number The trial was registered at [www.chictr.org.cn][1] with the identifier: ChiCTR2200066435. Data are available on reasonable request. Not applicable. [1]: http://www.chictr.org.cn","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"35 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To the editor: It is commonly reported that people with insomnia often experience comorbid emotional disorders, such as mood and anxiety disorders.1 2 A study found that fragmented rapid eye movement (REM) sleep in individuals with insomnia is associated with higher Beck Depression Inventory (BDI) scores.3 REM sleep architecture disruption is a typical symptom of insomnia.4 Sleep homeostasis and plasticity interact with each other and jointly regulate sleep patterns and sleep quality. Sleep homeostasis is a complex neurobiological phenomenon involving molecular pathways, neurotransmitter release, synaptic activity and neural networks.5 Repetitive transcranial magnetic stimulation (rTMS) is a commonly used non-invasive neuroregulation technique that regulates sleep by modulating synaptic plasticity and the strength of connections between brain regions.6 While evidence suggests the potential of 1 Hz trams at the left dorsal lateral prefrontal cortex (DLPFC_L) to improve sleep quality for patients with insomnia,7 the extent to which it influences REM sleep and the mechanisms involved remain unclear. REM sleep is initiated by basolateral amygdala dopamine signalling.8 Restless REM sleep interferes with the adaptation of the amygdala circuits, consequently affecting emotion processing.4 Individuals with insomnia are more likely to experience symptoms of depression or anxiety and they are closely connected by a bidirectional relationship.9 However, the effect of rTMS on depression in patients with insomnia and the underlying correlation with REM remain unknown. A recent study revealed that diverse patterns of synchronic interaction between the amygdala, hippocampus and neocortex play crucial roles in emotional processes.10 Thus, we hypothesised that 1 Hz rTMS at DLPFC_L may improve REM sleep and mood by modulating the amygdala–hippocampus circuits in patients with insomnia. The inclusion criteria of this study for patients with insomnia are as follows: aged 18–65 years; right-handed; meeting the diagnostic criteria for insomnia disorders in the …
{"title":"Dual roles of the amygdala–hippocampus circuit in the regulation of rapid eye movement sleep and depression symptoms by repetitive transcranial magnetic stimulation in patients with insomnia","authors":"Xiaoyang Liu, Xumeng Zhao, Ziqiang Shao, Yongjian Guo, Lirong Yue, Jiayi Liu, Dahua Yu, Xiaona Sheng, Yifei Zhu, Kai Yuan","doi":"10.1136/gpsych-2023-101183","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101183","url":null,"abstract":"To the editor: It is commonly reported that people with insomnia often experience comorbid emotional disorders, such as mood and anxiety disorders.1 2 A study found that fragmented rapid eye movement (REM) sleep in individuals with insomnia is associated with higher Beck Depression Inventory (BDI) scores.3 REM sleep architecture disruption is a typical symptom of insomnia.4 Sleep homeostasis and plasticity interact with each other and jointly regulate sleep patterns and sleep quality. Sleep homeostasis is a complex neurobiological phenomenon involving molecular pathways, neurotransmitter release, synaptic activity and neural networks.5 Repetitive transcranial magnetic stimulation (rTMS) is a commonly used non-invasive neuroregulation technique that regulates sleep by modulating synaptic plasticity and the strength of connections between brain regions.6 While evidence suggests the potential of 1 Hz trams at the left dorsal lateral prefrontal cortex (DLPFC_L) to improve sleep quality for patients with insomnia,7 the extent to which it influences REM sleep and the mechanisms involved remain unclear. REM sleep is initiated by basolateral amygdala dopamine signalling.8 Restless REM sleep interferes with the adaptation of the amygdala circuits, consequently affecting emotion processing.4 Individuals with insomnia are more likely to experience symptoms of depression or anxiety and they are closely connected by a bidirectional relationship.9 However, the effect of rTMS on depression in patients with insomnia and the underlying correlation with REM remain unknown. A recent study revealed that diverse patterns of synchronic interaction between the amygdala, hippocampus and neocortex play crucial roles in emotional processes.10 Thus, we hypothesised that 1 Hz rTMS at DLPFC_L may improve REM sleep and mood by modulating the amygdala–hippocampus circuits in patients with insomnia. The inclusion criteria of this study for patients with insomnia are as follows: aged 18–65 years; right-handed; meeting the diagnostic criteria for insomnia disorders in the …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"63 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140625285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/gpsych-2023-101156
