Frontiers in Psychiatry最新文献

Introduction: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorders often co-occurring with sleep problems and other physical disorders. Vitamin D regulates sleep and supports normal brain function. Regrettably, no studies have looked at whether vitamin D insufficiency exacerbates sleep problems in ADHD children and further affects ADHD symptoms.

Objective: This study aimed to examine whether vitamin D insufficiency exacerbates sleep problems and ADHD symptoms in children aged 6-14 years.

Methods: This is a case-control study, 260 ADHD children (aged 6-14 years) were enrolled in, of whom 95 had vitamin D insufficiency and 165 had sufficiency. Collected all ADHD symptom severity and functional impairment scales, including Swanson, Nolan and Pelham (SNAP) scale, Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Conners parents symptom questionnaire (PSQ) and Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P). All guardians of children with ADHD complete the Children's Sleep Habits Questionnaire (CSHQ).

Results: The CSHQ total scores of the ADHD children in both groups were significantly higher than 41, which means that ADHD children overall have sleep problems. Compared to ADHD children with vitamin D sufficiency group, we observed significantly higher sleep duration and sleep disordered breathing scores in ADHD children with vitamin D insufficiency group (all p< 0.05). However, there was no direct effect of vitamin D insufficiency on the type of ADHD, symptoms or functional impairment (all p> 0.05). Further analyses showed a correlation between the CSHQ and symptoms, functional impairment scores in children with ADHD.

Conclusion: Sleep problems are highly prevalent in children with ADHD. Vitamin D insufficiency has a significant impact on both sleep duration and sleep disordered breathing, but no notable direct effects on ADHD symptoms or functional impairment. Our findings underscore the importance of screening for vitamin D insufficiency in children with ADHD, particularly given its association with sleep disturbances, which may indirectly affect symptom severity.

Introduction: Intrusive thoughts occurring independently of intention are symptoms of obsessive-compulsive disorders (OCD). However, they also appear in various other disorders, including substance use disorders, depression, post-traumatic stress disorder, and anxiety disorders, as well as in healthy individuals. Despite this, the diversity of intrusive thoughts remains largely unexplored. In this study, we aimed to (1) classify the factors causing intrusive thoughts as identified in previous research and (2) elucidate differences in the psychological states of intrusive thoughts.

Methods: We investigated 298 participants over 20 years old using a questionnaire that includes scales such as "obsessive-compulsive belief," "stress responses," "thought suppression," and "evaluation of intrusive thoughts." To analyze data, we applied co-clustering, a machine-learning technique, to the data obtained from the investigation.

Results: We identified three factors that affect the occurrence of intrusive thoughts: "Negative Evaluation of Intrusive Thoughts," "Stress Responses," and "Excessive Control of Intrusive Thoughts." Furthermore, based on the scoring patterns of these three factors, participants were classified into five subtypes characterized by their degree of OCD tendencies. Further analysis revealed that the three factors could not be explained by OCD tendencies. Additionally, it was found that the five subtypes employed different coping strategies.

Discussion: These findings suggest that intrusive thoughts cannot be fully explained solely by the degree of OCD tendencies, which could provide valuable insights into cognitive-behavioral support targeting the various psychological states associated with intrusive thoughts.

Substance use and the emergence of Novel Psychoactive Substances (NPS) present a significant public health challenge and diagnostic dilemma, particularly in the context of psychosis. The increasing availability of psychoactive substances among youth has led to a rise in Substance Use Disorders (SUDs), with profound implications for mental health. This paper explores the psychopathological distinctions between substance-induced psychoses (SIPs) and endogenous psychoses, such as schizophrenia, from a phenomenological perspective. We emphasize three key aspects: dissociation, mental automatism, and temporality, to elucidate the underlying mechanisms of these conditions. Dissociation, as a psychopathological organizer, is central to exogenous psychoses, particularly those triggered by NPS. This phenomenon leads to a fragmentation of consciousness, detachment from reality, and disintegration of identity, distinct from the spaltung observed in endogenous psychoses. The concept of mental automatism, as theorized by De Clerambault, is also explored, highlighting its role in the early stages of exogenous psychoses, where cognitive disruptions precede delusions and hallucinations. Furthermore, the temporal experience in SIPs is characterized by a disconnection from past and future, trapping individuals in an "eternal present." This contrasts with the fragmented temporality observed in schizophrenia, where patients struggle to maintain a coherent narrative of their lives. The phenomenological approach provides critical insights into the clinical differentiation between SIPs and Primary Psychotic Disorders (PPDs), emphasizing the need for targeted interventions that address the specific temporal and cognitive disruptions in substance-induced conditions. In conclusion, this paper underscores the importance of integrating phenomenological psychopathology into clinical practice, particularly in the face of the evolving landscape of substance use and psychosis. Understanding the distinct psychopathological mechanisms underlying SIPs can inform more accurate diagnoses and effective treatments, ultimately improving patient outcomes in the context of this growing public health issue.

