Frontiers in Psychiatry最新文献

Cognitive behavioral therapy (CBT) is one of the most researched evidence-based practices in mental health treatment. While studies have examined the effectiveness of music therapy in comparison or in addition to cognitive behavioral therapy, none have examined how to use principles of cognitive behavioral therapy within the four music therapy methods using flexibility within fidelity as a framework. A real case example is provided to illustrate the incorporation of CBT principles into music therapy methods resulting in resolution of PTSD and anxiety symptoms.

Background: Although depressive symptoms are suspected to influence cognitive health, prospective evidence linking depressive symptoms to mild cognitive impairment (MCI) is scarce within large-scale Chinese cohorts. This study sought to analyze the graded association between initial depressive symptom severity and subsequent MCI risk in middle-aged and older adults in China, as well as to assess whether this relationship was moderated by other underlying factors.

Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020), we included 9,461 participants aged ≥45 without baseline MCI. Depressive symptoms were assessed using the CESD-10 scale and categorized as none (<10), mild-moderate (10-20), or severe (≥21). Incident MCI was identified based on standardized criteria. Data analysis was performed using Cox proportional hazards regression models, which incorporated restricted cubic splines to flexibly model potential non-linear relationships. This primary analysis was further supplemented by comprehensive subgroup and sensitivity analyses to assess the heterogeneity of treatment effects and the robustness of the findings.

Results: During the nine-year follow-up period, a total of 1,276 new cases of MCI were documented. Analysis by depressive symptom severity revealed a graded increase in MCI risk relative to the asymptomatic reference group. In the fully adjusted model, participants with mild-to-moderate depressive symptoms exhibited a significantly increased risk of MCI (HR=1.363, 95%CI: 1.205-1.542, p<0.05), while a more pronounced risk elevation was observed in those with severe symptoms (HR=1.468, 95%CI: 1.123-1.918, p<0.05). Furthermore, each 1-SD (5.83 points) increase in CES-D score was associated with a 2.90% higher risk of MCI (HR=1.029, 95% CI: 1.020-1.039, p<0.001). Restricted cubic splines confirmed a significant linear dose-response relationship (p for nonlinear=0.419). Education significantly moderated the association, with a protective effect observed in individuals with higher education. The findings remained consistent when assessed through various sensitivity analyses.

Conclusion: Baseline depressive symptoms are independently and dose-dependently associated with higher MCI risk in Chinese adults aged 45 and above. Education serves as a significant moderator. Integrating depression screening into MCI prevention strategies is recommended, particularly in less-educated populations.

Background: Anxiety and depression are prevalent in cancer patients and often impair immune function, compromising antitumor responses. Anti-anxiety medications, such as olanzapine, show promise in alleviating psychological distress, potentially enhancing immune function in patients with malignant tumors.

Objective: This study aims to investigate immunological alterations in lung cancer patients with anxiety and depression and evaluate the immunomodulatory effects of olanzapine in this population.

Methods: We retrospectively analyzed data from 179 oncology patients at a single center. Of these, 38 lung cancer patients served as the control group, while 33 lung cancer patients, admitted under standard hospital conditions, received olanzapine therapy (treatment group) during hospitalization. We monitored complete blood count, blood biochemistry, and lymphocyte subsets (CD3, CD4, CD8, NK cells, B lymphocytes). Anxiety and depression were assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS).

Results: Lung cancer patients with concurrent anxiety and depression exhibited elevated CD3, CD4, CD8, NK cell counts, and CD4/CD8 ratio, alongside reduced Neutrophil-to-Lymphocyte Ratio (NLR) (P = 0.044, 0.001, 0.022, 0.039, 0.007, 0.003). Those with both conditions had lower serum albumin compared to patients with depression alone (P = 0.016) or either condition independently (P = 0.015). Patients with anxiety and depression showed reduced CD3, CD8, and NK cell counts compared to those with single conditions (P = 0.005, 0.037, 0.018). Baseline SAS/SDS scores showed no significant differences between groups (P = 0.385, 0.603). Olanzapine treatment significantly increased CD3, CD4, and NK cell counts (P = 0.001 each), reduced NLR and B lymphocytes (P<0.001, 0.036), and elevated HDL cholesterol (P = 0.014) compared to controls. Post-treatment, the treatment group's SDS scores decreased from 42.64 ± 6.32 to 37.06 ± 8.34 (P<0.001), and SAS scores dropped from 50.48 ± 12.94 to 43.61 ± 13.47 (P<0.001).

