Frontiers in Psychiatry最新文献

Objective: Limited research exists on the use of electroconvulsive therapy (ECT) for adolescents with major depressive disorder (MDD). This study investigates the effects of ECT on inflammatory markers in adolescents aged 13-18 suffering from severe MDD, evaluating its efficacy in modulating cellular inflammatory markers and ameliorating depressive symptoms.

Methods: A cohort of 38 adolescents with severe MDD received standard antidepressant therapy along with 6-8 ECT sessions spanning two weeks. A control group of 29 age-matched, healthy individuals was also assessed for comparative purposes. The investigation measured variations in depressive symptomatology and inflammatory marker levels (IL-1β, IL-6, IL-10) pre- and post-intervention.

Results: Post-ECT, a substantial decrease in pro-inflammatory cytokines (IL-1β and IL-6) and an increase in the anti-inflammatory cytokine (IL-10) were noted. Participants who responded to the treatment showed a significant decline in HAMD-17 scores, which accentuates ECT's therapeutic potential. Comparative analysis indicated a significant correlation between post-treatment inflammatory marker alterations and clinical improvement, implying that shifts in inflammatory state might serve as predictors of treatment response. Moreover, the mitigation of depressive symptoms exhibited a moderate correlation with post-treatment decrements in IL-1β and IL-6 levels, underscoring MDD's intricacy and ECT's comprehensive impact.

Conclusion: While initial inflammatory marker levels did not predict the response to ECT, the post-treatment measures appeared to be linked to clinical improvement. These findings suggest ECT's potential effectiveness in treating severe MDD in adolescents and point to the possible predictive value of inflammatory markers in therapeutic outcomes. The study contributes to our understanding of the biopsychosocial framework of MDD and indicates that ECT may be a viable treatment option for this population.

Objective: This study aims to examine the mental health of patients with lumbar disc herniation with radiculopathy (LDHR) and to evaluate the effects of percutaneous transforaminal endoscopic discectomy (PTED) on their mental well-being.

Method: This study included 114 LDHR patients who received PTED in the Spinal Orthopedics Department of Zhongshan Hospital of Traditional Chinese Medicine between May 2022 and May 2023. The study population was stratified into two groups according to the presence of preoperative anxiety and depression: Group A comprised patients with such symptoms, and Group B included the remainder. Patients were assessed using the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale for Pain (VAS), and the Oswestry Disability Index (ODI) at preoperative and final follow-up visits. Evaluations were performed using the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale, and the Oswestry Disability Index (ODI) at the time of preoperation and during the last follow-up.

Results: Among the 114 LDHR patients who obtained complete follow-up, fifty-four had anxiety/depression symptoms before surgery, which accounted for a incidence of 47%. Both Group A and Group B patients showed significant improvement in all evaluation indicators after PTED, but the overall prognosis of Group A was worse than that of Group B.

Conclusion: PTED can effectively improve patients' pain, functional activities and mental health, which has a positive impact on patients' quality of life, and there is a significant correlation between patients' preoperative mental health and prognosis.

Bullying refers to repetitive, aggressive behavior intended to harm or intimidate others. Cyberbullying extends this aggression to digital platforms, involving harassment via social media, texts, or emails. These forms of bullying are particularly damaging to LGBTQ+ youth, who often face discrimination based on their sexual orientation or gender identity. In the context of LGBTQ+ individuals, bullying and cyberbullying can lead to severe emotional and psychological harm, contributing to higher rates of depression, anxiety, and suicidal ideation. Despite extensive global efforts and campaigns to combat homophobia, LGBTQ+ students continue to face significant challenges, with the situation in Poland being notably severe. The review highlights various forms of bullying, including physical, verbal, and social aggression, and underscores the alarming involvement of school personnel in perpetuating such behaviors. The focus on the Polish context enriches the global discourse on LGBTQ+ rights and highlights the critical need for targeted interventions to support vulnerable youth in regions with prevalent conservative and religious sentiments.

Introduction: Anxiety disorder is one of the most prevalent mental disorders. Mindfulness-based cognitive therapy (MBCT) is effective for treating anxiety disorders. However, no studies have investigated the cost-effectiveness of MBCT for anxiety disorders. We aimed to conduct a cost-effectiveness analysis alongside a randomized controlled trial (RCT) to clarify the cost-effectiveness of MBCT for anxiety disorders.