Background: Workplace violence is a significant cause of work-related stress in nursing, affecting job performance and satisfaction and increasing burnout risk. This study aims to evaluate the prevalence of verbal and physical violence against psychiatric nurses and its impact on their quality of life.

Methods: This cross-sectional study was conducted from April to October 2024. A sample of 171 nurses was selected using a convenience sampling method. The study was carried out at Eradah Complex for Mental Health in Arar City, Eradah Hospital for Mental Health in Al Jouf City, and Mental Health Hospital in Al Qurayyat City. The authors evaluated workplace violence and quality of life among nurses using a questionnaire-based interview and a 36-item quality of life assessment tool. Statistical analysis was performed using SPSS version 25.

Results: The participants' mean age was 34.85 ± 4.74 years, 67.8% were male, and 52.7% had over 10 years of experience. The overall prevalence of workplace violence was found to be 100%, with 62% exposed to verbal violence and 38% to physical violence. Regarding quality of life, 66% had an average quality of life, 12.9% had a good quality of life, and 21.1% had a poor quality of life. Statistically significant associations were found between the type of violence and quality of life (P-value < 0.05).

Conclusion: The study found significant levels of verbal and physical workplace violence among psychiatric nurses, with a significant correlation between violence and their quality of life. These results highlight the need for targeted interventions, including training programs, improved workplace safety policies, and continuous monitoring to support nurse well-being and job satisfaction.

Introduction: It is recognized that around 25-30% of autistic children do not develop functional speech and remain minimally verbal beyond the age of 5. However, little is known about the clinical characteristics of this group.

Methods: We retrospectively examined a sample of 189 autistic children and adolescents classified as minimally verbal (mean age: 7.37 ± 1.51; 152 males, 37 females) and compared them with a group of 184 verbal autistic children and adolescents (mean age: 7.71 ± 2.52; 160 males, 24 females). We considered intellectual functioning, severity of autism, emotional and behavioural problems, and parenting stress.

Results: Children in the minimally verbal group exhibited significantly lower nonverbal Intelligent Quotient and an increase in restricted repetitive behaviours compared to the verbal group. Exploring potential differences in emotional and behavioural problems, the verbally group showed higher levels of anxiety symptoms. In addition, minimally verbal group showed high score of parenting stress.

Discussion: This study highlights the importance of accurately characterizing minimally verbal autistic children and adolescents to facilitate the identification of specific and individualized interventions based on individual functioning profiles.

Background: Affecting adolescent and young adults, anorexia nervosa (AN) has the highest death rate of all mental disorders. Effective treatment options are lacking and a significant proportion of patients develop severe and chronic forms of the disease with long-lasting functional impairment. Neurobiology of AN implicates the nucleus accumbens as a core structure of the ventral striatum highly connected to the prefrontal cortex, the insula and the limbic system. Several studies reported promising results of deep brain stimulation for treatment-resistant AN. The aim of this study was to investigate the safety and efficacy of bilateral nucleus accumbens deep brain stimulation in severe and enduring AN.

Methods and analysis: This is a prospective, multicentre, single-arm, open-label, non-randomized pilot trial of bilateral nucleus accumbens deep brain stimulation for severe and enduring AN. Patients will be followed up for 24 months after deep brain stimulation. The main objective of this study is to measure the safety and feasibility of nucleus accumbens deep brain stimulation in this population. The recruitment rate will be collected prospectively. Potential deep brain stimulation efficacy will be monitored by changes in: 1) health-related quality of life; 2) weight; 3) eating disorder symptomatology; 4) neuropsychological changes of cognitive flexibility, habits formation, emotional processing and central coherence; 5) psychiatric comorbidities (anxiety, depression, obsession). Local field potential recordings during an exposure task will be proposed to the patients. Additionally, caregiver quality of life will be assessed.

Discussion: We present the design and rationale for a pilot study investigating the safety of nucleus accumbens deep brain stimulation for treatment resistant anorexia nervosa. This trial will provide an estimated effect size of nucleus accumbens deep brain stimulation for treatment-resistant anorexia nervosa to support future larger-scale clinical trials.

Background: Teachers are more likely to experience mental health issues than the general population, yet few studies focus on Chinese teachers. After the "Double Reduction" policy, teacher workload and stress have risen significantly. In Dongguan, a city actively implementing educational reforms, teacher mental health may be particularly concerning. Anxiety, depression, and burnout are prevalent mental health issues. This study examined the prevalence and factors linked to anxiety, depression, and burnout among Dongguan teachers.