Conclusion: Anxiety and depression impair immune function in lung cancer patients, while olanzapine enhances CD3, CD4, and NK cell activity and reduces psychological distress, suggesting its potential as an adjunct in cancer immunotherapy.

Background: The serious problem posed by suicide deaths has led to increased awareness and the implementation of prevention plans in a large number of countries worldwide. The main aim of this study is to determine the relationship between the variation in completed suicide rates in Spain and its autonomous communities from 2010 to 2023, and the implementation of suicide prevention strategies at an autonomous community level.

Methods: The incidence rates of suicide deaths in the nineteen Spanish autonomous communities from 2010 to 2023 were obtained from the Spanish Statistical Office. Suicide prevention strategies were classified using the Universal-Selective-Indicated model, with strategies including interventions at all three levels considered multilevel. An interrupted time series analysis was conducted to evaluate the impact of suicide prevention programs on suicide rates. The fitted model included the pre-intervention trend, the immediate change after implementation, and the change in slope from that point onward. Suicide rates at the national level and in Murcia, where no prevention plan was implemented, were included as control variables.

Results: None of the tested interrupted time series analysis variants showed a significant reduction in the rate of completed suicides in any autonomous community. The only exceptions were the first year of implementation of the prevention plan in Galicia and Madrid after adjusting for the national rate and using Murcia as the control region for the after-intervention analysis.

Conclusion: Despite the suicide prevention plans launched by numerous Spanish autonomous communities, to date no significant reduction in the evolution of completed suicide rates has been demonstrated in any of these autonomous communities or nationwide.

Suicide is an unresolved issue in psychiatry to this day. Suicide risk (SR) is particularly high for psychiatric patients with bipolar I disorder (BD). Recent studies suggest an immunological dysregulation in the background. In our retrospective study, we investigated laboratory parameters of BD in-patients (n = 116) between January 2020 and June 2024. Data was collected regarding the following parameters: white blood cell, neutrophil, lymphocyte, monocyte and platelet count, monocyte-to-lymphocyte (MLR), neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), red blood cell distribution width (RDW) and mean platelet volume (MPV). Individuals with recent (≤ 48 hours prior) suicide attempt (SA) (n = 21) and with past (> 48 hours prior) SA (n = 16) represented the high SR group (n = 37). BD patients with no history of SA composed the intermediate SR group (n = 79). We found a significant increase in MLR, monocyte count, CRP and ESR in patients with recent SA compared to those with no history of SA. Comparing high and intermediate SR patients, MLR, monocyte count, CRP and ESR remained elevated in the former group. As implied by previous research, immunological mechanisms may contribute to the emergence of suicidality. Investigating BD patients as the subgroup at significant risk, changes in certain inflammatory markers further strengthen the assumption of immunological processes in the background of suicidality, and these parameters may serve as potential future biomarkers of SR.

Backgroud: Second-generation antipsychotics (SGAs) are widely used in the treatment of schizophrenia, however, growing concerns have emerged regarding their adverse effects on glucose and lipid metabolism. This study aimed to investigate the potential mechanisms underlying SGA-induced disturbances in glucose and lipid metabolism by integrating gut microbiota profiling with metabolomic analysis, thereby providing a scientific basis for future clinical interventions.

