Frontiers in Psychiatry最新文献

Background: Time perspective (TP) influences how individuals perceive and classify their past, present, and future, impacting their cognition, behavior, and psychological outcomes. Deviation from the balanced time perspective (DBTP) is associated with mental health problems (e.g., depression and anxiety). Emotion regulation (ER) encompasses cognitive and behavioral processes to regulate emotions, with maladaptive strategies like rumination and withdrawal linked to depression and anxiety. Despite extensive research on TP and ER, their joint impact, particularly in the context of depression and anxiety, and cultural differences remain underexplored.

Method: Participants (N = 513 Iranian, N = 470 Turkish) completed self-report questionnaires on time perspective, cognitive and behavioral ER, anxiety, and depression symptoms. A moderated mediation model was assessed, incorporating the exogenous variable of DBTP, with ER strategies as mediators, and endogenous variables of depressive and anxiety symptoms. The model accounted for cultural variations in the paths as a moderator.

Results: Significant associations were found between DBTP, ER strategies, depression, and anxiety symptoms. Mediation analyses revealed that both cognitive and behavioral ER strategies (except for adaptive behavioral ER strategies) significantly mediated the associations between DBTP and depression and anxiety. Additionally, multigroup analyses suggested that these mediating effects were consistent across Iranian and Turkish samples, with exceptions in adaptive cognitive ER strategies.

Conclusion: The study highlights the crucial role of TPs and ER strategies in predicting anxiety and depression symptoms, with notable cultural nuances. Specifically, maladaptive strategies exacerbate symptoms, while adaptive strategies mitigate them primarily in Iranian contexts. Cultural subtleties are discussed in detail.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental condition that affects millions of children and adolescents worldwide. Knowledge of risk factors associated with ADHD may reduce its prevalence and its severe impact on patient's quality of life. The aim of this study was to identify risk factors associated with ADHD and to discuss their involvement in the genesis of the disorder.

Methods: This is a case-control study involving a first group of 74 children (mean age = 9 years) diagnosed with ADHD. The second group included 80 healthy control children. They were randomly selected and matched for age and gender. A literature-based questionnaire assessing the socio-demographic data, biological and environmental factors associated with ADHD was administered to the parents. The diagnosis of ADHD group was made by a trained child psychiatrist according to the DSM-5 criteria supplemented by the Conners scales of parents and teachers. For the control group, we added to the questionnaire the MINI-kid section of ADHD to screen for possible presence of ADHD symptoms. Univariate then multivariate analyses were conducted to identify factors associated with ADHD.

Results: Several factors were more prevalent in children with ADHD than in controls: disturbed family dynamics, low socio-economic status, family history of psychiatric and organic pathologies, and particularly several early environmental factors, including passive smoking during pregnancy, prematurity, fetal distress, caesarean delivery and low birth weight. In the early childhood period, early exposure to television was also strongly associated with ADHD. However, the multivariate model conducted to determine the variables independently associated with ADD/ADHD revealed only three determining factors: passive smoking during pregnancy (OR = 4.60 [2.14, 9.94]; p < 0.001), acute fetal distress (OR = 5.08 [1.47, 17.52]; p = 0.01), and familial psychiatric history (OR = 9.37 [2.46, 35.59]; p = 0.001).

Discussion: The recognition of factors involved in the genesis of ADHD within different ethnic populations may help understanding and broaden our knowledge of this disorder to develop targeted strategies for prevention and early intervention. Further participants with more robust statistical output are required to confirm our findings to a more generalized population.

Background: Disturbances of circadian rhythms and everyday structures are hallmarks of alcohol use disorder (AUD). Recurring activities such as sleep, activity, and meals represent time cues, so called Zeitgebers, that synchronize the circadian system. With our newly developed therapy approach for AUD patients, we aim to reduce relapses and alcohol consumption in AUD patients undergoing a withdrawal program by strengthening their circadian rhythms.

Methods/design: We aim to achieve the improvement of circadian rhythms with personalized structure plans for daily Zeitgeber activities, which are used in parallel with the standard therapy at our clinic. The DAILY pilot study is a six-week monocentric trial with a controlled, randomized, single-blinded, parallel-group design. 41 AUD patients participated in the pilot study and were randomly assigned to an intervention group (IG) or a control group (CG).

Results: The variability of daily activities was significantly lower in the IG group than in the CG group. Of the IG participants, two had relapsed during the study (<12%), whereas ten relapsed in the CG group (>60%). The relapsing IG participants recorded a total of three alcohol consumption days, while the CG participants recorded 52 consumption days. Abstinent participants showed significantly less variability in the times of their daily activities than relapsed participants. In addition, our analyses indicate that craving for alcohol is related to variability in the time of getting up and that craving and temporal variability increase before relapses. Moreover, the general well-being of the IG participants improved more than that of the CG participants.