Ziyang Ren, Lirong Nie, Yushan Du, Jufen Liu
Background Depressive symptoms and cognitive impairment often interact, rendering their associations controversial. To date, their joint trajectories and associations with dementia and death remain underexplored. Aims To explore the interactions between depressive symptoms and cognitive function, their developmental trajectories and the associations with all-cause dementia, Alzheimer’s disease (AD) and all-cause death in older adults. Methods Data were from the Health and Retirement Study. Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status, respectively. All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses. All-cause death was determined by interviews. The restricted cubic spline, group-based trajectory modelling and subdistribution hazard regression were used. Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found, especially in women (p for interaction <0.05). Independent trajectory analysis showed that emerging or high (vs no) depressive trajectories and poor or rapidly decreased cognitive trajectories (vs very good) from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia, AD and all-cause death. 15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined, where rapidly decreased cognitive function was more common in those with no depressive symptoms. Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function, those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death, with subdistribution hazard ratios (95% confidence intervals) of 4.47 (2.99 to 6.67) and 1.84 (1.43 to 2.36), especially in women. Conclusions To effectively mitigate the risk of dementia and death, it is crucial to acknowledge the importance of preventing cognitive decline in older adults without depressive symptoms, particularly in women. Data are available upon reasonable request.
{"title":"Intertwined depressive and cognitive trajectories and the risk of dementia and death in older adults: a competing risk analysis","authors":"Ziyang Ren, Lirong Nie, Yushan Du, Jufen Liu","doi":"10.1136/gpsych-2023-101156","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101156","url":null,"abstract":"Background Depressive symptoms and cognitive impairment often interact, rendering their associations controversial. To date, their joint trajectories and associations with dementia and death remain underexplored. Aims To explore the interactions between depressive symptoms and cognitive function, their developmental trajectories and the associations with all-cause dementia, Alzheimer’s disease (AD) and all-cause death in older adults. Methods Data were from the Health and Retirement Study. Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status, respectively. All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses. All-cause death was determined by interviews. The restricted cubic spline, group-based trajectory modelling and subdistribution hazard regression were used. Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found, especially in women (p for interaction <0.05). Independent trajectory analysis showed that emerging or high (vs no) depressive trajectories and poor or rapidly decreased cognitive trajectories (vs very good) from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia, AD and all-cause death. 15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined, where rapidly decreased cognitive function was more common in those with no depressive symptoms. Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function, those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death, with subdistribution hazard ratios (95% confidence intervals) of 4.47 (2.99 to 6.67) and 1.84 (1.43 to 2.36), especially in women. Conclusions To effectively mitigate the risk of dementia and death, it is crucial to acknowledge the importance of preventing cognitive decline in older adults without depressive symptoms, particularly in women. Data are available upon reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"30 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140563277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/gpsych-2023-101501
Tashalee R Brown, Anita S Kablinger, Robert Trestman, Eraka Bath, Cynthia Rogers, Binx Yezhe Lin, Kevin Young Xu
