Frontiers in Psychiatry最新文献

Background: While psychological interventions are effective at improving symptoms of psychosis, accessible, cost- and time-efficient treatments remain limited. Personalized medicine has emerged as a promising approach, tailoring interventions to individual needs. Metacognitive Training (MCT), with its established efficacy and adaptable format, is well-suited for personalization. The PERMEPSY project (Towards a Personalized Medicine Approach to Psychological Treatment for Psychosis) aims to deliver tailored MCT intervention for individuals with psychosis.

Methods: PERMEPSY is an international study funded by ERAPerMed (JTC2022) involving five clinical partners (Spain, Chile, France, Germany, Poland) and one technological partner (Spain). The project involves a proof-of-concept clinical trial recruiting 51 participants from each center for a total of 255 adult participants with psychosis in a prospective study (Registration: NCT06603922, 19-09-2024). The trial will test the efficacy of a Machine Learning (ML)-derived platform at predicting clinical and functional outcomes from baseline scores and compare a personalized MCT (P-MCT) to a classical MCT based on the platform's predictions.

Aims: PERMEPSY seeks to (1) develop and test the predictive power of an algorithm that could support decision-making, and (2) ascertain whether P-MCT is more effective than MCT at improving key symptoms and cognitive impairments associated to psychosis.

Results: A harmonized retrospective database enabled the development of a predictive ML algorithm, integrated into an innovative platform. This platform provides clinicians with the information needed to deliver P-MCT. Predictions include changes in positive symptoms (e.g., delusions), insight, self-esteem, and treatment adherence.

Discussion: By integrating diverse data types and innovative technology, PERMEPSY addresses the need for personalized, effective treatment in psychosis, aiming to reduce individual and systemic burdens while supporting clinicians in their decision-making.

Introduction: Longitudinal studies have identified an increase in psychological distress throughout the general population during the COVID-19 pandemic. Nevertheless, the determinants of the variation in psychological distress are unclear. This paper investigated factors that were likely to be associated with psychological distress variation: exposure to COVID-19 and psychosocial factors.

Methods: Five waves of a prospective cohort survey were conducted with a convenience sample of the general population in Belgium between March 2020 and November 2021 (n=4,550). Psychological distress was measured using the GHQ-12. Two groups of exposures were investigated: self-reported exposure to COVID-19 and psychosocial factors (loneliness, social support, and social activities). We first partitioned the variance into an interindividual component (time-invariant) and an intraindividual component (time-variant). Linear mixed models were used for analysis.

Results: Most of the variance in psychological distress was interindividual. For both sources of variance (interindividual and intraindividual), the change in psychological distress was mainly associated with psychosocial factors, rather than pandemic-related factors. Loneliness emerged as the factor most strongly associated both with interindividual and intraindividual differences in psychological distress.

Discussion: Overall, these findings suggest that the variation in psychological distress between the waves was mostly influenced by social support, loneliness, and social activities, rather than by exposure to COVID-19. Mitigation policies aimed at controlling the pandemic should focus more on addressing specific individual psychosocial vulnerabilities.

Background: This study explored participant experiences with ecological momentary assessment (EMA) in the context of suicidal thoughts and behaviors (STBs).

Methods: 16 participants of a long-term EMA study (with varying STB occurrence during the study and low vs. high compliance) were interviewed on reactivity effects and feasibility of EMA. Qualitative content analysis was performed using an inductive-deductive approach and consensual coding.

Results: Reactivity to EMA was reported by some participants, with suicidal thoughts occasionally intensifying/being triggered by survey prompts. Importantly, no evidence indicated that EMA triggered suicidal actions. However, the burden increased over time for some, calling for more personalized monitoring durations. EMA's feasibility during acute suicidal crises was questioned due to reduced ability and willingness to respond.

Conclusions: Long-term EMA monitoring after psychiatric discharge was perceived as feasible and beneficial. Selection bias and the lack of quantitative validation limit generalizability. Findings underscore the value of mixed-methods approaches and participatory protocol design.

Objective: To examine abnormalities in EEG microstate dynamics in patients with major depressive disorder (MDD) and to explore their associations with anxiety and somatization symptoms.

Methods: We enrolled 30 patients with MDD and 40 healthy controls. Resting-state EEG was recorded and analyzed using microstate segmentation (classes A-D). Temporal parameters (mean duration, occurrence, time coverage, and transition probabilities) were compared between groups, and correlations with clinical symptoms (HAMD, HAMA, MADRS) were examined.

Results: Compared with controls, patients with MDD exhibited a significantly longer duration, higher occurrence, and greater time coverage of microstate C, while microstate B showed reduced occurrence and coverage. Transition probability analyses revealed fewer transitions from A to B, A to D, B to A, B to D, and D to A, and more transitions between C and D. Symptom correlations indicated that microstate B occurrence was positively associated with HAMD anxiety/somatization scores, while transitions from C to D and from D to C were negatively correlated with anxiety/somatization scores.

Conclusions: MDD is characterized by alterations in microstate B and C dynamics and disrupted transitions between C and D, some of which relate to symptom dimensions, suggesting that EEG microstate features may serve as potential neurophysiological markers in major depressive disorder.

Background: The periods of pregnancy are critical for the mental well-being of women. HIV positive pregnant women are especially vulnerable to experiencing depression and anxiety.

Aim: To determine the prevalence and determinant of depression and anxiety among HIV-positive and HIV negative pregnant women in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Nigeria.

Materials and methods: Between January 1 and May 30, 2024, 342 HIV-positive pregnant individuals and an equivalent number of HIV-negative prenatal attendees participated in a cross-sectional survey conducted at NAUTH in Nnewi. A structured questionnaire, the Generalized Anxiety Disorder Assessment, and the Patient Health Questionnaire were used to interview the subjects. IBM Statistical Package for Social Science version 26 was used to analyze the data, and a significance level of less than 0.05 was chosen.

