Frontiers in Psychiatry最新文献

[This corrects the article DOI: 10.3389/fpsyt.2024.1463879.].

Background: Depression poses a considerable personal and public health problem, particularly in the post-epidemic era. The present study aimed to investigate the association between meaning in life (MIL) and perceived social support (PSS) with depressive symptoms among vocational undergraduate students, employing a network analysis approach to gain a deeper understanding of the underlying pathways and to prevent the progression of depressive symptoms into disorders.

Methods: A total of 1367 Chinese vocational undergraduates (M _age = 20.1, SD = 1.6; 44.7% female) were recruited and were asked to complete a series of questionnaires, including the meaning in life questionnaire, perceived social support scale, and patient health questionnaire. The regularized partial correlation network was estimated. The partial correlations between nodes were calculated as edges. Moreover, network comparison tests were conducted to compare three subnetworks based on different levels of depression (minimal, subthreshold, and moderate/severe).

Results: The top strength nodes within each network were identified as sleep and motor in minimal group, anhedonia and concentration in subthreshold group, and anhedonia and sleep in moderate/severe group. Additionally, the bridge strength nodes were determined as MIL-3, MIL-4, sleep, guilt, and school in minimal group; MIL-4, anhedonia, suicide, and friend in subthreshold group; MIL-9, MIL-7, anhedonia, sleep, and family in moderate/severe group. Furthermore, network comparison tests showed significant differences in centrality (all p < 0.05), while network invariance remained constant across groups. Notably, the accuracy and stability coefficients for all network structures were greater than 0.5, indicating stable and reliable results.

Conclusion: These findings elucidate specific pathways and potential central nodes for interactions of MIL or PSS with depressive symptoms at different levels of depression, providing valuable insights for targeted prevention and intervention strategies.

Introduction: This case report details the presentation of a patient who initially sought consultation at a psychiatric outpatient clinic with symptoms suggestive of Attention-Deficit/Hyperactivity Disorder (ADHD); however, further evaluation revealed a diagnosis of Cerebrotendinous Xanthomatosis (CTX). CTX, a genetic disorder impacting lipid metabolism, is often overlooked in differential diagnoses due to its rarity. This case underscores the importance of considering alternative diagnoses in adults exhibiting ADHD-like symptoms without a childhood history of the disorder, adding to the literature on diagnostic complexities in psychiatric practice.

Case presentation: A 33-year-old man visited a psychiatric outpatient clinic with symptoms such as increasing distractibility and inattention, requesting an evaluation for adult ADHD. However, the absence of an ADHD history in childhood, coupled with progressive neurological symptoms and tendon xanthomas, led to further investigation. Comprehensive neurological assessments, including neuroimaging and genetic testing, ultimately diagnosed him with CTX. Treatment with chenodeoxycholic acid (CDCA) resulted in stabilization of cognitive function, although improvement in gait disturbances and tremors remained minimal.

Conclusion: This case demonstrates that CTX can masquerade as adult ADHD, emphasizing the necessity for thorough assessments in atypical ADHD presentations. Psychiatrists should consider rare metabolic disorders like CTX in similar cases, which may enable timely intervention and improve patient outcomes.

Background: Hypertension is a prevalent cardiovascular risk factor that significantly contributes to morbidity and mortality worldwide. Previous studies have highlighted the role of inadequate sleep during weekdays in the development of hypertension. However, the potential mitigative effects of weekend catch-up sleep (WCS) on hypertension have been less explored.

Methods: This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020, focusing on American adults. We assessed the association between WCS (defined as the difference in sleep duration between weekend and weekday) and the presence of hypertension. Participants were classified into two groups based on their WCS duration: none (below 1 hours), yes (over 1 hours). Multivariable logistic regression models adjusted for potential confounders such as age, gender, Body mass index (BMI), and lifestyle factors were utilized to explore this association. A Generalized Additive Model (GAM) was employed to generate smooth curves for a nuanced analysis of the nonlinear relationship.

Results: The findings indicated that moderate WCS (less than 4 hours) was significantly associated with a reduced risk of hypertension, while excessive WCS (greater than 4 hours) showed no significant protective benefits.

Conclusion: Moderate weekend catch-up sleep could serve as an effective intervention to mitigate hypertension risk, especially in populations with restricted weekday sleep. These results suggest the potential for integrating sleep management strategies into public health recommendations to address hypertension. Future longitudinal studies are needed to confirm these findings and clarify the mechanisms underlying the relationship between WCS and hypertension risk.

Introduction: The correct diagnosis of autistic individuals is an everyday challenge within autism outpatient services. While the short-story task (SST), a task measuring fiction-based mentalizing, has demonstrated promise in differentiating between autistic and non-autistic adults, its discriminative ability has not been investigated in a sample of individuals seeking autism diagnostics at outpatient services.

Methods: This study aimed to evaluate the utility of the SST in individuals seeking autism diagnostics between 2016 and 2022 at the Clinic and Polyclinic for Psychiatry & Psychotherapy of the University of Regensburg at medbo District Hospital Regensburg. The sample consisted of 211 individuals. In 100 of them an autism spectrum disorder has been diagnosed and 111 individuals were diagnosed with other conditions or none at all.