To the editor: Two recent advisories from the US surgeon general have underscored the unprecedented public health crisis in youth mental health and emphasised the need for “timely data collection and research to identify and respond to youth mental health needs more rapidly”.1 Increased rates of suicidal behaviour, depression and anxiety symptoms and substance use, particularly in adolescents and young adults, are part of an emerging landscape of high volumes of emergency room visits and hospitalisations for behavioural problems.2 3 Conduct disorder (CD) has emerged as an increasingly common presenting concern in adolescents and young adults receiving emergency and inpatient psychiatric care.4–6 Yet, CD remains among the least studied of paediatric psychiatric disorders, even though it is thought to be associated with a myriad of devastating social, legal and psychiatric consequences that may persist into adulthood and is frequently comorbid with other psychiatric disorders.7 Although recent studies estimate that CD affects approximately 2%–3% of the school-aged paediatric population worldwide,8 ambiguity remains about its association with other psychiatric conditions. CD is posited to be associated with increased rates of anxiety, depression, substance use and attention-deficit hyperactivity disorder (ADHD), as well as other externalising disorders, with a multisite analysis in Europe examining nearly 800 children with CD and found that more than one-third likely suffered from current ADHD symptoms and over three-fourths suffered from oppositional defiant disorder symptoms.9 Yet, estimates of comorbidity based on clinical data collected in settings that reflect actual psychiatric care, particularly in the USA, are lacking. Furthermore, many of the estimates of psychiatric comorbidity in adolescents and young adults, defined as ages 12–25, with CD, were conducted >10 years ago, preceding the ongoing paediatric mental health crisis in the USA. Untreated co-occurring psychiatric conditions in adolescents and young adults with behavioural disorders …
致编辑：1 自杀行为、抑郁和焦虑症状以及药物使用率的上升，尤其是在青少年和年轻成年人中，是因行为问题导致大量急诊就诊和住院的新现象的一部分。3 行为障碍（CD）已成为青少年和年轻成年人接受急诊和住院精神病治疗时越来越常见的一种症状。4-6 然而，行为障碍仍然是儿科精神疾病中研究最少的一种，尽管人们认为它与一系列破坏性的社会、法律和精神后果有关，这些后果可能会持续到成年，并且经常与其他精神疾病合并。尽管最近的研究估计，全球约有 2%-3% 的学龄儿童受到 CD 的影响，8 但 CD 与其他精神疾病的关系仍不明确。据推测，CD 与焦虑症、抑郁症、药物使用和注意力缺陷多动障碍（ADHD）以及其他外化性障碍的发病率增加有关，欧洲的一项多点分析对近 800 名 CD 儿童进行了检查，发现超过三分之一的儿童可能患有当前的 ADHD 症状，超过四分之三的儿童患有对立违抗障碍症状。此外，许多对患有 CD 的 12-25 岁青少年和年轻成年人精神疾病合并症的估计都是在 10 年前进行的，当时美国还没有出现持续的儿科精神健康危机。患有行为障碍的青少年和年轻成人中未经治疗的并发症...
{"title":"Psychiatric comorbidities in children with conduct disorder: a descriptive analysis of real-world data","authors":"Tashalee R Brown, Anita S Kablinger, Robert Trestman, Eraka Bath, Cynthia Rogers, Binx Yezhe Lin, Kevin Young Xu","doi":"10.1136/gpsych-2023-101501","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101501","url":null,"abstract":"To the editor: Two recent advisories from the US surgeon general have underscored the unprecedented public health crisis in youth mental health and emphasised the need for “timely data collection and research to identify and respond to youth mental health needs more rapidly”.1 Increased rates of suicidal behaviour, depression and anxiety symptoms and substance use, particularly in adolescents and young adults, are part of an emerging landscape of high volumes of emergency room visits and hospitalisations for behavioural problems.2 3 Conduct disorder (CD) has emerged as an increasingly common presenting concern in adolescents and young adults receiving emergency and inpatient psychiatric care.4–6 Yet, CD remains among the least studied of paediatric psychiatric disorders, even though it is thought to be associated with a myriad of devastating social, legal and psychiatric consequences that may persist into adulthood and is frequently comorbid with other psychiatric disorders.7 Although recent studies estimate that CD affects approximately 2%–3% of the school-aged paediatric population worldwide,8 ambiguity remains about its association with other psychiatric conditions. CD is posited to be associated with increased rates of anxiety, depression, substance use and attention-deficit hyperactivity disorder (ADHD), as well as other externalising disorders, with a multisite analysis in Europe examining nearly 800 children with CD and found that more than one-third likely suffered from current ADHD symptoms and over three-fourths suffered from oppositional defiant disorder symptoms.9 Yet, estimates of comorbidity based on clinical data collected in settings that reflect actual psychiatric care, particularly in the USA, are lacking. Furthermore, many of the estimates of psychiatric comorbidity in adolescents and young adults, defined as ages 12–25, with CD, were conducted >10 years ago, preceding the ongoing paediatric mental health crisis in the USA. Untreated co-occurring psychiatric conditions in adolescents and young adults with behavioural disorders …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"45 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1136/gpsych-2023-101281
