Frontiers in Psychiatry最新文献

Background: The revolving door phenomenon refers to patients with frequent hospital admissions and emerged after deinstitutionalization reforms have been implemented. Schizophrenia is a severe and debilitating mental disorder and has frequently been identified as one of the most prevalent disorders among revolving door patients. Therefore, this research aimed to identify socio-demographic and clinical factors associated with the revolving door phenomenon in patients with schizophrenia.

Methods: We conducted an observational and retrospective cohort study and collected data from the medical records of individuals admitted to the largest psychiatric hospital in Romania during a 2-year period. Patients with three or more admissions during a 12-month period were identified as revolving door.

Results: Of the total of 635 patients included in this study, 108 met the criteria for revolving door. Patients had a mean age of 44.55±12.83 years and most of them were single (81.7%) and receiving a disability pension (68.7%) and had an illness duration of more than 5 years (81.9%). Male gender (p=0.000), younger age (p<0.05), presence of psychiatric comorbidity (p<0.05), substance use disorder (p=0.000) and alcohol use disorder (p<0.01) were associated with the revolving door patients. A binary linear logistic regression revealed that male gender (OR=1.92, 95%CI:1.21-3.08), shorter hospitalization (OR=0.982, 95%CI:0.964-1.000), substance use disorder (OR=2.47, 95%CI:1.16-5.26), verbal (OR=1.44, 95%CI:1.05-1.98) and physical (OR=1.331, 95%CI:1.017-1.744) aggression were predictive factors for frequent use of inpatient services.

Conclusions: The results may facilitate development of future reform policies aimed at reducing the revolving door phenomenon, including implementing transitional care interventions between hospital and community services.

Introduction: Autistic individuals may show several psychiatric co-occurrences, including Feeding and Eating Disorders (FEDs). Avoidant and Restrictive Food Intake Disorder (ARFID) consists of avoidance or restriction in food intake, leading to significant weight loss, nutritional deficiencies, and marked interference with psychosocial functioning. Both Autism Spectrum Disorder (ASD) and ARFID are characterized by the two main features of cognitive rigidity and sensory sensitivity, which may complicate differential diagnosis. There is a notable lack of information on the manifestation of ASD-ARFID co-occurrence, as well as tailored assessment tools and practice, and therapeutic approaches.

Case description: This report provides a detailed description of L., a young girl with a late diagnosis of ASD who also developed unspecific depressive mood disorder and ARFID in co-occurrence. After the diagnosis of ASD, L. underwent multiple evaluations to address emerging psychiatric co-occurrences and symptom exacerbation, and in order to develop the most effective integrated treatment.

Conclusion: The case of L. expands the knowledge on the phenotype of Autistic females and exemplifies how delayed diagnosis may exacerbate functioning differences and increase the camouflage phenomenon. Additionally, it underscores the importance of improving tailored evaluation, combined treatment plans, with both cognitive-behavioral therapy and drugs, and monitoring the evolving patterns of Autistic manifestations and associated psychiatric co-occurrences.

Background: The rapid aging of the global population presents pressing public health challenges, notably an increase in suicide rates among older adults. Despite this critical issue, there is a scarcity of comprehensive assessments regarding the existing literature on suicide within this demographic. This study seeks to employ bibliometric analysis and knowledge mapping to elucidate prevailing research trends and the overall status of this field.

Methods: We performed a comprehensive computer-based search of the Web of Science Core Collection to identify relevant articles and reviews concerning suicide in the elderly. A bibliometric analysis was conducted, examining various aspects including countries or regions, institutions, authors, journals, keywords, and references. This analysis utilized tools such as CiteSpace, VOSViewer, Pajek, and Excel 365 to facilitate a thorough assessment.