Results: Performance on the SST did not significantly differ between the two groups, and receiver operator curve analysis did not support the SST as a reliable discriminator. However, linear regression analyses revealed that autism diagnosis was the sole significant predictor of SST mentalizing performance. Additionally, specific items of the SST showed significant differences between autistic and non-autistic individuals and constituted a significant predictor of autism diagnosis.

Discussion: While the SST may not be robust enough to accurately identify autistic individuals on its own, it does offer clinicians valuable insights into how individuals interpret others' actions and whether they grasp the broader context of a story versus focusing solely on details.

Background: College students are disproportionately affected by smartphone addiction, which has been linked to various health impairments, including sleep disorders. This study explores the relationship between smartphone addiction and sleep disorders, with a focus on negative emotions as a mediator and gender as a moderator.

Methods: Cluster sampling was used to survey 1056 Chinese college students. The Mobile Phone Addiction Index, Negative Affect Scale, and Sleep Disorder Scale were administered. Versions of SPSS 27.0 and PROCESS macro 4.0 were used for data analysis, employing Models 15 and 4 to examine moderation and mediation, respectively.

Results: A strong direct correlation was identified between smartphone addiction and sleep disorder, with negative emotions mediating this relationship, accounting for 33.7% of the effect. Gender significantly moderated the mediation process, with females demonstrating a greater correlation than males between sleep disorders and negative emotions.

Conclusion: Negative emotions partially mediated smartphone addiction's association with sleep disorder, whereas gender significantly moderated this mediation. These findings underscore the complex dynamics among smartphone addiction, emotional well-being, and sleep among college students.

Objective: Rumination and anxiety have been posited as correlates of smartphone dependence (SPD). However, little is known regarding how the components of both affect SPD symptoms at subtle levels. Therefore, we used the network analysis approach to identify the connections at a micro level to provide possible interventions for reducing SPD symptoms.

Methods: Using symptom-level network analysis, we used the ruminative response scale-10, the generalized anxiety disorder scale-7, and the mobile phone addiction index scale-17 to investigate Chinese preservice teachers (M _age = 21.1, N = 1160). Subsequently, we estimated a graphical lasso correlation network for these teachers, which encompassed rumination components, anxiety components, and SPD symptoms. Specifically, the central and bridge centralities within the network structure were examined for the impacts of rumination and anxiety on SPD symptoms.

Results: The three intracluster connections of rumination, anxiety, and SPD were tighter than the intercluster, with structural connections in rumination and anxiety networks closer than the triggered SPD symptoms cluster. Importantly, reflection reactions towards "write down what you are thinking and analyze it" (a component of rumination) were identified as a central and bridging node that might be a target for intervention for SPD symptoms.

Conclusion: We identify potential edge-bridging rumination and anxiety on SPD and locate highly central components within each cluster via network analysis.

Objective: This study compares the safety and effectiveness of theta-burst stimulation (TBS) and repetitive transcranial magnetic stimulation (rTMS) for treating treatment-resistant depression (TRD).

Methods: We reviewed randomized controlled trials (RCTs) that evaluated rTMS and TBS in managing TRD. Searches were conducted in PubMed, Embase, the Cochrane Library, and Web of Science for studies published up to July 31, 2024. Data from these studies were analyzed using statistical software.

Results: Five RCTs involving 1,196 patients were included, with 553 receiving rTMS and 663 receiving TBS. The analysis found no significant differences between rTMS and TBS in reducing depression [SMD = -0.07, 95% CI (-0.19, 0.04)] or anxiety [SMD = -0.02, 95% CI (-0.15, 0.11)], nor in side effects like headaches [OR = 1.00, 95% CI (0.72, 1.40)], nausea [OR = 1.42, 95% CI (0.79, 2.54)], or fatigue [OR = 0.87, 95% CI (0.46, 1.64)].

Conclusions: Both rTMS and TBS are similarly effective in reducing depression and anxiety symptoms, with comparable side effect profiles. However, TBS is more time-efficient, with sessions lasting only 192 seconds, making it a cost-effective option for patients. These findings support TBS as a practical treatment choice for TRD.

A 64-year-old male patient who suffered from traumatic life experiences and neuropathic pain after oncological chemotherapy was treated with medium to high doses of lysergic acid diethylamide (LSD) and high doses and microdoses of methylenedioxymethamphetamine (MDMA). At the beginning of treatment, the patient did not experience any acute subjective effects of LSD at a dose of 200 µg. After increasing the LSD dose to 400 µg, he experienced subjective acute effects, and the first lasting therapeutic effects were observed. After changing from LSD to MDMA at both high doses (150-175 mg) and repeated low doses (12.5-25 mg), the patient exhibited marked improvements in neuropathic pain that were sustained even after stopping repeated MDMA treatment. MDMA mini/microdosing has not yet been broadly investigated. This case documents benefits of low doses of MDMA for the treatment of a pain disorder. Further research is needed on effects of MDMA on pain.