Xin-Lu Cai, Qingying Ye, Ke Ni, Lin Zhu, Qian Zhang, Minmin Yin, Zhe Zhang, Wei Wei, David A. Preece, Bao-Ming Li
Background The alexithymia trait is of high clinical interest. The Perth Alexithymia Questionnaire (PAQ) was recently developed to enable detailed facet-level and valence-specific assessments of alexithymia. Aims In this paper, we introduce the first Chinese version of the PAQ and examine its psychometric properties and clinical applications. Methods In Study 1, the PAQ was administered to 990 Chinese participants. We examined its factor structure, internal consistency, test-retest reliability, as well as convergent, concurrent and discriminant validity. In Study 2, four groups, including a major depressive disorder (MDD) group (n=50), a matched healthy control group for MDD (n=50), a subclinical depression group (n=50) and a matched healthy control group for subclinical depression (n=50), were recruited. Group comparisons were conducted to assess the clinical relevance of the PAQ. Results In Study 1, the intended five-factor structure of the PAQ was found to fit the data well. The PAQ showed good internal consistency and test-retest reliability, as well as good convergent, concurrent and discriminant validity. In Study 2, the PAQ was able to successfully distinguish the MDD group and the subclinical depression group from their matched healthy controls. Conclusions The Chinese version of the PAQ is a valid and reliable instrument for comprehensively assessing alexithymia in the general population and adults with clinical/subclinical depression. Data are available upon reasonable request.
{"title":"Chinese version of the Perth Alexithymia Questionnaire: psychometric properties and clinical applications","authors":"Xin-Lu Cai, Qingying Ye, Ke Ni, Lin Zhu, Qian Zhang, Minmin Yin, Zhe Zhang, Wei Wei, David A. Preece, Bao-Ming Li","doi":"10.1136/gpsych-2023-101281","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101281","url":null,"abstract":"Background The alexithymia trait is of high clinical interest. The Perth Alexithymia Questionnaire (PAQ) was recently developed to enable detailed facet-level and valence-specific assessments of alexithymia. Aims In this paper, we introduce the first Chinese version of the PAQ and examine its psychometric properties and clinical applications. Methods In Study 1, the PAQ was administered to 990 Chinese participants. We examined its factor structure, internal consistency, test-retest reliability, as well as convergent, concurrent and discriminant validity. In Study 2, four groups, including a major depressive disorder (MDD) group (n=50), a matched healthy control group for MDD (n=50), a subclinical depression group (n=50) and a matched healthy control group for subclinical depression (n=50), were recruited. Group comparisons were conducted to assess the clinical relevance of the PAQ. Results In Study 1, the intended five-factor structure of the PAQ was found to fit the data well. The PAQ showed good internal consistency and test-retest reliability, as well as good convergent, concurrent and discriminant validity. In Study 2, the PAQ was able to successfully distinguish the MDD group and the subclinical depression group from their matched healthy controls. Conclusions The Chinese version of the PAQ is a valid and reliable instrument for comprehensively assessing alexithymia in the general population and adults with clinical/subclinical depression. Data are available upon reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140105518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Sleep disturbance is a common comorbidity of major depressive disorder (MDD). However, network homogeneity (NH) changes of the default mode network (DMN) in MDD with sleep disturbances are unclear. Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances. Methods Twenty-four patients with MDD and sleep disturbances (Pa_s), 33 patients with MDD without sleep disturbances (Pa_ns) and 32 healthy controls (HCs) were recruited in this study. Resting-state functional imaging data were analysed using NH. Results Compared with Pa_ns and HCs, Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus. There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances (r=−0.42, p=0.001) as well as a positive correlation between NH in the right precuneus and sleep disturbances (r=0.41, p=0.002) in patients with MDD. Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN, which could differentiate pa_s from pa_ns. The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances. Data are available upon reasonable request. Data has the potential to be shared with others upon request.
