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}
Pub Date : 2024-03-01DOI: 10.1136/gpsych-2023-101173
Jie Yang, Mingshu Tao, Rongguang Liu, Jiaxing Fang, Chunyan Li, Dexian Chen, Qi Wei, Xingyu Xiong, Wenxin Zhao, Wen Tan, Yuan Han, Hongxing Zhang, He Liu, Song Zhang, Junli Cao
Background Postoperative sleep disturbance (PSD) is a common and serious postoperative complication and is associated with poor postoperative outcomes. Aims This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on PSD in older patients undergoing lower limb major arthroplasty. Methods In this prospective, double-blind, pilot, randomised, sham-controlled trial, patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS (a-tDCS) or sham tDCS (s-tDCS). The primary outcomes were the objective sleep measures on postoperative nights (N) 1 and N2. Results 116 inpatients were assessed for eligibility, and a total of 92 patients were enrolled; 47 received a-tDCS and 45 received s-tDCS. tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups; the respective comparisons were as follows: the promotion of rapid eye movement (REM) sleep time on N1 (64.5 (33.5–105.5) vs 19.0 (0.0, 45.0) min, F=20.10, p<0.001) and N2 (75.0 (36.0–120.8) vs 30.0 (1.3–59.3) min, F=12.55, p<0.001); the total sleep time on N1 (506.0 (408.0–561.0) vs 392.0 (243.0–483.5) min, F=14.13, p<0.001) and N2 (488.5 (455.5–548.5) vs 346.0 (286.5–517.5) min, F=7.36, p=0.007); the deep sleep time on N1 (130.0 (103.3–177.0) vs 42.5 (9.8–100.8) min, F=24.4, p<0.001) and N2 (103.5 (46.0–154.8) vs 57.5 (23.3–106.5) min, F=8.4, p=0.004); and the percentages of light sleep and REM sleep on N1 and N2 (p<0.05 for each). The postoperative depression and anxiety scores did not differ significantly between the two groups. No significant adverse events were reported. Conclusion In older patients undergoing lower limb major arthroplasty, a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures. However, this benefit was temporary and was not maintained over time. Data are available upon reasonable request. De-identified individual clinical data will be made available upon request to the corresponding authors only for non-commercial research to individuals affiliated with academic or public health institutions.
{"title":"Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial","authors":"Jie Yang, Mingshu Tao, Rongguang Liu, Jiaxing Fang, Chunyan Li, Dexian Chen, Qi Wei, Xingyu Xiong, Wenxin Zhao, Wen Tan, Yuan Han, Hongxing Zhang, He Liu, Song Zhang, Junli Cao","doi":"10.1136/gpsych-2023-101173","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101173","url":null,"abstract":"Background Postoperative sleep disturbance (PSD) is a common and serious postoperative complication and is associated with poor postoperative outcomes. Aims This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on PSD in older patients undergoing lower limb major arthroplasty. Methods In this prospective, double-blind, pilot, randomised, sham-controlled trial, patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS (a-tDCS) or sham tDCS (s-tDCS). The primary outcomes were the objective sleep measures on postoperative nights (N) 1 and N2. Results 116 inpatients were assessed for eligibility, and a total of 92 patients were enrolled; 47 received a-tDCS and 45 received s-tDCS. tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups; the respective comparisons were as follows: the promotion of rapid eye movement (REM) sleep time on N1 (64.5 (33.5–105.5) vs 19.0 (0.0, 45.0) min, F=20.10, p<0.001) and N2 (75.0 (36.0–120.8) vs 30.0 (1.3–59.3) min, F=12.55, p<0.001); the total sleep time on N1 (506.0 (408.0–561.0) vs 392.0 (243.0–483.5) min, F=14.13, p<0.001) and N2 (488.5 (455.5–548.5) vs 346.0 (286.5–517.5) min, F=7.36, p=0.007); the deep sleep time on N1 (130.0 (103.3–177.0) vs 42.5 (9.8–100.8) min, F=24.4, p<0.001) and N2 (103.5 (46.0–154.8) vs 57.5 (23.3–106.5) min, F=8.4, p=0.004); and the percentages of light sleep and REM sleep on N1 and N2 (p<0.05 for each). The postoperative depression and anxiety scores did not differ significantly between the two groups. No significant adverse events were reported. Conclusion In older patients undergoing lower limb major arthroplasty, a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures. However, this benefit was temporary and was not maintained over time. Data are available upon reasonable request. De-identified individual clinical data will be made available upon request to the corresponding authors only for non-commercial research to individuals affiliated with academic or public health institutions.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"53 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140314844","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 The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation. Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety. Methods 1501 adolescents aged 12–19 years were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale, and 716 adolescents who scored ≥5 on both scales were selected as participants. Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms. Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9. A comparison was made between the depression–anxiety symptom networks of the two groups. Results ‘Restlessness’, ‘sad mood’ and ‘trouble relaxing’ were the most prominent central symptoms in the depression–anxiety symptom network, and ‘restlessness’, ‘nervousness’ and ‘reduced movement’ were the bridge symptoms in this network. ‘Sad mood’ was found to be directly related to ‘suicide ideation’ with the highest variance. The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group, with ‘restlessness’ and ‘sad mood’ exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group. Conclusion Restlessness and sad mood could be targeted for the intervention of depression–anxiety symptoms among adolescents with suicide ideation. Data are available upon reasonable request.