Results: The analysis covered 1,116 publications from 2005 to 2024. The annual number of publications showed a fluctuating upward trend, with notable decreases in 2007, 2012, 2015, 2017, and 2022, and increases in 2009, 2013, 2016, and 2019, peaking at 121 in 2021, with citations reaching 4,741 in 2022, but declining since then. The United States stands out as the most productive and influential country in the field, boasting the highest number of publications and citations. The country is home to institutions leading in both publication and citation metrics. Prominent authors contributing significantly to this domain include Conwell Yeates, Van Orden Kimberly A., and Waern Margda. Key journals disseminating crucial research are the Journal of Affective Disorders, American Journal of Geriatric Psychiatry, and Lancet. Frequent keywords in this field encompass depression, suicidal ideation, suicide, older-adults, risk, risk factors, prevalence, older adults, ideation, behavior, health, mental health, life, age, people, prevention, symptoms, scale, population, and elderly. The contemporary research emphasis is primarily on identifying, treating, and preventing the suicide risk associated with depression in older adults.

Conclusions: This study highlights the growing research focus on suicide in older adults, particularly related to depression and the identification, treatment, and prevention of suicide risk. The findings underscore the need for targeted prevention strategies and further investigation in this critical public health area.

[This corrects the article DOI: 10.3389/fpsyt.2024.1460801.].

Objective: With the evolving spectrum of diseases, psychological conditions such as anxiety and depression have emerged as significant global public health concerns. Notably, these psychological disorders are prevalent among patients suffering from knee osteoarthritis (KOA). Consequently, this study included 360 hospitalized patients diagnosed with KOA to examine their levels of anxiety and depression and to analyze the factors influencing these psychological states.

Methods: A cohort of KOA patients from the Second Hospital of Shanxi Medical University was assessed using a general condition questionnaire, European five-dimensional health status scale (EQ5D), Western Ontario and McMaster University Osteoarthritis (WOMAC), Social Support Rating Scale (SSRS), and Hospital Anxiety and Depression Scale (HADS). Logistic regression analysis was employed to identify the factors affecting anxiety and depression.

Results: Among 360 patients with KOA, 28.06% experienced anxiety, and 30.27% experienced depression. Multivariate logistic regression analysis showed that lower BMI, QOL, and utilization of social support scores are risk factors for anxiety and depression in KOA patients (P<0.05). Additionally, in patients with KOA, younger age, lower subjective support, and higher scores in function and daily activities emerged as significant risk factors for depression (P<0.05).

Conclusion: Anxiety and depression in patients with KOA warrant significant attention due to their impact on overall well-being. The factors influencing these mental health conditions are multidimensional. In clinical practice, it is essential to integrate these various influencing factors to develop targeted mental health care services. By doing so, healthcare providers can enhance the overall mental health and QOL for individuals suffering from KOA.

Background: We aimed to assess the effect of mindfulness-based cognitive behavior therapy (MB-CBT) as an intervention to reduce burnout among secondary school teachers in Nepal.

Methods: The baseline survey of this randomized controlled trial included 218 secondary school teachers from 37 schools in Kathmandu. At a one-month follow-up, 192 teachers completed post-test survey. The Maslach Burnout Inventory for Educators (MBI-ES) tool was used to measure burnout in three dimensions: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Teachers in the treatment arm (n=102) received MB-CBT, while those in the control arm (n=116) continued their regular activities. Linear regression models with generalized estimating equations were used to calculate the mean, mean change estimates, and their 95% confidence intervals (CIs).

Results: The mean level of EE decreased during the post-test for both treatment (mean change -0.93, 95% CI: -2.56 to 0.70) and control (-1.71, 95% CI: -3.24 to -0.18) arms. The mean level of DP also decreased in the treatment arm (-0.12, 95% CI: -0.98 to -0.75), but a sharper decline was observed in the control arm (-1.97, 95% CI: -2.78 to -1.16). The mean level of PA increased in both the treatment (1.04, 95% CI: -0.21 to 2.30) and control (1.53, 95% CI: 0.35 to 2.70) arms.