{"title":"Association between abnormal default mode network homogeneity and sleep disturbances in major depressive disorder","authors":"Muzhi Huang, Yangpan Ou, Huabing Li, Feng Liu, Ping Li, Jingping Zhao, Bing Lang, Wenbin Guo","doi":"10.1136/gpsych-2023-101371","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101371","url":null,"abstract":"Background Sleep disturbance is a common comorbidity of major depressive disorder (MDD). However, network homogeneity (NH) changes of the default mode network (DMN) in MDD with sleep disturbances are unclear. Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances. Methods Twenty-four patients with MDD and sleep disturbances (Pa_s), 33 patients with MDD without sleep disturbances (Pa_ns) and 32 healthy controls (HCs) were recruited in this study. Resting-state functional imaging data were analysed using NH. Results Compared with Pa_ns and HCs, Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus. There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances (r=−0.42, p=0.001) as well as a positive correlation between NH in the right precuneus and sleep disturbances (r=0.41, p=0.002) in patients with MDD. Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN, which could differentiate pa_s from pa_ns. The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances. Data are available upon reasonable request. Data has the potential to be shared with others upon request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"67 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140173119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1136/gpsych-2023-101262
Yunsong Hu, Rong Zeng, Juan Yue, Qiu Ge, Hongxiao Wang, Zijian Feng, Jue Wang, Yufeng Zang
To the editor: Transcranial magnetic stimulation (TMS) is a non-invasive brain modulation technique. One important usage of TMS is the transient interruption of cognitive brain function (also named virtual lesion) for investigating precisely where and when a specific cortical region contributes to a specific cognitive function.1 A more important usage of TMS is the treatment of brain disorders by repetitive TMS (rTMS). The spatial accuracy of the ‘Figure-8’ coil could be up to 3 mm with a TMS robot.2 Functional magnetic resonance imaging (fMRI) has been used to guide neuronavigation systems for precise positioning of TMS targets.3–6 While rTMS is a routine treatment approach in many hospitals, few practitioners are using neuronavigation systems. One major reason is the expense of neuronavigation systems which is usually more than CN¥350 000 (US$50 000) and more expensive than the TMS machine itself. Another reason is the complexity of its usage. Here, we proposed a simple, precise and cheap method, named Caliper-based precise positioning of the target (CALIPPOT) for TMS without a neuronavigation system. After MRI scanning with two or more imageable marks, experimenters use two outside callipers to precisely locate the stimulation target on the scalp. Each outside calliper costs about CN¥200 (US$28) and is reusable. The imageable marks are disposable and cost about CN¥0.6 (US$0.08) for each participant. The positioning duration is less than 10 min. Two experimenters tested the accuracy in 10 participants. The mean error was 2.32 mm. All participants signed informed consent before scanning. The following introduces the positioning steps and then the verification experiment. ### Step 1. Marks on the scalp MRI imageable marks were purchased from an e-shop (https://shop196017839.taobao.com)—this is a kind of anti-collision silica gel (round, 10 mm diameter, 2 mm thickness) with glue on one side. Before putting the marks on the scalp, we drew a point at the centre …
{"title":"Caliper-based precise positioning of the target (CALIPPOT) for transcranial magnetic stimulation without neuronavigation system","authors":"Yunsong Hu, Rong Zeng, Juan Yue, Qiu Ge, Hongxiao Wang, Zijian Feng, Jue Wang, Yufeng Zang","doi":"10.1136/gpsych-2023-101262","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101262","url":null,"abstract":"To the editor: Transcranial magnetic stimulation (TMS) is a non-invasive brain modulation technique. One important usage of TMS is the transient interruption of cognitive brain function (also named virtual lesion) for investigating precisely where and when a specific cortical region contributes to a specific cognitive function.1 A more important usage of TMS is the treatment of brain disorders by repetitive TMS (rTMS). The spatial accuracy of the ‘Figure-8’ coil could be up to 3 mm with a TMS robot.2 Functional magnetic resonance imaging (fMRI) has been used to guide neuronavigation systems for precise positioning of TMS targets.3–6 While rTMS is a routine treatment approach in many hospitals, few