Discussion: The data from this pilot study show that following a personalized daily structure plan helps AUD patients to remain abstinent during withdrawal therapy. The analyses indicate that temporal variability of daily activities and the risk of relapse are correlated. On the one hand, adherence to the daily structure may prevent relapse, on the other hand, an increase in variability may be a helpful predictor of approaching relapse. In our view, these data justify a continuation of the DAILY study with the addition of further measurements such as the determination of endogenous circadian rhythms.

Clinical trial registration: https://drks.de, identifier DRKS00019093.

Objective: This study compares the clinical features of Treatment-Resistant Schizophrenia (TRS) and Non-Treatment-Resistant Schizophrenia (NTRS) using network analysis.

Methods: We recruited 511 patients, dividing them into TRS (N = 269) and NTRS (N = 242) groups. Eight scales were used: Positive and Negative Syndrome Scale (PANSS), Positive Symptom Assessment Scale (SAPS), Scale for Assessment of Negative Symptoms (SANS), Simpson-Angus Scale (SAS), Abnormal Involuntary Movements Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Calgary Schizophrenia Depression Scale (CDSS), and Global Assessment of Functioning Scale (GAF). Demographic and clinical data were analyzed using T-tests and Chi-square tests. Network analysis was then applied to compare clinical features.

Results: Significant differences were found in the overall architectures (S = 1.396, p < 0.002) and edge weights (M = 0.289, p < 0.009) of TRS and NTRS networks. Nine edges (p < 0.05) and five nodes (p < 0.01) differed, indicating a correlation between clinical symptoms of the two groups. TRS core symptoms were linked to social functions through both positive (SAPS) and negative symptoms (SANS), while NTRS core symptoms were related to general psychopathological symptoms (PANSS-G).

Conclusion: For TRS, it is essential to address both negative and positive symptoms, focusing on the impact of negative symptoms on functioning. Additionally, managing medication side effects is crucial to avoid worsening negative symptoms.

Background: The purpose of this study was to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) therapy on sleep quality in patients with more than mild depressive mood.

Methods: Randomized controlled trials in PubMed, Cochrane Library, Web of Science, Embase, Scopus, and ScienceDirect on rTMS to improve sleep quality in patients with more than mild depressive mood up to September 2023 were searched. A meta-analysis was performed using RevMan 5.4 and Stata 17.0 software.

Results: A total of 11 studies, which involved 548 patients, were included. After rTMS treatment, the effect on sleep quality improvement in patients with more than mild depressive mood was better in the experimental group than in the control group [I ² = 53%, mean difference (MD) = -2.27, 95%CI = -2.97 to -1.57, p < 0.00001]. The results of the subgroup analyses showed that, in terms of stimulation frequency, compared with the 5-Hz and 10-Hz groups, the treatment effect of the 1-Hz group was better (I ² = 32%, MD = -2.69, 95%CI = -3.78 to -1.60, p < 0.00001). In terms of treatment duration, compared with the 2-week and 4-week groups, the group with more than 4 weeks of treatment had better treatment outcomes (I ² = 0%, MD = -2.81, 95%CI = -3.22 to -2.40, p < 0.00001). In terms of whether combination therapy was used or not, compared with the combination therapy group (I ² = 29%, MD = -1.39, 95%CI = -2.30 to -0.48, p = 0.003), the non-combination therapy group had a better treatment effect (I ² = 0%, MD = -2.93, 95%CI = -3.36 to -2.50, p < 0.00001).

Conclusion: rTMS significantly improves sleep quality in patients with more than mild depression. Subgroup analyses showed that the group using the 1-Hz stimulation frequency, the group with more than 4 weeks of treatment time, and the group with rTMS alone had better efficacy in treating the sleep quality of patients with more than mild depressive mood using rTMS, with the use of combination treatment or not being the main source of heterogeneity.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023467971.

Introduction: Given the high incidence of depression among adolescents and its serious consequences, investigating its influencing factors and mechanisms is of great theoretical and practical significance. This study aims to explore the mediating effects of a sense of alienation and life satisfaction on the relationship between the presence of meaning in life and depression among Chinese high school seniors.

Methods: Six hundred and twenty-one senior high school students (17.09 ± 0.45 years, 266 boys) were recruited from Shandong, China, to participate in the study. Participants completed the Adolescent Students' Sense of Alienation (ASAS), Meaning in Life Questionnaire (MLQ), Satisfaction with Life Scale (SWLS), and Beck Depression Inventory-II (BDI-II).

Results: Our findings revealed that (1) the sense of alienation and life satisfaction play a chain mediating role between the presence of meaning in life and depression among Chinese high school seniors; (2) the sense of alienation plays a mediating role between the presence of meaning in life and depression; (3) there are gender differences in the chain mediation model of the influence of the presence of meaning in life on depression.

Conclusion: This study reveals potential pathways through which the presence of meaning in life affects depression among Chinese high school seniors, offering support and a basis for future mental health interventions for this population.

Introduction: Major depression and alcohol use disorder affect millions of individuals worldwide and cause significant disability. They often occur together, and their co-occurrence is associated with more negative outcomes than each disorder on its own. Yet, there is a lack of knowledge on how to best treat co-occurring depression and alcohol use disorder. A pilot study was conducted to investigate the feasibility, credibility, patient satisfaction, preliminary effect, and potential negative effects of an integrated treatment for depression and alcohol use disorder, which has shown promising results in an earlier pilot trial.