Methods: A cross-sectional survey evaluated the mental health of primary and secondary school teachers in Dongguan, China, using two-stage random sampling. Eleven schools were randomly selected, with 30 teachers chosen from each of 330 invited participants, 313 completed the survey (94.8% response rate), and 259 valid responses were retained after excluding incomplete or inconsistent answers. The study used the Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and Maslach Burnout Inventory-Educators Survey (MBI-ES). Wilcoxon rank-sum and Kruskal-Wallis tests identified factors linked to anxiety, depression, and burnout. Variables with p ≤ 0.10 in univariate analysis were included in multivariate logistic regression, with cut-offs of 50 for SAS, 53 for SDS, 27 for Emotional Exhaustion (EE), 13 for Depersonalization (DP), and 31 for Personal Accomplishment (PA). A p ≤ 0.10 threshold was used to avoid omitting potential predictors.

Results: The study found anxiety, depression, and burnout prevalence rates of 19.3%, 34.7%, and 74.5%, respectively (95% CI: 14.5-24.1; 28.9-40.6; 69.2-79.9). Junior high school teachers (OR = 0.47) and those with higher education (OR = 0.39) had a lower depression risk. Female teachers (OR = 1.96) had a higher risk of emotional exhaustion (EE), while older teachers (OR = 0.923) had a lower risk of reduced personal accomplishment (PA). Anxiety and depersonalization (DP) showed no significant associations.

Conclusion: The study found high rates of depression and burnout among teachers, influenced by educational level, school type, sex, and age. Authorities should address these issues by clarifying teacher responsibilities, providing mental health training, and establishing monitoring systems. As a cross-sectional study, it cannot determine causality, and further longitudinal research is needed to confirm these findings.

Background: Dentofacial deformity (DFD) is a disease in which the maxillary complex markedly diverges from normal proportions. The incidence of DFD is approximately 20% worldwide, and patients with DFDs are at increased risk for depression. Attention should be given to depression in patients with DFDs. However, factors affecting depression in patients with DFDs remain unclear. Previous studies have suggested that the type of DFD and esthetic expectations may influence patient depression, but few studies have clarified the effects of the type of DFD and esthetic expectations on patient depression.

Methods: A total of 471 patients with DFDs were enrolled. The diagnosis of DFD was made by two maxillofacial surgeons according to the Angle's classification. The visual analog assessment scale of esthetic expectations was used to assess patients' esthetic expectations. The 9-item Patient Health Questionnaire depression module was utilized to explore patient depression. SPSS 26.0 was used to analyze the data in this study.

Results: Compared with DFD patients who had a master's degree or above, those who had a high school education were more prone to depression (OR=3.848, 95% CI: 1.546-9.574). Compared with Class II DFDs, Class III DFDs were associated with a greater risk of depression (OR=1.458, 95% CI: 1.007-2.078). Compared with those who had extremely low esthetic expectations, those who had extremely high esthetic expectations (OR: 2.25, 95% CI: 1.053-4.086) were more prone to depression.

Conclusions: Patients who had a high school education, were diagnosed with Class III DFDs, and had higher esthetic expectations had a greater risk of depression. The above populations may need more psychological support.

Background: Anxiety disorders (AD), ADHD, and head and neck cancer (HNC) are complex conditions with potential genetic interconnections that remain to be fully elucidated. The purpose of this study is to investigate gene-level connections among ADHD, AD, and HNC.

Method: A comprehensive literature mining approach identified potential gene-disease relationships from PubMed and bioinformatics databases, analyzing 19,924 genes. An AI-driven computational process constructed a gene-disease relationship table using the Adjusted Binomial Method Algorithm (ABMA) to evaluate association reliability. Overlapping genes were analyzed through protein-protein interaction (PPI) networks, functional annotations, and literature-based pathway analyses to elucidate shared and unique genetic mechanisms linking these diseases.

Results: The analysis identified 141 significant genes associated with AD, 153 with ADHD, and 1,065 with HNC (q-value < 0.05). These genes demonstrated significant overlap (odds ratio ≥ 1.8; p ≤ 2.58E-2) and high interconnectivity (PPI network density ≥ 0.39, clustering coefficient ≥ 0.76, and diameter ≤ 3). Centrality analysis revealed core genes such as IL-6, MYC, NLRP3, and CXCR4 as critical mediators. Functional enrichment analysis identified key pathways, including serotonergic synapse, inflammatory response, and Toll-like receptor signaling, highlighting the involvement of neuronal and immune mechanisms. Functional pathway analysis demonstrated reciprocal genetic influences among AD, ADHD, and HNC, emphasizing shared and distinct gene-level connections that may underlie their co-occurrence and mutual risk factors.

Conclusion: This study reveals a complex and interconnected genetic network among AD, ADHD, and HNC, highlighting shared pathways, unique mechanisms, and critical genes, providing valuable insights into the genetic underpinnings of these conditions and potential avenues for therapeutic exploration.