practitioners are using neuronavigation systems. One major reason is the expense of neuronavigation systems which is usually more than CN¥350 000 (US$50 000) and more expensive than the TMS machine itself. Another reason is the complexity of its usage. Here, we proposed a simple, precise and cheap method, named Caliper-based precise positioning of the target (CALIPPOT) for TMS without a neuronavigation system. After MRI scanning with two or more imageable marks, experimenters use two outside callipers to precisely locate the stimulation target on the scalp. Each outside calliper costs about CN¥200 (US$28) and is reusable. The imageable marks are disposable and cost about CN¥0.6 (US$0.08) for each participant. The positioning duration is less than 10 min. Two experimenters tested the accuracy in 10 participants. The mean error was 2.32 mm. All participants signed informed consent before scanning. The following introduces the positioning steps and then the verification experiment. ### Step 1. Marks on the scalp MRI imageable marks were purchased from an e-shop (https://shop196017839.taobao.com)—this is a kind of anti-collision silica gel (round, 10 mm diameter, 2 mm thickness) with glue on one side. Before putting the marks on the scalp, we drew a point at the centre …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"58 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140170963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1136/gpsych-2023-101216
Meng-Di Yuan, Jun-Fa Liu, Bao-Liang Zhong
Background The prevalence of prolonged grief disorder (PGD) and its symptoms among the bereaved population in China vary considerably. Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China. Methods We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023, for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals. The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data (‘JBI checklist’) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), respectively. The ‘metaprop’ package in R V.4.1.2 was used to synthesise the prevalence. Results A total of 28 studies involving 10 994 bereaved individuals were included in the analysis, with JBI checklist scores between 3 and 7. The combined prevalence (95% confidence interval) of PGD and its symptoms was 8.9% (4.2% to 17.6%) and 32.4% (18.2% to 50.8%), respectively. PGD and its symptoms were most prevalent among those who had lost their only child (22.7%) and those bereaved by earthquakes (80.4%), respectively. The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms. Conclusions The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China. This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes. Further methodologically rigorous studies are needed to provide more accurate prevalence estimates. PROSPERO registration number CRD42023432553. All data relevant to the study are included in the article.
{"title":"Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China: a systematic review and meta-analysis","authors":"Meng-Di Yuan, Jun-Fa Liu, Bao-Liang Zhong","doi":"10.1136/gpsych-2023-101216","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101216","url":null,"abstract":"Background The prevalence of prolonged grief disorder (PGD) and its symptoms among the bereaved population in China vary considerably. Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China. Methods We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023, for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals. The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data (‘JBI checklist’) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), respectively. The ‘metaprop’ package in R V.4.1.2 was used to synthesise the prevalence. Results A total of 28 studies involving 10 994 bereaved individuals were included in the analysis, with JBI checklist scores between 3 and 7. The combined prevalence (95% confidence interval) of PGD and its symptoms was 8.9% (4.2% to 17.6%) and 32.4% (18.2% to 50.8%), respectively. PGD and its symptoms were most prevalent among those who had lost their only child (22.7%) and those bereaved by earthquakes (80.4%), respectively. The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms. Conclusions The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China. This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes. Further methodologically rigorous studies are needed to provide more accurate prevalence estimates. PROSPERO registration number CRD42023432553. All data relevant to the study are included in the article.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"123 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140046160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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