Methods: A self-controlled before-after study was conducted on subjects who were initially medication-free (pre-medication group) and subsequently initiated on second-generation antipsychotics for 3 months (post-medication group). Anthropometric measurements-including waist circumference, hip circumference, body weight-as well as fasting blood samples (for assessment of glucose, insulin, C peptide, blood lipid) and stool samples were collected at baseline and after three months of treatment. Gut microbiota composition and fecal metabolomic profiles were analyzed using high-throughput sequencing and mass spectrometry-based approaches, respectively.

Results: Firstly, Gut microbial diversity differed significantly between groups. At genus level, the abundances of Escherichia and Bifidobacterium were increased significantly in the post-medication patients, while the abundances of Faecalibacterium and Blautia were decreased. Metabolomic analysis revealed decreased levels of oleamide and stearamide in the post-medication group, which exhibited a negative correlation with the abundance of Faecalibacterium. Additionally, the arginine and proline metabolic pathway, D-amino acid metabolic pathway, and arginine biosynthesis pathway were also altered in this group. Ornithine was identified as a key player in these three differential metabolic pathways.

Conclusion: In summary, first-time exposure to second-generation antipsychotics in patients with schizophrenia is associated with disturbances in glucose and lipid metabolism, which appear to be closely linked to SGA-induced perturbations in gut microbiota composition and their associated metabolic profiles.

Background: The pathophysiological mechanisms of adolescent atypical depression (A-D) remain unclear. This study used resting-state functional magnetic resonance imaging (rs-fMRI) and independent component analysis (ICA) to compare functional network connectivity (FNC) and intrinsic brain activity between healthy control, A-D, and non-atypical depression (N-AD) adolescents.

Methods: Fifteen healthy control (HC), 17 A-D, and 18 N-AD adolescents underwent rs-fMRI. Clinical symptoms were assessed using the 30-item Inventory of Depressive Symptomatology (IDS-30R). ICA was employed to analyze internetwork FNC and fractional amplitude of low-frequency fluctuations (fALFF).

Results: The A-D group exhibited decreased connectivity between the primary visual (IC4) and visuospatial (IC10) networks but increased connectivity between IC4 and the sensorimotor network (IC11), and between the ventral and dorsal default mode networks (IC8 and IC17, respectively). Higher fALFF values were found in the right fusiform face area and left superior occipital gyrus of the A-D group than the N-AD group. Increased appetite correlated positively with IC4-IC10 connectivity (r = 0.573, p = 0.016), and interpersonal rejection sensitivity was correlated with fALFF in the right fusiform area (r = 0.625, p = 0.007).

Conclusion: Aberrant functional connectivity of the visual network and altered activity in visual-processing regions are associated with specific A-D symptoms, providing new insights into its neurophysiology.

Introduction: Insomnia has emerged as a major concern among youth following the lifting of coronavirus disease 2019 (COVID-19) restrictions in China. This study aimed to explore the prevalence and influencing factors of insomnia, as well as its associations with mental health, in young students during this period.

Methods: A cross-sectional survey was conducted among 82,873 students in Sichuan Province, China, using a self-designed questionnaire and standardized assessment tools. Chi-square tests, ANOVA with post-hoc test analyses, and logistic regression were employed to identify the prevalence and influencing factors of insomnia and its associations with mental health.

Results: A total of 28,178 (34.0%) students reported insomnia. Self-reported history of mental disorders, neglectful parenting, and initiating alcohol consumption during the pandemic were associated with higher odds of insomnia, whereas satisfaction with the academy, full recovery of daily routines, greatly improved family relationships, no change in friendships, and higher maternal education were associated with lower odds of insomnia (p < 0.001). Severe insomnia was strongly associated with depression, anxiety, and posttraumatic stress disorder (PTSD; ORs: 17.55, 3.35, and 17.45, respectively). Interaction effects were observed between mild to moderate insomnia and COVID-19 infection on depression, anxiety, and PTSD.

Conclusion: Following the lifting of COVID-19 restrictions, insomnia remained prevalent among young Chinese students. Preexisting self-reported mental disorders, neglectful parenting, and pandemic-related maladaptive behaviors increase the risk of insomnia, whereas positive lifestyle adjustments, stable relationships, and higher maternal education appear protective. A significant association was observed between insomnia severity and symptoms of depression, anxiety, and PTSD. These findings highlight the persistent links among social, behavioral, and demographic factors, sleep, and mental health, emphasizing the importance of addressing sleep disturbances after the public health crisis.