Methods: The study was conducted at an outpatient unit in Stockholm, Sweden. Women (n=7) with current depression and alcohol use disorder were offered integrated group treatment that included evidence-based treatment for depression and alcohol use disorder. Criteria for feasibility were based on an earlier study, treatment credibility was measured using the Credibility/Expectancy Questionnaire and patient satisfaction with the Client Satisfaction Questionnaire.

Results: Feasibility, credibility, and patient satisfaction were high. Depression symptom severity and alcohol consumption decreased from baseline to follow up. Negative effects were reported in terms of increased adverse emotional experiences.

Discussion: The investigated integrated treatment for co-occurring depression and alcohol use disorder continues to show promise. Randomized clinical trials are needed to evaluate its effectiveness.

Introduction: In recent decades, psychosomatic medicine has developed into a distinct specialty, bringing specific clinical concepts to bear seeking to acknowledge the unity (not the identity) of the mind and body in clinical care. Such concepts form the identity of the psychosomatic field as a distinct discipline and its epistemological status between somatic medicine and psychiatry. Despite the importance of these concepts from an educational and a research perspective, too little attention has been paid to their clinical impact.

Methods: This paper investigated the general nature of concepts and their role and significance in structuring the clinical encounter and care, including consideration of their relevance for the hidden curriculum.

Results: Conceptual competence is defined as a transformative awareness of the multilayered, fallible, and plural nature of human concepts, which have both descriptive and evaluative and action-guiding properties having both an explicit and an implicit meaning. Conceptual competence in psychosomatic medicine entails dealing competently with the mind-body-distinction and the biopsychosocial model (and criticism of it) with respect to the clinical situation.

Discussion: Conceptual research is presented as an autonomous research area and the complement of empirical research, having a descriptive and a normative function: descriptively analyzing the concepts we have and normatively searching for the concepts that we need for the integrated care we strive for.

Background: Major depressive disorder (MDD) in adolescents poses a significant threat to physical health. Previous studies have indicated that adolescents with MDD exhibit immune activation.

Objective: This study aimed to compare cytokine levels in adolescents with MDD to healthy controls and assess their diagnostic value.

Methods: This cross-sectional study included 58 adolescent patients with depression from Beijing Anding Hospital (outpatients and inpatients) and 40 healthy adolescents recruited from the community. Multiplex cytokine analysis (Luminex xMAP) was used to measure serum levels of several cytokines. Data analysis was performed using SPSS (version 26.0) to compare cytokine levels between adolescents with MDD and healthy controls and assess gender differences. Correlations between cytokine levels and demographic data, clinical features and depressive symptoms were also analyzed. The receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of cytokines.

Results: Serum IL-4, IFN-γ, and TNF-α levels were significantly elevated in MDD group compared with healthy controls (p < 0.05). In MDD group, the age of first onset of depression in females was significantly younger than that in males (p < 0.05), and female serum TNF-α levels were significantly higher than those in males (p < 0.05). BMI and serum IL-4 levels were significantly positively correlated in adolescents with MDD. The area under the ROC curve for serum IL-4 and TNF-α in diagnosing adolescent depression was 0.695 (95% confidence interval [CI]: 0.580 - 0.809; p < 0.05), with a sensitivity of 0.793 and specificity of 0.675.

Conclusion: Compared with healthy controls, adolescents with depression demonstrated significantly elevated serum cytokine levels, indicating immune activation which were higher in female. Cytokines may have promising diagnostic value in adolescent depression, but further validation with additional indicators is needed.

Background: Inpatient psychiatry is a critical service in a community-based care system for persons with serious mental illness (SMI). Currently, there are few generally accepted or widely used outcomes to assess the effectiveness of inpatient treatment.

Method: Following a Donabedian Model of Health Care Quality, we utilized eight scales from the RAI Mental Health assessment to derive a clinician-scored outcome measure consisting of 4 domains (Psychosis, Depression, Impairment, and Aggression). We combined subscales measuring these domains into a Composite Measure. We used this measure to assess the entire population (N=719) of our large specialized mental health hospital at the beginning (T1) and end (T2) of three months in the hospital (or admission to discharge in shorter stays). We evaluated the content validity of the measure by comparing items and scales with a list of putative contributors to hospital admission (symptoms and complications). To evaluate concurrent validity, we compared mean scores among hospital units with varying lengths of stay and clinical complexity (acute versus chronic versus complex chronic). We used ROC analysis to evaluate the CIIMHS's ability to predict discharge from the hospital. To evaluate construct validity, we examined the measure's responsiveness to changes among patients after treatment in the hospital.

Results: We found strong evidence for all four kinds of validity.

Conclusions: The composite measure represents a valid measure of inpatient mental health status and will serve as a valuable measure of the quality of care for inpatient psychiatry.