{"title":"Network analysis of suicide ideation and depression–anxiety symptoms among Chinese adolescents","authors":"Shuyin Xu, Yumeng Ju, Xiyu Wei, Wenwen Ou, Mohan Ma, Guanyi Lv, Xiaotian Zhao, Yaqi Qin, Yunjing Li, Liang Li, Mei Huang, Siqi Yang, Yimei Lu, Yafei Chen, Junwu Liu, Jin Liu, Bangshan Liu, Yan Zhang","doi":"10.1136/gpsych-2023-101225","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101225","url":null,"abstract":"Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation. Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety. Methods 1501 adolescents aged 12–19 years were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale, and 716 adolescents who scored ≥5 on both scales were selected as participants. Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms. Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9. A comparison was made between the depression–anxiety symptom networks of the two groups. Results ‘Restlessness’, ‘sad mood’ and ‘trouble relaxing’ were the most prominent central symptoms in the depression–anxiety symptom network, and ‘restlessness’, ‘nervousness’ and ‘reduced movement’ were the bridge symptoms in this network. ‘Sad mood’ was found to be directly related to ‘suicide ideation’ with the highest variance. The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group, with ‘restlessness’ and ‘sad mood’ exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group. Conclusion Restlessness and sad mood could be targeted for the intervention of depression–anxiety symptoms among adolescents with suicide ideation. Data are available upon reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"249 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140323917","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 Schizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights for targeted interventions. Aims This study aimed to discern the stages of personal recovery in Thai patients with schizophrenia and elucidate the associated factors with each stage. Methods A multistage sampling technique was employed, selecting 231 patients with schizophrenia from mental health outpatient departments of general and psychiatric hospitals. Data collected from March to May 2023 included screening for psychotic symptoms using the Brief Psychiatric Rating Scale and six self-report questionnaires—Stage of Recovery Scale, Beck Cognitive Insight Scale, Brief Resilience Scale, Family Support, Therapeutic Relationship-Patients Version and Social Support Questionnaire—along with personal data sheets. Pearson correlation and multinomial logistic regression were performed. Results The predominant personal recovery stage among participants was stage 3, ‘living with disabilities’, comprising 42.4% of the participants. Key factors contributing to personal recovery, explaining approximately 38.4% of the variance, included resilience, family support, therapeutic alliance, hospitalisations since onset and recovery-oriented nursing service utilisation. Logit equations for stages 3 and 4 are as follows: stage 3 (living with disability): logit=−4.44+0.74×resilience+0.07×therapeutic alliance+0.02×recovery-oriented nursing service utilisation; stage 4 (living beyond disability): logit=−11.57–0.05×hospitalisation since onset+1.96×resilience+0.11×family support+0.06×therapeutic alliance. Conclusion The findings emphasise the significance of mental health nursing interventions. In conjunction with recovery-oriented nursing services, strengthening resilience, therapeutic alliances and family support may accelerate personal recovery and reduce hospitalisations among individuals with schizophrenia. Data may be obtained from a third party and are not publicly available.
{"title":"Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals","authors":"Jutharat Thongsalab, Jintana Yunibhand, Penpaktr Uthis","doi":"10.1136/gpsych-2023-101325","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101325","url":null,"abstract":"Background Schizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights for targeted interventions. Aims This study aimed to discern the stages of personal recovery in Thai patients with schizophrenia and elucidate the associated factors with each stage. Methods A multistage sampling technique was employed, selecting 231 patients with schizophrenia from mental health outpatient departments of general and psychiatric hospitals. Data collected from March to May 2023 included screening for psychotic symptoms using the Brief Psychiatric Rating Scale and six self-report questionnaires—Stage of Recovery Scale, Beck Cognitive Insight Scale, Brief Resilience Scale, Family Support, Therapeutic Relationship-Patients Version and Social Support Questionnaire—along with personal data sheets. Pearson correlation and multinomial logistic regression were performed. Results The predominant personal recovery stage among participants was stage 3, ‘living with disabilities’, comprising 42.4% of the participants. Key factors contributing to personal recovery, explaining approximately 38.4% of the variance, included resilience, family support, therapeutic alliance, hospitalisations since onset and recovery-oriented nursing service utilisation. Logit equations for stages 3 and 4 are as follows: stage 3 (living with disability): logit=−4.44+0.74×resilience+0.07×therapeutic alliance+0.02×recovery-oriented nursing service utilisation; stage 4 (living beyond disability): logit=−11.57–0.05×hospitalisation since onset+1.96×resilience+0.11×family support+0.06×therapeutic alliance. Conclusion The findings emphasise the significance of mental health nursing interventions. In conjunction with recovery-oriented nursing services, strengthening resilience, therapeutic alliances and family support may accelerate personal recovery and reduce hospitalisations among individuals with schizophrenia. Data may be obtained from a third party and are not publicly available.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"97 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140170964","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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