Introduction: Stroke is a leading cause of mortality and disability globally, with post-stroke depression and post-stroke anxiety being common and significant complications that hinder recovery and adversely affect quality of life. Although these conditions frequently co-occur, their heterogeneity remains poorly understood. This study integrates the Health Ecology Model (HEM) and employs Latent Profile Analysis (LPA) to identify distinct psychological profiles of depression and anxiety among patients with acute ischemic stroke (AIS), as well as to investigate their multilevel determinants.

Methods: Patients with AIS from a tertiary hospital in Guangdong Province, China, from January to November 2024 were included. Within one week of stroke onset, the data of sociodemographic, clinical characteristics, swallowing function, stroke severity, activities of daily living, resilience and social support were collected according to the HEM guidelines. The Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 were used to assess the depression and anxiety symptoms of the patients three months after stroke onset. LPA was employed to identify distinct psychological profiles, and variables with a P < 0.1 in the univariate analysis were retained for inclusion in the subsequent multivariate analysis.

Results: A total of 551 patients with AIS were included in the study, 49 were lost to follow-up or withdrew, resulting in a final analytic sample of 502 participants (91.11%). Three distinct psychological profiles were identified: no depression-anxiety (67.93%), high-risk depression-anxiety (21.12%) and major depression-anxiety (10.95%). In the multivariate analysis, the results indicated that occupation (OR = 0.61, 95% CI [0.40-0.93]), National Institutes of Health Stroke Scale (NIHSS, OR = 1.60, 95% CI [1.06-2.42]), Barthel Index (BI, OR = 1.67, 95% CI [1.27-2.19]) and hypertension (OR = 2.37, 95% CI [1.29-4.35]) were independent predictors of the high-risk depression-anxiety profile, while NIHSS (OR = 2.33, 95% CI [1.42-3.85]), BI (OR = 2.65, 95% CI [1.62-4.35]) and resilience (OR = 0.92, 95% CI [0.87-0.98]) were significantly associated with the major depression-anxiety profile.

Conclusions: This study reveals significant heterogeneity in psychological distress among AIS survivors. Key predictors of post-stroke emotional comorbidity include occupation, hypertension, stroke severity, activities of daily living and low resilience. Early identification of high-risk individuals can significantly enhance screening and intervention strategies, particularly by focusing on symptoms such as anhedonia and nervousness. Future research should focus on longitudinal designs and objective biomarkers to better understand the mechanisms behind post-stroke emotional comorbidity.

Research has demonstrated the significant roles that smartphone addiction and emotion regulation difficulties play in juvenile delinquency. However, the mediating role of smartphone addiction in the relationship between emotion regulation difficulties and delinquent behavior has not been extensively explored. To address this gap, data were collected via a survey administered to 210 sentenced male juvenile delinquents, aged 14 to 17, who frequently use multiple social media applications via smartphones. Our findings reveal that male juveniles exhibit high levels of smartphone addiction, which significantly disrupts their daily functioning and fosters a strong orientation toward virtual life. These juveniles frequently experience withdrawal symptoms when not using their smartphones. Additionally, they report substantial difficulties in regulating their emotions, including problems with impulse control, non-acceptance of emotional responses, and lack of emotional clarity. These emotional regulation challenges are closely linked to a higher frequency of delinquent behaviors. Furthermore, a significant positive relationship was found between smartphone addiction (which disrupts adaptive functioning) and delinquency. The results further suggest that smartphone addiction mediates the relationship between emotion regulation difficulties and delinquency. Specifically, difficulties in emotion regulation increase the likelihood of smartphone addiction, which in turn escalates the risk of engaging in delinquent behavior. Furthermore, emotion regulation difficulties directly influence juvenile delinquency, independent of smartphone addiction.