Frontiers in Psychiatry最新文献

Introduction: Anxiety disorders are prevalent mental health conditions characterized by significant impairments in daily functioning and social interactions. Despite the effectiveness of pharmacological treatments, challenges such as medication resistance, adverse side effects, and the high rate of relapse necessitate the exploration of alternative therapies. Recently, electroacupuncture (EA) has garnered attention as a promising non-pharmacological intervention for anxiety disorders; however, the mechanisms by which EA exerts its anxiolytic effects remain poorly understood. This study aims to elucidate the role of microglial cells in anxiety, specifically examining how EA modulates microglial morphology and function within the basolateral amygdala (BLA) in the context of anxiety induced by social isolation.

Methods: Utilizing a mouse model of social isolation-induced anxiety, we evaluated anxiety-like behaviors through the Elevated Plus Maze (EPM) and Open Field Test (OFT). Additionally, biochemical analyses and immunofluorescence imaging were performed to assess the expression of NADPH oxidase 2 (NOX2), microglial activation markers, and levels of oxidative stress.

Results: Our findings reveal that EA treatment significantly mitigates anxiety-like behaviors in mice, correlating with a reduction in NOX2 expression within BLA microglia and decreased levels of reactive oxygen species (ROS). Furthermore, EA was observed to restore normal microglial morphology, indicating its potential role in modulating microglial activity.

Discussion: The results of this study suggest that EA exerts its anxiolytic effects through the modulation of oxidative stress and the activity of microglia in the BLA. These findings provide new insights into the cellular mechanisms underlying the therapeutic effects of EA, highlighting the potential for non-pharmacological strategies in the management of anxiety disorders and paving the way for future research aimed at improving clinical outcomes for individuals suffering from anxiety.

Introduction: Medical students are exposed to various stressors. Among the many factors that determine the possibility of a mental crisis, there is also a personality profile and a sense of meaning in life.

Materials and methods: Sets of anonymous surveys were distributed among medical students of different years studying at the Medical University of Lodz. The set of surveys included a sociodemographic survey, Beck's Depression Inventory version II (BDI-II), the NEO Five Factory Inventory (NEO-FFI), Reker's Life Attitude Profile - Revised questionnaire (LAP-R), Osman's Suicidal Behavior Questionnaire (SBQ-R).

Results: The study cohort comprised of 276 students (mean age 21.7 years). According to the BDI-II, 79 participants (28.4%) were identified as having depressive symptoms. Additionally, 80 participants (28.9%) were assessed to be at significant risk of suicide according to the SBQ-R scale. Based on the results of these questionnaires, we identified four groups: 1. Participants with depressive symptoms (D). 2. Participants with suicide risk (SR), 3. Participants with both depressive symptoms with suicide risk (D and SR), 4. A control group. Students from D and D and SR groups, exhibited higher neuroticism scores compared to those with suicide risk alone (SR) and the control group. In terms of extroversion, the control and SR groups scored higher compared to the D with SR group. Participants with SR and those with D and SR had higher openness scores compared to the D and control groups. D and SR group obtained statistical lower score then control group in the terms of conscientiousness. In life control score, participants in D and D with SR group has significant lower score then SR and control group. The conditions: personal meaning index and life attitude balance in the control group achieved significantly higher values compared to all other groups.

Conclusion: People with depressive symptoms, suicide risk and both of these variables simultaneously differed in terms of personality profile and components influencing the meaning of life.

Background: Coercive measures in psychiatric practice are controversial due to their potential for severe negative effects. Ethical debates focus on respecting autonomy, minimizing damaging effects, and acting in the patient's best interest.

Case: We present a unique case of a young patient suffering from a first episode of catatonic psychosis, in which striking this balance was especially difficult given the patient's complete mutism and opposition, given the absence of immediate danger to herself or others, the lack of anamnestic information, and her avoidance of social support, which would have meant that she would not have encountered psychiatric care, were it not for an exceptional government plan in place at the time of hospitalization. The patient showed a very favorable, persistent response to nonvoluntary treatment with haloperidol and lorazepam, which could be discussed and debriefed once she recovered, after almost 5 months of hospitalization and follow-up.

Discussion: Arguments for and against nonvoluntary treatment are reviewed based on discussion with the local ethics committee, providing a useful reference for future similar cases. Finally, this case highlights an atypical onset of psychosis in a previously high-functioning individual and explores the mental health impact of international tensions, particularly the Russian-Ukrainian war, on individuals.

Introduction: The neural mechanisms that underpin cognitive impairments in patients with schizophrenia remain unclear. Previous studies have typically treated patients as a homogeneous group, despite the existence of distinct symptom presentations between deficit and non-deficit subtypes. This approach has been found to be inadequate, necessitating separate investigation.