Results: The research involved 684 participants, all of whom screened positive for anxiety and depression. The average scores for anxiety in HIV-positive and HIV-negative women were 16.8 ± 3.8 compared to 8.7 ± 2.3; P <0.001, while for depression the scores were 11.1 ± 4.3 versus 3.1 ± 3.3; P < 0.001, respectively. A significant presence of major depressive and anxiety disorders was discovered among HIV-positive women, with moderate and severe depression affecting 47.7% and 21.9%, respectively, while moderate and severe anxiety were observed in 21.3% and 73.6% of the women. The majority of women in the control group exhibited mild mental health disorders. For HIV-positive women, the significant factors influencing depression included being 30 years old or younger, having a gestational age of 30 weeks or less, possessing a lower educational level, being employed, and being married; for anxiety, key factors were being para 0-3, experiencing psychological IPV, and being married. Among HIV-negative women, significant determinants of depression included being 30 years old or younger, having a low educational level, and being married.

Conclusion: The prevalence of mental health disorders in the study group is extremely high. The rate is unacceptably elevated among pregnant women who are HIV-positive. This emphasizes the need to integrate mental health services into standard maternal healthcare for all women, especially those living with HIV.

Introduction: Brain fog describes a heterogenous symptom encompassing cognitive symptoms, mental fatigue and reduced mental clarity, particularly prevalent among individuals with Post COVID - 19 Condition (PCC). This study aimed to translate and validate the Brain Fog Scale (BFS), originally developed in Polish, among a Greek-speaking population and explore whether individuals diagnosed with PCC report significantly more brain fog symptoms, compared to those without PCC.

Methods: The BFS was translated in Greek, using a forward - backward translation process and was administered online. Principal Component Analysis and Confirmatory Factor Analysis were run to assess factor structure.

Results: A total of 602 individuals (76.6% female) completed the BFS, of which 36 had a self-reported diagnosis of PCC. Internal consistency for the entire sample was excellent, α = 0.96. The BFS largely retained its original three factor structure with little variability: (1) impaired cognitive acuity (α = 0.95), (2) inattentiveness (α = 0.92), (3) mental exhaustion (α = 0.84). A Mann-Whitney U test revealed that individuals diagnosed with PCC reported significantly more brain fog symptoms compared to those without PCC, U = 2178.50, p = .011. MANOVA analyses further indicated significantly higher scores in the impaired cognition Factor among individuals with PCC, F(1, 125) = 7.32, p = .008.

Conclusion: The BFS comprises a valid tool for assessment of brain fog and can facilitate person-centred rehabilitation planning in PCC. Findings are discussed in relation to the literature regarding brain fog symptom burden in PCC with suggestions for future research made.

Objective: Children with ADHD are at increased risk for developing gaming addiction, but the psychosocial mechanisms underlying this relationship remain poorly understood. This study aimed to identify factors that mediate this risk.

Method: We analyzed data from three consecutive waves (Years 2-4) of the Adolescent Brain Cognitive Development^SM (ABCD^®) Study, including approximately 7,260 participants. Linear mixed-effects models were used to assess the longitudinal association between ADHD diagnosis (measured via the Kiddie Schedule for Affective Disorders and Schizophrenia [KSADS]) and scores on the Video Game Addiction Questionnaire (VGAQ). A parallel mediation model was then employed to evaluate the role of nine psychosocial factors in mediating this relationship.

Results: Children with ADHD had significantly higher VGAQ scores over time, with an average increase of 1.3 points (p < 0.001) compared to those without ADHD. The mediation model identified three significant psychosocial mediators: prosocial peer involvement (7.4% of the total effect), school involvement (5.8%), and family conflict (5.1%).

Conclusion: Prosocial peer involvement, school engagement, and family conflict emerged as key psychosocial pathways linking ADHD to gaming addiction. These findings have important public health implications and suggest that strengthening peer networks and family environments may be effective targets for intervention in children with ADHD.

Given the research consensus that personality disorder often onsets in adolescence, more work is needed to investigate parent-child discrepancies in reporting on personality disorder, particularly during the pre- and early adolescent period when more significant impairment in personality functioning may be developing or can already be observed. The current study examined concordance of parent- and child-reported level of personality functioning (LPF, as defined in the DSM-5 Alternative Model of Personality Disorders) among pre- and early adolescents and examined the extent to which this concordance was associated with clinically relevant outcomes. Participants included N = 432 children between the ages of 10 and 15 years from three samples oversampled for psychopathology symptoms and their parents. Children and their parents reported on child impairment in personality functioning with the Level of Personality Functioning Scale Brief Form 2.0. Outcomes included parent-reported caregiver strain, parent-reported child functional impairment, and child-reported history of thoughts and behaviors related to suicide and non-suicidal self-injury. Latent profile analysis was conducted to identify profiles of children based on patterns of convergence and divergence between parent- and child-reported LPF. Profile membership was then used to predict outcomes. A four-profile model, with two parent-child convergent and two parent-child divergent profiles, demonstrated the best fit. Convergence on high impairment in LPF demonstrated the strongest associations with outcomes. Divergent profiles also demonstrated stronger associations with outcomes reported by the informant who had endorsed higher impairment in LPF. Findings suggested that both parent- and child-reported LPF, and the degree of their concordance, may have unique value for predicting clinically important outcomes in pre- and early adolescence. Research and clinical practice utilizing new dimensional approaches with adolescents may therefore benefit from multi-informant assessment of personality functioning.