Conclusions: The prevalence of high EE and low PA decreased in both arms. However, the prevalence of high DP remained constant in the treatment arm but sharply decreased in the control arm. No significant differences between the arms were found in the post-test mean levels of EE, DP, and PA. The virtual MB-CBT intervention showed no significant impact on reducing burnout. Nonetheless, small reductions in burnout were observed in both groups.

Background: Electroconvulsive therapy (ECT)-induced fever can significantly affect patient experience, treatment adherence, and the course of treatment. However, little is known about the prevalence of ECT-induced fever and its associated risk factors in patients with major mental disorders (MMD).

Methods: This retrospective, case-control study included 113 cases and 226 age-matched controls (1:2). The case group comprised patients who exhibited an axillary temperature of ≥37.5°C (99.5°F) at least once within 24 hours post-ECT. Patients diagnosed with MMD underwent ECT between January 1, 2021, and December 31, 2021, at a large psychiatric hospital in China. Demographic and clinical data were extracted from the electronic chart management system (ECMS) for both groups.

Results: The prevalence of ECT-induced fever in patients with MMD was 6.8% [113/1,674, 95% confidence interval (CI): 5.6% to 8.0%], with a session-based prevalence of 1.1% (130/11,570, 95% CI: 0.9% to 1.3%). Multivariate logistic regression analysis identified paliperidone [odds ratios (OR)=2.5, 95% CI: 1.2 to 4.9] as a risk factor, while quetiapine (OR=0.4, 95% CI: 0.3 to 0.8) was found to be protective. No significant association between etomidate and ECT-induced fever was observed in univariate analysis (p>0.05).

Conclusions: This study found a relatively low prevalence of ECT-induced fever. Paliperidone was identified as a risk factor, while quetiapine had a protective effect. Etomidate was not significantly associated with ECT-induced fever in patients with MMD.

Background: Adolescent bipolar depression (ABD) refers to depressive episodes that arise in adolescent patients with bipolar disorder. Its identification and diagnosis are challenging, and it is characterized by a high rate of misdiagnosis and disability. Studies have revealed that patients with ABD are more prone to non-suicidal self-injury (NSSI) compared to those with unipolar depression. However, the neuropathophysiological mechanisms behind NSSI in ABD remain unclear. Therefore, this study employed proton magnetic resonance spectroscopy (¹H-MRS) technology to investigate the potential relationship between NSSI and neurometabolism in the ventromedial prefrontal cortex (vmPFC) of patients with ABD.

Methods: This study compared brain biochemical metabolism between ABD with and without NSSI. Forty ABD were recruited and divided into groups with (n=21) and without NSSI (n=19). Proton magnetic resonance spectroscopy (¹H-MRS) was used to detect the ratio of biochemical metabolites in the ventromedial prefrontal cortex (vmPFC) of all patients.

Results: There was no statistically significant difference (P>0.05) in the age, gender, only child status, residential status, education level, age of onset, disease course, family history, and 24-item Hamilton Depression Scale (HAMD) score between patients in the NSSI group and those without NSSI group. The N-acetylaspartate (NAA)/creatine (Cr) of patients with NSSI was lower than that of patients without NSSI, and the difference was statistically significant (Z=-4.347,P<0.001). There was no statistically significant difference in choline (Cho)/Cr and myo-inositol (mI)/Cr between the group with NSSI and the group without NSSI (P>0.05).There is a positive correlation (r=0.703,P<0.00625) between Cho/Cr and HAMD scores in patients with NSSI, while there is a varying degree of negative correlation (r=-0.605,P=0.006;r=0.624,P=0.004) between mI/Cr and age and onset age in patients without NSSI. There is no correlation (P>0.05) between other indicators.

Conclusion: Compared with ABD without NSSI, ABD with NSSI have reduced NAA/Cr metabolism in the vmPFC brain area. The level of membrane phospholipid breakdown metabolism in the vmPFC brain area of ABD with NSSI may be related to the severity of depression. The level of phosphoinositol cycle in the vmPFC brain area of ABD without NSSI may be related to age or onset age. Therefore, further validation was required.