Methods: A cost-effectiveness analysis alongside an RCT was conducted for 8 weeks in 40 patients with anxiety disorders at a university hospital. Patients (1) aged 20-75 years; (2) who were diagnosed with panic disorder/agoraphobia or social anxiety disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria; and (3) who provided written consent were analyzed. The participants were allocated randomly (1:1 ratio) to the augmented MBCT group (i.e., MBCT plus treatment as usual [TAU]) or TAU (waitlist control) group. The cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER), which is the ratio of the incremental costs divided by the incremental state-trait anxiety inventory- state (STAI-S), state-trait anxiety inventory- trait (STAI-T), and quality-adjusted life years (QALYs). The QALYs were estimated using The Japanese version of EuroQoL five-dimensional 3-level questionnaire. The unit cost data were derived from the government-regulated fees. This study was conducted from a public healthcare insurance perspective. No discount rates were considered.

Results: A total of 38 participants with complete data were included in the analysis. The MBCT was JPY 13,885 more than the cost of TAU and was associated with a STAI-S, STAI-T, and QALY increase of 10.13, 12.00, 0.009 respectively. The ICER were JPY 1,371 (USD13) per STAI-S, JPY 1,157 (USD 11) per STAI-T, and JPY 1,566,357 (USD 14,940) per QALY respectively. MBCT had an 77.5% probability of being cost-effective at a willingness to pay threshold in Japan (JPY 5,000,000 per QALY). The results of the four one-way sensitivity analyses supported the robustness of the base-case analysis findings.

Discussion: Augmented MBCT for anxiety disorders is cost-effective compared with TAU post-treatment from a public healthcare insurance perspective. Future studies should include long-term observations, and analysis from a societal perspective.

Background: Iron-sulfur cluster assembly 2 (ISCA2) deficiency is linked to an autosomal recessive disorder known as multiple mitochondrial dysfunctions syndrome 4 (MMDS4). This disorder is characterized by leukodystrophy and neuroregression. Currently, most of the reported patients are from Saudi Arabia. All these patients carry a homozygous founder variant (NM_194279.2:c.229G>A:p.Gly77Ser) in ISCA2.

Methods: We describe a patient who underwent full clinical evaluation, including metabolic, neurological, and radiological examinations. Standard genetic testing, including whole exome sequencing coupled with autozygome analysis, was undertaken, as were assessments of mitochondrial DNA (mtDNA) copy number and mtDNA sequencing on DNA extracted from blood and cultured fibroblasts. Functional workup consisted of splicing assessment of ISCA2 using RT-PCR, biochemical assessment of complex I status using dipstick assays, and mitochondrial respiration measurements using a Seahorse XFp analyzer.

Results: We present the clinical and functional characterization of a novel homozygous ISCA2 missense variant (NM_194279.3:c.70A>G:p.Arg24Gly), leading to aberrant splicing in a patient presenting with neuroregression, generalized spasticity with exaggerated deep tendon reflexes and head lag, and progressive loss of acquired milestones. The novel variant was fully segregated in a wider family and was absent in a large control cohort, ethnically matching in-house exomes, local databases such as CGMdb and Saudi Human Genome Program, and ClinVar.

Conclusions: Our analyses revealed that the variant is pathogenic, disrupting normal ISCA2 splicing and presumably leading to a truncated protein that disturbs metabolic pathways in patient-derived cells.

Objective: Sleep disorder is a common non-motor symptom (NMS) of Parkinson's disease. However, the global research focus on Parkinson's sleep-related disorders (PDSDs) and future trends remains unclear. Currently, there is no bibliometric analysis of PDSDs. We aim to fill this gap, determine the status of current research, and predict future research hotspots.

Methods: We selected 1490 publications from the Web of Science Core Collection (WoSCC) database from 2008 to 2023. Based on CiteSpace and VOSviewer, the analysis was performed from the perspectives of the trend in the number of annual publications, countries, institutions, authors, journals, and co-citations.

Results: A total of 1490 publications from 590 authors from 409 institutions in 77 countries are included. The United States, China, and the United Kingdom are the leading countries. University College London (UCL) is the most prolific institution. Harvard University is the key for cooperation among institutions. Chaudhuri Kallol Ray is a leader in this field. "Movement Disorders" is the most influential journal. "A systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005 to 2015" is the publication with the highest co-citation intensity.

Conclusion: The total volume of publications on PDSDs is on the rise, entering a relatively high-yield stage in 2020. The COVID-19 pandemic and the emergence of new keywords may be the reasons behind this phenomenon. "quality of life" and "circadian rhythm" are the mainstream topics of PDSD research. Daytime sleepiness is the PDSD subtype that has received the most attention. Sleep quality, biomarkers, and neurodegeneration are likely to become future research hotspots.