Methods: This study was conducted at Daizhuang Hospital in Jining City, China, from January 2022 to October 2023. The study sample comprised 30 healthy controls, 19 patients with deficit schizophrenia, and 19 patients with non-deficit schizophrenia, all aged between 18 and 45 years. Cognitive abilities were evaluated using a change detection task. The NeuroScan EEG/ERP System, comprising 64 channels and utilising standard 10-20 electrode placements, was employed to record EEG signals. The multiscale entropy and sample entropy of the EEG signals were calculated.

Results: The healthy controls demonstrated superior task performance compared to both the non-deficit (p < 0.001) and deficit groups(p < 0.001). Significant differences in multiscale entropy between the three groups were observed at multiple electrode sites. In the task state, there are significant differences in the sample entropy of the β frequency band among the three groups of subjects. Under simple conditions of difficulty, the performance of the healthy controls exhibited a positive correlation with alpha band sample entropy(r = 0.372) and a negative correlation with beta band sample entropy (r = -0.411). Deficit patients demonstrated positive correlations with alpha band sample entropy (r = 0.370), whereas non-deficit patients exhibited negative correlations with both alpha and beta band sample entropy (r = -0.451, r = -0.362). Under difficult conditions of difficulty, the performance of healthy controls demonstrated a positive correlation with beta band sample entropy (r = 0.486). Deficit patients exhibited a positive correlation with alpha band sample entropy (r = 0.351), while non-deficit patients demonstrated a negative correlation with beta band sample entropy (r = -0.331).

Conclusion: The results of this study indicate that cognitive impairment in specific subtypes of schizophrenia may have distinct physiological underpinnings, underscoring the need for further investigation.

Objective: Sleep deficiency, a broad term that encompasses sleep disorder symptoms and other aspects of disturbed sleep, is an established risk factor for suicide. Although several studies have examined the relationship between sleep, suicidal ideation, and suicide attempts among individuals with psychotic disorders, few studies have focused on the early stages of illness. The current study addressed this gap in the literature by examining the relationship between sleep deficiencies, recent suicidal ideation, and lifetime suicidal behavior across the psychosis continuum.

Method: A retrospective chart review was used to obtain relevant data for individuals at clinical high-risk for psychosis (CHR-P), individuals with first-episode psychosis (FEP), and individuals with longstanding illness.

Results: Results indicate that sleep deficiencies are prevalent across all stages of illness, though individuals at CHR-P have significantly higher rates of sleep deficiency than individuals with FEP and longstanding psychosis. Additionally, there was a strong relationship between sleep deficiencies and suicidal ideation across the entire sample.

Conclusions: Further research is needed to clarify the specific nature of these sleep deficiencies and to elucidate the mechanisms by which sleep deficiencies might increase risk for suicide in this population.

Background: Emotion regulation (ER) and distress tolerance (DT) are considered transdiagnostic risk factors for a range of anxiety disorders. This study investigated the relationship between anxiety sensitivity (AS) and health anxiety (HA) in the general population, focusing on the mediating roles of DT and ER.

Methods: The study was conducted as a cross-sectional survey from October to December 2023 in Tehran Province, Iran. A total of 971 individuals participated in this study (52.8% female; mean age 39.04 years, SD=10.64). Participants completed self-report questionnaires to assess HA (The Short Health Anxiety Inventory), AS (The Anxiety Sensitivity Index-3), DT (The 15-item Distress Tolerance Scale) and ER (The 10-item Emotion Regulation Questionnaire). We used structural equation modeling (SEM) to examine the hypothesis that DT and ER would mediate the relationship between AS and the HA.

Results: AS was modestly related to all measures (r from -0.40 to 0.55). According to the SEM analysis, AS (β = 0.45, 95%CI [0.34, 0.56]) had a significant direct effect on HA. However, the analysis of the indirect effects revealed that both DT (β = 0.10, 95% CI [0.06, 0.16]) and emotion regulation strategies-cognitive reappraisal (β = 0.06, 95% CI [0.01, 0.11]) and expressive suppression (β = 0.11, 95% CI [0.06, 0.18])-act as partial mediators in the relationship between AS and HA.

Conclusions: AS plays a crucial role in predisposing individuals to HA. The mediating roles of DT and ER provide insight into the link between AS and HA. Nevertheless, the study's cross-sectional design and reliance on a non-clinical sample limit the applicability of the results. Further research involving different samples and intervention studies is needed to validate and expand upon these findings.

Introduction: Childhood traumatization can result in physical and mental health problems in adulthood, such as post-traumatic stress disorder (PTSD), which negatively influences quality of life and social functioning. Although evidence based trauma treatments benefit clients with PTSD after childhood abuse and comorbid personality disorders, they are less effective than in clients who were traumatized in adulthood, and drop-out is substantial. The current study aims to assess the effects of inpatient dialectical behavior therapy combined with prolonged exposure (DBT-PTSD) on severity of PTSD, dissociation, parasuicidal behavior and borderline personality disorder (BPD) in clients with severe PTSD and comorbid psychiatric disorders. Secondary outcomes are social functioning, quality of life, borderline and cluster C personality disorder symptoms as treatment predictors, treatment trajectories, clients' experiences and health economic consequences.

Methods: The naturalistic, longitudinal Trauma Therapy Study is conducted from January 2019 until May 2025 in a mental healthcare center in the Netherlands. Clients with severe PTSD and comorbid conditions who are referred to inpatient DBT-PTSD are included into the study. Based on power analyses a total sample size of N=56 is needed. Measurements take place before the waiting list period, at pre- and posttreatment and at six- and twelve-months follow-up. Clients fill in a daily DBT-PTSD diary, which gives insight into individual symptom trajectories.

Results: Statistical analyses include two-sided paired samples t-tests, linear mixed model analyses and cost-effectiveness analyses. Qualitative interviews are conducted within two years posttreatment and analyzed using a phenomenological approach. We correct for chance capitalization by using a conservative α-level of.01. Multiple imputation is used to handle missing data.

Discussion: Research on the effects of integrated treatment programs for clients with severe PTSD and co-morbid conditions is scarce. This study extends current knowledge on the effects of inpatient DBT-PTSD on PTSD and BPD symptoms, clients' social functioning and quality of life. In addition, it provides insight into individual symptom trajectories and experiences, inspiring future treatment improvements for clients with severe psychopathology.

Trial registration: Medical Ethical Committee approval (NL669060018, RTPO1044/01.10.2018). Preregistration: Dutch registration database Centrale Commissie Mensgebonden Onderzoek and International Clinical Trials Registry Platform (NL-OMON46167/01.10.2018/https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON46167).

Objective: Although research on psychological interventions in generalized anxiety disorder (GAD) has provided evidence of their effectiveness regarding self-reported outcomes, few studies have examined their psychophysiological effects. Heart rate is emerging as a potential biomarker of efficacy in anxiety disorders. This study aimed to investigate the effects of a self-compassion intervention versus a mindfulness intervention on physiological arousal in response to induced stress.

Methods: Forty-seven patients with GAD had heart rate data collected during a stress task before and after a 2-week pharmacological treatment (known as treatment as usual, TAU), a self-compassion intervention + TAU or a mindfulness intervention + TAU. They also reported state anxiety, positive affect, and negative affect at pre- and post- intervention before the stress task. ANOVAs were conducted to analyze the effects on electrocardiogram data self-reported measurements.

Results: Self-compassion intervention uniquely decreased heart rate response to a stressor whereas mindfulness intervention did not. Both treatments decreased state anxiety and negative affect to a stressor, while increased positive affect in this context. We also demonstrated a significant correlation between decreased heart rate response and less negative emotions.

Conclusion: The Findings provides novel physiological evidence that self-compassion interventions buffer stress reactivity in individuals with GAD. Attention shall be paid to the limitations in small and unequal sample size and a non-randomized study design.

Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects the brain's function. Electroencephalography (EEG) is a non-invasive technique that measures the electrical activity of the brain and can reveal its dynamics and information processing. This study explores an eyes-opened resting state quantitative EEG analysis of 49 children with ASD and 39 typically developing (TD or Control) children, using various features of entropy and complexity. Time and frequency domain features were applied for all EEG channels, such as the power spectra, brain rate, sample entropy, permutation entropy, spectral entropy, Tsallis entropy, Rényi entropy, Lempel-Ziv complexity, and Higuchi fractal dimension. The features were compared between the ASD and TD groups and tested for statistical significance. The results showed that the ASD group had a lower brain rate, higher Tsallis entropy and Rényi entropy, and lower Lempel-Ziv complexity than the TD group. The entropy results show impaired neural synchronization, increased randomness, and noise in ASD. The Lempel-Ziv complexity results showed that it is a potential indicator of the existence of focal spikes in the EEG signals of ASD. The brain-rate results show a low level of arousal in ASD. The findings suggest that entropy and complexity measures can be useful tools for characterizing the EEG features of ASD and provide insights into the neurophysiological mechanisms of the disorder.